is the 2 h recommended maximum driving time appropriate for both healthy older and treated...
DESCRIPTION
Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?. A.J . Filtness, L.A. Reyner ESRS 2010 - Occupation and environment Thursday, 16 September 2010. Overview . Background Method Driving simulator Results - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/1.jpg)
Is the 2 h recommended maximum driving time appropriate for both
healthy older and treated obstructive sleep apnoea drivers?
A.J. Filtness, L.A. ReynerESRS 2010 - Occupation and environment
Thursday, 16 September 2010
![Page 2: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/2.jpg)
2
Overview
BackgroundMethod
Driving simulatorResults
Successful completion Safe driving time
Conclusion
![Page 3: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/3.jpg)
3
Background
Obstructive Sleep Apnoea (OSA)Group 1 licence holders (car/ motorcycle) diagnosed with sleep
apnoea must stop driving until the symptoms have been controlled and confirmed by medical opinion.
Driver fatigue recommendationThe UK Department for Transport produces the Highway code. A
list of rules and recommendations for road users.
![Page 4: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/4.jpg)
UK Highway Code
The Highway code - Fitness to drive: rule 91Driving when you are tired greatly increases your risk of collision. To minimise this risk make sure you are fit to drive. Do not begin a journey if you are tired. Get a good night’s
sleep before embarking on a long journey avoid undertaking long journeys between midnight and 6 am, when natural alertness is
at a minimum plan your journey to take sufficient breaks. A minimum break of at least 15 minutes
after every two hours of driving is recommended if you feel at all sleepy, stop in a safe place. Do not stop on the hard shoulder of a
motorway the most effective ways to counter sleepiness are to drink, for example, two cups of
caffeinated coffee and to take a short nap (at least 15 minutes).
4
![Page 5: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/5.jpg)
UK Highway Code
The Highway code - Fitness to drive: rule 91Driving when you are tired greatly increases your risk of collision. To minimise this risk make sure you are fit to drive. Do not begin a journey if you are tired. Get a good night’s
sleep before embarking on a long journey avoid undertaking long journeys between midnight and 6 am, when natural alertness is
at a minimum plan your journey to take sufficient breaks. A minimum break of at least
15 minutes after every two hours of driving is recommended if you feel at all sleepy, stop in a safe place. Do not stop on the hard shoulder of a
motorway the most effective ways to counter sleepiness are to drink, for example, two cups of
caffeinated coffee and to take a short nap (at least 15 minutes).
5
![Page 6: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/6.jpg)
6
Aim
To assess the appropriateness of this recommendation for OSA patients treated with CPAP, compared with healthy controls of a similar age.
Following a normal night’s sleep (OSA with CPAP) Under sleep restriction conditions (5h) (OSA with CPAP) Following normal sleep length, OSA without CPAP
![Page 7: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/7.jpg)
Method – Driving Simulator
38 participants male, age 50 – 75y 19 OSA patients, ave 8.6y CPAP 19 healthy control participantsDual carriageway2 h afternoon drive
7
Repeat measure counterbalanced design Normal nights sleep (8 h) Sleep restriction to (5 h)
Additional study night OSA participants without CPAP (n=11)
![Page 8: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/8.jpg)
8
Measures
Driving Incidents: car wheels crossed a lane demarcation line
Incidents were classified as “sleep related” or “non sleep related”
![Page 9: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/9.jpg)
9
Results
Percent of drives successfully completed Average time to first incident
![Page 10: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/10.jpg)
10
Results – Percent of Successful Completion
Normal sleep Sleep restriction0
102030405060708090
100
Control
OSA with CPAP
OSA without CPAP
Perc
ent
![Page 11: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/11.jpg)
11
Results – Percent of Successful Completion
Normal sleep Sleep restriction0
102030405060708090
100
Control
OSA with CPAP
OSA without CPAP
Perc
ent
![Page 12: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/12.jpg)
12
Results – Percent of Successful Completion
Normal sleep Sleep restriction0
102030405060708090
100
Control
OSA with CPAP
OSA without CPAP
Perc
ent
![Page 13: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/13.jpg)
13
Results – Safe Driving Time
Normal Sleep Sleep Restriction0
20
40
60
80
100
120
Control
OSA with CPAP
OSA without CPAP
Tim
e (m
in) t
o fir
st in
cide
nt
![Page 14: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/14.jpg)
14
Results – Safe Driving Time
0
10
20
30
40
50
60
Control
OSA with CPAP
OSA without CPAP
Tim
e (m
in) t
o fir
st in
cide
nt
Condition [F(1,36) = 9.24, p<0.05]Condition, group interaction[F(1,36) = 4.16, p<0.05]
![Page 15: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/15.jpg)
15
Results – Safe Driving Time
0
10
20
30
40
50
60
Control
OSA with CPAP
OSA without CPAP
Tim
e (m
in) t
o fir
st in
cide
nt
OSA. Condition [F(2,20) = 8.8, p<0.05]
![Page 16: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/16.jpg)
16
Summary of findings
UK Highway Code recommends to break from driving every 2 hours to avoid driver fatigue.
52.6% of all 2h drives were completed successfully. The drive presented was a ‘worst case scenario’.
Sleep restriction significantly affected both control and OSA participants.
OSA participants were more affected by sleep restriction than controls.
![Page 17: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/17.jpg)
17
Implications
Recommend older drivers take a break from driving every 90 minutes, more often if sleep restricted. Older drivers do not cause a high percent of road traffic incidents
so may break from driving every 2 hours for reasons other than sleepiness.
Education of OSA patients: non-compliance with CPAP can significantly impair driving performance and vulnerability to sleep restriction.
![Page 18: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/18.jpg)
18
Conclusion
It is important to get a full night’s sleep prior to completing a long motorway drive.
It is important for OSA drivers to be compliant with CPAP treatment every night.
![Page 19: Is the 2 h recommended maximum driving time appropriate for both healthy older and treated obstructive sleep apnoea drivers?](https://reader035.vdocuments.us/reader035/viewer/2022070501/56816950550346895de0f33d/html5/thumbnails/19.jpg)
19
Acknowledgements
Prof. Jim Horne,Loughborough UniversityDr Andrew Hall and Dr Chris Hanning, Leicester General Hospital
Thank you for listening