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Updated: Oct 26, 2026
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Integrated assessment of driving performance, eye movements, and cognitive function in obstructive sleep apnea: A
Tomoya Tateishi1,2, Meiyo Tamaoka1, Shunsuke Takagi3
1Department of Respiratory Medicine, Institute of Science Tokyo Hospital, Tokyo, Japan.
Objectives:
Motor vehicle accident (MVA) risk is greater in patients with obstructive sleep apnea (OSA), yet the functional domains most closely linked to driving-related impairment remain incompletely understood. This exploratory pilot study aimed to perform an integrated assessment of driving performance, eye movements, vigilance, and cognitive function in OSA and to examine their relationships with disease severity and treatment response.
Methods:
Adult drivers with suspected OSA underwent assessment using a driving simulator, Psychomotor Vigilance Test (PVT), eye-tracking, and the Cambridge Neuropsychological Test Automated Battery (CANTAB). Participants with moderate-to-severe OSA (apnea-hypopnea index ≥20) who initiated continuous positive airway pressure (CPAP) therapy underwent re-evaluation after 6-12 months.
Results:
At baseline, single-task reaction time in the driving simulator was positively correlated with apnea severity. In contrast, response accuracy under multitask plus steering conditions was associated with nocturnal hypoxemia (T90), suggesting differential contributions of apnea frequency and oxygen desaturation to driving performance. Eye-tracking parameters, including saccade amplitude and fixation duration, were significantly correlated with both driving performance and spatial working memory error scores. Following CPAP therapy, simple reaction times improved in both the driving simulator and PVT, whereas changes in multitasking performance and CANTAB measures were not statistically significant.
Conclusions:
Basic psychomotor speed was associated with OSA severity and improved following CPAP therapy, suggesting within-subject improvement of vigilance-dependent processes. In contrast, integrated oculomotor and executive function measures were more closely linked to complex driving performance, indicating that multidomain assessment may better characterize driving-related impairment in OSA. These findings provide preliminary evidence to guide future hypothesis-driven studies.
