The Psychomotor Vigilance Test Compared to a Divided Attention Steering Simulation in Patients with Moderate or Severe Obstructive Sleep Apnea
Received 8 April 2020
Accepted for publication 27 May 2020
Published 23 July 2020 Volume 2020:12 Pages 509—524
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Steven A Shea
Ying Huang,1 Steve Hennig,1 Ingo Fietze,1 Thomas Penzel,1,2 Christian Veauthier1
1Interdisciplinary Center of Sleep Medicine, Charité University Medicine Berlin, Berlin 10117, Germany; 2Department of Biology, Saratov State University, Saratow, Russia
Correspondence: Christian Veauthier
Interdisziplinäres Schlafmedizinisches Zentrum, Charité Universitätsmedizin Berlin, Luisenstraße 13, Berlin 10117 Tel +49 30 513 232
Fax +49 30 513 959
Background: Sleepiness at the wheel affects 10% to 15% of drivers and is one major cause of death on highways with one-third of fatal accidents. Obstructive sleep apnea (OSA) is one of the most common sleep disorders leading to sleepiness at the wheel. The aim of this study was to compare the psychomotor vigilance test reaction time (PVT RT) in OSA patients and controls (morning and afternoon) with the results of a divided attention steering simulator (DASS). A second purpose was to compare these results with the mean sleep latencies in the multiple sleep latency test (MSLT), the Epworth Sleepiness Scale (ESS) values and a neurocognitive test (test of attentional performance, TAP).
Patients and Methods: Thirty eight OSA patients and 16 age and sex matched healthy controls were investigated by ESS, PVT, TAP, MSLT, and DASS (response time, failed responses, lane deviation, and off-road-events).
Results: With increasing age, the performance in the DASS decreased. There was no correlation between the DASS and the results of the MSLT and ESS. The controls showed a significantly faster DASS response time in the morning compared to OSA patients (median 2.1 versus 3.0; p=0.044) and fewer off-road events (9 versus 37; p=0.042). We found a moderate correlation between the PVT RT and all parameters of the DASS, as well as the TAP “alertness” subtest.
Conclusion: The increase of PVT RT as well as the decreased tonic alertness in the TAP in untreated OSA patients correlated with an impairment of simulated driving performance. The PVT and the TAP are both suitable diagnostic tools for measuring impaired driving ability in OSA patients. The MSLT did not correlate with the simulated driving performance. We recommend investigation of a longer version of the PVT in order to increase its sensitivity.
Keywords: polysomnography, sustained attention, tonic alertness, vigilance, MSLT, simulated driving performance
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