Driving and Sleep Apnoea – The Rules in Short

Golden Rules

There are two Golden Rules whether or not you have sleep apnoea;

• You alone are responsible for deciding whether you are fit to drive. It doesn’t matter whether you suspect you may have sleep apnoea, were up all night with a new baby, or watching election results. If you are likely to be sleepy to the point where your driving could be impaired, you must not drive.

If you do, you are breaking the law, and may invalidate your insurance.

• If your GP, your consultant, or any other medical professional tells you that you must not drive, you must not do so.

If you do, you are breaking the law, and may invalidate your insurance.

The DVLA, Sleepiness and Driving

If the sleep clinic diagnoses Obstructive Sleep Apnoea (OSA) but says that any sleepiness during waking hours is not excessive you can continue to drive and do not need to notify the DVLA. However if the sleepiness gets any worse you go back to your GP / sleep clinic.

If the Sleep Clinic diagnoses moderate or severe OSA with excessive sleepiness, you must stop driving until your sleep clinic is satisfied that your CPAP or other treatment, has your sleepiness under control. You then need to notify the DVLA.

When you notify the DVLA they continue to advise that you do so in writing, rather than by telephone or email.

If you have already had your driving license revoked by the DVLA, and you think this was because of a mistake on their part, or because you, your GP or your consultant or sleep clinic gave DVLA wrong advice, the detailed guidance tells you what to do.

Categories of Driver

The DVLA rules for drivers of cars and motorcycles (Group 1) are slightly different than those for bus and lorry drivers (Group 2). Taxi drivers, and drivers of emergency vehicles, e.g. police, fire, coastguard, ambulance and health service vehicles may have to comply with additional medical standards set by their relevant tax licensing authority, or their individual force, service, or other relevant body. The DVLA recommends to local authorities that taxi drivers should meet at least the same medical standards as Group 2 bus and lorry drivers.

Diagnosis

N.B. Whenever the term “excessive sleepiness” is used it means “excessive sleepiness having, or likely to have, an adverse effect on driving”, as defined by the DVLA. Where DVLA guidance refers to “drowsiness” it should be interpreted as excessive sleepiness.

Group 1, Car and Motorcycle Drivers

Mild, moderate or severe Obstructive Sleep Apnoea (OSA) without excessive sleepiness:
You may continue to drive as normal and you do not need to notify the DVLA.

Mild Obstructive Sleep Apnoea Syndrome (OSAS), i.e. Obstructive Sleep Apnoea with the symptom of excessive sleepiness:
You must not drive until your excessive sleepiness symptom has been satisfactorily controlled. If your excessive sleepiness symptom cannot be controlled within three months you must notify the DVLA.

Moderate or severe Obstructive Sleep Apnoea Syndrome (OSAS) i.e. Obstructive Sleep Apnoea with the symptom of excessive sleepiness:
You must not drive until your Sleep Clinic has confirmed to you that your OSAS is under control, your sleepiness is no longer excessive, and you are complying with CPAP treatment. You must notify the DVLA. The DVLA will require medical confirmation that your symptoms are under control. If your driving license has already been revoked, you then can apply for it to be restored.

Excessive sleepiness where Obstructive Sleep Apnoea Syndrome (OSAS) is suspected:
You must not drive until OSAS has been diagnosed and your Sleep Clinic has confirmed that your excessive sleepiness is being satisfactorily controlled by treatment. If moderate or severe OSAS is diagnosed the notification requirements in the previous paragraph will apply. If mild OSAS is diagnosed you only need to notify the DVLA if your excessive sleepiness cannot be controlled within three months.

Group 2, Bus and Lorry (and Taxi) Drivers

Mild, moderate or severe Obstructive Sleep Apnoea (OSA) without excessive sleepiness:
You may continue to drive as normal and you do not need to notify the DVLA.

Mild Obstructive Sleep Apnoea Syndrome (OSAS), i.e. Obstructive Sleep Apnoea with the symptom of excessive sleepiness:
You must not drive until your excessive sleepiness symptom has been satisfactorily controlled. If your excessive sleepiness symptom cannot be controlled within three months you must notify the DVLA.

