Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, 3800, Australia.
Behav Res Methods. 2021 Aug;53(4):1488-1501. doi: 10.3758/s13428-020-01509-x. Epub 2020 Nov 23.
The pupillographic sleepiness test (PST) is an accurate predictor of alertness failure and performance impairment across sleep deprivation. At 11 min in duration, the task is considered too long to be used in occupational or roadside settings. We therefore investigated the predictive capacity of the PST at seven shortened test durations. Eighteen healthy young adults (aged 21.4 ± 3.2 years, 10 men) underwent 40 h of continuous wakefulness, completing an 11-min PST and a 10-min psychomotor vigilance task (PVT) every 2 h. Waking electroencephalography was recorded and scored for microsleeps during PVTs. The PST was divided into eight equal 82-s blocks and the predictive capacity of the pupillary unrest index (PUI) calculated at descending PST durations by systematically removing blocks. PUI increased significantly with time awake for all test durations (p < .0001), with a similar amplitude of PUI observed for test durations of 5.5 min and longer. While all test durations accurately predicted PVT impairment (AUC: 0.72-0.86, p < .001) and microsleep (AUC: 0.74-0.84, p < .0001), 5.5 min was the shortest duration where accuracy remained high across level and type of impairment (AUC: 0.79-0.86). For the 5.5-min duration, the positive predictive value (PPV) and negative predictive value (NPV) were on average 50.1% and 89.4%, respectively, and were comparable to the full 11-min task (PPV: 49.2%; NPV: 91%). The PST can be shortened to 5.5 min without compromising accuracy in detecting performance impairment or physiological drowsiness. The PST is an ideal candidate for fitness-for-duty or fitness-to-drive testing, and future studies should examine its predictive capacity, at shorter durations, against operationally relevant outcomes.
瞳孔记录睡眠测试(PST)是一种准确预测睡眠剥夺后警觉失败和表现受损的方法。该测试持续时间为 11 分钟,被认为太长而无法在职业或路边环境中使用。因此,我们研究了 PST 在七个缩短的测试持续时间下的预测能力。18 名健康的年轻成年人(年龄 21.4±3.2 岁,10 名男性)接受了 40 小时的连续清醒,每 2 小时完成一次 11 分钟的 PST 和 10 分钟的精神运动 vigilance 测试(PVT)。在 PVT 期间,记录并记录清醒脑电图中的微睡眠。将 PST 分为八个相等的 82 秒块,并通过系统地删除块来计算瞳孔无约束指数(PUI)在下降的 PST 持续时间内的预测能力。对于所有测试持续时间,PUI 随着清醒时间的增加而显著增加(p<.0001),对于测试持续时间为 5.5 分钟及更长时间,观察到相似的 PUI 幅度。虽然所有测试持续时间都能准确预测 PVT 损伤(AUC:0.72-0.86,p<.001)和微睡眠(AUC:0.74-0.84,p<.0001),但 5.5 分钟是最短的持续时间,在损伤的水平和类型上准确性仍然很高(AUC:0.79-0.86)。对于 5.5 分钟的持续时间,平均阳性预测值(PPV)和阴性预测值(NPV)分别为 50.1%和 89.4%,与完整的 11 分钟任务相当(PPV:49.2%;NPV:91%)。PST 可以缩短至 5.5 分钟,而不会降低检测表现损伤或生理困倦的准确性。PST 是适用于履行职责或驾驶能力测试的理想选择,未来的研究应该在更短的时间内研究其预测能力,并与操作性相关的结果进行比较。