Local on-ramp queue management strategy with mainline speed recovery

Ramp metering is an effective motorway control tool beneficial for mainline traffic, but the long on-ramp queues created interfere with surface traffic profoundly. This study deals with the conflict between mainline benefits and thecosts of on-ramp and surface traffic. A novel local on-ramp queue management strategy with mainline speed recovery is proposed. Microscopic simulation is used to test the new strategy and compare it with other strategies. Simulation results reveal that the ramp metering with queue management strategy provides a good balance between the mainline and on-ramp performances.

Cross-layer design and optimization for wireless networked control systems

Wireless networked control systems (WNCSs) have been widely used in the areas of manufacturing and industrial processing over the last few years. They provide real-time control with a unique characteristic: periodic traffic. These systems have a time-critical requirement. Due to current wireless mechanisms, the WNCS performance suffers from long time-varying delays, packet dropout, and inefficient channel utilization. Current wirelessly networked applications like WNCSs are designed upon the layered architecture basis. The features of this layered architecture constrain the performance of these demanding applications. Numerous efforts have attempted to use cross-layer design (CLD) approaches to improve the performance of various networked applications. However, the existing research rarely considers large-scale networks and congestion network conditions in WNCSs. In addition, there is a lack of discussions on how to apply CLD approaches in WNCSs. This thesis proposes a cross-layer design methodology to address the issues of periodic traffic timeliness, as well as to promote the efficiency of channel utilization in WNCSs. The design of the proposed CLD is highlighted by the measurement of the underlying network condition, the classification of the network state, and the adjustment of sampling period between sensors and controllers. This period adjustment is able to maintain the minimally allowable sampling period, and also maximize the control performance. Extensive simulations are conducted using the network simulator NS-2 to evaluate the performance of the proposed CLD. The comparative studies involve two aspects of communications, with and without using the proposed CLD, respectively. The results show that the proposed CLD is capable of fulfilling the timeliness requirement under congested network conditions, and is also able to improve the channel utilization efficiency and the proportion of effective data in WNCSs.

Effects of air pollution exposure on adult bicycle commuters : an investigation of respiratory health, motorised traffic proximity and the utility of commute re-routing

