Driving Skills of Adolescents with Obstructive Sleep Apnea (OSA)

阻塞性睡眠呼吸暂停 (OSA) 青少年的驾驶技能

• 批准号: 9894821
• 负责人: Dean W. Beebe
• 金额: $ 18.72万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9894821
• 关键词: 19 year old; Accident Prevention; Address; Adolescent; Adult; Age; Aging; Alcohols; Attention; Attentional deficit; Automobile Driving; Automobiles; Awareness; Behavior; Breathing; Caring; Cause of Death; Cessation of life; Child; Childhood; Detection; Diagnosis; Diagnostic; Drowsiness; Equipment; Ethics; Eye; Future; Health; Injury; Investments; Laws; Licensing; Link; Measurement; Mediating; Nature; Obstruction; Obstructive Sleep Apnea; Pathology; Positioning Attribute; Prevalence; Primary Care Physician; Public Health; Publishing; Research; Resources; Risk; Risk Behaviors; Safety; Sampling; Severities; Sleep; Societies; Statistical Data Interpretation; Suggestion; Teenagers; Testing; Text Messaging; Time; Update; Vehicle crash; Work; Young driver; Youth; cost; dashboard; disability; distraction; driving skills; experience; falls; impaired driving performance; improved; inattention; middle age; neurobehavioral; novel; population based; prevent; simulation; skills; societal costs; sound; tool; vigilance; visual information

Project Summary Despite major public health efforts, auto crashes remain by far the leading cause of death among 16-19 year-olds and are a major cause of non-fatal injuries. There is a clear, ongoing need to identify unaddressed, reversible conditions that increase risk for adolescent drivers. We propose that obstructive sleep apnea (OSA) is an under-recognized, treatable condition that worsens driving skills in adolescents by inducing sleepiness and inattention. Suggestive evidence converges from studies of (a) crash risk in adults with OSA, (b) neurobehavioral functioning in youth with OSA, and (c) neurobehavioral and driving skills in sleep-deprived adolescents. If our hypotheses are correct, documenting and addressing the effect of adolescent OSA on driving skills could improve OSA care and prevent thousands of crash-related injuries and deaths every year. However, evidence remains circumstantial and it is questionable to generalize findings from research on highly-experienced middle-aged adult drivers to inexperienced adolescent drivers, for whom the act of driving places much greater demands on vigilance and divided attention. Our long-term plan is to conduct a detailed on-road study which could definitively speak to the driving-related risk and reversibility of adolescent OSA. Before making that investment of time and resources, we first must clearly show driving skill deficits in a sample of rigorously-diagnosed adolescents with and without OSA in a controlled setting that allows for sensitive measurement of effects and ethical presentation of driving challenges. The proposed small-scale study will accomplish those critical first steps, while also providing key guidance on likely mechanisms of effect. Thirty 16-19-year-old drivers with untreated OSA and thirty OSA-free controls will undergo driving simulation of a nature that is sensitive to OSA in adults and to sleep restriction in teens. Our first aim is to test whether adolescent OSA increases driving risk. Compared to controls, we expect that that adolescents with OSA will have more difficulty maintaining their lanes in the simulator, as well as more protracted eye glances from the roadway when engaged in a text messaging conversation. Our second aim is to test whether inattention and daytime sleepiness are key mechanism in inducing OSA-linked driving risk. This novel study will be the first to test the presence and mechanisms underlying driving skill deficits in youth with OSA. It capitalizes on the unique equipment available at Cincinnati Children's and the unique expertise of our research team, which includes experts in adolescent sleep pathology, neurobehavioral assessment, adolescent attention, driving simulation, statistical analyses, and generalization to real-world driving settings. While quite treatable, adolescent OSA is rarely detected, let alone treated. If our hypotheses are correct, this study will open new opportunities to improve the health and safety of young drivers with currently undetected OSA, as well as the millions more with whom they share the road.

项目摘要 尽管做出了重大的公共卫生努力，但车祸仍然是16-19岁人群死亡的主要原因 而且是造成非致命性伤害的主要原因。有一种明显的、持续的需求，需要确定 未解决的、可逆的情况增加了青少年司机的风险。我们认为这是一个障碍 睡眠呼吸暂停(OSA)是一种未被认识到的可治疗的疾病，它通过以下方式恶化青少年的驾驶技能 导致昏昏欲睡和注意力不集中。提示性证据来自对(A)成人车祸风险的研究 关于阻塞性睡眠呼吸暂停综合征，(B)阻塞性睡眠呼吸暂停综合征青少年的神经行为功能，以及(C) 睡眠不足的青少年。如果我们的假设是正确的，记录和解决 青少年OSA关于驾驶技能的培训可以改善OSA护理并防止数千起与车祸有关的伤害 以及每年的死亡人数。然而，证据仍然是间接的，因此不能一概而论。 从经验丰富的中年司机到经验不足的青少年司机的研究结果， 对他们来说，开车的行为对警觉和分散注意力提出了更高的要求。我们的长期合作 计划是进行一项详细的道路研究，可以明确地说明与驾驶相关的风险和 青少年阻塞性睡眠呼吸暂停的可逆性。在投入时间和资源之前，我们首先必须明确 在患有和不患有阻塞性睡眠呼吸暂停综合征的经过严格诊断的青少年样本中显示驾驶技能缺陷 受控设置，允许敏感地测量驾驶的影响和合乎道德的展示 挑战。拟议的小规模研究将完成这些关键的第一步，同时也提供 关于可能的作用机制的关键指导。30名16-19岁的司机患有未经治疗的阻塞性睡眠呼吸暂停综合症和30名 不含OSA的控制组将进行驾驶模拟，模拟成人对OSA和睡眠敏感的性质 对青少年的限制。我们的第一个目标是测试青少年阻塞性睡眠呼吸暂停综合症是否会增加驾驶风险。与.相比 控制措施，我们预计患有阻塞性睡眠呼吸暂停综合征的青少年将更难维持他们在 模拟器，以及在进行短信时更长时间地从道路上瞥一眼 交谈。我们的第二个目标是测试注意力不集中和日间嗜睡是否是 引发与阻塞性睡眠呼吸暂停综合征相关的驾驶风险。这项新的研究将是第一个测试存在和机制的研究 患有阻塞性睡眠呼吸暂停综合征的青少年潜在的驾驶技能缺陷。它充分利用了以下地址提供的独特设备 辛辛那提儿童和我们研究团队的独特专业知识，其中包括青少年专家 睡眠病理学，神经行为评估，青少年注意力，驾驶模拟，统计分析， 并将其推广到真实世界的驾驶环境。虽然完全可以治疗，但青少年阻塞性睡眠呼吸暂停综合症很少被检测到， 更不用说治疗了。如果我们的假设是正确的，这项研究将为改善健康打开新的机会 以及目前未被发现的OSA年轻司机的安全，以及与他们一起工作的数百万人 分享这条路。