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One night's CPAP withdrawal in otherwise compliant OSA patients: marked driving impairment but good awareness of increased sleepiness

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journal contribution
posted on 30.07.2014, 14:11 by Ashleigh FiltnessAshleigh Filtness, Louise Reyner, James A. Horne
PURPOSE. OSA patients effectively treated by and compliant with 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. 11 long-term compliant CPAP treated 50-75y male OSA participants completed a 2h afternoon, simulated, realistic monotonous drive in an instrumented car, twice, following one night: i) normal sleep with CPAP ii) nil CPAP. Drifting out of road lane (‘incidents’), subjective sleepiness every 200sec and continuous 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 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.

History

School

  • Sport, Exercise and Health Sciences

Published in

SLEEP AND BREATHING

Volume

16

Issue

3

Pages

865 - 871 (7)

Citation

FILTNESS, A.J., REYNER, L.A. and HORNE, J.A., 2012. One night's CPAP withdrawal in otherwise compliant OSA patients: marked driving impairment but good awareness of increased sleepiness. Sleep and Breathing, 16 (3), pp. 865-871.

Publisher

© Springer-Verlag

Version

SMUR (Submitted Manuscript Under Review)

Publication date

2012

Notes

The final publication is available at Springer via http://dx.doi.org/10.1007/s11325-011-0588-8.

ISSN

1520-9512

Language

en