Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
J Clin Sleep Med. 2013 Sep 15;9(9):907-20, 920A-920B. doi: 10.5664/jcsm.2992.
Numerous ocular parameters have been proposed as reliable physiological markers of drowsiness. A device that measures many of these parameters and then combines them into a single metric (the Johns Drowsiness Scale [JDS]) is being used commercially to assess drowsiness in professional drivers. Here, we examine how these parameters reflect changes in drowsiness, and how they relate to objective and subjective indices of the drowsy state in a controlled laboratory setting.
A within subject prospective study.
29 healthy adults (18 males; mean age 23.3 ± 4.6 years; range 18-34 years).
N/A.
Over the course of a 30-h extended wake vigil under constant routine (CR) conditions, participants were monitored using infrared reflectance oculography (Optalert) and completed bi-hourly neurobehavioral tests, including the Karolinska Sleepiness Scale (KSS) and Psychomotor Vigilance Task (PVT). Ocular-defined increases in drowsiness were evident with extended time awake and during the biological night for all ocular parameters; JDS being the most sensitive marker of drowsiness induced by sleep regulatory processes (p < 0.0001). In addition, the associations between JDS in the preceding 10-min period and subsequent PVT lapses and KSS were stronger (AUC 0.74/0.80, respectively) than any other ocular metric, such that PVT lapses, mean response time (RT), and KSS increased in a dose-response manner as a function of prior JDS score (p < 0.0001).
Ocular parameters captured by infrared reflectance oculography detected fluctuations in drowsiness due to time awake and during the biological night. The JDS outcome was the strongest predictor of drowsiness among those tested, and showed a clear association to objective and subjective measures of drowsiness. Our findings indicate this real-time objective drowsiness monitoring system is an effective tool for monitoring changes in alertness and performance along the alert-drowsy continuum in a controlled laboratory setting.
许多眼部参数已被提出作为困倦的可靠生理标志物。一种测量许多这些参数并将它们组合成单个指标（约翰斯困倦量表 [JDS]）的设备正在商业上用于评估专业驾驶员的困倦程度。在这里，我们研究这些参数如何反映困倦程度的变化，以及它们如何与受控实验室环境中困倦状态的客观和主观指标相关。
一项前瞻性的单组研究。
29 名健康成年人（18 名男性；平均年龄 23.3 ± 4.6 岁；范围 18-34 岁）。
无。
在恒常作息（CR）条件下进行的 30 小时延长清醒监测过程中，使用红外反射眼动描记术（Optalert）监测参与者，并完成每两小时一次的神经行为测试，包括卡尔斯塔德困倦量表（KSS）和精神运动警觉任务（PVT）。随着清醒时间的延长和所有眼部参数的生物夜间，都可以看到眼部定义的困倦增加；JDS 是睡眠调节过程引起的困倦最敏感的标志物（p < 0.0001）。此外，在之前的 10 分钟内 JDS 与随后的 PVT 失误和 KSS 之间的关联更强（AUC 分别为 0.74/0.80），比任何其他眼部指标都强，因此，PVT 失误、平均反应时间（RT）和 KSS 随着之前 JDS 得分的增加而呈剂量反应方式增加（p < 0.0001）。
红外反射眼动描记术捕捉到的眼部参数检测到由于清醒时间和生物夜间引起的困倦波动。JDS 结果是测试中最能预测困倦的指标，与困倦的客观和主观测量指标有明显的关联。我们的发现表明，这种实时客观困倦监测系统是一种有效的工具，可用于监测在受控实验室环境中警觉性和性能沿着警觉-困倦连续体的变化。
