The impact of aging on driving performance in patients with untreated obstructive sleep apnea

Jennifer M. Cori, Christopher Gordon, Melinda L. Jackson, Allison Collins, Rohit Philip, David Stevens, Aqsa Naqvi, Ruth Hosking, Clare Anderson, Maree Barnes, Mark E. Howard, Andrew Vakulin

Research output: Contribution to journalArticlepeer-review


Objective: To determine the influence of age on sleepiness-related driving performance in individuals with obstructive sleep apnea (OSA). Design: Extended wakefulness protocol comparing simulated driving performance in younger and older individuals with OSA. Participants: Fifty-two individuals with OSA (15 female) were median split into younger (≤55 years, n = 26) and older (>55 years, n = 26) groups. Measurements: Participants underwent polysomnography to derive sleep parameters and confirm OSA diagnosis. One-to-2 weeks following polysomnography, participants completed a 60-minute driving simulation 4 hours prior to their habitual bedtime. Participants remained awake to 3 hours post habitual bedtime before repeating the task. Results: Median age was 44.5 years (25th, 75th centiles = 37.0, 48.0) for the younger group and 64.5 years (60.0, 70.0) for the older group. When comparing the performance change between baseline and extended wakefulness, the younger patients had greater deterioration on all driving simulator parameters (crashes, standard deviation of lateral position, speed deviation and braking reaction time, all p < .05), compared to the older group. Linear regression found a 10-year age increase was associated with an a ∼30%-41% reduction in crash occurrence when accounting for covariates (p = .023). Age also predicted standard deviation of lateral position deviation, but not when sleep efficiency and self-reported sleepiness were included as covariates. Conclusion: Older participants with OSA were less vulnerable than younger participants to sleepiness-related driving simulator impairment when assessed at night-time following extended wakefulness. Future work should assess naturalistic on-road driving to determine if this extends to a variety of challenging driving scenarios.

Original languageEnglish
Pages (from-to)652-660
Number of pages9
JournalSleep Health
Issue number5
Publication statusPublished - Oct 2021

Bibliographical note

Funding Information:
Jennifer M Cori, Andrew Vakulin, Christopher Gordon, Clare Anderson and Mark E Howard have received research support from the Cooperative Research Centre (CRC) for Alertness, Safety and Productivity for this work and unrelated work. For the CRC, Jennifer M Cori and Christopher Gordon were project leaders (for unrelated projects), Andrew Vakulin was a project leader for the current project and unrelated projects; and Clare Anderson and Mark Howard were theme leaders. Andrew Vakulin reports research funding from the National Health Medical Research Council (NHMRC) for unrelated work, as well as equipment from ResMed and Philips Respironics for unrelated work.

Funding Information:
This work was supported by the Cooperative Research Centre for Alertness, Safety and Productivity .

Publisher Copyright:
© 2021 National Sleep Foundation


  • Age
  • Alertness
  • Crashes
  • Fatigue
  • Sleep disordered breathing
  • Sleepiness


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