Hundreds of thousands of people in the UK are failing to receive an accurate diagnosis and treatment for excessive sleepiness [i], with potentially fatal consequences, according to the Sleep SOS Report launched today by the Sleep Alliance. Excessive sleepiness affects approximately 6% of the adult population, over 3.5 million people in the UK [ii], and is a common and debilitating symptom of many chronic medical conditions. [iii], [iv], [v], [vi], [vii], [viii], [ix]

As well as impairing quality of life, untreated excessive sleepiness is a major contributing factor to fatal road accidents, lost productivity and the breakdown of relationships. Yet in many parts of the UK sleep medicine takes a low priority and funding of sleep services is being restricted or withdrawn.

"Sleep is considered by many within the medical profession to be a complex discipline that is arduous to investigate and the role and benefits of providing a sleep medicine service are often poorly understood," explained Dr Melissa Hack, Lead Consultant, Gwent Sleep Centre, South Wales.

The Sleep Alliance claims that the problem is exacerbated by the low priority afforded to sleep medicine in today's medical schools. A recent study estimates the average time given to sleep disorders in undergraduate teaching to be only five minutes. [x]

Dr John Shneerson, Director of Respiratory Support and Sleep Centre, Papworth Hospital, Cambridgeshire said "Although excessive sleepiness is a common debilitating symptom of a number of chronic medical conditions, many people who experience sleep-related problems are reluctant to trouble their doctor. Yet trying to live with excessive sleepiness can place livelihoods and relationships at risk, as well as endangering lives."

Excessive sleepiness is a major contributing factor to road accidents accounting for 20% of motorway crashes, [xi] with death tolls estimated to be 50% higher in accidents where the driver is asleep at the wheel compared to other accidents, because they do not swerve or apply their brakes. [xii]

The Sleep SOS Report also demonstrates that relationships with friends and family can be damaged by the effects of excessive sleepiness. In a survey commissioned by the Sleep Alliance, over two-thirds of respondents (67%) felt that obstructive sleep apnoea / hypopnoea syndrome (OSAHS) had a negative effect on past and present relationships with half (51%) advising that their partner sleeps / has slept in a separate room. Whilst at work, 43% of patients felt that the condition affected their performance and they could not pursue promotion / business opportunities as a result of excessive sleepiness. For many, the effects were compounded by the delay in diagnosis and treatment; over a third of respondents waited 10 years or more before consulting their GP after they were told they snored loudly, a common symptom of OSAHS. [xiii]

"Unfortunately, society as a whole - healthcare professionals included - is guilty of trivialising excessive sleepiness as a medical symptom. This is echoed by the low priority placed on local sleep services within the NHS and public awareness of sleep disorders. Yet, relatively small investment in the provision of sleep services is required to treat and manage patients with excessive sleepiness," explained Professor John Stradling, Clinical Director, Sleep Unit, Churchill Hospital, Oxford.

The report highlights that untreated obstructive sleep apnoea / hypopnoea syndrome costs the NHS over 400 million a year. [xiv] This is largely due to preventable hospital admissions, sleep related road traffic accidents and treatment for related vascular conditions such as hypertension, [xv], [xvi], [xvii] which is common in people with untreated OSAHS.

The Sleep Alliance is calling on government and the NHS to increase resources for sleep services. The group's 'call for action' urges greater recognition of the impact of sleep-related disorders, and the financial resources to support an adequate infrastructure for the management of excessive sleepiness.

-ENDS- To speak to individuals about their personal experiences of excessive sleepiness contact Kirsten Mason at Munro & Forster Communications, tel: 020 7815 3900. Out of office hours contact Bryony Box on 0773 4299 736 or Fiona Cheetham on 07984415468.

