DVLA

Hi there

So, my Dr referred me for a sleep study and I saw a nurse on Monday who said I had mild to moderate sleep apnea but she can't diagnose me as she's a nurse. My consultant appointment is not until August! In the meantime, although I am starting CPAP treatment, do I need to inform DVLA? I am always yawning but never dropped off in the day. Only time I find myself napping is 9pm onwards lying on the sofa watching TV. I don't feel it affects my driving but medically could be wrong.

Should I let the DVLA know without a "firm" diagnosis? Form SL1 does refer to an actual diagnosis which is still outstanding.

Many thanks

Which country are you referring to?

Sorry, DVLA is UK.

That is a long time to wait.
(((Incorrect advice deleted)))

Thanks!

Yes a long time to wait, but it's on the NHS so can't grumble too much. I'm grateful the nurse let me take the equipment to get started in the meantime!

This site gets high ranking on Google and other search engines - which is why people from the UK and other places outside the USA arrive here. But you need to understand, rls535, that most people in the US don't have the information you are seeking. They're good on helping you adjust and modify your treatment - I've learned a lot from the people here - but what you're asking is outside their purview.

Fortunately, I live in Gloucestershire, England, so perhaps I can be of assistance.

1. One of the courtesies you can follow on this site is to say where you're from - as in "Town or City, England". And it would help me guide you too, since, as you may know, there are variations in treatment in different parts of our country.

2. You say your GP (US equivalent, PCP) referred you 'for a sleep study'. Where was this? And what kind of study was it? Was it:

- (a) a do-at-home sleep study with just the thing on your finger plus the thing that looks like a big watch on your wrist?

- (b) a do-at-home sleep study with the thing on your finger plus the tube round your chest plus the two-pronged plastic tube in your nostrils all going into a little recorder? or

- (c) did they have you in to the hospital over-night, wired up a dozen different ways, in what they call a sleep-lab?

The reason I ask is that the method involved can affect the reliability of the diagnosis.

3. You say the nurse told you have 'mild to moderate' sleep apnea. That means anything from 6 to 15 interruptions per hour - the Apnea/ Hypopnea Index, or AHI. Did the nurse give you a number?

The reason I ask is that the policy in Gloucestershire is that "we only treat at 15 or above" - and I'm wondering what the policy is in your area.

4. You say you are "starting treatment" - what does that mean? Have they issued you with a machine and mask, and shown you how to use it? Or is that to come? If you are now (or are soon to be) using a machine on the authority of the sleep service nurse or sleep department physiologist, then you can take it that you have sleep apnea.

Being seen by the consultant is, in my experience, just a formality. I saw my consultant only once. In every annual follow-up since, I've seen one of the specialist sleep nurses or physiologists.

If you tell the DVLA that you've been diagnosed in this way, but you still have the doctor's appointment to come, then they will take that into account. As it is, they say their paperwork process takes at least six weeks.

BTW. If your foundation trust hospital decides to treat at 'mild-to-moderate' - say, 10 or 12 - then you're lucky. But most sleep function units in the UK seem to only issue fixed-pressure machines. You might find it's worth buying a more-flexible machine with your own money, like I did.

If you are starting cpap for sleep apnoea, I'd say that's enough of a diagnoses for you to be held liable by the dvla and the courts in event of an accident. I'm pretty sure your insurance would say this would invalidate your insurance if not declared. I don't see them making a distinction between a nurse or a Dr telling you the diagnoses - the numbers are the same who ever reads them.
The dvla and insurance just need it on their records - if you are compliant with treatment they won't actually do anything. It may well be if you aren't officially diagnosed they won't even record it - presumably the nurse should be able to advise you on this as well, since you won't be the only one in this limbo.

DVLA means drivers licensing-(YIKES)---so no doubt the doctors have already notified them,
(Or you MUST!). and that is probably why you were sent home with a machine.
That does not sound as horrible as them ignoring you until August.
The doc will probably know about the machine, and will need data from it, or something.

rick blaine wrote:This site gets high ranking on Google and other search engines - which is why people from the UK and other places outside the USA arrive here. But you need to understand, rls535, that most people in the US don't have the information you are seeking. They're good on helping you adjust and modify your treatment - I've learned a lot from the people here - but what you're asking is outside their purview.

Fortunately, I live in Gloucestershire, England, so perhaps I can be of assistance.

...

Nice post.

rick blaine wrote:This site gets high ranking on Google and other search engines - which is why people from the UK and other places outside the USA arrive here. But you need to understand, rls535, that most people in the US don't have the information you are seeking. They're good on helping you adjust and modify your treatment - I've learned a lot from the people here - but what you're asking is outside their purview.

Fortunately, I live in Gloucestershire, England, so perhaps I can be of assistance.

1. One of the courtesies you can follow on this site is to say where you're from - as in "Town or City, England". And it would help me guide you too, since, as you may know, there are variations in treatment in different parts of our country.

2. You say your GP (US equivalent, PCP) referred you 'for a sleep study'. Where was this? And what kind of study was it? Was it:

- (a) a do-at-home sleep study with just the thing on your finger plus the thing that looks like a big watch on your wrist?

