부산대학교 도서관

Aims: This research project assessed the usefulness of a portable PC-administered driving performance task, the “AusEd” simulator, in assessing driving performance in patients with obstructive sleep apnoea/hypopnoea syndrome (OSAHS), a group known to be at increased risk of motor vehicle accidents. Methods: The studies comprised a parallel-limb, randomised single blind, placebo-controlled trial of 4 weeks of CPAP therapy or an oral placebo and also a case-control study of AusEd performance. An array of secondary, sleep-specific outcomes were assessed in each of these trials including FOSQ, SF36, symptoms scale, IQ decrement and self-reported driving ability and 5-year accident history. Results: Symptom scores and two subscales of the SF36 and 3 subscales of the FOSQ were significantly improved in the CPAP treated group. However no differences in simulated driving performance were found with CPAP treatment. In the case-control trial median reaction time was significantly longer in the untreated patients than controls in the AusEd performance, and this was abolished with CPAP treatment. EEG spectral density power showed increased sleepiness between baseline and the 20 seconds before a crash event recorded by the AusEd simulator. Time-on-task blink frequency during the driving task was not significantly different between treated and untreated patients and controls. In the driving based questionnaire study untreated OSAHS patients reported more accidents and near miss accidents than treated patients, however only sleep related incidents were commoner than in community acquired controls. Treated OSAHS patients also reported fewer accidents than the controls. Conclusion: The PC based driving simulator did not distinguish driving performance between treated and untreated patients and only separated untreated OSAHS patients and controls by reaction time.