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.

项目概要 尽管做出了巨大的公共卫生努力，车祸仍然是 16-19 岁人群死亡的主要原因 岁儿童，是非致命伤害的主要原因。明确且持续需要确定 未解决的、可逆转的情况会增加青少年驾驶员的风险。我们建议，阻碍 睡眠呼吸暂停 (OSA) 是一种未被充分认识、可治疗的疾病，它会通过以下方式降低青少年的驾驶技能： 导致困倦和注意力不集中。提示性证据来自对 (a) 成人碰撞风险的研究 OSA 患者的神经行为功能，(b) 患有 OSA 的青少年的神经行为功能，以及 (c) 青少年的神经行为和驾驶技能 睡眠不足的青少年。如果我们的假设是正确的，记录并解决以下问题的影响： 青少年 OSA 驾驶技能可以改善 OSA 护理并预防数以千计的车祸相关伤害 以及每年的死亡人数。然而，证据仍然是间接的，概括起来是值得怀疑的 对经验丰富的中年成年司机和缺乏经验的青少年司机的研究结果， 对于他们来说，驾驶行为更加需要警惕和分散注意力。我们的长期 计划是进行一项详细的道路研究，该研究可以明确说明与驾驶相关的风险和 青少年 OSA 的可逆性。在投入时间和资源之前，我们首先必须清楚 显示了经过严格诊断的患有或不患有 OSA 的青少年样本中的驾驶技能缺陷 受控设置，允许敏感地测量驾驶的效果和道德表现 挑战。拟议的小规模研究将完成这些关键的第一步，同时还提供 关于可能的作用机制的关键指导。三十名 16-19 岁的司机患有未经治疗的 OSA，三十名 无 OSA 的控制将接受对成人 OSA 和睡眠敏感的性质的驾驶模拟 青少年的限制。我们的首要目标是测试青少年 OSA 是否会增加驾驶风险。相比 控制，我们预计患有 OSA 的青少年将更难以维持自己的车道 模拟器，以及在发短信时更长时间地从道路上扫视 对话。我们的第二个目标是测试注意力不集中和白天嗜睡是否是睡眠障碍的关键机制。 诱发与 OSA 相关的驾驶风险。这项新颖的研究将是第一个测试其存在和机制的研究 患有 OSA 的青少年潜在的驾驶技能缺陷。它利用了现有的独特设备 辛辛那提儿童医院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、 并推广到现实世界的驾驶环境。虽然青少年 OSA 是可以治疗的，但很少被发现， 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带来新的机会 以及目前尚未发现的患有 OSA 的年轻驾驶员以及与他们在一起的数百万人的安全 共享道路。