title: [Driving simulator performance in patients with obstructive sleep apnea syndrome: what consequences for driving capability?].
abstract: OBJECTIVE
  Patients with obstructive sleep apnea (OSA) have an increased accident risk. The German Society of Sleep Research and Sleep Medicine (DGSM) recommends for patients with OSA and daytime sleepiness that their driving ability should be re-established 6 weeks after the initiation of CPAP (continuous positive airway pressure), with documentation of therapeutic effects on daytime symptoms and performance. The present study was conducted to investigate whether an improvement of driving ability can be documented in neuropsychological tests and a simulated driving situation 14 days after the initiation of CPAP.
  
  
  METHODS
  Driving simulation and neuropsychological tests of vigilance were conducted in 36 patients (36 males, aged 54 9 years) with OSAS before and 2 (n=23), 14 (n=18) and 42 days (n=17) after initiation of CPAP.
  
  
  RESULTS
  Vigilance tests showed only slight changes under CPAP. Frequency of accidents during driving simulation was reduced after 14 days of CPAP, but a statistically remarkable decrease was achieved only on day 42. In contrast, concentration faults were reduced after 2 and 14 days of CPAP.
  
  
  CONCLUSIONS
  In OSA-patients improvement of daytime performance in a simulated driving situation can be documented 14 days after initiation of CPAP. There is need for investigating larger cohorts of patients so that current recommendations for driving licensing can be modified and permission to drive can be given earlier.
authors.affiliation: Medizinische Klinik III, Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, BG-Kliniken Bergmannsheil, Universitätsklinik, Ruhr-Universität Bochum. Maritta.Orth@ruhr-uni-bochum.de
authors.forename: M
authors.initials: M
authors.lastname: Orth
authors.forename: A
authors.initials: A
authors.lastname: Herting
authors.forename: H-W
authors.initials: HW
authors.lastname: Duchna
authors.forename: J W
authors.initials: JW
authors.lastname: Walther
authors.forename: J
authors.initials: J
authors.lastname: de Zeeuw
authors.forename: T T
authors.initials: TT
authors.lastname: Bauer
authors.forename: G
authors.initials: G
authors.lastname: Schultze-Werninghaus
authors.forename: S
authors.initials: S
authors.lastname: Kotterba
mesh_terms: D001334:Automobile Driving; D002940:Circadian Rhythm; D003198:Computer Simulation; D045422:Continuous Positive Airway Pressure; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology* / Q000628:therapy; D014851:Wakefulness / Q000502:physiology*