Bicycle commuting has the potential to be an effective contributing solution to address some of modern society’s biggest issues, including cardiovascular disease, anthropogenic climate change and urban traffic congestion. However, individuals shifting from a passive to an active commute mode may be increasing their potential for air pollution exposure and the associated health risk. This project, consisting of three studies, was designed to investigate the health effects of bicycle commuters in relation to air pollution exposure, in a major city in Australia (Brisbane). The aims of the three studies were to: 1) examine the relationship of in-commute air pollution exposure perception, symptoms and risk management; 2) assess the efficacy of commute re-routing as a risk management strategy by determining the exposure potential profile of ultrafine particles along commute route alternatives of low and high proximity to motorised traffic; and, 3) evaluate the feasibility of implementing commute re-routing as a risk management strategy by monitoring ultrafine particle exposure and consequential physiological response from using commute route alternatives based on real-world circumstances; 3) investigate the potential of reducing exposure to ultrafine particles (UFP; < 0.1 µm) during bicycle commuting by lowering proximity to motorised traffic with real-time air pollution and acute inflammatory measurements in healthy individuals using their typical, and an alternative to their typical, bicycle commute route. The methods of the three studies included: 1) a questionnaire-based investigation with regular bicycle commuters in Brisbane, Australia. Participants (n = 153; age = 41 ± 11 yr; 28% female) reported the characteristics of their typical bicycle commute, along with exposure perception and acute respiratory symptoms, and amenability for using a respirator or re-routing their commute as risk management strategies; 2) inhaled particle counts measured along popular pre-identified bicycle commute route alterations of low (LOW) and high (HIGH) motorised traffic to the same inner-city destination at peak commute traffic times. During commute, real-time particle number concentration (PNC; mostly in the UFP range) and particle diameter (PD), heart and respiratory rate, geographical location, and meteorological variables were measured. To determine inhaled particle counts, ventilation rate was calculated from heart-rate-ventilation associations, produced from periodic exercise testing; 3) thirty-five healthy adults (mean ± SD: age = 39 ± 11 yr; 29% female) completed two return trips of their typical route (HIGH) and a pre-determined altered route of lower proximity to motorised traffic (LOW; determined by the proportion of on-road cycle paths). Particle number concentration (PNC) and diameter (PD) were monitored in real-time in-commute. Acute inflammatory indices of respiratory symptom incidence, lung function and spontaneous sputum (for inflammatory cell analyses) were collected immediately pre-commute, and one and three hours post-commute. The main results of the three studies are that: 1) healthy individuals reported a higher incidence of specific acute respiratory symptoms in- and post- (compared to pre-) commute (p < 0.05). The incidence of specific acute respiratory symptoms was significantly higher for participants with respiratory disorder history compared to healthy participants (p < 0.05). The incidence of in-commute offensive odour detection, and the perception of in-commute air pollution exposure, was significantly lower for participants with smoking history compared to healthy participants (p < 0.05). Females reported significantly higher incidence of in-commute air pollution exposure perception and other specific acute respiratory symptoms, and were more amenable to commute re-routing, compared to males (p < 0.05). Healthy individuals have indicated a higher incidence of acute respiratory symptoms in- and post- (compared to pre-) bicycle commuting, with female gender and respiratory disorder history indicating a comparably-higher susceptibility; 2) total mean PNC of LOW (compared to HIGH) was reduced (1.56 x e4 ± 0.38 x e4 versus 3.06 x e4 ± 0.53 x e4 ppcc; p = 0.012). Total estimated ventilation rate did not vary significantly between LOW and HIGH (43 ± 5 versus 46 ± 9 L•min; p = 0.136); however, due to total mean PNC, accumulated inhaled particle counts were 48% lower in LOW, compared to HIGH (7.6 x e8 ± 1.5 x e8 versus 14.6 x e8 ± 1.8 x e8; p = 0.003); 3) LOW resulted in a significant reduction in mean PNC (1.91 x e4 ± 0.93 x e4 ppcc vs. 2.95 x e4 ± 1.50 x e4 ppcc; p ≤ 0.001). Commute distance and duration were not significantly different between LOW and HIGH (12.8 ± 7.1 vs. 12.0 ± 6.9 km and 44 ± 17 vs. 42 ± 17 mins, respectively). Besides incidence of in-commute offensive odour detection (42 vs. 56 %; p = 0.019), incidence of dust and soot observation (33 vs. 47 %; p = 0.038) and nasopharyngeal irritation (31 vs. 41 %; p = 0.007), acute inflammatory indices were not significantly associated to in-commute PNC, nor were these indices reduced with LOW compared to HIGH. The main conclusions of the three studies are that: 1) the perception of air pollution exposure levels and the amenability to adopt exposure risk management strategies where applicable will aid the general population in shifting from passive, motorised transport modes to bicycle commuting; 2) for bicycle commuting at peak morning commute times, inhaled particle counts and therefore cardiopulmonary health risk may be substantially reduced by decreasing exposure to motorised traffic, which should be considered by both bicycle commuters and urban planners; 3) exposure to PNC, and the incidence of offensive odour and nasopharyngeal irritation, can be significantly reduced when utilising a strategy of lowering proximity to motorised traffic whilst bicycle commuting, without significantly increasing commute distance or duration, which may bring important benefits for both healthy and susceptible individuals. In summary, the findings from this project suggests that bicycle commuters can significantly lower their exposure to ultrafine particle emissions by varying their commute route to reduce proximity to motorised traffic and associated combustion emissions without necessarily affecting their time of commute. While the health endpoints assessed with healthy individuals were not indicative of acute health detriment, individuals with pre-disposing physiological-susceptibility may benefit considerably from this risk management strategy – a necessary research focus with the contemporary increased popularity of both promotion and participation in bicycle commuting.

The impact of co-locating regulatory and directional signs on driver performance

The use of intelligent transport systems is proliferating across the Australian road network, particularly on major freeways. New technology allows a greater range of signs and messages to be displayed to drivers. While there has been a long history of human factors analyses of signage, no evaluation has been conducted on this novel, sometimes dynamic, signage or potential interactions when co-located. The purpose of this driving simulator study was to investigate drivers’ behavioural changes and comprehension resulting from the co-location of Lane Use Management Systems with static signs and (Enhanced) Variable Message Signs on Queensland motorways. A section of motorway was simulated, and nine scenarios were developed which presented a combination of signage cases across levels of driving task complexity. Two higher-risk road user groups were targeted for this research on an advanced driving simulator: older (65+ years, N=21) and younger (18-22 years, N=20) drivers. Changes in sign co-location and task complexity had small effect on driver comprehension of the signs and vehicle dynamics variables, including difference with the posted speed limit, headway, standard deviation of lane keeping and brake jerks. However, increasing the amount of information provided to drivers at a given location (by co-locating several signs) increased participants’ gaze duration on the signs. With co-location of signs and without added task complexity, a single gaze was over 2s for more than half of the population tested for both groups, and up to 6 seconds for some individuals.

