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Test of fitness to drive in patients with sleepiness syndrome

January 20, 2000

A three-year project grant of £61,783 has been awarded by Chest, Heart and Stroke Scotland to Dr Heather Engleman and Professor Neil Douglas of the Centre, which is located in the University of Edinburgh's Respiratory Medicine Unit. The money will enable clinical and psychometric validation work to be performed on an objective test of driving skill, developed in collaboration with the University of Sydney.
Explained Dr Engleman: "Sleepiness produces greater impairment of driving performance than alcohol intoxication, and has overtaken alcohol as a major cause of injury and death on the roads. The most common medical cause of daytime sleepiness is the sleep apnoea/hypopnoea syndrome (SAHS), affecting 4% of men and 2% of women in middle age."
Patients with SAHS usually suffer symptoms of heavy snoring and breathing pauses during sleep, leading to a number of daytime problems including excessive sleepiness, slowed responses and difficulties with mental tasks. These symptoms can all be reversed by available effective treatment. However, RTA rates in untreated patients with SAHS are eight times higher than in healthy individuals, either as a result of falling asleep or mental slowing. At present, there is no easily-administered test to assess impairment by sleepiness.
The Sleep Centre researchers will scrutinise a test, administered on an ordinary PC, which presents a realistic road scene, driven for 30 minutes, using a steering wheel and pedals, and measuring steering and braking skills. The test will be performed twice by 100 individuals, both patients with SAHS and healthy controls, during the three year project. All will also take part in laboratory tests of sleep quality, daytime sleepiness and mental performance.
"The planned study protocols will investigate the age- and ability-scaled normal range for performance on the driving test, whether driving scores are normalised by treatment for SAHS, and the relationships between driving performance, sleepiness and cognitive function," said Dr Engleman. "These will contribute to assessing whether this driving task could provide an affordable, portable, sensitive and specific means of identifying individual patients with SAHS whose driving skills are affected, who are at increased risk of RTAs, and in need of urgent treatment. Although currently a research tool, the driving task may contribute in the long-term to clinical decision-making."
For further information,
please contact:
Dr Heather Engleman, Edinburgh Sleep Centre, Tel: 0131 536 2360

Edinburgh, University of