Research article summary (published 4 Oct 2009):

Effects of alcohol and sleep restriction on simulated driving performance in untreated patients with obstructive sleep apnea.

Full Abstract

BACKGROUND: 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. OBJECTIVE: To compare the effects of sleep restriction and alcohol on driving simulator performance in patients with OSA and age-matched control participants. DESIGN: Driving simulator assessments in 2 groups under 3 different conditions presented in random order. SETTING: Adelaide Institute for Sleep Health, Sleep Laboratory, Adelaide, Australia. PARTICIPANTS: 38 untreated patients with OSA and 20 control participants. MEASUREMENTS: Steering deviation, crashes, and braking reaction time. INTERVENTION: 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. RESULTS: 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. LIMITATION: Simulated driving was assessed rather than on-road driving. CONCLUSION: Patients with OSA are more vulnerable than healthy persons to the effects of alcohol consumption and sleep restriction on various driving performance variables. PRIMARY FUNDING SOURCE: Australian National Health and Medical Research Council.

Author information

Author/s: Vakulin, Andrew (A); Baulk, Stuart D (SD); Catcheside, Peter G (PG); Antic, Nick A (NA); van den Heuvel, Cameron J (CJ); Dorrian, Jillian (J); McEvoy, R Doug (RD);

Affiliation: Repatriation General Hospital, University of Adelaide, Adelaide, SA 5041, Australia. andrew.vakulin(-atsign-)health.sa.gov.au

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Annals of internal medicine (Ann Intern Med), published in United States. (Language: eng)

Reference: 2009-Oct; vol 151 (issue 7) : pp 447-55

Dates: Created 2009/10/06; Completed 2009/10/21;

PMID: 19805768, status: MEDLINE (last retrieval date: 10/21/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

SummaryForPatientsIn: Ann Intern Med. 2009 Oct 6;151(7):I-32. (PMID: 19805765)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Accidents, Traffic Adult Alcohol Drinking - adverse effects Automobile Driving Case-Control Studies Computer Simulation Ethanol - blood Female

Humans Male Middle Aged Polysomnography Reaction Time Sleep Apnea, Obstructive - blood; physiopathology Sleep Deprivation Task Performance and Analysis

Associated Chemicals: Ethanol (64-17-5)

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