Driving a motor vehicle is an essential part of most people’s lives. However the privilege of driving also comes with certain responsibilities. Driving a motor vehicle is a complex task that requires perception, good judgement, adequate responsiveness and reasonable physical capabilitiy.
A range of medical conditions (mental and physical) may adversely affect your ability to drive safely, and could result in a crash causing death or injury. This includes sleep apnoea, and other sleep disorders.
A recent study published in SLEEP, an international medical publication, reviewed articles on sleep and driving compiled from nine electronic databases. The systematic review of literature analysed Continuous Positive Airway Pressure (CPAP) therapy on motor vehicle crash risk among drivers with OSA. The study also investigated the optimal time on treatment needed for CPAP to improve driver safety. The review of the literature showed that drivers with Obstructive Sleep Apnoea (OSA) had a significantly reduced risk of accident. The researchers also noted that there was a significant improvement in daytime sleepiness after just one night on CPAP therapy which should lead to reduced risk of motor vehicle accident due to tiredness.
Sleep disorders can cause excessive sleepiness which slows reaction time, decreases awareness, impairs judgment and increases aggressiveness. If that sounds familiar, it should — you’ve heard the same warnings about driving under the influence of alcohol and drugs. Just like driving drunk or drugged, drowsy driving causes you to make mistakes behind the wheel — mistakes that can injure or kill the driver, passengers or total strangers.
According to the U.S. National Highway Traffic Safety Administration (NHTSA), drowsiness or fatigue is the principal cause of up to 100,000 police-reported passenger vehicle crashes every year, killing at least 1,500 people and injuring 71,000. Many more fatigue-related crashes go unreported. But don’t blame it on the long-haul truckers: Less than 1 percent of all sleep-related crashes involve truck drivers, who are prohibited, by federal regulation, from driving more than 10 hours in a 24-hour period.
The story of Jet Rowland demonstrates why managing your medical condition is essential.
In 2004, a driver with epilepsy had a seizure and crashed into the car Jet was travelling in. Jet, 22 months old, was killed by the impact of the crash. Jet’s seven-year-old brother Bailey was confined to a wheelchair and his mother Anita was also severely injured.
A recent study showed that 20 percent of crashes and 12 percent of near-crashes were caused by drowsy drivers.
How did the researchers determine a driver was drowsy? Each of 100 vehicles was outfitted with five cameras that linked to computers to record driver action and reaction. Drivers were monitored for more than one year and nearly 2 million miles of driving. Researchers determined that the drivers were drowsy if their eyes closed for longer than a blink, or if their heads bobbed forward and then bolted back upright. Also making the cut were drivers who didn’t move at all, staring fixedly ahead instead of reacting to oncoming traffic or checking the rearview or sideview mirrors.
Surprisingly, the study showed that the majority of crashes and near-crashes occur during daytime hours, when roads are more crowded, rather than at night. But sleep-related accidents at night tend to be more serious because they are more likely to occur on high-speed highways and rural roads, when the driver is alone.
Among the groups studied, all the age groups had the same percentage of drowsy-driving crashes and near-crashes, except for one. “The 18-20 age group was involved in five times more fatigue-related accidents and near-accidents than any other group,” she said, due to inexperience behind the wheel and irregular sleep habits.
It’s not just age, it’s work schedule. Another study, based on interviews with drivers after crashes, indicated that drowsy drivers were nearly twice as likely to work at more than one job and their primary job was much more likely to involve non-standard hours. Working the night shift increased the odds of a sleep-related accident by nearly six times.
Additionally, many people are commuting much longer now, increasing the number of drowsy-driving incidents.
Drivers should be aware of these warning signs:
Your doctor will refer to the private and commercial medical standards for driving in the Assessing Fitness to Drive publication. These standards are recognised by all Australia driver licensing authorities. Your doctor will provide advice on how your condition may affect your driving ability and how to manage it. However, the department makes the final decision on your ability to hold a driver license.
If you drive heavy vehicles, public passenger vehicles (eg buses or taxis) or vehicles carrying dangerous goods, you must meet the commercial medical standards in the Assessing Fitness to Drive publication. These standards are more stringent than private standards and reflect the increased risk associated with motor vehicle crashes involving such vehicles. Despite having a medical condition, with treatment and regular review you may be able to continue to drive such vehicles under a conditional license.
Your doctor may advise that you restrict your driving activity temporarily if your condition is only short-term. In this case your driver license status will not be affected and you do not need to report the condition to the department.
Yes. If you are a Queensland driver license holder 75 years or older, you must carry a current medical certificate while driving and drive in accordance with the certificate. This is mandatory regardless of whether or not you have a medical condition.
You must promptly give your medical certificate to the department if your doctor completes a Medical Certificate for Motor Vehicle Driver (form http://www.support.transport.qld.gov.au/qt/formsdat.nsf/qtforms/QF3712
stating in their opinion one of the following:
In most cases, having a medical condition will not stop you from driving.
Your doctor must determine whether you are:
Yes. If your driver license is subject to conditions, it will have an ‘M’condition on it. You must carry your current medical certificate and drive in accordance with it at all times. You must also show it to a police officer if asked to do so.
You must comply with any conditions imposed on your license. If you fail, you may receive a penalty of $2000.
Your license may be suspended for a period of time or be cancelled. If your license is cancelled, you must surrender it to the department.
If you do not agree with this decision, you may appeal or ask the department to reconsider.
If you continue to drive during your license suspension or cancellation, you may receive a $4000 penalty or be imprisoned for up to 1 year.
If your medical condition contributes to a crash, your license could be cancelled.
There may also be legal implications including imprisonment.
Yes. If your doctor has given you advice and is concerned that it may be ignored, or they feel that your condition poses a risk to public safety. They are encouraged to tell the department.
Your doctor is provided protection under legislation when giving information in good faith to the department about your fitness to drive.
It is important that you advise them to talk to their doctor. With appropriate treatment or restrictions the person may be able to continue to drive.
If they are unwilling to talk to their doctor, you can provide this advice in writing to the department. Supporting evidence, such as advice from a police officer or health professional, should be included where possible to substantiate your claims. Include your name and address, together with the name and address of the person you believe is medically unfit to drive.
The department may suspend or cancel the person’s Queensland driver license, or withdraw their authority to drive in Queensland if they are a non-Queensland license holder.
As a Queensland driver holder, you are required to promptly tell the Department of Transport and Main Roads of any long-term or permanent medical condition that is likely to adversely affect your ability to drive safely.
You must tell the department as soon as a condition developed or if there will be a long-term increase to an existing condition. You cannot wait until you renew your license.
When applying for a Queensland driver license, you must tell the department of any medical condition that may adversely affect your ability to drive safely.
You will need a medical certificate confirming your fitness to drive. Your doctor may also recommend that your license be subject to conditions.
If you fail to report your condition, you may receive a $6000 penalty and be disqualified from driving.
For more information or to download the Medical Certificate for Motor Vehicle Driver form (form F3712), visitwww.transport.qld.gov.au/medical conditions
Alternatively, contact the department’s call centre on 13 23 80 Monday to Friday 8am – 5 pm, excluding public holidays. The Assessing Fitness to Drive publication, used by your doctor to assess your fitness to drive, can be viewed atwww.austroads.com.au/aftd
References: Tregear, S., Reston, J., Schoelles, K. and Phillips, B (2010). CPAP and Motor Vehicle Crash Risk: Review and Meta-Analysis. Sleep, 33 (10).
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