peterp

https://www.perplexity.ai/search/Wha...TS2x1uQB6viblg (originally posted by @Manifold )

Text of Link Above:

Numerous studies have investigated the effects of Obstructive Sleep Apnea (OSA) on driving accidents, consistently finding that OSA significantly increases the risk of motor vehicle crashes. Here is a summary of key research findings:

Key Studies and Findings

Increased Risk of Accidents

1. American Academy of Sleep Medicine (AASM) Study (2018):
   • This study found that patients with OSA were nearly 2.5 times more likely to be involved in motor vehicle accidents compared to the general population. The risk was further increased by factors such as severe excessive daytime sleepiness, short sleep duration, and use of sleeping pills. However, the incidence of accidents was reduced by 70% among patients who used Continuous Positive Airway Pressure (CPAP) therapy for at least 4 hours per night

• National Sleep Foundation Study (2005):
  • This study reported that 66% of OSA sufferers experienced daytime sleepiness at least three days a week. Drivers with sleep apnea were found to be seven times more likely to be involved in automobile accidents than those without sleep apnea
• Danish Nationwide Cohort Study (2022):
  • This study found that the prevalence of motor vehicle accidents in OSA patients was 1.4%, higher than the 0.98% in the reference population. The hazard ratio for motor vehicle accidents in OSA patients was 1.29, and CPAP therapy significantly reduced the risk
• Systematic Review and Meta-Analysis (2009):
  • This review concluded that individuals with OSA are at a significantly increased risk for crashes, with a crash-rate ratio likely falling within the range of 1.21 to 4.89. Factors such as BMI, apnea-hypopnea index, oxygen saturation, and daytime sleepiness were associated with increased crash risk

Impact of CPAP Therapy

1. Swedish Traffic Accident Registry Data (2015):
   • This study demonstrated that CPAP therapy significantly reduces the risk of motor vehicle accidents in OSA patients. The accident rate normalized after the initiation of CPAP treatment, highlighting its effectiveness in mitigating crash risk

• Meta-Analysis on CPAP Compliance (2018):
  • A meta-analysis found that CPAP treatment reduces daytime sleepiness and the risk of motor vehicle crashes among drivers with OSA. The protective effect of CPAP was evident in both actual accidents and driving simulator performance

1. Commercial Motor Vehicle (CMV) Drivers:
   • Research indicates that OSA is highly prevalent among CMV drivers, with estimates ranging from 28% to 78%. CMV drivers with untreated OSA are at a significantly higher risk of accidents due to their high mileage and the nature of their work. Effective screening and treatment are crucial for this group

• Adolescents with OSA:
  • A study on adolescents found no significant differences in simulated driving skills between those with and without OSA. However, the adolescents in the study had relatively mild OSA, suggesting that more research is needed to explore the impact of severe OSA on adolescent driving safety

Behavioral and Physiological Factors

1. Sleepiness at the Wheel (SW):
   • Sleepiness at the wheel, a common symptom of OSA, is a major factor contributing to road traffic accidents. Studies have shown that untreated OSA increases the risk of motor vehicle accidents by 1.5 to 2.5 times compared to the general population. CPAP therapy effectively reduces this risk by alleviating excessive daytime sleepiness

• Driving Simulators:
  • Driving simulators have been used to assess the impact of OSA on driving performance. While they provide valuable insights, their ability to predict real-life accidents is limited. Simulated driving performance is associated with subjective and objective sleepiness but does not reliably predict real-life near-misses or accidents

Conclusion

The body of research consistently shows that OSA significantly increases the risk of motor vehicle accidents due to excessive daytime sleepiness and impaired cognitive function. CPAP therapy is highly effective in reducing this risk. Further research is needed to explore the impact of OSA on specific populations and to develop more reliable methods for assessing driving risk in OSA patients.

winders

Note: I don't actually have OSA and don't have or need a CPAP.

You are not very smart. The reason PCA cares about CPAP use is to make sure the driver is not compromised. But, what if my compromised driving is better than your regular driving? If PCA is so worried about my CPAP use and performance, maybe they should be worried about everyone's performance and have tests to measure that performance. Or maybe they should just trust that my doctor is gathering my CPAP data and would not clear me for racing if I were not using it.

peterp

I've already answered your question. This entire discussion is about the medical review process. One of these things in your scenario is preventable during the medical process (confirming CPAP use) and other is not (lesser driving skill of an individual applicant). Liability risk occurs from not preventing that which was preventable. Your question equating preventable (at the medical review level) and unpreventable isn't relevant. A slight variation of your hypothetical that is relevant, however, is this: What if it was the far lesser skilled driver in your scenario who also doesn't use his CPAP machine? Why would you assume it's somebody at Luigi's driving skill level? It could be anyone.

I don't disagree at all with the idea of PCA taking a driver's word for it -- that's why I proposed, and I still think, that having a driver check a box that says they use it daily is sufficient and also transfers liability. But, for now, PCA has required data of all drivers and they have submitted it. I'm sure PCA believes there is far less risk (or even minimal risk) with Luigi individually given his experience and success level, but it's not fair to other drivers that submitted it to exclude him as the policy stands currently. Also, excluding him individually, very, very publicly (given this thread), would expose them to massive liability in the unlikely event there was a serious incident on track ("you ignored your own rules!" never plays well in court (or at a hospital, since PCA is more a community of friends than an isolated corporate entity). I would guess that submitting data would get him back on track immediately, which is why a handful of us have encouraged that. I would encourage those who actually want to help Luigi get back on track to suggest the same, instead of continuing to throw gas on a dumpster fire and advising him in a losing direction by encouraging objectively false arguments (read post #1096 several times).

