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

Filtness, Ashleigh J., Reyner, Louise A., & Horne, James 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.

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Purpose Obstructive sleep apnoea (OSA) patients effectively treated by and compliant with continuous positive air pressure (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 Eleven long-term compliant CPAP-treated 50–75-year-old male OSA participants completed a 2-h afternoon, simulated, realistic monotonous drive in an instrumented car, twice, following one night: (1) normal sleep with CPAP and (2) nil CPAP. Drifting out of road lane (‘incidents’), subjective sleepiness every 200 s and continuous electroencephalogram (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 that 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.

Impact and interest:

13 citations in Scopus
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11 citations in Web of Science®

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ID Code: 63470
Item Type: Journal Article
Refereed: Yes
Keywords: Driving performance, Subjective sleepiness, EEG, Obstructive sleep apnoea, CPAP, CPAP withdrawal
DOI: 10.1007/s11325-011-0588-8
ISSN: 1522-1709
Divisions: Current > Research Centres > Centre for Accident Research & Road Safety - Qld (CARRS-Q)
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Psychology & Counselling
Copyright Owner: Copyright 2011 Springer-Verlag
Copyright Statement: The final publication is available at
Deposited On: 17 Oct 2013 23:31
Last Modified: 07 Apr 2014 05:33

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