Simulated Long-Term Driving Performance before and after Uvulopalatopharyngoplasty

Abstract

To investigate whether automobile drivers with the clinical features of sleep apnea syndrome (SAS) perform worse than controls in a simulated long-term test drive, and to see if their driving improves after uvulopalatopharyngoplasty (UPPP), 15 male drivers with SAS, suffering from sleep spells whilst driving, and 10 matched controls without a history of SAS or hypersomnia at the wheel were tested in an advanced driving simulator. Brake reaction time, lateral position deviation and off-road episodes were measured during a 90-min rural drive at twilight conditions. The clinical evaluation was made by a questionnaire scoring symptoms of snoring, sleep disturbances and diurnal sleepiness before and after surgery. Before UPPP the patient group showed impaired performance in all three effect measures compared to controls. UPPP resulted in improved reaction time performance (average mean improvement: 0.5 s, average 90th percentile improvement 0.8 s). Furthermore, 12 of the 15 patients reported a marked improvement regarding sleepiness whilst driving. For these clinically successful cases the number of off-road episodes decreased substantially. We conclude that most patients improve their long-term driving performance as a result of UPPP.

Daytime driving simulation performance and sleepiness in obstructive sleep apnoea patients

“…The complexity of the driving simulation tests varies widely but the results are quite consistent in their outcome: driving simulated performance is worse in sleepy patients, regardless the cause of sleepiness, and when sleep apnoea patients are treated (either with n-CPAP or uvulopalatopharyngoplasty) -not surprisingly -their performances on driving simulator tasks improve according to current accident rates Findley et al, 1989Findley et al, , 1995Findley et al, , 1999George, 2003;George et al, 1996aGeorge et al, ,b, 1997George, 2004;Hack et al, 2000Hack et al, , 2001Haraldsson et al, 1991Haraldsson et al, , 1995aJuniper et al, 2000;Lloberes et al, 2000;Munoz et al, 2000;Orth et al, 2005;Pizza et al, 2004;Risser et al, 2000;Sagaspe et al, 2007;Turkington et al, 2001Turkington et al, , 2004.…”

ENT-specific therapy of obstructive sleep apnoea in adults

“…UPPP is the only operation in OSA for which a decrease of driving-accident risk [27,28] and a normalisation of raised CRP-measures in serum [29] could be shown.…”

Reduction in motor vehicle collisions following treatment of sleep apnoea with nasal CPAP

“…Moreover, the risk of accidents varies from series to series. Nonetheless, simulated driving performance improves with successful treatment of OSA with nasal continuous positive airway pressure (CPAP)10 11 or uvulopalatopharyngoplasty (UPPP)12 13 and there are several subjective reports of reduced collisions once patients are treated 14-1718…”