Fidler Andrea L, Zhang Nanhua, Simakajornboon Narong, Epstein Jeffery N, Kirk Shelley, Beebe Dean W
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Children (Basel). 2023 Sep 29;10(10):1624. doi: 10.3390/children10101624.
Auto crashes are a leading cause of death and injury among adolescents. Untreated obstructive sleep apnea (OSA) can cause sleepiness and inattention, which could negatively impact novice drivers, but OSA-related studies have focused on older drivers. This study used a driving simulator to examine whether licensed 16-19-year-old adolescents with OSA have diminished driving skills. Twenty-one adolescents with OSA and twenty-eight without OSA (both confirmed using polysomnography) completed two randomly ordered driving trials in a simulator (with induced distractions versus without). A mixed ANOVA examined the between-subjects effect of the OSA group, the within-subjects effect of the distraction condition, and the group-by-condition interaction effect on the ability to maintain lane position and the frequency of extended eye glances away from the roadway. T-tests were also used to examine group differences in reported sleepiness and inattention during daily life. The distraction task increased extended off-road glances and difficulties maintaining lane position ( < 0.001). However, adolescents with OSA did not display worse eye glance or lane position than controls and there were no significant group-by-condition interactions. Although the groups differed on polysomonographic features, there were also no significant differences in reported sleepiness or inattention. The distraction task negatively impacted both groups of adolescent drivers, but those with OSA did not fare differentially worse. Most adolescents in our study had mild OSA (median obstructive apnea-hypopnea index = 4.4), the most common form in the community. It remains possible that youth with more severe OSA would show increased driving impairment.
汽车碰撞是青少年死亡和受伤的主要原因。未经治疗的阻塞性睡眠呼吸暂停（OSA）会导致嗜睡和注意力不集中，这可能会对新手驾驶员产生负面影响，但与OSA相关的研究主要集中在年长的驾驶员身上。本研究使用驾驶模拟器来检验患有OSA的16至19岁持照青少年的驾驶技能是否会下降。21名患有OSA的青少年和28名未患OSA的青少年（均通过多导睡眠图确诊）在模拟器中完成了两项随机排序的驾驶试验（有诱导分心与无诱导分心）。一项混合方差分析检验了OSA组的组间效应、分心条件的组内效应以及组与条件的交互效应对保持车道位置能力和长时间视线离开道路频率的影响。还使用t检验来检验两组在日常生活中报告的嗜睡和注意力不集中方面的差异。分心任务增加了长时间的视线离开道路情况以及保持车道位置的困难（<0.001）。然而，患有OSA的青少年在视线和车道位置方面并不比对照组差，并且不存在显著的组与条件的交互作用。尽管两组在多导睡眠图特征上存在差异，但在报告的嗜睡或注意力不集中方面也没有显著差异。分心任务对两组青少年驾驶员都有负面影响，但患有OSA的青少年表现并没有更差。我们研究中的大多数青少年患有轻度OSA（中位阻塞性呼吸暂停低通气指数=4.4），这是社区中最常见的形式。患有更严重OSA的青少年仍有可能表现出驾驶能力受损增加。
