PURPOSE: Obstructive sleep apnoea (OSA) patients effectively treated by and compliant with continuous positive air pressure (CPAP) occasionally miss a night's treatment. The purpose of this study was to use a real car interactive driving simulator to assess the effects of such an occurrence on the next day's driving, including the extent to which these drivers are aware of increased sleepiness. METHODS: Eleven long-term compliant CPAP-treated 50-75-year-old male OSA participants completed a 2-h afternoon, simulated, realistic monotonous drive in an instrumented car, twice, following one night: (1) normal sleep with CPAP and (2) nil CPAP. Drifting out of road lane ('incidents'), subjective sleepiness every 200 s and continuous electroencephalogram (EEG) activities indicative of sleepiness and compensatory effort were monitored. RESULTS: Withdrawal of CPAP markedly increased sleep disturbance and led to significantly more incidents, a shorter 'safe' driving duration, increased alpha and theta EEG power and greater subjective sleepiness. However, increased EEG beta activity indicated that more compensatory effort was being applied. Importantly, under both conditions, there was a highly significant correlation between subjective and EEG measures of sleepiness, to the extent that participants were well aware of the effects of nil CPAP. CONCLUSIONS: Patients should be aware that compliance with treatment every night is crucial for safe driving.
PURPOSE: Obstructive sleep apnoea (OSA) patients effectively treated by and compliant with continuous positive air pressure (CPAP) occasionally miss a night's treatment. The purpose of this study was to use a real car interactive driving simulator to assess the effects of such an occurrence on the next day's driving, including the extent to which these drivers are aware of increased sleepiness. METHODS: Eleven long-term compliant CPAP-treated 50-75-year-old male OSA participants completed a 2-h afternoon, simulated, realistic monotonous drive in an instrumented car, twice, following one night: (1) normal sleep with CPAP and (2) nil CPAP. Drifting out of road lane ('incidents'), subjective sleepiness every 200 s and continuous electroencephalogram (EEG) activities indicative of sleepiness and compensatory effort were monitored. RESULTS: Withdrawal of CPAP markedly increased sleep disturbance and led to significantly more incidents, a shorter 'safe' driving duration, increased alpha and theta EEG power and greater subjective sleepiness. However, increased EEG beta activity indicated that more compensatory effort was being applied. Importantly, under both conditions, there was a highly significant correlation between subjective and EEG measures of sleepiness, to the extent that participants were well aware of the effects of nil CPAP. CONCLUSIONS:Patients should be aware that compliance with treatment every night is crucial for safe driving.
Authors: Pierre Philip; Patricia Sagaspe; Jacques Taillard; Cédric Valtat; Nicholas Moore; Torbjorn Akerstedt; André Charles; Bernard Bioulac Journal: Sleep Date: 2005-12 Impact factor: 5.849
Authors: Lichuan Ye; Atul Malhotra; Karen Kayser; Danny G Willis; June A Horowitz; Mark S Aloia; Terri E Weaver Journal: Sleep Med Rev Date: 2014-05-09 Impact factor: 11.609
Authors: Anneclaire V M T Vroegop; Jim W Smithuis; Linda B L Benoist; Olivier M Vanderveken; Nico de Vries Journal: Sleep Breath Date: 2014-12-09 Impact factor: 2.816
Authors: Kingman P Strohl; Daniel B Brown; Nancy Collop; Charles George; Ronald Grunstein; Fang Han; Lawrence Kline; Atul Malhotra; Alan Pack; Barbara Phillips; Daniel Rodenstein; Richard Schwab; Terri Weaver; Kevin Wilson Journal: Am J Respir Crit Care Med Date: 2013-06-01 Impact factor: 21.405