Simulation study highlights potential driving risk posed by patients with obstructive sleep apnea

September 6, 2016, European Lung Foundation

The potential driving risk posed by patients with obstructive sleep apnoea syndrome (OSAS) is highlighted in a simulation study presented today (7 September, 2016) at this year's European Respiratory Society (ERS) International Congress in London. The study is by Dr Akshay Dwarakanath and Dr Mark Elliott, St. James' University Hospital, Leeds, UK and colleagues.

Some OSAS patients are at higher risk of being involved in traffic accidents. There is significant variation in the advice given by doctors on this issue. However, in this study, standard deviation of lane position (SDLP) in a simulator was used to try to identify potential risk and create a model for use in future cases.

Various data were collected from patients, including their 'Epworth Sleepiness Score'(ESS) - a validated sleepiness score to assess subjective sleepiness, and also their oxygen desaturation index (ODI) - a measure of the severity of their OSAS. A total of 129 untreated OSAS patients (Mean age 53 years, ESS 14, ODI 41,Body mass index 36, years with driving licence 31) and 79 controls (mean Age 56 years, ESS 4, BMI 28, licence years 34) completed a driving questionnaire prior to simulator run. Controls performed the simulator run once while OSAS patients performed the simulator run on two occasions. Simulator outcome was based on preset criteria, with three potential results - pass, intermediate, and fail.

OSAS patients as compared to controls reported more episodes of nodding, admitted to a high chance of sleepiness while driving, and were less likely to pass (31% versus 53%) and more likely to fail (20% v/s 0%) than controls. In the controls, 53% passed, 47% were intermediate and nobody failed. In the OSAS patients, 31% passed, 49% were intermediate and 20% failed. Lane deviation was significantly worse in those who failed the test.

The authors say: "Worse lane position deviation is a marker of poor driving performance and this is significantly worse in OSAS patients who fail the simulator as compared to controls. Comparing with controls may be useful in advising patients whether they are at increased risk of an accident. Defining a normal range based on a combination of real time events, simulator performance and outcome holds promise and is a step ahead towards developing an objective test in evaluating the at risk OSAS patients."

They add that on average untreated OSAS patients are at a 2-6 times increased a risk of road traffic accidents as compared to controls. "We have also shown that nodding at the wheel and admitting to sleepiness at the wheel are more likely in patients as compared to controls," says Dr Elliott. "At the moment there are no validated tools to assess this aspect."

Since 2-4% of the general population suffers OSAS, the authors say it is vital that objective tests exist to ensure the safety of people driving and other road users. There is current advice from the Driver and Vehicle Licencing Agency (DVLA) for and medical professionals, but Dr Elliott says: "The current criteria are arbitrary, loosely based on evidence and have the potential to prevent a lot of people from driving who are in fact safe to drive. This has major potential implications for society and the economy. For example, OSAS is more common in the overweight and, many lorry drivers are overweight; if they are prevented from driving unnecessarily this has major implications for them and their employers. There is also the possibility that the problem will be driven underground without proper tools for assessment. There is considerable variability in the advice the clinicians give. Having an objective test would be a real advantage."

Explore further: Sleep apnoea patients more likely to report nodding at the wheel and fail driving simulator tests

Related Stories

Sleep apnoea patients more likely to report nodding at the wheel and fail driving simulator tests

April 11, 2013
People with sleep apnoea are more likely to fail a driving simulator test and report nodding whilst driving, according to new research.

Updated recommendations for sleep apnea in children

August 27, 2012
(HealthDay)—The American Academy of Pediatrics (AAP) is revising its recommendations for the diagnosis and management of obstructive sleep apnea syndrome (OSAS) in children and adolescents, according to a clinical practice ...

Benefits for intra-, extracapsular tonsillectomy in peds OSA

December 2, 2015
(HealthDay)—For children with obstructive sleep apnea syndrome (OSAS), both extracapsular tonsillectomy and adenoidectomy (ETA) and intracapsular tonsillectomy and adenoidectomy (ITA) are effective, according to a study ...

Why apnea patients are prone to suffer from glaucoma

July 22, 2016
Scientists at Hokkaido University have successfully measured the eye pressure of sleeping patients with obstructive sleep apnea syndrome for the first time, finding an unexpected correlation with glaucoma.

Greater weight gain after early adenotonsillectomy for OSA

July 30, 2014
(HealthDay)—For children with obstructive sleep apnea syndrome (OSAS), early adenotonsillectomy (eAT) is associated with greater weight gain, according to a study published online July 28 in Pediatrics.

Traffic accidents increased by 50 percent in patients with implantable cardioverter defibrillator

August 28, 2016
The risk of traffic accidents is increased by 50% in patients with an implantable cardioverter defibrillator (ICD) compared to age and gender matched controls, according to a Danish nationwide registry study presented at ...

Recommended for you

Synthetic cannabinoid reduces sleep apnea

November 29, 2017
A synthetic version of a molecule found in the cannabis plant was safe and effective in treating obstructive sleep apnea in the first large, multi-site study of a drug for the sleep disorder funded by the National Institutes ...

Sleeping through the snoring: Researchers identify neurons that rouse the brain to breathe

November 2, 2017
A common and potentially serious sleep disorder, obstructive sleep apnea affects at least one quarter of U.S. adults and is linked to increased risk of diabetes, obesity and cardiovascular disease. In a paper published today ...

Remede system approved for sleep apnea

October 9, 2017
(HealthDay)—The Remede sleep system, an implanted device that treats central sleep apnea by activating a nerve that sends signals to the diaphragm to stimulate breathing, has been approved by the U.S. Food and Drug Administration.

Inflammation may precede sleep apnea, could be treatment target

September 1, 2017
Inflammation is traditionally thought of as a symptom of sleep apnea, but it might actually precede the disorder, potentially opening the door for new ways to treat and predict sleep apnea, according to researchers.

More evidence: Untreated sleep apnea shown to raise metabolic and cardiovascular stress

August 31, 2017
Sleep apnea, left untreated for even a few days, can increase blood sugar and fat levels, stress hormones and blood pressure, according to a new study of sleeping subjects. A report of the study's findings, published in the ...

Sleep patterns contribute to racial differences in disease risk

August 18, 2017
Poor sleep patterns could explain, in part, the differences in the risk of cardiometabolic disease between African-Americans and European-Americans, according to a new study published in Proceedings of the National Academy ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.