Patient Stories: Sebastian - Train Driver with Complex (Mixed) Sleep Apnoea

Whether it was sorting mail or delivering shopping, I had always worked shifts and consequently I felt I had a good reason for feeling tired. I then qualified as a mainline train driver where my shift pattern became even more extreme!

Although I was unaware of it at the time, the first indication that something was seriously wrong with me was when I found out I was very deficient in Vitamin D (which I now realise this is a common link in people who have sleep apnoea), but taking a high dose of supplement did little to improve the issue. Eventually the fatigue and the continuous unwell feeling caught up with me.....

.....On a particularly intense and tiresome shift my eyelids dropped for what felt like just a second whilst I was at the train's controls. Thankfully nobody was hurt and there was no damage when I coasted into a buffer at relatively low speed. Fortunately, my employer was very understanding and had me referred to a fatigue specialist.

A simple sleep study showed that I was suffering from a mixture of Obstructive and Central Sleep Apnoea with an AHI of 12.1. Whilst this is not classed as a particularly high AHI under the NHS guidelines to warrant CPAP therapy, I would stop breathing in my sleep long enough for my blood oxygen saturation to drop to around 80%, and it was this that was causing my heavy daytime fatigue.

My therapy came in the form of an Adaptive Servo Ventilator (ASV) in order to deal with both types of apnoeas I was experiencing. Although it took a couple of weeks to get used to wearing a mask to sleep, I noticed a difference within a few days!

I no longer experience drowsiness or fatigue during the day, my moods and general well-being have improved and getting up to go to work in the small hours isn't half the struggle it once was, and of course just as importantly the passengers are now very safe on my train .