Crisis response planning in tunnel and road networks

Critical road infrastructure (such as tunnels and overpasses) is of major significance to society and constitutes major components of interdependent, ‘systems and networks’. Failure in critical components of these wide area infrastructure systems can often result in cascading disturbances with secondary and tertiary impacts - some of which may become initiating sources of failure in their own right, triggering further systems failures across wider networks. Perrow1) considered the impact of our increasing use of technology in high-risk fields, analysing the implications on everyday life and argued that designers of these types of infrastructure systems cannot predict every possible failure scenario nor create perfect contingency plans for operators. Challenges exist for transport system operators in the conceptualisation and implementation of response and subsequent recovery planning for significant events. Disturbances can vary from reduced traffic flow causing traffic congestion throughout the local road network(s) and subsequent possible loss of income to businesses and industry to a major incident causing loss of life or complete loss of an asset. Many organisations and institutions, despite increasing recognition of the effects of crisis events, are not adequately prepared to manage crises2). It is argued that operators of land transport infrastructure are in a similar category of readiness given the recent instances of failures in road tunnels. These unexpected infrastructure failures, and their ultimately identified causes, suggest there is significant room for improvement. As a result, risk profiles for road transport systems are often complex due to the human behaviours and the inter-mix of technical and organisational components and the managerial coverage needed for the socio-technical components and the physical infrastructure. In this sense, the span of managerial oversight may require new approaches to asset management that combines the notion of risk and continuity management. This paper examines challenges in the planning of response and recovery practices of owner/operators of transport systems (above and below ground) in Australia covering: • Ageing or established infrastructure; and • New-build infrastructure. With reference to relevant international contexts this paper seeks to suggest options for enhancing the planning and practice for crisis response in these transport networks and as a result support the resilience of Critical Infrastructure.

Exploring dependencies of 5.9 GHz DSRC throughput and reliability on safety applications

Dedicated Short Range Communication (DSRC) is the emerging key technology supporting cooperative road safety systems within Intelligent Transportation Systems (ITS). The DSRC protocol stack includes a variety of standards such as IEEE 802.11p and SAE J2735. The effectiveness of the DSRC technology depends on not only the interoperable cooperation of these standards, but also on the interoperability of DSRC devices manufactured by various manufacturers. To address the second constraint, the SAE defines a message set dictionary under the J2735 standard for construction of device independent messages. This paper focuses on the deficiencies of the SAE J2735 standard being developed for deployment in Vehicular Ad-hoc Networks (VANET). In this regard, the paper discusses the way how a Basic Safety Message (BSM) as the fundamental message type defined in SAE J2735 is constructed, sent and received by safety communication platforms to provide a comprehensive device independent solution for Cooperative ITS (C-ITS). This provides some insight into the technical knowledge behind the construction and exchange of BSMs within VANET. A series of real-world DSRC data collection experiments was conducted. The results demonstrate that the reliability and throughput of DSRC highly depend on the applications utilizing the medium. Therefore, an active application-dependent medium control measure, using a novel message-dissemination frequency controller, is introduced. This application level message handler improves the reliability of both BSM transmissions/receptions and the Application layer error handling which is extremely vital to decentralized congestion control (DCC) mechanisms.

On the use of Bluetooth MAC Scanners for live reporting of the transport network

Recently there has been significant interest of researchers and practitioners on the use of Bluetooth as a complementary transport data. However, literature is limited with the understanding of the Bluetooth MAC Scanner (BMS) based data acquisition process and the properties of the data being collected. This paper first provides an insight on the BMS data acquisition process. Thereafter, it discovers the interesting facts from analysis of the real BMS data from both motorway and arterial networks of Brisbane, Australia. The knowledge gained is helpful for researchers and practitioners to understand the BMS data being collected which is vital to the development of management and control algorithms using the data.