Moderate or severe Obstructive Sleep Apnoea Syndrome (OSAS) i.e. Obstructive Sleep Apnoea with the symptom of excessive sleepiness:
You must not drive until your Sleep Clinic has confirmed to you that your OSAS is under control, your sleepiness is no longer excessive, and you are complying with CPAP treatment. You must notify the DVLA. The DVLA will require medical confirmation that your symptoms are under control. If your driving license has already been revoked, you then can apply for it to be restored.

Excessive sleepiness where Obstructive Sleep Apnoea Syndrome (OSAS) is suspected:
You must not drive until OSAS has been diagnosed and your Sleep Clinic has confirmed that your excessive sleepiness is being satisfactorily controlled by treatment. If moderate or severe OSAS is diagnosed the notification requirements in the previous paragraph will apply. If mild OSAS is diagnosed you only need to notify the DVLA if your excessive sleepiness cannot be controlled within three months.

Review of Treatment.

The DVLA guidelines require you, as the driver, to confirm that a review of your condition has been undertaken at least every three years if you are a Group 1 driver, and at least annually if you are a Group 2 driver. It will be your responsibility to contact your Sleep Clinic to arrange for this review in good time before the end of each three-year, or annual, period. How this review will be undertaken will be a matter for your Sleep Clinic, and options may range from a simple telephone conversation to a visit to the Sleep Clinic.

What Should I do?

There is a common element in the revised DVLA Guidelines. This is that where excessive sleepiness is present and OSAS is suspected you must not drive until a diagnosis is confirmed, and the excessive sleepiness symptoms are controlled.

If you have some of the symptoms described above, particularly excessive sleepiness, do not drive, seek an appointment with your GP, and ask the GP for a referral to a Sleep Clinic.

If you are a professional driver who relies on your driving licence for your livelihood, or you are disabled, or have little access to public transport and others depend on you for transport etc, you should mention this to your GP and ask that on your referral letter the GP clearly requests the Sleep Clinic to provide fast tracked treatment.

If your Sleep Clinic diagnoses Sleep Apnoea, their diagnosis needs to be clear and precise so that you can make a decision on whether or not you have to inform the DVLA. If they have diagnosed Obstructive Sleep Apnoea without excessive sleepiness, no notification is necessary. If their diagnosis is Obstructive Sleep Apnoea with excessive sleepiness, in other words, Obstructive Sleep Apnoea Syndrome (OSAS), notification will be required.

Do not notify the DVLA until you have been diagnosed and then only if the rules state that you have to.

If this guidance suggests that you do need to notify the DVLA, its recommended that you do so in writing rather than telephoning their helpline number or sending them an e-mail.
You must of course continue not to drive until you have started your prescribed treatment (probably by means of CPAP) and your Sleep Clinic is satisfied that the treatment is controlling your excessive sleepiness.

A simple letter can be as follows:

[Your address]

Drivers Medical Group
DVLA
Swansea
SA99 1DF

[Date]

Dear Sir,

I have been diagnosed with sleep apnoea and am being treated using CPAP therapy.

This letter is to notify you as is required.

Yours faithfully,

[Your NAME]

Make a copy and post the letter to the “Drivers Medical Group, DVLA, Swansea, SA99 1DF.

It is much more likely that a letter will receive a more carefully considered response than a telephone call or e-mail. Also, if your Sleep Clinic has issued you with a CPAP, and has confirmed that the treatment is successful, by the time the DVLA sends you the form to fill in (SL1 or SL1V) you should be in a position to tell DVLA that you are no longer sleepy and there will be no need to withdraw your licence.

If in doubt, consult your Sleep Clinic for advice before completing Form SL1 or SL1V.

How Do I Complete SL1 Form - (Group 1 Drivers)

1. Your Sleep Condition(s)

Question 1.1  Do you have, or have you had excessive sleepiness during normal waking hours?

If you have not experienced excessive sleepiness during normal waking hours you should not normally be completing
this form at all.
If you have been sent the form because you, your GP or your Sleep Clinic have contacted DVLA please refer to
Section 4 below.

Question 1.2  Which condition have you been diagnosed with?

Sleep Apnoea
Tick this box if your Sleep Clinic has diagnosed Sleep Apnoea and you have excessive sleepiness symptoms.

Obstructive Sleep Apnoea Syndrome (OSAS)
If your Sleep Clinic diagnosis confirms OSAS, ie Sleep Apnoea with excessive sleepiness, tick this box.

Question 1.3. Is your condition under control?

