Narcolepsy – the need for drivers to be aware!

Keeping our roads safe is vitally important and we all need to be aware of changes in our health which could have a detrimental effect on our fitness to drive and the safety of others.

One of the things drivers need to be aware of is Narcolepsy – a rare long-term condition of the brain which causes a person to fall asleep suddenly at the most inappropriate of times, which obviously can have major implications in terms of road safety.

How does it work?

Narcolepsy interferes with the normal sleep pattern, resulting in excessive daytime sleepiness and causes sudden attacks of sleep due to overwhelming tiredness. It is important to be aware of narcolepsy as it can affect the ability to drive safely by causing individuals to feel particularly sleepy in situations and at times they would not expect.

It can happen when driving, or sometimes when simply talking or eating. The dangers are evident and narcolepsy, unsurprisingly, is known to increase the risk of road traffic accidents.

What causes narcolepsy?

It remains a bit of a mystery and the cause of narcolepsy isn’t known but it may be related to some underlying genetic factors.

Fortunately, it is not common, affecting only around 25 in 100,000 people – nonetheless it is important to be aware of the condition due to its implications.

It arises because the brain is not able to regulate sleeping and waking patterns normally, leading to excessive sleepiness during the daytime, feeling drowsy throughout the day and difficulty in staying awake and concentrating.

Features of the condition, some of which are specific to and only occur in those with narcolepsy, include: 

• Cataplexy – A sudden loss in muscle power due to strong emotions, such as laughter or anger. 
• Automatism – When a person acts in an automatic manner in a situation, as they lack full awareness. This can lead to inappropriate behaviour as a person may not know what they are doing.  
• Sleep paralysis – When you are unable to move or speak, usually occurring when waking up or falling asleep. 
• Hallucinations – These also occur when waking or falling asleep and include sensing stimuli which are not really there, which can be seeing images, hearing sounds, feeling abnormal sensations or even sensing smells.  

Narcolepsy can also mimic other conditions such as obstructive sleep apnoea, which also causes disrupted sleep and daytime tiredness. 

Action needed

It is important to see your GP for a referral for sleep studies if you are suffering with excessive daytime sleepiness, and to be aware of the condition in others to ensure our roads remain safe for everyone.  

Excessive sleepiness is a significant problem with up to one in five accidents on motorways being caused by drivers falling asleep at the wheel. DVLA guidance reflects this problem and specifically states that all individuals suffering with excessive sleepiness must stop driving immediately and inform the DVLA. 

This rule applies to both Group 1 and Group 2 licence holders. A medical form must be completed to assess the individual risk and those affected are usually able to drive again once the condition is being controlled. There would, however, be a need to satisfy the DVLA of a fitness to drive and regular medical reviews would normally be necessary. 

Although there is no cure for narcolepsy, much can be done to improve it. This includes optimising your sleep routine by incorporating scheduled naps and avoiding caffeine, alcohol and smoking – particularly towards the end of the day.

There are medications available which help to reduce these sleep attacks, including Ritalin which is commonly used to treat ADHD. Its stimulant effect means it is also a treatment option in narcolepsy.