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Threat to Drivers License Obstructs Treatment

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Commentator

How do you deal with the risk that you might lose your license if you seek treatment for sleep disorders?

What experiences have you had or heard of in this regard?

I live in Australia and have very severe sleep Apnea. When I first sought help the doctor considered restricting my license but decided not to take action at that time, presumably because she felt that if the treatment was effective it might not be warranted.

I have other issues revolving around sleep that I should seek medical help with because once again effective treatment might help me be more functional in all areas of my life including driving, but I am concerned about the potential consequences.

This is a big country and I have responsibilities so having my licence under threat at the whim of a pen stroke in the wrong box is a serious disincentive. Yes it is necessary for the greater good and I should be responsible and accountable but I believe I am and will continue to act with care and caution but I do not trust strangers to make these decisions on my behalf. I understand that there is some consultation in the process and that there is an appeal system if I was prepared to take months to fight an excessive restriction through the local courts but that sounds like a very unpleasant way to spend my time and I doubt that the outcome would be any different.

So, am I just imagining these potential issues or are they real?

Is there a way to consult with doctors, sleep specialists and neurologists, to get the treatment I need, without putting my license at risk?

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sleeptech +1 point · 6 months ago Sleep Enthusiast

What you describe is a genuine problem. The law in Australia is that a doctor is required to report a patient to the motor vehicles department if they think the patient's ability to drive is impaired. Some research has been done into the matter and it suggests quite clearly that more people would be treated, and thus we would all be safer, if reporting of patients was not mandatory. What happens to your licence is largely up to the doctor involved with your case. Most of them are sensible and generous in how they apply the law, but you never know. I have also heard from a lot of my patients that in the last year the authorities responsible have become much stricter in chasing up people with OSA.

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Commentator

Seems like Catch 22 or at least a self fulfilling prophecy. By the time I am able to safely seek medical help it will be too late and I will have quit driving of my own volition because of the severity of my untreated illnesses.

I made a number of appointments some weeks back including a sleep specialist but when I prepared a brief medical history and realised how many potential red flags could be invoked I cancelled most of those appointments.

I figured that the odds were stacked against me and the more people I consulted the more likely it was that one of them would tick the wrong box and I would lose my license, especially after I read this article.

https://www.smh.com.au/national/nsw/unpaid-fines-no-longer-the-main-reason-for-drivers-licence-suspensions-20180226-p4z1qo.html

I left the neurologist appointment in place because I have to get some help, regardless of the risk, but I will need to be cautious in how I answer his questions, which does not bode well for effective treatment.

Anyways, enough of my whining.

Who has been through this already and how did you deal with it?

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Sierra +0 points · 6 months ago Sleep Innovater

I have not dealt with the same thing, but perhaps similar. We like to travel and need travel insurance. Pre-existing conditions become an issue. I am quite careful about reporting issues to my doctor that might require a prescription change or special test as that resets the pre-existing condition time clock. If my health was at immediate risk I would just set travel plans aside. That said, your situation is more difficult to deal with.

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sleeptech +0 points · 6 months ago Sleep Enthusiast

It's worth bearing in mind that, as long as you are in the process of pursuing treatment that your licence shouldn't be in jeopardy. In almost every case I've heard of, people only lose their licence if the flat out refuse to be treated. If you do as the doctor suggests, even if it takes a long time, you should be OK because you are doing all that you can. Of course, there are no guarantees.

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Commentator

Well I survived the appointment with a Neurologist so I might try another roll of the dice and go see a sleep specialist.

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MountainGoat +0 points · 6 months ago

I have a condition M on my driver's licence (Queensland) due to type 2 diabetes that isn't controlled by diet and exercise. The last medical certificate was valid for two years as the doctor agreed that with T2DM that is well controlled, there is no risk to other road users. The sleep lab that did the sleep study sent me a whole bunch of literature with the report, which I duly ignored as I don't suffer from excessive daytime sleepiness, although diagnosed with severe OSA. It is really up to the opinion of the doctor, in my case the GP, who issues the certificate if your condition impairs your ability to be a safe driver. My only advice is to speak to your GP about the potential issues. Hopefully he or she is a reasonable person that can have a mature discussion. If not, you may need to reconsider the relationship you have with the GP.

Sadly though, in my view there are many other medical conditions that should also require a condition M, but don't. This includes high cholesterol, because you could have a heart attack while driving etc. Blood disorders that could cause a stroke, the use of some ED drugs that could cause sudden blindness etc. etc.

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Biguglygremlin +0 points · 6 months ago Original Poster Sleep Commentator

You are right about other causes. Fatigue and sleepiness are in epidemic proportions even without any obvious causes and they are usually the main symptoms of nearly every other illness and disease.

As to all the other driving impediments I seem to recall some early road rules that exempted drivers from responsibility if they were sneezing at the time so perhaps we should add asthma and all other allergies as well as colds and flu to the danger list.

Then there are equally dangerous influences like distress, anger, confusion or worse yet ........ running late.

For a doctor to use something like the Epworth Sleepiness Test to reach a verdict is insane. It is just too ambiguous and subjective.

When it comes to our local doctors it's difficult to have a relationship at all because nowadays they mostly work out of medical centres with a number of other doctors and prefer their patients to see the first available doctor. Yes you can request a specific doctor but it can double your waiting time.

I find it hard to place my future in someone else's hands so although I don't object to the principle behind the processes I would like to have more say in what I am and am not able to do safely and responsibly.

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sleeptech +0 points · 5 months ago Sleep Enthusiast

I agree that the Epworth Sleepiness Scale was misused in this case. It was designed to track CHANGES in perceived sleepiness over time. It was never meant to be an objective measure of sleepiness at any given moment. A One-off result is, as you say, far to objective to have meaning, and should not be used to determine whether someone is disqualified from driving. I'm told that Dr who instituted use of the Epworth gets very upset about how people misuse his Sleepiness Scale.

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Sierra +0 points · 5 months ago Sleep Innovater

I am not a doctor, sleep specialist or neurologist, but if you want to post a SleepyHead Daily Detail screenshot here I will give you my sleep apnea sufferer opinion. I don't take driver's licences away and I have seen some pretty bad SleepyHead reports. See below.

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