Doctors focus on deadly dangers of sleeping disorder: Report seeks greater awareness of condition

EXCESSIVE sleepiness in the daytime is the commonest cause of road accidents after alcohol, yet the condition is largely unrecognised and untreated, leading physicians said yesterday.

They estimate that between 30,000 and 100,000 predominantly middle-aged men, who snore and snort during sleep, suffer from obstructive sleep apnoea, a treatable condition, which wakes them briefly 200 to 400 times a night, usually without their knowledge. Researchers in the United States say that as many as 1 in 25 middle-aged men suffer the condition.

Professor Leslie Turnberg, president of the Royal College of Physicians, said it was essential that patients and doctors recognise that the prime symptom, regularly falling asleep in the day, is an abnormal condition.

The college is so concerned about the consequences of sleep apnoea that it has organised a meeting with the police and the Department of Transport to alert them to the dangers and encourage more research.

At the launch of its special report, Sleep Apnoea and Related Conditions, the experts said that Britain was behind other countries in recognising the seriousness of the condition first identified about 30 years ago.

Apart from the hazards for drivers and machine operators sleep apnoea is linked to heart attacks and stroke probably because of the repeated sharp rises in blood pressure as the sufferer finally gains a breath.

Dr John Stradling, of the Osler Chest Unit, Churchill Hospital, Oxford, a member of the college's working party, said that in sleep apnoea the upper airway collapses causing suffers to stop breathing, sometimes for up to a minute. During this time they will struggle to breathe, often making small snorting noises until the body's defence mechanisms come into play, waking the sleeper who regains breath usually with loud snoring noises.

In the US where research is more advanced, they estimate that between 1 and 4 per cent of middle- aged men are affected and 2 per cent of women. In addition, 13 per cent of 50,000 road accident deaths in the US are said to be caused by the driver falling asleep at the wheel. A study by Leicestershire Police found that 20 to 25 per cent of motorway accidents had the same cause.

Dr Stradling said that partners were more likely to be aware of the condition than the sufferers. The report says: 'In 90 per cent of cases bed partners described intermittent apnoeas terminated by loud snorts followed by the resumption of snoring. Over 95 per cent of cases give a history of loud snoring for many years. Bed partners also report restless sleep as the patient fights for breath.'

About half of the sufferers are obese and losing weight can help as can avoiding alcohol. But the treatment offered is sleeping with a face mask connected to a quiet pump which delivers air to the sleeper at slightly above atmospheric pressure which keeps the airway open.

Dr Stradling said these pumps cost between pounds 400 and pounds 600 but they estimated that only about 2,000 sufferers were provided with them. The royal college appealed to health authorities to acknowledge the existence of the problem and provide money for treatment.

Sleep Apnoea and Related Conditions; Royal College of Physicians Publications Department, 11 St Andrew's Place, Regent's Park, London NW1 4LE; pounds 9.50.