Tuesday, July 5, 2011

Impaired Driving Simulator Performance in Treated Obstructive Sleep Apnea

Another interesting article in the June edition of the Journal of Clinical Sleep medicine about driving simulator performance. Studies have shown that untreated obstructive sleep apnea (OSA) impairs driving performance. Studies have also shown that treating OSA with continuous positive airway pressure (CPAP) improves driving simulator performance and reduces accident risk. However, these studies have some methodological limitations, such as driving simulator programs that are too short (less than 20 minutes, for example). Finally, other studies have shown that CPAP treatment may only be partially effective at restoring cognitive function, cortical activation, and daytime sleepiness, meaning that even treated OSA patients could have persistent, impaired driving performance.

The researchers studied patients with severe OSA and healthy controls to see if 3 months of CPAP therapy could improve driving performance in simulators of 90 minutes, similar to a long, country drive. The results showed that patients with untreated severe OSA had impaired driving simulator performance compared to matched controls. And 3 months of CPAP therapy did improve performance, but not to the same level as matched controls. This means that despite adequate treatment for OSA, these patients could be at increased risk for driving accidents compared to drivers without OSA.

As this study was small, it will be interesting to see it repeated in a larger population, as the public health implications could be dramatic.

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