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Research Summary

Does Alcohol Use Affect Driving Performance in Patients with Obstructive Sleep Apnea?

Alcohol use and lack of sleep may affect the driving performance of patients with obstructive sleep apnea (OSA) more than it affects healthy people. In this study, researchers compared the simulated 90-minute driving performance of 38 patients with untreated OSA and 20 healthy age- and gender-matched controls randomized to 1 of 3 experimental conditions: ingestion of vodka to achieve a calculated target blood alcohol concentration of 0.05 g/dL, sleep restricted to a maximum of 4 hours, and unrestricted sleep.

  • Participants with OSA were more likely than controls to have at least 1 crash (odds ratio [OR], 25.4*). They were also more likely to crash after alcohol use (OR, 2.3) or restricted sleep (OR, 4.0).
  • Participants with OSA had greater steering deviation than controls at baseline. Alcohol use and restricted sleep were each associated with a 40% greater increase in steering deviation in participants with OSA compared with controls.
  • Alcohol use did not affect braking reaction time in either group.
*The high OR probably reflects the fact that only 1 crash occurred in the control group.


In this well-designed study, blood alcohol concentrations less than the typical legal limits for driving were associated with significantly poorer driving performance in participants with untreated OSA than in controls. Patients with untreated OSA should be urged to seek OSA treatment and to avoid alcohol use. This study does not address the question of whether the same level of alcohol use would have a similar effect on driving performance among patients with treated OSA. Kevin L. Kraemer, MD, MSc



Vakulin A, Baulk SD, Catcheside PG, et al. Effects of alcohol and sleep restriction on simulated driving performance in untreated patients with obstructive sleep apnea. Ann Intern Med. 2009;151(7):447–455.