Philip Pierre, Sagaspe Patricia, Taillard Jacques, Chaumet Guillaume, Bayon Virginie, Coste Olivier, Bioulac Bernard, Guilleminault Christian
Université Bordeaux 2, Paris, France.
Ann Neurol. 2008 Oct;64(4):410-6. doi: 10.1002/ana.21448.
Sleepiness at the wheel is a major risk factor for traffic accidents. Because of the potential medical and legal implications, in this study, we evaluated the correlation between subjective and objective measures of sleepiness and driving performances in patients suffering from excessive daytime sleepiness.
Thirty-eight untreated sleep apnea patients (mean age +/- standard deviation, 51 +/- 9 years; mean apnea-hypopnea index +/- standard deviation, 41 +/- 25), and 14 healthy control subjects (mean age +/- standard deviation, 46 +/- 9 years) were included in the study. Nocturnal polysomnography, mean sleep latency as measured by four 40-minute Maintenance of Wakefulness Test (MWT) trials, Epworth Sleepiness Scale, Karolinska Sleepiness Scale, and the number of inappropriate line crossings during a 90-minute real-life driving session were analyzed.
The number of inappropriate line crossings correlated with MWT scores (Spearman's Rho: r = -0.339; p < 0.05), Karolinska Sleepiness Scale scores measured at halfway in total driving distance (Rho: r = 0.367; p < 0.01), and Epworth Sleepiness Scale (Rho: r = 0.389; p < 0.01). We found a significant difference in the number of inappropriate line crossings among the four groups defined by MWT scores (very sleepy [0-19 minutes], sleepy [20-33 minutes], alert [34-40 minutes], and controls) (Kruskal-Wallis test: H = 11.319; p < 0.01). Very sleepy and sleepy patients had more inappropriate line crossings than the control drivers (p < 0.05).
In addition to subjective sleepiness scales, the MWT can be used to assess driving ability in untreated sleep apnea patients.
驾车时困倦是交通事故的主要危险因素。鉴于其潜在的医学和法律影响，在本研究中，我们评估了日间过度嗜睡患者困倦的主观和客观指标与驾驶性能之间的相关性。
本研究纳入了38名未经治疗的睡眠呼吸暂停患者（平均年龄±标准差，51±9岁；平均呼吸暂停低通气指数±标准差，41±25）和14名健康对照者（平均年龄±标准差，46±9岁）。分析了夜间多导睡眠图、通过四次40分钟清醒维持测试（MWT）试验测得的平均睡眠潜伏期、爱泼华嗜睡量表、卡罗林斯卡嗜睡量表以及90分钟现实驾驶过程中不适当越线的次数。
不适当越线次数与MWT评分（斯皮尔曼等级相关系数：r = -0.339；p < 0.05）、在总驾驶距离一半时测得的卡罗林斯卡嗜睡量表评分（等级相关系数：r = 0.367；p < 0.01）以及爱泼华嗜睡量表（等级相关系数：r = 0.389；p < 0.01）相关。我们发现，由MWT评分定义的四组（非常困倦[0 - 19分钟]、困倦[20 - 33分钟]、警觉[34 - 40分钟]和对照组）之间不适当越线次数存在显著差异（Kruskal - Wallis检验：H = 11.319；p < 0.01）。非常困倦和困倦的患者比对照驾驶员有更多不适当越线情况（p < 0.05）。
除了主观嗜睡量表外，MWT可用于评估未经治疗的睡眠呼吸暂停患者的驾驶能力。
