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Updated: Feb 15, 2026

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
DRIVING PERFORMANCE AND DRIVER STATE IN OBSTRUCTIVE SLEEP APNEA: WHAT CHANGES WITH POSITIVE AIRWAY PRESSURE?
Nazan Aksan1, Robert Marini1, Jon Tippin1
1University of Iowa, Iowa City IA USA.
Abstract:
We evaluated naturalistic driving in 65 drivers with obstructive sleep apnea (OSA) before and after positive airway pressure (PAP) therapy and in 43 comparison drivers. Driving performance metrics included speed (mean, variability), and lateral, and longitudinal acceleration (g's). Driver state measures included sleepiness and attention to the driving task based on sampled trigger and baseline video clips. OSA drivers showed less variability in speed and lateral g's compared to control drivers before and after PAP treatment when vehicle speed was <45mph. There were no driving performance differences when vehicle speed exceeded 45 mph. OSA drivers remained less alert than comparison drivers before and after PAP. Average hours of nightly PAP-use predicted improved alertness and lower levels of sleepiness among OSA drivers. The findings suggest increased crash risk among OSA drivers may result from lower levels of attention to the driving task that result in performance lapses that may lead to crashes, rather than to clear and specific patterns of performance deficits in vehicle control.
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