Driving Simulator Performance in Patients with Sleep Apnea

Findley, Larry J.; Fabrizio, Michael; Knight, Herbert; Norcross, Barbara B.; LaForte, A. J.; Suratt, Paul M.

doi:10.1164/ajrccm/140.2.529

Cited by 170 publications

(106 citation statements)

References 2 publications

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“…This has been noted previously in a group of sleepy patients [17]. Therefore not all patients with excessive daytime sleepiness were worse than healthy subjects on the simulation.…”

Section: Discussionsupporting

confidence: 81%

Steering simulation performance in patients with obstructive sleep apnoea and matched control subjects

et al. 2000

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Patients with obstructive pulmonary disease (OSA) have an increased rate of driving accidents, perhaps due to poor vigilance or impaired cognitive skills that influence their driving ability. The authors have assessed whether patients with OSA perform differently to control subjects on a steering simulator which allows the separate assessment of the two visual tasks required for steering a car, immediate positioning on road with reference to the road edges, and assessment of the curve of the oncoming road which allows faster driving. Twelve patients with OSA and 12 control subjects, matched for age, sex and driving experience, performed three 30‐min drives with either all the oncoming road visible, only the near part of the road visible, or only the distant part of the road visible. Steering was assessed by measuring the sd around the theoretical perfect path (steering error) and the number of times the driver went “off road”. Subjects identified the appearance of target numbers at the four corners of the screen as quickly as possible, thus making the test a divided attention task. Patients with OSA performed significantly less well on the three different road fields as measured by steering error (p<0.001), time to detect the target number (p<0.03), and off road events (p<0.03). The patients appeared to be particularly impaired on the two drives when only part of the road ahead was available to guide steering. This steering simulator, with its more realistic view of the road ahead, identifies impaired performance in patients with obstructive sleep apnoea. In addition it suggests that patients with obstructive sleep apnoea may be more disadvantaged compared to normal subjects when the view of the road ahead is limited (such as in fog).

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“…This has been noted previously in a group of sleepy patients [17]. Therefore not all patients with excessive daytime sleepiness were worse than healthy subjects on the simulation.…”

Section: Discussionsupporting

confidence: 81%

Steering simulation performance in patients with obstructive sleep apnoea and matched control subjects

et al. 2000

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“…The period of time elapsed between these two events (reaction time) was recorded in a computer for later analysis, following the methodology previously reported in the authors' laboratory [24]. The test was performed, between 10:00± 12:00 h. The level of vigilance was investigated using the Steer-Clear1 test (Findley & Fabricio, Charlottesville, VA, USA) [25], also between 10:00±12:00 h.…”

Section: Measurementsmentioning

confidence: 99%

Long-term effects of CPAP on daytime functioning in patients with sleep apnoea syndrome

Muñoz¹,

Mayoralas²,

Barbé³

et al. 2000

Eur Respir J

136

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Daytime sleepiness, impaired cognitive performance and dysphoric mood are often present in patients with obstructive sleep apnoea syndrome (SAS). This prospective controlled study evaluates the effects of treatment with continuous positive airway pressure (CPAP) during 1 yr on daytime functioning in a large group of patients with SAS.The authors studied 80 patients (mean SEM 49 1 yrs) with SAS with a mean apnoea-hypopnoea index of 60 2 h -1 , and 80 healthy control subjects matched for sex and age (46 1 yrs.). Measurements were obtained at the beginning of the study and 12 1 months later, and included: daytime sleepiness (Epworth scale), depression and anxiety (Beck tests), vigilance (Steer-Clear1) and reaction time (Psychometer Vigilance Test 1921). Drug, coffee and alcohol intake, as well as the sleep schedule, were also recorded.Results showed that, before treatment, patients were more somnolent (p<0.001), anxious (p<0.01) and depressed (p<0.001) than control subjects. Also, they had a longer reaction time (p<0.05) and poorer vigilance (p<0.01). The use of CPAP improved significantly the levels of somnolence (p<0.0001) and vigilance (p<0.01), but failed to modify anxiety and depression. Reaction time changes were minor. Variables with a potential confounding effect did not change during the study.These results provide firm evidence to substantiate the use of continuous positive airway pressure in patients with sleep apnoea syndrome. Eur Respir J 2000; 15: 676±681.

