Shropshire’s Richard Mundy is campaigning for lorry drivers to undergo medical tests to see if they have a condition that could cause them to fall asleep at the wheel.
SD3368753@thursday For most people, falling asleep isn’t generally a problem.
But what if you are in the middle of a busy shopping centre and you have no idea it’s happening?
“It happened to me standing in Telford centre waiting for my wife outside a shop and I fell asleep standing up,” says Richard Mundy from Wellington, who suffers from a condition called sleep apnoea. It means that without treatment he could nod off any time, any place, and anywhere.
“It happened to me at the cinema and my son had to nudge me, and when I went the theatre.
“I would wake up in the morning and it was like my brain had turned to stone. It’s not like a normal headache, you start the day feeling like you want to go back to bed, thinking about how on earth you are going to face the day.
“But the cumulative effect of living like that for years without diagnosis is that you become a big liability.”
Sometimes it can be too late. Richard says he is dismayed to read with alarming regularity the number of reported road accidents in the region caused by lorry drivers falling asleep at the wheel.
Now he is campaigning for them to undergo regular medical tests, with statistics showing that many serious accidents caused by truckers are because they fall asleep at the wheel – suffering not from fatigue but from the very condition that he suffers with.
A study in 2005 found that around one in six British HGV drivers suffers from sleep apnoea, a potential “killer in the cab”. The Respironics research looked at more than 900 drivers in England and Wales, but the Road Haulage Association denied the problem was rife among truck drivers in the UK.
Kate Gibb, spokesperson for the RHA, welcomes Mr Mundy’s awareness campaign but tells the Shropshire Star: “As far as compulsory testing, I don’t know that we would go that far. Road accidents caused by drivers falling asleep at the wheel – I would think very few are from sleep apnoea, but we do think that testing could be done on a voluntary basis.”
But Richard continues: “Part of the problem is that you fall asleep in the day. If you work at a computer that’s one thing, but if you fall asleep at the wheel of a 40-tonne artic it can have an unthinkable consequence.
“The problem is getting to the stage that you realise there is something wrong. If you live on your own and don’t have a bed partner you might never know. You might go to the doctor and say you feel horrible and he might say you’ve got a bug.
“It’s unbelievable how long it takes without help.”
Sleep apnoea is a fairly common condition that occurs because of the collapse of the muscles in the airway. It causes sufferers to briefly stop breathing during sleep. Breathing difficulties also mean that not enough oxygen is getting into the blood, causing you to feel fatigued and fall asleep during the daytime.
Snoring
Obstructive sleep apnoea, whose symptoms can include snoring, is a relatively common condition that affects men more than women. In the UK, it is estimated that about 3.5 per cent of men and 1.5 per cent of women have OSA. The condition is most common in people aged 40 or over, although it can affect people of all ages, including children.
Obesity is a major risk factor for OSA because excessive body fat can place strain on the muscles in the throat.
Sufferers can stop breathing for periods of 10 seconds or more when asleep. These interruptions, or apnoeas, occur when the airway narrows so much that it closes. This stops the breathing and the brain reacts by waking the person, causing the airways to re-open and breathing to start again.
Richard says: “Every two minutes I’d wake up. That means you are not asleep. Rapid-eye-movement sleep – deep sleep – is valuable but you never get into that.”
Sufferers can wake up hundreds of times during the night and are usually unaware of it happening. The next day they are so tired they can barely function and their risk of being involved in a life-threatening accident, such as a car crash, is dramatically increased.
Research has shown that someone who has been deprived of sleep due to OSA has the same impairment in judgement and reaction time as someone who is over the drink-drive limit, so it’s little wonder that sufferers who drive for a living could be a liability.
Richard is hoping his cause will be taken up by the Royal Society for the Prevention of Accidents. He has also had discussions with the Department for Transport and a number of leading clinicians on the subject.
The condition can easily be treated, or managed, using a device called a C-Pap, or Constant Positive Airway Pressure machine, which blows air under pressure through a tube attached to the nose or face and pressure keeps the airway open.
Harmesh Moudgil, consultant physician at the Princess Royal Hospital, Telford, helped Richard manage his condition. He says: “Attention paid to drivers is important, with published research reporting increased risk of at least fourfold in road traffic accidents across any severity of disease, with an even higher ratio where more significant personal injuries have occurred.
“It is not known for certain, however, whether this is necessarily because of the short unpredictable micro sleep episodes at the wheel or because of the reduced attention span throughout driving as suggested by various psycho-motor function tests.”
He says that nationally requests to investigate sleep disorders are fast becoming the second highest referral to hospital respiratory units.
“Local to Shropshire, NHS provisions and maintenance of CPAP machines and consumables is presently through the Shrewsbury and Telford Hospital NHS Trust based at Princess Royal Hospital in Telford, with technicians and trained nurses working with the respiratory team and supported by the local primary care trusts.
“The nature of patients presenting is diverse, with many highlighting driving issues rather than necessarily the health-related complications. Once initiated on relevant therapy, DVLA looks favourably to patients diagnosed and the majority return back to their normal lifestyle.”
Richard Mundy adds: “Sleep apnoea is more common than you would think and the thing is, it’s so easily treated, once you have been diagnosed.
“It would save lives and improve the quality of hundreds of thousands of other people’s lives.”