Sleep Research and Treatment Center, Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
Mental Health Center, Shantou University Medical College, China.
J Clin Sleep Med. 2017 Sep 15;13(9):1049-1056. doi: 10.5664/jcsm.6720.
Excessive daytime sleepiness (EDS) is a key symptom of obstructive sleep apnea (OSA). The Psychomotor Vigilance Task (PVT) has been suggested as an objective easy-to-use, inexpensive alternative to the Multiple Sleep Latency Test (MSLT) to measure EDS. In patients with OSA, physiological sleepiness, but not subjective EDS (Epworth Sleepiness Scale [ESS]), has been associated with increased levels of the sleep- inducing proinflammatory cytokine interleukin-6 (IL-6). The goal of this study was to assess the association of PVT with objectively measured sleepiness (MSLT) and subjectively measured sleepiness (ESS) and IL-6 levels in patients with OSA.
We studied 58 untreated patients with OSA who underwent an 8-hour in-laboratory polysomnography for 4 consecutive nights. MSLT, PVT, and 24-hour serial profiles of IL-6 were assessed on the fourth day. PVT variables included number of lapses, mean reciprocal of the fastest 10% and slowest 10% reaction times, and median of 1/reaction time. ESS was assessed on day 1 of the study.
Higher ESS scores were significantly associated with greater number of lapses (β = .34, = .02) and lower values of 1/RT (β = -.36, = .01) and slowest 10% RTs (β = -.30, = .04). No significant association was observed between PVT and MSLT, nor PVT and IL-6 levels.
Our findings suggest that PVT is associated with subjectively assessed daytime sleepiness, but not with physiological sleepiness nor IL-6 levels in patients with OSA. It appears that ESS and PVT may be useful in predicting risks associated with impaired performance, such as traffic accidents, in patients with OSA.
日间嗜睡（EDS）是阻塞性睡眠呼吸暂停（OSA）的一个关键症状。精神运动警觉任务（PVT）已被建议作为一种客观、易于使用且廉价的替代多睡眠潜伏期测试（MSLT）的方法，用于测量 EDS。在 OSA 患者中，生理困倦，但不是主观 EDS（Epworth 嗜睡量表[ESS]），与睡眠诱导促炎细胞因子白细胞介素 6（IL-6）水平升高有关。本研究的目的是评估 PVT 与 OSA 患者客观测量的嗜睡（MSLT）和主观测量的嗜睡（ESS）和 IL-6 水平的相关性。
我们研究了 58 名未经治疗的 OSA 患者，他们连续 4 个晚上在实验室进行了 8 小时的多导睡眠图检查。在第四天评估了 MSLT、PVT 和 24 小时连续的 IL-6 图谱。PVT 变量包括潜伏期次数、最快 10%和最慢 10%反应时间的倒数平均值以及 1/反应时间的中位数。ESS 在研究的第一天进行评估。
较高的 ESS 评分与潜伏期次数增加（β=.34， =.02）以及 1/RT 降低（β= -.36， =.01）和最慢 10% RTs（β= -.30， =.04）显著相关。在 OSA 患者中，PVT 与 MSLT 之间以及 PVT 与 IL-6 水平之间均无显著相关性。
我们的研究结果表明，PVT 与主观评估的日间嗜睡相关，但与 OSA 患者的生理嗜睡或 IL-6 水平无关。ESS 和 PVT 似乎可用于预测与 OSA 患者的认知表现受损相关的风险，例如交通事故。
