New DVLA guidance for assessing fitness to drive of patients with sleep apnoea

The driving regulations for patients with sleep apnoea have been modified by the DVLA.

The new guidance updates a 2016 EU directive intended to harmonise the rules across the EU.  The problem was this directive was poorly translated by UK lawyers and caused confusion because it inappropriately emphasised the apnoea-hypopnoea index (AHI) or equivalent.

The wording implied that in some situations driving should cease (and the DVLA informed) even if there were no symptoms, and before a provisional diagnosis had been confirmed. This led to anxiety over the possible and unnecessary loss of a driving licence.  

New workable guidelines have now been agreed following meetings between the DVLA and the OSA (Obstructive Sleep Apnoea) Alliance, a group set up to address the issue. 

The guidance now recommends:

• Stopping driving depends on the presence of sleepiness ‘having, or likely to have, an adverse effect on driving’ (for whatever reason).
• If OSA is suspected as the explanation for such sleepiness then driving must cease but the DVLA do not need to be informed until a diagnosis of OSA has been confirmed (i.e. the sleepiness is diagnosed as being due to the OSA following a sleep study).
• Once the diagnosis of OSA as the cause has been made the DVLA must be notified by the patient. 

The OSA Alliance recommends that the patient writes to the DVLA (rather than ringing) to ensure a consistent response. It says hopefully sleep units will be able to treat these patients quickly so that when the DVLA writes back to the patient with an SL1 form to fill in, the treated patient can honestly say they are no longer sleepy. The EU directive also demands some form of check every three years for Group 1 licence holders and every year for Group 2 licence holders, that confirm the patient’s symptoms remain under control, although the exact requirements for this are as yet unclear.

Dr Tahmina Siddiqui, a GP in Milton Keynes and commissioner of a local sleep service, comments: “It is very helpful that DVLA have clarified that they don’t need to be informed about a patient who is still driving until they have a confirmed diagnosis of OSA. This will encourage people who are concerned about their sleep to come forward and seek medical advice, without the immediate threat of having to stop driving.”

The updated DVLA guidance for professionals can be downloaded HERE