Real time information provision benefit measured by macroscopic fundamental diagram

The existence of Macroscopic Fundamental Diagram (MFD), which relates space-mean density and flow, has been shown in urban networks under homogeneous traffic conditions. Since MFD represents the area-wide network traffic performances, studies on perimeter control strategies and an area traffic state estimation utilizing the MFD concept has been reported. One of the key requirements for well-defined MFD is the homogeneity of the area-wide traffic condition with links of similar properties, which is not universally expected in real world. For the practical application of the MFD concept, several researchers have identified the influencing factors for network homogeneity. However, they did not explicitly take the impact of drivers’ behaviour and information provision into account, which has a significant impact on simulation outputs. This research aims to demonstrate the effect of dynamic information provision on network performance by employing the MFD as a measurement. A microscopic simulation, AIMSUN, is chosen as an experiment platform. By changing the ratio of en-route informed drivers and pre-trip informed drivers different scenarios are simulated in order to investigate how drivers’ adaptation to the traffic congestion influences the network performance with respect to the MFD shape as well as other indicators, such as total travel time. This study confirmed the impact of information provision on the MFD shape, and addressed the usefulness of the MFD for measuring the dynamic information provision benefit.

A microscopic simulation model to estimate bus rapid transit station bus capacity

The Bus Rapid Transit (BRT) station is the interface between passengers and services. The station is crucial to line operation as it is typically the only location where buses can pass each other. Congestion may occur here when buses maneuvering into and out of the platform lane interfere with bus flow, or when a queue of buses forms upstream of the platform lane blocking the passing lane. Further, some systems include operation where express buses do not observe the station, resulting in a proportion of non-stopping buses. It is important to understand the operation of the station under this type of operation and its effect on BRT line capacity. This study uses microscopic traffic simulation modeling to treat the BRT station operation and to analyze the relationship between station bus capacity and BRT line bus capacity. First, the simulation model is developed for the limit state scenario and then a statistical model is defined and calibrated for a specified range of controlled scenarios of dwell time characteristics. A field survey was conducted to verify the parameters such as dwell time, clearance time and coefficient of variation of dwell time to obtain relevant station bus capacity. The proposed model for BRT bus capacity provides a better understanding of BRT line capacity and is useful to transit authorities in BRT planning, design and operation.

Planning for sustainability of non motorised public transport in a developing city

Most large cities around the world are undergoing rapid transport sector development to cater for increased urbanization. Subsequently the issues of mobility, access equity, congestion, operational safety and above all environmental sustainability are becoming increasingly crucial in transport planning and policy making. The popular response in addressing these issues has been demand management, through improvement of motorised public transport (MPT) modes (bus, train, tram) and non-motorized transport (NMT) modes (walk, bicycle); improved fuel technology. Relatively little attention has however been given to another readily available and highly sustainable component of the urban transport system, non-motorized public transport (NMPT) such as the pedicab that operates on a commercial basis and serves as an NMT taxi; and has long standing history in many Asian cities; relatively stable in existence in Latin America; and reemerging and expanding in Europe, North America and Australia. Consensus at policy level on the apparent benefits, costs and management approach for NMPT integration has often been a major transport planning problem. Within this context, this research attempts to provide a more complete analysis of the current existence rationale and possible future, or otherwise, of NMPT as a regular public transport system. The analytical process is divided into three major stages. Stage 1 reviews the status and role condition of NMPT as regular public transport on a global scale- in developing cities and developed cities. The review establishes the strong ongoing and future potential role of NMPT in major developing cities. Stage 2 narrows down the status review to a case study city of a developing country in order to facilitate deeper role review and status analysis of the mode. Dhaka, capital city of Bangladesh, has been chosen due to its magnitude of NMPT presence. The review and analysis reveals the multisectoral and dominant role of NMPT in catering for the travel need of Dhaka transport users. The review also indicates ad-hoc, disintegrated policy planning in management of NMPT and the need for a planning framework to facilitate balanced integration between NMPT and MT in future. Stage 3 develops an integrated, multimodal planning framework (IMPF), based on a four-step planning process. This includes defining the purpose and scope of the planning exercise, determining current deficiencies and preferred characteristics for the proposed IMPF, selection of suitable techniques to address the deficiencies and needs of the transport network while laying out the IMPF and finally, development of a delivery plan for the IMPF based on a selected layout technique and integration approach. The output of the exercise is a planning instrument (decision tool) that can be used to assign a road hierarchy in order to allocate appropriate traffic to appropriate network type, particularly to facilitate the operational balance between MT and NMT. The instrument is based on a partial restriction approach of motorised transport (MT) and NMT, structured on the notion of functional hierarchy approach, and distributes/prioritises MT and NMT such that functional needs of the network category is best complemented. The planning instrument based on these processes and principles offers a six-level road hierarchy with a different composition of network-governing attributes and modal priority, for the current Dhaka transport network, in order to facilitate efficient integration of NMT with MT. A case study application of the instrument on a small transport network of Dhaka also demonstrates the utility, flexibility and adoptability of the instrument in logically allocating corridors with particular positions in the road hierarchy paradigm. Although the tool is useful in enabling balanced distribution of NMPT with MT at different network levels, further investigation is required with reference to detailed modal variations, scales and locations of a network to further generalise the framework application.

