Sleep Research Centre, Loughborough University, Leicestershire LE11 3TU, UK.
Sleep Med. 2011 Oct;12(9):838-43. doi: 10.1016/j.sleep.2011.07.002. Epub 2011 Oct 1.
To examine the effects on monotonous driving of normal sleep versus one night of sleep restriction in continuous positive airway pressure (CPAP) treated obstructive sleep apnoea (OSA) patients compared with age matched healthy controls.
Nineteen CPAP treated compliant male OSA patients (OSA-treated patients (OPs)), aged 50-75 years, and 20 healthy age-matched controls underwent both a normal night's sleep and sleep restriction to 5h (OPs remained on CPAP) in a counterbalanced design. All participants completed a 2h afternoon monotonous drive in a realistic car simulator. Driving was monitored for sleepiness-related minor and major lane deviations, with 'safe' driving time being total time driven prior to first major lane deviation. EEGs were recorded continuously, and subjective sleepiness ratings were taken at regular intervals throughout the drive.
After a normal night's sleep, OPs and controls did not differ in terms of driving performance or in their ability to assess the levels of their own sleepiness, with both groups driving 'safely' for approximately 90 min. However, after sleep restriction, OPs had a significantly shorter (65 min) safe driving time and had to apply more compensatory effort to maintain their alertness compared with controls. They also underestimated the enhanced sleepiness. Nevertheless, apart from this caveat, there were generally close associations between subjective sleepiness, likelihood of a major lane deviation and EEG changes indicative of sleepiness.
With a normal night's sleep, effectively treated older men with OSA drive as safely as healthy men of the same age. However, after restricted sleep, driving impairment is worse than that of controls. This suggests that, although successful CPAP treatment can alleviate potential detrimental effects of OSA on monotonous driving following normal sleep, these patients remain more vulnerable to sleep restriction.
研究正常睡眠与连续气道正压通气（CPAP）治疗阻塞性睡眠呼吸暂停（OSA）患者一夜睡眠限制对单调驾驶的影响，并与年龄匹配的健康对照组进行比较。
19 名 CPAP 治疗依从性良好的男性 OSA 患者（OSA 治疗患者（OPs）），年龄 50-75 岁，和 20 名年龄匹配的健康对照组在平衡设计中分别进行正常夜间睡眠和 5 小时睡眠限制（OPs 继续使用 CPAP）。所有参与者都在现实汽车模拟器中完成了 2 小时下午单调的驾驶。监测驾驶与困倦相关的小和大车道偏离情况，“安全”驾驶时间是第一次大车道偏离前的总驾驶时间。脑电图（EEG）连续记录，主观困倦评分在驾驶过程中定期进行。
在正常睡眠后，OPs 和对照组在驾驶表现或评估自身困倦程度的能力方面没有差异，两组在大约 90 分钟内安全驾驶。然而，在睡眠限制后，OPs 的安全驾驶时间明显缩短（65 分钟），与对照组相比，他们不得不付出更多的补偿努力来保持警觉。他们还低估了增强的困倦感。然而，除了这一注意事项之外，主观困倦感、发生重大车道偏离的可能性和脑电图变化之间通常存在密切关联，这些变化表明困倦。
在正常睡眠的情况下，经过有效治疗的老年 OSA 男性与同龄健康男性一样安全地驾驶。然而，在睡眠受限后，驾驶障碍比对照组更严重。这表明，尽管成功的 CPAP 治疗可以减轻 OSA 对正常睡眠后单调驾驶的潜在不利影响，但这些患者仍然更容易受到睡眠限制的影响。