If you have not experienced excessive sleepiness tick “No” and proceed to question 2.
If you have had excessive sleepiness tick “Yes” and proceed to Question 1.4.

Question 1.4. If yes, how long has it been controlled?

If your Sleep Apnoea is recently diagnosed and is being successfully treated, the most likely box to tick will be “Less than 3 mths”, or possibly “3 mths – 12 mths”.

2. Declaration.

Question 2.1. Do you agree to regular reviews and to follow medical advice regarding any necessary treatment?

If you have experienced excessive sleepiness and you do not agree to regular reviews etc your licence will be revoked.
If you have no excessive sleepiness you do not need to answer this question.

3. Healthcare Professional

Question 3.1. Have you seen a healthcare professional about your condition in the last 12 months?
    

The appropriate answer is “Yes”; if you have not seen a healthcare professional within the previous 12 months, DVLA could revoke your licence.  

Question 3.2. Who should we contact if we need to investigate your condition further?
    

It is recommended that you suggest your Consultant rather than your GP for further DVLA contact.

4. If you have been sent Form SL1 or SL1V but have no symptoms of excessive sleepiness.

If your Sleep Clinic has diagnosed Sleep Apnoea without symptoms of excessive sleepiness:

Tick “No” in Question 1.1,

Tick “Sleep Apnoea” in Question 1.2.

Tick “Yes” in Question 1.3 and, assuming you have always been free from excessive sleepiness symptoms,

Tick “More than 7yrs” in Question 1.4.

Do not complete Question 2.1:

Tick “Yes” in Question 3.1

and, we suggest Tick “Consultant” in Question 3.2.

How Do I Complete SL1V Form – (Group 2 Drivers)

1. Your Sleep Condition

Question 1.1. Do you have, or have you had excessive sleepiness during normal waking hours?
    

If you have not experienced excessive sleepiness during normal waking hours you should not be completing this form at all.
If you have been sent the form because you, your GP or your Sleep Clinic have contacted DVLA please refer to Section 4 below.

Question 1.2 .Which condition have you been diagnosed with?

Sleep Apnoea
Tick this box if your Sleep Clinic has diagnosed Sleep Apnoea and you have excessive sleepiness symptoms.

Obstructive Sleep Apnoea Syndrome (OSAS)    

If your Sleep Clinic diagnosis confirms OSAS, ie Sleep Apnoea with excessive sleepiness, tick this box.    

Question 1.3. Is your condition under control?
    

If you have not experienced excessive sleepiness tick “No” and proceed to question 2.
If you have had excessive sleepiness tick “Yes” and proceed to Question 1.4.

Question 1.4. If yes, how long has it been controlled?
    

If your Sleep Apnoea is recently diagnosed and is being successfully treated, the most likely box to tick will be “Less than 3 mths”, or possibly “3 mths – 12 mths”.

Question 1.5. If yes, how is it controlled?
    

The boxes labelled “CPAP”, and “Mandibular device” are the most likely ones to complete, as appropriate.
If your recommended treatment is “Weight Loss”, or “Other” it does not suggest excessive sleepiness is a factor, so you should not be completing this form at all.

Question 1.6
    

Answer as appropriate.

2. Declaration

Question 2.1. Do you agree to regular reviews and to follow medical advice regarding any necessary treatment?
    

If you have experienced excessive sleepiness and you do not agree to regular reviews etc your licence will be revoked.
If you have no excessive sleepiness you do not need to answer this question.

3. Healthcare Professional

Question 3.1. Have you seen a healthcare professional about your condition in the last 12 months?
    

The appropriate answer is “Yes”; if you have not seen a healthcare professional within the previous 12 months, DVLA could revoke your licence.

Question 3.2. Who should we contact if we need to investigate your condition further?
    

It is recommended that you suggest your Consultant rather than your GP for further DVLA contact.

4. If you have been sent Form SL1 or SL1V but have no symptoms of excessive sleepiness.

If your Sleep Clinic has diagnosed Sleep Apnoea without symptoms of excessive sleepiness:

Tick “No” in Question 1.1,

Tick “Sleep Apnoea” in Question 1.2.

Tick “Yes” in Question 1.3 and, assuming you have always been free from excessive sleepiness symptoms,
Tick “More than 7yrs” in Question 1.4.

Do not complete Question 2.1:

Tick “Yes” in Question 3.1

and, we suggest Tick “Consultant” in Question 3.2.