Notes to Editor:

-- Members of the Sleep Alliance represent the following organisations: Brake; British Lung Foundation; British Sleep Society; British Snoring & Sleep Apnoea Association; British Thoracic Society; Relate; Royal College of Physicians; Royal College of Psychiatrists; Royal Society for Prevention of Accidents; Sleep Apnoea Trust Association

-- The Sleep Alliance aims to create greater awareness of sleep disorders amongst the general public and the medical community and calls for a more proactive approach to reducing sleep-related morbidity and mortality. It also seeks to improve funding in an area where additional resources are needed and will achieve a real difference to the everyday lives of patients.

-- Excessive sleepiness is a common symptom of several chronic medical conditions, not only sleep disorders such as narcolepsy and obstructive sleep apnoea / hypopnoea syndrome, but also chronic medical conditions such as Parkinson's disease, multiple sclerosis and depression.

-- This survey was conducted for Munro & Forster Communications. The results were analysed and processed by TNS Healthcare. The patients surveyed, all members of The Sleep Apnoea Trust Association, received a postal self-completion survey in December 2003. Of the 543 people who completed the questionnaire, three quarters were male with the majority falling into the 51-70 age bracket.

References:

Katherine Riedtmann
Account Manager
Munro & Forster Communications
89, Albert Embankment
London, SE1 7TP

Tel: 020 7815 3975
Fax: 020 7815 3999

[i] Calculation by Stradling J on behalf of the Sleep Alliance based on prevalence data in Scottish Intercollegiate Guidelines Network (SIGN). Management of-Obstructive Sleep Apnoea/ Hypopnoea Syndrome in Adults. 2003.

[ii] Sleep Foundation. Gallup Survey 1997: Sleepiness in America - Excessive Daytime Sleepiness http:www.sleepfoundation/publications 23rd June 2004

[iii] Douglas NJ. Clinicians' Guide to Sleep Medicine. Arnold 2002. p.41

[iv] Scottish Intercollegiate Guidelines Network (SIGN). Management of-Obstructive Sleep Apnoea/ Hypopnoea Syndrome in Adults. 2003

[v] Shneerson JM. Handbook of sleep medicine. Blackwell Science 2000. p.122-127

[vi] Beusterien KM, Rogers AE, Walslenben J et al. Health Related Quality of Life Effects of Modafinil for Treatment of Narcolepsy. Sleep 1999; 22(6): 757-765

[vii] Tandberg E et al. Excessive daytime sleepiness and sleep benefits in Parkinson's Disease: a community-based study. Mov Disord 1999; 14: (6) 922-927

[viii] Rubinsztein JS et al. Apathy and hypersomnia are common features of myotonic dystrophy. J Neurol Neurosurg Psych 1998; 64 : 510-515

[ix] Freal JE, Kraft GH, Coryell JK. Symptomatic fatigue in multiple sclerosis. Arch Phys Med Rehabil 1984; 65(3): 135-8

[x] Stores G, Crawford C. Medical student education in sleep and its disorders J R Coll Physicians Lond 1998; 32(2): 149-153

[xi] Horne JA, Reyner LA. Sleep-related vehicle accidents. BMJ 1995; 310: 565-567

[xii] Royal Society for the Prevention of Accidents (Rospa). Driver Fatigue and Road Accident: A Literature Review and Position Paper. February 2001

[xiii] Obstructive Sleep Apnoea / Hypopnoea Syndrome Patient Survey. Source: TNS Healthcare. January 2004

[xiv] Calculation based on data published in Douglas NJ, Thorax 2002; 57 and Kapur V. Journal of Sleep 1999; 22. Presented at BTS Summer Meeting 2003 by MacKay T.

[xv] Nieto FJ, Young TB, Lind BK et al. Association of Sleep-Disordered Breathing, Sleep Apnea, and Hypertension in a large community-based study. JAMA 2000; 283: 1829-1836

[xvi] Shahar E, Whitney CW, Redline S et al. Sleep-Disordered Breathing and Cardiovascular Disease. Am J Respir Crit Care Med 2001; 163: 19-25

[xvii] Shepard JW Jr. Cardiopulmonary consequences of obstructive sleep apnea. Mayo Clin Proc 1990; 65(9): 1250-9

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