- (b) a do-at-home sleep study with the thing on your finger plus the tube round your chest plus the two-pronged plastic tube in your nostrils all going into a little recorder? or

- (c) did they have you in to the hospital over-night, wired up a dozen different ways, in what they call a sleep-lab?

The reason I ask is that the method involved can affect the reliability of the diagnosis.

3. You say the nurse told you have 'mild to moderate' sleep apnea. That means anything from 6 to 15 interruptions per hour - the Apnea/ Hypopnea Index, or AHI. Did the nurse give you a number?

The reason I ask is that the policy in Gloucestershire is that "we only treat at 15 or above" - and I'm wondering what the policy is in your area.

4. You say you are "starting treatment" - what does that mean? Have they issued you with a machine and mask, and shown you how to use it? Or is that to come? If you are now (or are soon to be) using a machine on the authority of the sleep service nurse or sleep department physiologist, then you can take it that you have sleep apnea.

Being seen by the consultant is, in my experience, just a formality. I saw my consultant only once. In every annual follow-up since, I've seen one of the specialist sleep nurses or physiologists.

If you tell the DVLA that you've been diagnosed in this way, but you still have the doctor's appointment to come, then they will take that into account. As it is, they say their paperwork process takes at least six weeks.

BTW. If your foundation trust hospital decides to treat at 'mild-to-moderate' - say, 10 or 12 - then you're lucky. But most sleep function units in the UK seem to only issue fixed-pressure machines. You might find it's worth buying a more-flexible machine with your own money, like I did.

Hi, thanks for your reply!

My GP referred me for a home test with nasal cannula. Unfortunately over the course of the night I must have ripped them out due to my horrendously snotty nose or they became dislodged. So there is not a full nights reading. Around 2/3 when my partner went to work I woke up and shoved them back up there (so, B.)

Due to the nose cannula becoming dislodged the nurse couldnt give an accurate number although she suspects mild to moderate. She provided the CPAP on a weeks loan as a "secondary diagnosis" and we revaluate next Tuesday.

Unfortunately I can't give you any new information regarding the policy in my area, as I am in yours

Seems as though I'm lucky to have found you, thank you for your post.

As a side question, my other half was as surprised as I was by the results. With no symptoms coupled with the fact that I actually record my sleep (albeit only sound) the only thing that sounds dodgy on playback is my congestion which causes coughing in the night. The sound wave pictures all look very regular and I can't see any gap longer than 10 seconds. Is this just inaccurate data or could my sleep test results be incorrect die to my congestion issues?

Just to confirm I know the programme actually records me because I can hear my partner in the background snoring/sleep talking and my cat screaming for food all night ha ha.

I have had issues since a child, lots of ENT appointments resulting in my adenoids being removed but I have heard they can grow back.

Apologies if this sounds ignorant.

Scratch that. I know it sounds ignorant. I am in denial. But not in denial about being in denial What a few days this has been... Kudos to all you long timers for keeping it together

Once I know for certain I am ALL IN. Trust me. It appears the hospital knows for certain, i'm sure my body knows for certain but the stupid head of mine... agh.

I was actually relieved by my apnea diagnosis.
It explained many of my health problems and provided a simple solution,
that was neither surgery nor having to take a toxic drug forever.

OK, it sounds like there are still a few things you need to know before informing the DVLA.

The machine they gave you for a week was probably an auto-adjusting PAP (or APAP). Most likely a Philips Respironics System One 551 or 561. (If you ever need to know, you can just look at the label on the underneath.)

This machine examines your breathing patterns in a moving five-minute window, and on the basis of what it 'sees', adjusts the pressure it is delivering. It does this to keep the airway open - or 'patent' in medical talk.

It also has memory chips in it, and it keeps a record of: how long you used the machine for; how often your breathing got interrupted, and how long for; how much you snored; how much your breathing got 'agitated' (my word for a couple of very technical terms) - and especially, the pressure changes it made.

And it makes a copy of all this data on the SD card (in the slot at the back). It is what some people call a 'data compliant' machine.

The sleep service staff plug that SD card into their computer, and the software they bought from Philips Respironics tells them how you did. And the results from seven nights on APAP are more representative than the numbers from one incomplete night of home sleep study.

That's what I think the nurse meant when she said "secondary diagnosis".

Which means, AFAIK, there is nothing for you to tell the DVLA (Driver and Vehicle Licensing Authority) - yet. As I understand it, someone has to give you a formal diagnosis - be it the consultant, or the chief physiologist acting on behalf of the consultant, or your GP, having been informed by the sleep service - before you are obliged to inform the Authority.

As to your question about snoring, and the sound recording you made of it - not all sleep apneacs snore. It is possible to have completely silent apneas, and a not-very-loud 'fuss' when breathing starts again.

What counts is (a) how often there are interruptions, (b) how long are the interruptions, (c) how low is the oxygen saturation in your blood because of the interruptions, and (d) how rested your sleep is.

As you say, you'll get more information next Tuesday.