Sleep, work and ill health

摘要

1. Excessive daytime sleepiness has the potential to reduce fitness for work and jeopardise the safety of the patient and others 2. Fatigue may be a manifestation of many forms of physical or psychological ill health, but, in the absence of other identifiable causes, sleep apnoea should be considered 3. Sleep apnoea is a disorder characterised by episodes of airflow cessation (apnoea) or reduction in airflow (hypopnoea) during sleep 4. Obstructive sleep apnoea (OSA) is the most common form, and is characterised by obstruction of the upper airways; obstructive sleep apnoea syndrome describes the condition when it is accompanied by daytime sleepiness 5. Simple screening for OSA can be undertaken in occupational health by using the Epworth Sleepiness Scale and enquiry about likely contributory factors, such as weight and collar size 6. Where conservative measures fail, treatment of OSA by continuous positive airway pressure airway (CPAP) is usually effective 7. The need for workplace adjustments for people with OSA should be considered in the context of the Equality Act 2010, although effective treatment may obviate the need for such adjustments in the longer term 8. Sleep disorders, including circadian rhythm sleep disorder, should be considered during statutory assessment of fitness for night work 9. Healthcare professionals have a responsibility to ensure that statutory bodies, including the DVLA, are informed when there is a risk to the safety of others.