Sleep apnoea: 'I fell asleep at work'
He had just started a new job as a locum doctor in Blackpool. During the week, he lived near work in a motorhome and drove home to Herefordshire at weekends.
The 62-year-old knew he didn't sleep well. On Sunday nights, instead of lying in bed wide awake, he would set off for Blackpool in the dead of night.
During the first months in his new job, Malcolm's lethargy didn't seem to affect his performance. "My managers were happy with my work," he says.
However, his need to take naps throughout the day didn't go unnoticed. "My colleagues noticed that I began getting tired more easily as the day went on," he says. "It was around this time that I fell asleep in front of a patient."
How sleep apnoea affected Malcolm
Malcolm was sitting at his desk listening to the patient. "I just nodded off for about 30 seconds," he says. He completed the consultation and blamed his slump on the heat in the room.
A few days later, the patient's family wrote to the surgery to raise their concerns about Malcolm's impromptu snooze.
"My employment was ended and I was advised to seek medical help," he says.
His wife had been urging him to attend a sleep clinic for some time because of his loud snoring, which led to the couple sleeping in separate rooms.
"She was getting more and more annoyed at the noise I was making, even though she's a deep sleeper," says Malcolm.
He was referred to a specialist clinic in Gloucester, which gave him equipment to take home to measure his vital statistics during sleep.
He was diagnosed with sleep apnoea. "I couldn't believe it," says the father of three. "I qualified as a doctor in 1971, and courses then didn't cover sleep apnoea. This condition was new to me."
Successful sleep apnoea treatment
Specialists told Malcolm he had been getting no more than one or two hours of sleep a night over the past five years.
He believes his condition might have been caused by a non-cancerous tumour that was removed from his back when he was 55, which may have damaged his spinal cord.
Malcolm was prescribed continuous positive airway pressure (CPAP). Sleep apnoea occurs when the upper airway becomes narrow as the muscles relax naturally during sleep. This reduces oxygen in the blood and interrupts sleep.
The CPAP machine stops this by delivering a stream of compressed air to a nose mask, via a hose. This has the additional benefit of reducing or eliminating snoring.
Malcolm knows he will need CPAP for the rest of his life, but he doesn't mind. "Since I started using the equipment, the improvement to my quality of life has been dramatic," he says.
"Within days, having a proper night's sleep made me feel 20 years younger. I never knew I could feel so good. I thought, at 62, that being tired and lacking energy was part of growing old. I had just adapted to it."
Malcolm has since found work as a locum closer to home, and he now works night shifts, which he never used to have the energy to do.
"The treatment has given me a new lease of life," he says. "I love swimming, cycling and doing the gardening. Now I can enjoy being active again.
"My relationship with my wife has never been better. The snoring's stopped, and we're back to sleeping together in the same bed."
Article provided by NHS Choices
Record managed by Oxfordshire Family Information Service