Univ. de Bordeaux, Sommeil, Attention et Neuropsychiatrie, USR 3413, F-33000 Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France; CHU Pellegrin, F-33076 Bordeaux, France.
Int J Psychophysiol. 2013 Aug;89(2):195-202. doi: 10.1016/j.ijpsycho.2013.05.013. Epub 2013 May 28.
Sleepiness at the wheel is a risk factor for traffic accidents. Past studies have demonstrated the validity of the Maintenance of Wakefulness Test (MWT) scores as a predictor of driving impairment in untreated patients with obstructive sleep apnea syndrome (OSAS), but there is limited information on the validity of the maintenance of wakefulness test by MWT in predicting driving impairment in patients with hypersomnias of central origin (narcolepsy or idiopathic hypersomnia). The aim of this study was to compare the MWT scores with driving performance in sleep disorder patients and controls.
19 patients suffering from hypersomnias of central origin (9 narcoleptics and 10 idiopathic hypersomnia), 17 OSAS patients and 14 healthy controls performed a MWT (4×40-minute trials) and a 40-minute driving session on a real car driving simulator. Participants were divided into 4 groups defined by their MWT sleep latency scores. The groups were pathological (sleep latency 0-19 min), intermediate (20-33 min), alert (34-40 min) and control (>34 min). The main driving performance outcome was the number of inappropriate line crossings (ILCs) during the 40 minute drive test.
Patients with pathological MWT sleep latency scores (0-19 min) displayed statistically significantly more ILC than patients from the intermediate, alert and control groups (F (3, 46)=7.47, p<0.001).
Pathological sleep latencies on the MWT predicted driving impairment in patients suffering from hypersomnias of central origin as well as in OSAS patients. MWT is an objective measure of daytime sleepiness that appears to be useful in estimating the driving performance in sleepy patients.
驾驶时困倦是交通事故的一个危险因素。过去的研究已经证明，维持清醒测试（MWT）分数作为未经治疗的阻塞性睡眠呼吸暂停综合征（OSAS）患者驾驶障碍的预测因子是有效的，但关于中央性嗜睡症（发作性睡病或特发性嗜睡症）患者的维持清醒测试（MWT）预测驾驶障碍的有效性的信息有限。本研究的目的是比较睡眠障碍患者和对照组的 MWT 评分与驾驶表现。
19 名患有中枢性嗜睡症（9 名发作性睡病患者和 10 名特发性嗜睡症患者）、17 名 OSAS 患者和 14 名健康对照者进行了 MWT（4×40 分钟试验）和 40 分钟真实汽车驾驶模拟器驾驶。参与者根据 MWT 睡眠潜伏期评分分为 4 组。这些组分别是病理性（睡眠潜伏期 0-19 分钟）、中间性（20-33 分钟）、警觉性（34-40 分钟）和对照组（>34 分钟）。主要的驾驶表现结果是在 40 分钟的驾驶测试中不适当的线路交叉（ILC）的次数。
MWT 睡眠潜伏期为病理性（0-19 分钟）的患者比中间性、警觉性和对照组的患者出现的 ILC 多得多（F（3,46）=7.47，p<0.001）。
MWT 上的病理性睡眠潜伏期预测了患有中枢性嗜睡症以及 OSAS 患者的驾驶障碍。MWT 是日间嗜睡的客观测量方法，似乎可用于估计困倦患者的驾驶表现。
