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https://hdl.handle.net/2440/57694
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Type: | Journal article |
Title: | Effects of alcohol and sleep restriction on simulated driving performance in untreated patients with obstructive sleep apnea |
Author: | Vakulin, A. Baulk, S. Catcheside, P. Antic, N. van den Heuvel, C. Dorrian, J. McEvoy, R. |
Citation: | Annals of Internal Medicine, 2009; 151(7):447-W145 |
Publisher: | Amer Coll Physicians |
Issue Date: | 2009 |
ISSN: | 0003-4819 1539-3704 |
Statement of Responsibility: | Andrew Vakulin, Stuart D. Baulk, Peter G. Catcheside, Nick A. Antic, Cameron J. van den Heuvel, Jillian Dorrian and R. Doug McEvoy |
Abstract: | <h4>Background</h4>Because of previous sleep disturbance and sleep hypoxia, patients with obstructive sleep apnea (OSA) might be more vulnerable to the effects of alcohol and sleep restriction than healthy persons.<h4>Objective</h4>To compare the effects of sleep restriction and alcohol on driving simulator performance in patients with OSA and age-matched control participants.<h4>Design</h4>Driving simulator assessments in 2 groups under 3 different conditions presented in random order.<h4>Setting</h4>Adelaide Institute for Sleep Health, Sleep Laboratory, Adelaide, Australia.<h4>Participants</h4>38 untreated patients with OSA and 20 control participants.<h4>Measurements</h4>Steering deviation, crashes, and braking reaction time.<h4>Intervention</h4>Unrestricted sleep, sleep restricted to a maximum of 4 hours, and ingestion of an amount of 40% vodka calculated to achieve a blood alcohol level of 0.05 g/dL.<h4>Results</h4>Patients with OSA demonstrated increased steering deviation compared with control participants (mean, 50.5 cm [95% CI, 46.1 to 54.9 cm] in the OSA group and 38.4 cm [CI, 32.4 to 44.4 cm] in the control group; P < 0.01) and significantly greater steering deterioration over time (group by time interaction, P = 0.02). The increase in steering deviation after sleep restriction and alcohol was approximately 40% greater in patients with OSA than in control participants (group by condition interaction, P = 0.04). Patients with OSA crashed more frequently than control participants (1 vs. 24 participants; odds ratio [OR], 25.4; P = 0.03) and crashed more frequently after sleep restriction (OR, 4.0; P < 0.01) and alcohol consumption (OR, 2.3; P = 0.02) than after normal sleep. In patients with OSA, prolonged eye closure (>2 seconds) and microsleeps (> 2 seconds of theta activity on electroencephalography) were significant crash predictors (OR, 19.2 and 7.2, respectively; P < 0.01). Braking reaction time was slower after sleep restriction than after normal sleep (mean, 1.39 [SD, 0.06] seconds vs. 1.22 [SD, 0.04] seconds; P < 0.01) but not after alcohol consumption. No group differences were found.<h4>Limitation</h4>Simulated driving was assessed rather than on-road driving.<h4>Conclusion</h4>Patients with OSA are more vulnerable than healthy persons to the effects of alcohol consumption and sleep restriction on various driving performance variables.<h4>Primary funding source</h4>Australian National Health and Medical Research Council. |
Keywords: | Humans Sleep Apnea, Obstructive Sleep Deprivation Ethanol Polysomnography Case-Control Studies Alcohol Drinking Task Performance and Analysis Reaction Time Accidents, Traffic Automobile Driving Computer Simulation Adult Middle Aged Female Male |
Description: | © 2009 American College of Physicians |
DOI: | 10.7326/0003-4819-151-7-200910060-00005 |
Published version: | http://www.annals.org/content/151/7/447.full.pdf+html |
Appears in Collections: | Aurora harvest 5 Paediatrics publications |
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