Risky driving behaviors increase as common sleep disorder worsens
Diagnosing, treating sleep apnea may make driving safer for older adults


Date:
April 20, 2022
Source:
Washington University School of Medicine
Summary:
Up to half of older adults may have sleep apnea, a condition in
which breathing and sleep are briefly interrupted many times a
night. A new study shows that this chronic tiredness can have
serious implications for road safety.



FULL STORY ========================================================================== People with sleep apnea wake up tired in the morning, no matter how many
hours they actually sleep. The condition causes them to briefly stop
and restart breathing dozens or even hundreds of times a night. Even
though such breathing interruptions often don't awaken those with apnea,
they prevent them from sinking into deep, refreshing sleep.


==========================================================================
A new study puts a number on how dangerous such chronic tiredness can
be, at least in regard to driving. For every eight additional breathing interruptions per hour, the odds of making a dangerous driving move
such as speeding, braking hard or accelerating suddenly increase by 27%, according to a study by researchers at Washington University School of
Medicine in St. Louis.

Older adults are more likely to develop sleep apnea. They also are more
likely to be seriously injured or killed in a car accident. The findings, available online in the journal Sleep, suggest that screening older
adults for sleep apnea and for treatment, if needed, may help older
people continue driving safely for longer.

"The percentage of older adults with mild sleep apnea is 30% to 50%,
but if such adults don't have daytime sleepiness or other evidence of impairment, they may not come to medical attention," said co-senior
author Brendan Lucey, MD, an associate professor of neurology and
director of Washington University's Sleep Medicine Center. "However,
these findings suggest that we might want a lower threshold to evaluate
older adults for sleep apnea and track their breathing interruptions. If
their conditions worsen by just eight interruptions an hour, that could
have significant adverse effects on their driving and their risk of
suffering serious injury." People 65 and over are the most responsible
drivers on the road. They obey speed limits. They drive defensively. They
avoid driving at night, in bad weather and in unfamiliar places. But
the changes that often come with advancing age -- such as deteriorating
vision, slower reflexes and, yes, difficulty sleeping -- can undermine
even the safest habits.

Lucey teamed up with driving researcher Ganesh M. Babulal, PhD, OTD,
an assistant professor of neurology and the paper's co-senior author,
to investigate the relationship between sleep apnea and risky driving behaviors.

Participants were recruited from ongoing studies at Washington
University's Charles F. and Joanne Knight Alzheimer Disease Research
Center (Knight ADRC).

Babulal and Lucey monitored the driving and sleep habits of 96 older
adults under real-world conditions. They used a commercially available take-home test to identify people with sleep apnea and measure its
severity. Less than five breathing interruptions per hour is considered
normal, five to 15 is mild sleep apnea, 15 to 30 is moderate, and greater
than 30 is severe.

To assess driving habits, the researchers installed a chip developed by
Babulal and colleagues into participants' personal vehicles and monitored
their driving for a year, focusing on episodes of hard braking, sudden acceleration and speeding. In total, they collected data on more than
100,000 trips.

Participants also were evaluated by researchers at the Knight ADRC for cognitive impairments and molecular signs of early Alzheimer's disease.

Even though all participants were cognitively normal, about a third had
brain changes indicative of early Alzheimer's disease. The researchers
found that the frequency with which drivers made dangerous moves behind
the wheel rose in parallel with the frequency with which their sleep
was interrupted at night, regardless of whether their brains bore the
marks of early Alzheimer's.

"We didn't have cameras in the vehicles, so we don't know exactly
what happened that caused someone to, say, brake hard suddenly,"
Babulal said. "But it could be something like a stoplight that they
didn't realize was red until they got close and had to stomp on the
brakes. The more tired you are, the less attention you have to deploy to
the task at hand, especially if it is novel and constantly changing."
The study helps untangle the ways aging-associated risk factors such
as poor sleep and Alzheimer's disease put older adults in danger while
driving, and could aid efforts to find ways to maximize years of safe
driving, the researchers said.

"Driving always carries the risk of crashing, and older adults are at risk
of more severe injury than younger adults if they experience a crash,"
Babulal said. "But we can't just tell them to give up their keys. When
older people stop driving, they lose a lot of their independence and
mobility, which is often associated with negative health and social
outcomes. What we want to understand is what puts them at a higher risk
so we can intervene and help them stay behind the wheel, safely, for as
long as possible."

========================================================================== Story Source: Materials provided by
Washington_University_School_of_Medicine. Original written by Tamara
Bhandari. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Jason M Doherty, Catherine M Roe, Samantha A Murphy, Ann M Johnson,
Ella
Fleischer, Cristina D Toedebusch, Tiara Redrick, David Freund,
John C Morris, Suzanne E Schindler, Anne M Fagan, David M Holtzman,
Brendan P Lucey, Ganesh M Babulal. Adverse driving behaviors are
associated with sleep apnea severity and age in cognitively normal
older adults at risk for Alzheimer's disease. Sleep, 2022; DOI:
10.1093/sleep/zsac070 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/04/220420170509.htm

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