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I have sleep apnoea. The key to diagnosis isn't the tiredness - this can be caused by a wide number of things, including narcolepsy. It is the irregular heartbeat.

As you describe, people with sleep apnoea stop breathing hundreds of times during the night, depriving the brain of oxygen and waking them up. This causes strain on the heart and lungs as they labour to function without oxygen.

The major consequence of sleep apnoea isn't traffic accidents - though I don't downplay the seriousness of driving while sleepy. It is heart failure, caused by years of irregular heartbeats. People suffering from sleep apnoea simply drop dead in their sleep, never knowing what hit them.

The treatment for sleep apnoea can consist either of moving the obstruction through surgery (less common) or through forcing air into the lungs during sleep (more common). This requires the use of a Continuous Positive Airway Pressure (CPAP) machine during sleep.

Users wear a breathing mask which is attached to the CPAP. The machine monitors breathing patterns and increases air pressure if breathing slows.

The CPAP is expensive ($2000) and the masks ($200 per) are fragile. They are not covered under Canada health care and only partially covered by group health insurance. So they are a significant expense.

That said, they are worth every penny. I have suffered from sleep apnoea since I was young, but having a CPAP over the last four years or so has made a huge difference in my quality of life. I really notice it on those rare days when I don't use it or when I am having trouble with a mask (as I am now).

It means I have to take the CPAP with me when I travel, so I get to know airport security people very well. The machine is large (1 foot long) and too fragile (and important) for baggage, so it consumes most of my carry-on space. And hotels are stingy with power plug-ins, so setting it up on the road can require acrobatics.

Seb, thanks for the stats and the update. More accidents than drunk driving? And Stephen, I have to learn more about the apnea/heart connection. (Apnea is one of those colourful words spelt differently in the United States.)

I just got my CPAP machine. The only wait here was for sleep lab results. BTW, a night in a sleep lab here costs $3,000+. Luckily, my insurance picks up the cost of the lab and the machine.

Heartwise, I have atrial fibrilation. I'm not conscious of it. Various attempts by my cardiologist to re-boot my heart haven't worked. We've been hoping that my giving up alcohol (sob!) would bring things back to normal. Maybe the CPAP will help out, too.

My CPAP looks like this.


Sleep apnoea as a condition and sleep apnoea as a contributory factor in road accidents are clearly related but responses to them are somehow different.

The story of your nephew is tragic - with two victims, primarily Toby (and his family) but also the driver who had consulted a doctor.

I am wondering if this condition results in exclusion from driving like epilepsy [It does, once diagnosed, with a driver who fails to report the diagnosed condition to DVLA liable to a fine - Seb] , or even a 'moral' self-exclusion from driving or other activities that might endanger others.

Thanks for comment, Frances. Some medical experts argue that even sleep apnoea sufferers have the early warning signs of feeling sleepy. Of course the condition varies in its impact on individual sufferers, and it is hard to generalise. Recent US work indicates "that individuals with OSA are between 30 percent and 472 percent more likely to have a crash. The mean crash risk ratio is 2.72, which indicates a 172 percent increased chance of a crash. He concluded that, based on the data, individuals with OSA are at an increased risk for a motor vehicle crash."

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