Driving simulator performance remains impaired in patients with severe OSA after CPAP treatment
Date
2011
Authors
Vakulin, A.
Baulk, S.
Catcheside, P.
Antic, N.
van den Heuvel, C.
Dorrian, J.
McEvoy, R.
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Journal article
Citation
The Journal of Clinical Sleep Medicine, 2011; 7(3):246-253
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Andrew Vakulin, Stuart D. Baulk, Peter G. Catcheside; Nick A. Antic, Cameron J. van den Heuvel, Jillian Dorrian and R. Doug McEvoy
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Abstract
Study Objectives: To assess the effectiveness of CPAP treat¬ment in improving 90-minute driving simulator performance in severe OSA patients compared to age/gender matched con¬trols. Design: Driving simulator performance was assessed at base-line 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 ~3 months follow-up. At baseline, OSA subjects demonstrated significantly greater steering de¬viation 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 ~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 ~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 grow¬ing 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 driv¬ing simulator impairment and to determine whether this is as¬sociated with persistent elevated real-life accident risk.
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