A new clinical tool is being assessed by Flinders University researchers about the fitness-to-drive for people affected by Obstructive Sleep Apnoea (OSA), a common sleep disorder linked with increased daytime sleepiness, impaired driving performance and a more than two-fold increased motor vehicle accident risk.
Researchers from the Adelaide Institute for Sleep Health at Flinders University are now calling for volunteers to help further the development and success of this important new tool.
Obstructive sleep apnoea (OSA) affects 1 in 4 middle-aged adults. It impairs neurobehavioral function, excessive sleepiness, and is linked to such serious conditions as heart disease and diabetes.
Alarmingly, 38% of Australian truck drivers have OSA. As a result, OSA has a critical impact on an estimated 1400 road fatalities costing $15.9 billion annually in the United States and exceeding $3 billion in Australia.
Changing this outcome is problematic, as the prevalence of undiagnosed moderate-to-severe OSA has risen to 25% of the Australian population – however, not all patients are impaired by OSA, and identifying patients at risk is a daily clinical challenge for sleep specialists.
Dr Andrew Vakulin, NHMRC Career Development Fellow at the Adelaide Institute for Sleep Health at Flinders University, says there is an urgent need for new, simple and cost-effective clinical tools that can be used routinely in all patients to assist clinicians and policy makers to assess alertness failure and accident risk in OSA.
He says clinicians cannot rely on patient self-report or standard sleep study metrics to assess accident risk, and it is impractical to send every driver or transport worker with OSA for a day-long Maintenance of Wakefulness Test (MWT) assessment.
To change this situation, the Adelaide Institute for Sleep Health is commencing a project to change driving risk assessment in OSA. This project, funded by the ³Ô¹ÏÍøÕ¾ Health and Medical Research Council of Australia (NHMRC), will test the performance of new biomarkers that may help to predict sleepiness related driving impairment in OSA and compare this new approach with the current standard (the maintenance of wakefulness test).
The ambition of this project is to establish a clinical test that uses measurements of sleep and breathing from routine clinical sleep studies, along with simple tests of cognitive function as well as physiological and biological markers to predict future driving performance impairment risk. There is scope to develop computer software or an application that could measure the performance tests, or the required assessments could be integrated into clinical assessment protocol and become part of clinical sleep assessment.
The Adelaide Institute for Sleep Health is now recruiting participants for the project which will run experiments over the next two years. It wants people aged between 35 and 65 years who have been diagnosed with obstructive sleep apnoea but are not on any treatment, or who suspect they might have obstructive sleep apnoea but have not been formally diagnosed. The institute is also looking for volunteers in the same age group with no sleep complaints or problems to be control participants.
Participants must attend the sleep laboratory on two occasions, for an information and screening visit to be introduced to all study tests and procedures followed by a main experimental visit consisting of an overnight sleep study the sleep laboratory followed by continuous wakefulness for 20 hours into early morning hours to induce mild sleep deprivation. During this visit, participants will be repeatedly tested on cognitive tests, driving tests and their physiology measured throughout the whole process.
All project participants will be reimbursed – and have their sleep formally evaluated in a sleep laboratory for no charge.
