Vigilance and Automobile Accidents in Patients With Sleep Apnea or Narcolepsy

Findley, Larry J.; Unverzagt, Mark E.; Guchu, Ruth; Fabrizio, Michael; Buckner, Jan C.; Suratt, Paul M.

doi:10.1378/chest.108.3.619

Cited by 228 publications

(158 citation statements)

References 19 publications

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“…Drivers with OSAS have an increased crash risk that is in the neighborhood of 2-4 times that of the general population (Findley et al, 1995;George et al, 1987;Teran-Santos et al, 1999;Wu & YanGo, 1996). Affected individuals typically have fragmented sleep periods associated with snoring and intermittent airway obstruction.…”

Section: Introductionmentioning

confidence: 99%

Driver performance in the moments surrounding a microsleep

Boyle

Tippin

Paul

et al. 2008

Transportation Research Part F: Traffic Psychology and Behaviou

132

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This study examined if individuals who are at increased risk for drowsy-driving because of obstructive sleep apnea syndrome (OSAS), have impairments in driving performance in the moments during microsleep episodes as opposed to during periods of wakefulness. Twenty-four licensed drivers diagnosed with OSAS based on standard clinical and polysomnographic criteria, participated in an hour-long drive in a high-fidelity driving simulator with synchronous electroencephalographic (EEG) recordings for identification of microsleeps. The drivers showed significant deterioration in vehicle control during the microsleep episodes compared to driving performance in the absence of microsleeps on equivalent segments of roadway. The degree of performance decrement correlated with microsleep duration, particularly on curved roads. Results indicate that driving performance deteriorates during microsleep episodes. Detecting microsleeps in real-time and identifying how these episodes of transition between wakefulness and sleep impair driver performance is relevant to the design and implementation of countermeasures such as drowsy driver detection and alerting systems that use EEG technology.

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Section: Introductionmentioning

confidence: 99%

Driver performance in the moments surrounding a microsleep

Boyle

Tippin

Paul

et al. 2008

Transportation Research Part F: Traffic Psychology and Behaviou

132

View full text Add to dashboard Cite

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“…This disease is associated with excessive daytime sleepiness (EDS), neurocognitive deficits, and psychological problems (Day et al 1999). Furthermore, this disease is a risk factor for traffic accidents (Findley et al 1995, Barbé et al 1998 and cardiovascular disease morbidity and mortality (Peter et al 1995, Leung andBradley 2001).…”

Section: Introductionmentioning

confidence: 99%

Nonlinear characteristics of blood oxygen saturation from nocturnal oximetry for obstructive sleep apnoea detection

Álvarez¹,

Hornero²,

Abásolo³

et al. 2006

Physiol. Meas.

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Nocturnal oximetry is an attractive option for the diagnosis of obstructive sleep apnoea (OSA) syndrome because of its simplicity and low cost compared to polysomnography (PSG). The present study assesses non-linear analysis of blood oxygen saturation (SaO 2 ) from nocturnal oximetry as a diagnostic test to discriminate between OSA positive and OSA negative patients. A sample of 187 referred outpatients, clinically suspected of having OSA, were studied using nocturnal oximetry performed simultaneously with complete PSG. A positive OSA diagnosis was found for 111 cases, while the remaining 76 cases were classified as OSA negative. The following oximetric indexes were obtained: cumulative time spent below a saturation of 90% (CT90), oxygen desaturation indexes of 4% (ODI4), 3% (ODI3) and 2% (ODI2), and the delta index (∆ index). SaO 2 records were subsequently processed applying two non-linear methods: central tendency measure (CTM) and Lempel-Ziv (LZ) complexity. Significant differences (p < 0.01) were found between OSA positive and OSA negative patients. Using CTM we obtained a sensitivity of 90.1% and a specificity of 82.9%, while with LZ the sensitivity was 86.5% and the specificity was 77.6%. CTM and LZ accuracy was higher than that provided by ODI4, ODI3, ODI2 and CT90. The results suggest that non-linear analysis of SaO 2 signals from nocturnal oximetry could yield useful information in OSA diagnosis.

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“…Performances of many, but not all, sleep apnoea patients during these tasks have been shown to be worse than that of controls under the influence of alcohol [13,14]. After treatment with continuous positive airway pressure (CPAP), performance on simulators improved [15,16] and the number of motor-vehicle crashes seemed to return to normal [17][18][19].…”

mentioning

confidence: 99%

“…However, even if some authors showed a relationship between performances using driving simulators and real road accidents [17,20], in-laboratory measurements do not allow assessment of the complexity of real driving performances [19]. Driving simulators are useful tools, but their measurements are limited to controlled and simplified environments.…”

mentioning

confidence: 99%

Driving ability in sleep apnoea patients before and after CPAP treatment: evaluation on a road safety platform

Mazza

Pépin²,

Naëgelé³

et al. 2006

European Respiratory Journal

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Sleepiness is considered to be the major cause of increased traffic accidents in patients with obstructive sleep apnoea syndrome (OSAS). Until now, OSAS patients9 driving ability has been assessed using driving simulators, but no assessment in a more natural driving environment has been carried out to date.The aim of the present study was to evaluate driving parameters in OSAS and in controls on a road safety platform, and to compare them with attentional in-laboratory measures before and after continuous positive airway pressure treatment.The parameters measured were: reaction time; distance to stop and number of collisions on the platform; maintenance of wakefulness; and sustained, selective and divided attention in laboratory.Patients exhibited much longer reaction times than controls, leading to a lengthening of the vehicle9s stopping distance of 8.8 m at 40 km?h -1 and to twice the number of collisions. Patients did not demonstrate objective sleepiness or selective and sustained attention deficits. Divided attention deficits were found. However, they did not allow the prediction of real driving impairment. After CPAP treatment, there was no longer any difference between patients and controls regarding driving and attention performances. Driving abilities are significantly impaired in obstructive sleep apnoea syndrome. After continuous positive airway pressure treatment, deficits were normalised. This stresses the importance of evaluating attentional parameters in apnoeic patients and of offering continuous positive airway pressure treatment even to non-sleepy subjects.

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Vigilance and Automobile Accidents in Patients With Sleep Apnea or Narcolepsy

Cited by 228 publications

References 19 publications

Driver performance in the moments surrounding a microsleep

Driver performance in the moments surrounding a microsleep

Nonlinear characteristics of blood oxygen saturation from nocturnal oximetry for obstructive sleep apnoea detection

Driving ability in sleep apnoea patients before and after CPAP treatment: evaluation on a road safety platform

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