The impact of incidents on macroscopic fundamental diagram

Macroscopic Fundamental Diagram (MFD) has been proved to exist in large urban road and freeway networks by theoretic method and real data in cities. However hysteresis and scatters have also been found existed both on motorway network and urban road. This paper investigates how the incident variables affect the scatter and shape of the MFD using both the simulated data and the real data collected from the Pacific Motorway M3 in Brisbane, Australia. Three key components of incident are investigated based on the simulated data: incident location, incident duration time and traffic demand. Results based on the simulated data indicate that MFD shape is a property not only of the network itself but also of the incident characteristics variables. MFDs for three types of real incidents (crash, hazard and breakdown) are explored separately. The results based on the empirical data are consistent with the simulated results. The hysteresis phenomenon occurs on both the upstream and the downstream of the incident location, but for opposite hysteresis loops. Gradient of the MFD for the upstream is more than that for the downstream on the incident site, when traffic demand is off peak.

Fuel consumption and gas emissions of an automatic transmission vehicle following simple eco-driving instructions on urban roads

Following eco-driving instructions can reduce fuel consumption between 5 to 20% on urban roads with manual cars. The majority of Australian cars have an automatic transmission gear-box. It is therefore of interest to verify whether current eco-driving instructions are e cient for such vehicles. In this pilot study, participants (N=13) drove an instrumented vehicle (Toyota Camry 2007) with an automatic transmission. Fuel consumption of the participants was compared before and after they received simple eco-driving instructions. Participants drove the same vehicle on the same urban route under similar tra c conditions. We found that participants drove at similar speeds during their baseline and eco-friendly drives, and reduced the level of their accelerations and decelerations during eco-driving. Fuel consumption decreased for the complete drive by 7%, but not on the motorway and inclined sections of the study. Gas emissions were estimated with the VT-micro model, and emissions of the studied pollutants (CO2, CO, NOX and HC) were reduced, but no di erence was observed for CO2 on the motorway and inclined sections. The di erence for the complete lap is 3% for CO2. We have found evidence showing that simple eco-driving instructions are e cient in the case of automatic transmission in an urban environment, but towards the lowest values of the spectrum of fuel consumption reduction from the di erent eco-driving studies.

Emergency Health Services (EHS) : demand and service delivery models. monograph 3 : patients’ reasons and perceptions