Zhao

Garbage information though when it comes to racing. Its taking data about apples and applying it to oranges.

Stats show old people have significantly compromised reaction times. Stats also show young drivers are statistically more likely to be involved in more accidents. Stats also show males are likely to be involved in more accidents than women. Those stats say my wife should be a better driver than Max Verstappen or Randy Pobst. We know that isn't true so why try to pretend street driving stats have any correlation with race track stats. Anyone thinking they correlate only proves that they probably have never raced and/or do not have a mind that capable of making decisions like this.

Circuit Racing is a high adrenalin sport; I've literally been up 30+ hours doing endurance racing and having already driven multiple times and jumped into the race car and been 100% awake for every single lap no different than if I slept 12 hours. As soon as I got out of the car and the adrenalin wore off I crashed, but no sleepiness behind the wheel. Go drive a car at 100% and see if you are capable of nodding off.

thebishman

“Further research is needed to explore the impact of OSA on specific populations and to develop more reliable methods for assessing driving risk in OSA patients.”


No one denies that someone with clinically significant OSA will benefit from using CPAP therapy for myriad reasons, but all of those studies you site above are based on drivers on the street and especially driving for long durations/miles.

You can NOT site one actual medical study that shows that a driver on a road course during a 1-2 hour race is impaired by not using their CPAP recently as the study doesn’t exist, and conflating what untreated OSA does to the driving ability of Commercial over the road drivers to road racers is disingenuous at best. The closest we have is the study I noted way back that shows withdrawing CPAP therapy for 1-2 weeks from chronic users of CPaP showed no decreased acuity in a Driving Simulator or in their reaction times.

This is why the Medical Committee’s stubborn adherence to an OTR Truck driving OSA standard for what occurs during a race is ludicrous, and frankly embarrassing.

NightBlueTTS

I’ll just set this down right here…..

dgrobs

When you do argue with fools, it's typical that they bring you down to their level, then beat you with experience. Buyer beware...

Manifold

Problem is that we don't really know how a driver's physical and mental state contributes to track incidents. There are pretty much no studies on that, and it's not information that's typically obtained when track incidents are investigated.

I've driven on track when I slept poorly, quite tired, worn down from heat, etc., and I never had any incidents nor would any observer have noticed any problems with my driving, but that doesn't mean that I wasn't at increased risk of an incident.

Because of the uncertainties, and because there's isn't a clear link between physical and mental state vs the track incidents which do occur, there are varying practices for addressing this issue, ranging from just trusting drivers to not go on track if they feel they shouldn't go on track (the norm for DE) to the other end of the spectrum as demonstrated by PCA club racing, where you have a lot of medical disclosure, signoff needed by both the personal doctor and PCA, requests for additional information, etc.

To me, a middle ground approach seems best, where the driver is made aware of the kinds of health issues which could affect ability to drive on the track, and is required to attest that they're fit to be on track. I don't think there should be any disclosure of health issues or treatments, since that's an invasion of privacy.

peterp

Which do you think will take precedence in a lawsuit, the multiple objective studies in post #1095, or your personal anecdote?

How do you think your logic, that is is unsafe for driving on the road (not debatable given the data), but is absolutely fine when you are on track at 3-4 times the speed with competitors around you, will fair in court? How does it fair in the court of common sense?

You all are moving the issue backwards and digging a deeper hole by encouraging arguments that would be blown to bits in court.

NaroEscape

So here's one for you peterp. I will never be diagnosed with OSA. Why? Because I would lie to my doctor before I was ever prescribed a CPAP. I would never wear it. Ever. It would make my sleep issue worse because I'd never sleep if I had to wear it. I am a very light sleeper and ANYTHING not right wakes me up. I can't sleep on my back, I sleep on my side and stomach. I'm also a very restless sleeper. I can't even imagine wearing one of those things. I'd probably tangle myself up and choke to death.
I tried wearing ear plugs once when there was loud noises going on at a hotel we stayed at. I couldn't sleep with them in. Didn't sleep all night.

So what's worse: a guy that admits he has OSA and admits he uses his CPAP every day - even bought a portable one so he can use it when he travels - and is willing to sign an affidavit to that that affect? Or me (and many others) that willingly will never know if i have OSA and continue on like nothings wrong?

And what about the Non-CPAP remedies for OSA that don't collect data?

peterp

I am FOR Luigi’s point of having an affidavit, that’s why I proposed several times adding a checkbox to say that they will use the machine, which also transfers PCA liability to the applicant, and helps ensure the driver will be diligent.

That’s a potentially winnable case with valid arguments. Just don’t sink his case with arguments that would be laughed at and obliterated in court. Asking for trust of use while (essentially) saying that it’s a joke that they even require CPAP use, hurts the the trust argument for reasons that should be very, very obvious. All of this moves it in the opposite direction.

They are asking Luigi for data because he has a CPAP machine that has data. If he had some other device, they would use whatever means they felt appropriate to validate it. There is no reason to expect anything different.

CraigT

"It's not just the cars .... it's the people".
I had a friend sum it up very well once - "I joined this club to have fun driving my car, not to deal with this BS!"
We've both backed away just because of that - it's the people.

Manifold

It's not really the people, it's how the social dynamics of a large car club staffed mostly by volunteers influences the behavior of the people operating in it. It works well enough to keep going or even growing, but feathers get ruffled along the way.

ProCoach

Are we at 85,000 views yet?

winders

No, it's the power dynamics of the National Office staffed by "volunteers" hand picked by those holding power not endowed by the membership.