Sleep Apnoea Bill (P) [Failed Bill 2003/04 Session]

A Private Members Bill tabled by Alice Mahon (Lab, Halifax) calling for the government and NHS managers to recognise the importance of sleep disorders and devote more resources to treating them. This is the first ever Bill aimed at tackling the problems caused by Sleep Apnoea and other sleep disorders.

Alice Mahon writes:

The “Sleep Apnoea Bill” would empower the Secretary of State for Health to ensure there is sufficient provision for the diagnosis and treatment of sleep disorders. The Bill also calls for Primary Care Trusts to place a higher priority on the management of these disorders, and instructs the National Institute for Clinical Excellence to review the clinical management of sleep disorders.

Sleep disorders affect over 770,000 people in the UK.The most common sleep disorder is Obstructive Sleep Apnoea (OSA).A patient with OSA suffers repeated collapses at the back of the throat during sleep, which stops them breathing. This can occur up to five hundred times a night, leading to heavily disrupted sleep, and periods of extreme sleepiness during the day. However, sufferers may not be aware that they have a treatable medical condition.

Sleep disorders have a dramatic effect on thousands of people’s lives.Excessive daytime sleepiness can result in road accidents, accidents at work and in sufferers losing their jobs.

The good news is that treatment of sleep disorders is very cost effective. Research undertaken by Edinburgh University’s Sleep Centre puts the cost of treating five hundred sleep apnoea patients for five years at £400,000. The cost to the Government of projected road accidents caused by the same patients if they are untreated is estimated at £5.3m for the same five-year period.Effective diagnosis and treatment could save the Chancellor millions, as well as saving patients and victims of accidents a great deal of unnecessary suffering.

There are severe safety implications, particularly for those who drive or operate machinery for a living.For office workers, there is the problem of falling asleep on the job. This cliché is a reality to many sleep apnoea patients.In the absence of any guidance, and particularly when employees are not aware that their tiredness is caused by a medical disorder, employers understandably instigate disciplinary procedures when an employee is unable to stay awake at work.

Effective treatments for sleep disorders are available on the NHS although there is inequity in provision, waiting times are unacceptable, and centres of expertise are few and far between.The first line of treatment for OSA involves patients using Continuous Positive Airway Pressure treatment, where a machine delivers air at a low but constant pressure, through a face mask worn overnight.

However, there are currently several barriers to patients receiving appropriate treatment.Many OSA patients feeling tired will regard it as a sign of being run down without realising they are suffering from a specific, and treatable, medical condition. As a result, they are unlikely to seek medical advice.Those who do seek medical attention don’t always receive appropriate treatment.With medical students receiving just ten minutes training on sleep disorders during the five-year degree in medicine, doctors may fail to recognise the symptoms of sleep apnoea.Furthermore, when a patient’s symptoms are recognised and they are referred to a ‘sleep centre’, the lack of funding for such centres means waiting times can be well over a year.Several centres in England have had to close altogether, following the removal of funding.

Clinicians argue that this situation could be addressed by the publication of Government guidelines on sleep disorders, forcing Primary Care Trusts to pay more attention to the disease area.

The second reading of the Bill is scheduled for April 30^th.

Alice Mahon MP chairs the Working Group on Sleep Disorders, a Parliamentary group set up to raise awareness of sleep-related conditions.The Group features representatives from the British Thoracic Society, the Royal College of Physicians, and the Sleep Apnoea Trust.

For more information on the Sleep Apnoea Bill, please contact Alice Mahon on 020 7219 4464.For more details on the activity of the Working Group on Sleep Disorders, please contact the Group Co-ordinator Chris West on 020 7067 0341.

House of Commons

First reading: February 10 2004 (HC Bill 50)