Stephens, Melissa (2006) The Effects of Untreated and Treated Obstructive Sleep Apnoea on Subjective Sleepiness, Microsleeps, Simulated Driving Performance and Neurocognitive Functioning. Other Degree thesis, Victoria University.

Abstract

Obstructive sleep apnoea (OSA) is a complex disorder of neural respiratory control and upper airway dysfunction that results in repeated complete and partial occlusion of the upper airway during sleep. Obstructive sleep apnoea has been linked to fatigue, increased rates of road and work-related accidents and deficits across a range of neurocognitive domains. The most widely used treatment for OSA is continuous positive airway pressure (CPAP). This study aimed to compare neurocognitive functioning, simulated driving performance, vigilance, objective and subjective sleepiness in patients with moderate to severe OSA with control participants before and after treatment with CPAP. It was hypothesised that patients with OSA would report higher levels of subjective sleepiness, perform poorer on a simulated driving task and neurocognitive tests, demonstrate reduced vigilance and reaction times, and show increased objective sleepiness in comparison to control participants. It was also hypothesised that performance in these tasks would improve in OSA patients following CPAP treatment. Fifteen patients (12 males and 3 females) with moderate to severe OSA between the ages of 40 and 71 were recruited from the Austin and Repatriation Medical Centre and 15 healthy controls (12 males and 3 females) aged between 37 and 70 matched for gender and closely matched for age and weight were recruited from the community. Participants were assessed on a driving simulator, psychomotor vigilance task and a battery of neurocognitive tests. The results showed that OSA patients displayed significant impairments related to daytime sleepiness and a novel finding of this study was that OSA patients demonstrated a lowered capacity for procedural learning. The current study also found that following CPAP treatment, OSA patients improved on measures of sustained attention, reaction time, simulated driving performance, memory and procedural learning. Findings of the present study indicate the importance of detecting impairments relating to performance in OSA patients in order to minimise the risk of accidental injury to themselves or others. Increased sleepiness and deficits in simulated driving and neurocognitive tasks may be alleviated with CPAP treatment. Continued research into this area is warranted so that significant consequences for the quality of life of patients and for other road users can be identified.

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