Executive Summary Emergency health is a critical component of Australia’s health system and emergency departments (EDs) are increasingly congested from growing demand and blocked access to inpatient beds. The Emergency Health Services Queensland (EHSQ) study aims to identify the factors driving increased demand for emergency health and to evaluate strategies which may safely reduce the future demand growth. This monograph addresses the perspectives of users of both ambulance services and EDs. The research reported here aimed to identify the perspectives of users of emergency health services, both ambulance services and public hospital Emergency Departments and to identify the factors that they took into consideration when exercising their choice of location for acute health care. A cross-sectional survey design was used involving a survey of patients or their carers presenting to the EDs of a stratified sample of eight hospitals. A specific purpose questionnaire was developed based on a novel theoretical model which had been derived from analysis of the literature (Monograph 1). Two survey versions were developed: one for adult patients (self-complete); and one for children (to be completed by parents/guardians). The questionnaires measured perceptions of social support, health status, illness severity, self-efficacy; beliefs and attitudes towards ED and ambulance services; reasons for using these services, and actions taken prior to the service request. The survey was conducted at a stratified sample of eight hospitals representing major cities (four), inner regional (two) and outer regional and remote (two). Due to practical limitations, data were collected for ambulance and ED users within hospital EDs, while patients were waiting for or under treatment. A sample size quota was determined for each ED based on their 2009/10 presentation volumes. The data collection was conducted by four members of the research team and a group of eight interviewers between March and May 2011 (corresponding to autumn season). Of the total of 1608 patients in all eight emergency departments the interviewers were able to approach 1361 (85%) patients and seek their consent to participate in the study. In total, 911 valid surveys were available for analysis (response rate= 67%). These studies demonstrate that patients elected to attend hospital EDs in a considered fashion after weighing up alternatives and there is no evidence of deliberate or ill-informed misuse. • Patients attending ED have high levels of social support and self-efficacy that speak to the considered and purposeful nature of the exercise of choice. • About one third of patients have new conditions while two thirds have chronic illnesses • More than half the attendees (53.1%) had consulted a healthcare professional prior to making the decision. • The decision to seek urgent care at an ED was mostly constructed around the patient’s perception of the urgency and severity of their illness, reinforced by a strong perception that the hospital ED was the correct location for them (better specialised staff, better care for my condition, other options not as suitable). • 33% of the respondent held private hospital insurance but nevertheless attended a public hospital ED. Similarly patients exercised considered and rational judgements in their choice to seek help from the ambulance service. • The decision to call for ambulance assistance was based on a strong perception about the severity of the illness (too severe to use other means of transport) and that other options were not considered appropriate. • The decision also appeared influenced by a perception that the ambulance provided appropriate access to the ED which was considered most appropriate for their particular condition (too severe to go elsewhere, all facilities in one spot, better specialised and better care). • In 43.8% of cases a health care professional advised use of the ambulance. • Only a small number of people perceived that ambulance should be freely available regardless of severity or appropriateness. These findings confirm a growing understanding that the choice of professional emergency health care services is not made lightly but rather made by reasonable people exercising a judgement which is influenced by public awareness of the risks of acute health and which is most often informed by health professionals. It is also made on the basis of a rational weighing up of alternatives and a deliberate and considered choice to seek assistance from a service which the patient perceived was most appropriate to their needs at that time. These findings add weight to dispensing with public perceptions that ED and ambulance congestion is a result of inappropriate choice by patients. The challenge for health services is to better understand the patient’s needs and to design and validate services that meet those needs. The failure of our health system to do so should not be grounds for blaming the patient, claiming inappropriate patient choices.

A methodological framework for benchmarking smart transport cities

Besides responding to challenges of rapid urbanization and growing traffic congestion, the development of smart transport systems has attracted much attention in recent times. Many promising initiatives have emerged over the years. Despite these initiatives, there is still a lack of understanding about an appropriate definition of smart transport system. As such, it is challenging to identify the appropriate indicators of ‘smartness’. This paper proposes a comprehensive and practical framework to benchmark cities according to the smartness in their transportation systems. The proposed methodology was illustrated using a set of data collected from 26 cities across the world through web search and contacting relevant transport authorities and agencies. Results showed that London, Seattle and Sydney were among the world’s top smart transport cities. In particular, Seattle and Paris ranked high in smart private transport services while London and Singapore scored high on public transport services. London also appeared to be the smartest in terms of emergency transport services. The key value of the proposed innovative framework lies in a comparative analysis among cities, facilitating city-to-city learning.

One night CPAP withdrawal impairs performance at a driving simulator task faster than sleep restriction to 5 hours with treatment in OSA patients

Introduction Sleep restriction and missing 1 night’s continuous positive air pressure (CPAP) treatment are scenarios faced by obstructive sleep apnoea (OSA) patients, who must then assess their own fitness to drive. This study aims to assess the impact of this on driving performance. Method 11 CPAP treated participants (50–75 yrs), drove an interactive car simulator under monotonous motorway conditions for 2 hours on 3 afternoons, following;(i)normal night’s sleep (average 8.2 h) with CPAP (ii) sleep restriction (5 h), with CPAP (iii)normal length of sleep, without CPAP. Driving incidents were noted if the car came out of the designated driving lane. EEG was recorded continually and KSS reported every 200 seconds. Results Driving incidents: Incidents were more prevalent following CPAP withdrawal during hour 1, demonstrating a significant condition time interaction [F(6,60) = 3.40, p = 0.006]. KSS: At the start of driving participants felt sleepiest following CPAP withdrawal, by the end of the task KSS levels were similar following CPAP withdrawal and sleep restriction, demonstrating a significant condition, time interaction [F(3.94,39.41) = 3.39, p = 0.018]. EEG: There was a non significant trend for combined alpha and theta activity to be highest throughout the drive following CPAP withdrawal. Discussion CPAP withdrawal impairs driving simulator performance sooner than restricting sleep to 5 h with CPAP. Participants had insight into this increased sleepiness reflected by the higher KSS reported following CPAP withdrawal. In the practical terms of driving any one incident could be fatal. The earlier impairment reported here demonstrates the potential danger of missing CPAP treatment and highlights the benefit of CPAP treatment even when sleep time is short.