Figure 1.
Figure 2.
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Figure 4.
Patient characteristics, sleep study results, time In bed (actigraphy)_
| Variable | N/Mean(SD) |
|---|---|
| Males/Females (N) | 14/3 |
| Age (yrs) | 53.2 (11.6) |
| Body-Mass Index (BMI) | 36.8 (8.0) |
| Apnea Hypopnea Index (AHI: events/hr) | 64.6 (18.0) |
| % of sleep time with SaO2<90% | 9.9 (15.1 |
| Average SaO2 desaturation | 4.9 (2.3) |
| Epworth Sleepiness Scale (ESS) | 10.6 (5.4) |
| Time in Bed (mins) | |
| Normal Sleep | 444 (95) |
| Sleep Restriction | 213 (0) |
Definitions of non-verbal behaviours in OSA patients_
| Behaviour | Definition |
|---|---|
| Self-centred gestures | |
| Touching head | Hand touches any point on the face, defined from the jaw line upwards, inclusive of scalp, eyes and ears. |
| Touching neck | Hand touches any point on the circumference of the neck, from thorax to nape. |
| Touching arms | Hand touches opposite arm, from and inclusive of hand to shoulder. |
| Touching torso | Hand touches upper torso - defined from sternum to collarbone and deltoid to deltoid. |
| Non-verbal facial activities | |
| Yawn | Progressive, involuntary opening of mouth during deep inhalation. A closed or open hand may move to cover the mouth during a yawn. |
| Stretch face | Extension of facial muscles without hands present. May include: stretching of facial features along horizontal or vertical axes, exaggerated raising of eyebrows, or tightening and slight recession of ears and scalp. |
| Licking lip | Extension of tongue onto upper or lower lips, which may be held stationary, or moved horizontally in either direction across the chosen lip. |
| Biting lip | Insertion of either upper or lower lip into the mouth until held between upper and lower front teeth. Both lips may be inserted at the same time. |
| Postural Adjustments | |
| Tilt torso | Tilting of torso in any direction, keeping original point of contact on the seat. |
| Tilt head | Tilting of head in any direction, keeping original neck position. A tilting behaviour is not to be recorded if it is a function of another behaviour. i.e. tilting head left to scratch the head. |
| Shift position | Relocation of seating position marked by the brief rising to fall into a new position on the seat. Rising can occur either through the use of one or two hands pushing down against the armrests, or brief and partial propulsion by the legs. |
| Exercise shoulders | Movement of one or both shoulders in a backwards direction, stretching the shoulders and chest. One or both shoulders may also be rotated from the torso in a clockwise or anticlockwise direction, stretching the shoulders and chest. |
| Stretch arms | Removal of one or both arms from the steering wheels and full extension of one or both elbow joints, resulting in a stretch of the respective arms muscles. |
| Non-self-centred-gestures | |
| Play with hair | Hand extends to hair on scalp or face and commences one of the following behaviours: wrapping hair around fingers, repetitively stroking hair mass, tugs hair against follicle roots, or moving fingers through or under hair mass. |
| Tap fingers | Repetitive initiation and cessation of contact of one or more fingers against a surface. If multiple fingers are in use, they may tap in consecutive motion. |
| Touch environment | One or more of digits removed from the steering wheel and placed on an inanimate piece of the surrounding environment. i.e. chair, simulator cupboard. |
| Eye closures | |
| Closed eyes (>1s) | Simultaneous closing of both eyelids for a duration lasting for greater than one second. |
Incident rate ratio for exhibiting behaviour_
| Condition | Time | |||||||
|---|---|---|---|---|---|---|---|---|
| IRR | 95%CI | 95%CI | 95%CI | |||||
| Behaviour | IRR | lower | Upper | Z | IRR | lower | Upper | Z |
| Crash | 3.44 | 1.74 | 6.84 | 3.54** | 1.24 | 1.09 | 1.40 | 3.40** |
| Self-centred | 1.02 | 0.87 | 1.21 | 0.26 | 1.08 | 1.05 | 1.12 | 4.69** |
| Non-verbal facial | 1.12 | 0.96 | 1.31 | 1.38 | 1.03 | 0.99 | 1.06 | 1.73 |
| Eye closure | 2.13 | 1.75 | 2.60 | 7.48** | 1.24 | 1.19 | 1.29 | 10.82** |
| Postural | 1.49 | 1.29 | 1.72 | 5.48** | 1.11 | 1.08 | 1.41 | 7.42** |
| Non-self-centred gestures | 0.53 | 0.36 | 0.78 | -3.28** | 1.11 | 1.03 | 1.19 | 2.90** |
Incident rate ratio for exhibiting behaviour preceding crash or non-crash events_
| Condition | Time | |||||||
|---|---|---|---|---|---|---|---|---|
| IRR | 95%CI | 95%CI | 95%CI | |||||
| Behaviour | IRR | lower | Upper | Z | IRR | lower | Upper | Z |
| Self-centred | 0.86 | 0.52 | 1.42 | -0.57 | 0.98 | 0.9 | 1.07 | -0.37 |
| Non-verbal facial | 1.02 | 0.57 | 1.81 | 0.06 | 0.97 | 0.88 | 1.08 | -0.5 |
| Eye closure | 2.13 | 1.42 | 3.78 | 3.37** | 1.07 | 0.99 | 1.17 | 1.68 |
| Postural | 0.91 | 0.59 | 1.41 | -0.41 | 0.97 | 0.89 | 1.05 | 0.04 |