Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
Stichting Epilepsie Instelling Nederland (SEIN), Heemstede, The Netherlands.
Traffic Inj Prev. 2021;22(2):120-126. doi: 10.1080/15389588.2020.1862804. Epub 2021 Feb 5.
Excessive Daytime Sleepiness is a core symptom of narcolepsy and idiopathic hypersomnia, which impairs driving performance. Adequate treatment improves daytime alertness, but it is unclear whether driving performance completely normalizes. This study compares driving performance of patients with narcolepsy and idiopathic hypersomnia receiving treatment to that of healthy controls.
Patients diagnosed with narcolepsy type 1 (NT1, n = 33), narcolepsy type 2 (NT2, n = 7), or idiopathic hypersomnia (IH, n = 6) performed a standardized one-hour on-the-road driving test, measuring standard deviation of lateral position (SDLP).
Results showed that mean SDLP in patients did not differ significantly from controls, but the 95%CI of the mean difference (+1.02 cm) was wide (-0.72 to +2.76 cm). Analysis of subgroups, however, showed that mean SDLP in NT1 patients was significantly increased by 1.90 cm as compared to controls, indicating impairment. Moreover, four NT1 patients requested to stop the test prematurely due to self-reported somnolence, and two NT1 patients were stopped by the driving instructor for similar complaints.
Driving performance of NT1 patients may still be impaired, despite receiving treatment. No conclusions can be drawn for NT2 and IH patients due to the low sample sizes of these subgroups. In clinical practice, determination of fitness to drive for these patients should be based on an individual assessment in which also coping strategies are taken into account.
日间过度嗜睡是嗜睡症和特发性嗜睡症的核心症状，会损害驾驶表现。充分的治疗可以提高白天的警觉性，但尚不清楚驾驶表现是否完全正常。本研究比较了接受治疗的嗜睡症和特发性嗜睡症患者的驾驶表现与健康对照组的差异。
诊断为 1 型嗜睡症（NT1，n = 33）、2 型嗜睡症（NT2，n = 7）或特发性嗜睡症（IH，n = 6）的患者进行了一项标准化的 1 小时道路驾驶测试，测量侧向位置标准差（SDLP）。
结果显示，患者的平均 SDLP 与对照组无显著差异，但平均差异的 95%置信区间（+1.02cm）较宽（-0.72 至 +2.76cm）。然而，对亚组的分析显示，NT1 患者的平均 SDLP 比对照组显著增加了 1.90cm，表明存在损害。此外，有 4 名 NT1 患者因自我报告的嗜睡要求提前停止测试，有 2 名 NT1 患者因类似的抱怨被驾驶指导员停止测试。
尽管接受了治疗，NT1 患者的驾驶表现仍可能受损。由于这些亚组的样本量较小，无法对 NT2 和 IH 患者得出结论。在临床实践中，应根据个体评估确定这些患者是否适合驾驶，其中还应考虑应对策略。
