Assessing fitness to drive

In the UK, the DVLA states clearly that a patient with OSA should inform them of the condition and that driving should cease until symptoms are controlled. A patient who is successfully treated for their sleep related breathing disorder can continue driving provided they are no longer symptomatic.

The Physician should regularly ask about history of drowsy driving and sleepiness-related accidents or near-miss accidents. Consider the history of snoring, witnessed apnoeas and other features suggestive of a sleep disorder.

Sleepy patients should be advised that if they hold a driving licence they must follow the DVLA’s guidance. Include in your consultation:

    • Their driving habits
    • Their dependence on driving for work
    • Episodes of drowsy driving
    • Information from family members
    • Any MVCs, or near misses, which could be attributed to sleepiness or poor concentration

People whose work involves driving or operating heavy machinery are particularly at risk if they have undiagnosed OSA, because if they fall asleep on the job they may cause serious accidents. The current estimate for the prevalence of OSA in HGV drivers is over 15%. OSA is therefore not just a risk for the individual, but also to society as a whole due to the increased risk of fatal accidents. The impact of these road collisions, which include fatalities and lifelong disability, are associated with great emotional distress and broader societal costs. One fatal accident is estimated to cost approximately £1.5 million to society, and sleepiness accounts for around 20% of all road collisions. Many of these are likely to be caused by people with undiagnosed OSA although exact figures are unavailable.

The DVLA advises:

    • Patients must tell DVLA if they hold a current driving licence of any type
    • Patients can tell the DVLA by email or by downloading an SL1 form from
    • Patients can also tell DVLA by post, fax, or phone
    • A third-party notification will only be accepted in writing and must be signed by the letter writer
    • Include full name, address and date of birth
    • DVLA will send patients an SL1 form so they can give details about their OSA. It also enables them to provide consent for DVLA medical advisers to ask the medical professionals involved for more information
    • The DVLA normally provides a decision within six weeks about the patient’s safety to drive
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DVLA Guide for Healthcare Professionals: Assessing fitness to drive

© Institute of Clinical Science and Technology (ICST) 2020