Driving Simulator Performance Remains Impaired In Patients With Severe OSA after CPAP Treatment

作者：Vakulin Andrew^*; Baulk Stuart D; Catcheside Peter G; Antic Nick A; van den Heuvel Cameron J; Dorrian Jillian; McEvoy R Doug

来源：Journal of Clinical Sleep Medicine, 2011, 7(3): 243-250.

DOI：10.5664/JCSM.1062

• OSA
• CPAP
• driving performance

Study Objectives: To assess the effectiveness of CPAP treatment in improving 90-minute driving simulator performance in severe OSA patients compared to age/gender matched controls.
Design: Driving simulator performance was assessed at baseline and 3 months later, with OSA patients treated with CPAP during the interval.
Setting: University Teaching Hospital.
Participants: Patients with severe OSA (n = 11) and control subjects without OSA (n = 9).
Interventions: CPAP
Measurements and Results: Simulator driving parameters of steering deviation, braking reaction time and crashes were measured at baseline and similar to 3 months follow-up. At baseline, OSA subjects demonstrated significantly greater steering deviation compared to controls (mean [95% CI], OSA group, 49.9 cm [43.7 to 56.0 cm] vs control group, 34.9 cm [28.1 to 41.7 cm], p = 0.003). Following similar to 3 months of CPAP treatment (mean +/- SD 6.0 +/- 1.4 h/night), steering deviation in OSA subjects improved by an average of 3.1 cm (CI, 1.4 to 4.9), p < 0.001, while no significant steering changes were observed in the control group. Despite the improvement, steering deviation in the OSA group remained significantly higher than in controls (OSA group, 46.7 cm [CI, 40.6 to 52.8 cm] vs control group, 36.1 cm [CI, 29.3 to 42.9 cm], p = 0.025).
Conclusions: While driving simulator performance improved after similar to 3 months of CPAP treatment with high adherence in patients with severe OSA, performance remained impaired compared to control subjects. These results add to the growing body of evidence that some neurobehavioral deficits in patients with severe OSA are not fully reversed by treatment. Further studies are needed to assess causes of residual driving simulator impairment and to determine whether this is associated with persistent elevated real-life accident risk.
Trial Registration: Data presented in this manuscript was collected as part of a clinical trial "Experimental Investigations of Driving Impairment in Obstructive Sleep Apnoea" ACTRN12610000009011, http://www.anzctr.org.au/trial_view.aspx?ID=334979

• 出版日期2011