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“…Findley 1988. godine nalazi 2,6 puta veću stopu udesa u odnosu na prosek u Virdži-niji, a trećina OSA ispitanika je imala udes u proteklih 5 godina [50]. Ista grupa istraživača je 1989. ustanovila da pacijenti sa teškom OSA prave više grešaka u vožnji u odnosu na kontrole a da primena terapije vazduhom pod kontinuiranim pozitivnim pritiskom preko nazalne maske (Nasal Continous Positive Air Pressure, NCPAP) dovodi do poboljšanja senzomotornih sposobnosti [51]. Haraldson (Haraldson) i saradnici [52] su na uzorku pacijenata klinike za uho, grlo i nos ustanovili da pacijenti sa kliničkom slikom OSA imaju veći rizik od saobraćajnih udesa u odnosu na kontrolnu grupu, i pokazuju lošije rezultate na simulaciji vožnje, koji se mogu poboljšati primenom hirurške terapije OSA (uvulopalatofaringoplastika, UPPP) [53].…”

Section: Osa I Saobraćajne Nezgodeunclassified

Excessive sleepiness and the risk of obstructive apnoea syndrome in professional ambulance drivers

Popević¹,

Milovanović²

2014

Engrami

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Saobraćajni traumatizam predstavlja značajan problem u zemljama Evrope i sveta. Ukupan broj saobraćajnih nezgoda u Srbiji pokazuje trend pada,uz porast teških telesnih povreda i smrtnih ishoda, a gubici u opremi i uslugama mere se milijardama dinara. Prekomerna pospanost u vožnji je direktno uzročno-posledično povezana sa nastankom saobraćajnih nezgoda. Smatra se da 20-25% nezgoda u Evropi nastaje kao posledica prekomerne pospanosti. Poremećaji disanja u snu, pre svega sindrom opstruktivne apneje u spavanju (OSA) imaju veliki uticaj na pojavu prekomerne pospanosti, pospanosti za volanom i nastanak saobraćajnih udesa. Procenjuje se da 13% muškaraca i 6% žena uzrasta 30-70 godina boluje od umerene do teške forme bolesti, a da kod 85% pacijenata oboljenje nije prepoznato. Prevalenca OSA je 26-50% u populaciji profesionalnih vozača. Vozači sa nelečenom ili nedijagnostikovanom OSA imaju dva do sedam puta veći rizik od saobraćajne nezgode. Primena terapije OSA dovodi do redukcije pospanosti i saobraćajnih nezgoda. U velikom broju zemalja postoji obaveza zdravstvenih pregleda vozača na prisustvo OSA. U Srbiji ne postoje epidemiološki podaci o prevalenci OSA, o učestalosti prekomerne pospanosti ili OSA u populaciji vozača učesnika saobraćajnih nezgoda. Preliminarna istraživa-nja na uzorku profesionalnih vozača ukazuju da trećina ispitanika ima prekomernu pospanost i povećan rizik od OSA koji su povezani sa pojavom saobraćajnih nezgoda.Ključne reči: apneja u spavanju, prekomerna pospanost, saobraćajne nezgode, vozači

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Driving Simulator Performance in Patients with Sleep Apnea

Cited by 170 publications

References 2 publications

Steering simulation performance in patients with obstructive sleep apnoea and matched control subjects

Steering simulation performance in patients with obstructive sleep apnoea and matched control subjects

Long-term effects of CPAP on daytime functioning in patients with sleep apnoea syndrome

Excessive sleepiness and the risk of obstructive apnoea syndrome in professional ambulance drivers

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