Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands; Sleep-Wake Center, Stichting Epilepsie Instellingen Nederlands (SEIN), Heemstede, the Netherlands.
Sleep-Wake Center, Stichting Epilepsie Instellingen Nederlands (SEIN), Heemstede, the Netherlands.
Sleep Med. 2023 Aug;108:105-113. doi: 10.1016/j.sleep.2023.06.007. Epub 2023 Jun 10.
OBJECTIVE/BACKGROUND: Evaluation of hypersomnolence disorders ideally includes an assessment of vigilance using the short Sustained Attention to Response Task (SART). We evaluated whether this task can differentiate between hypersomnolence disorders, whether it correlates with subjective and objective sleepiness, whether it is affected by the time of day, and symptoms of anxiety and depression.
PATIENTS/METHODS: We analyzed diagnostic data of 306 individuals with hypersomnolence complaints diagnosed with narcolepsy type 1 (n=100), narcolepsy type 2 (n=20), idiopathic hypersomnia (n=49), obstructive sleep apnea (n=27) and other causes or without explanatory diagnosis (n=110). We included the Multiple Sleep Latency Test (MSLT), polysomnography, Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale and SART, which were administered five times during the day (outcomes: reaction time, total, commission and omission errors).
The SART outcomes did not differ between groups when adjusted for relevant covariates. Higher ESS scores were associated with longer reaction times and more commission errors (p<.01). The main outcome, total errors, did not differ between times of the day. Reaction times and omission errors were impacted (p<.05).
The SART quantifies disturbed vigilance, an important dimension of disorders of hypersomnolence. Results do not suggest that depressive symptoms influence SART outcomes. A practice session is advised. Testing time should be taken into account when interpreting results. We conclude that the SART does not differentiate between central disorders of hypersomnolence. It may be a helpful addition to the standard diagnostic workup and monitoring of these disorders.
目的/背景：评估嗜睡障碍理想情况下包括使用短持续注意力反应任务（SART）评估警觉性。我们评估了该任务是否可以区分嗜睡障碍，是否与主观和客观嗜睡相关，是否受一天中的时间影响，以及焦虑和抑郁症状的影响。
患者/方法：我们分析了 306 名有嗜睡主诉的个体的诊断数据，这些个体被诊断为 1 型发作性睡病（n=100）、2 型发作性睡病（n=20）、特发性嗜睡症（n=49）、阻塞性睡眠呼吸暂停（n=27）和其他原因或无解释性诊断（n=110）。我们纳入了多次睡眠潜伏期试验（MSLT）、多导睡眠图、Epworth 嗜睡量表（ESS）、医院焦虑和抑郁量表以及 SART，这些测试在一天中进行五次（结果：反应时间、总时间、错误和遗漏错误）。
调整相关协变量后，各组之间的 SART 结果没有差异。较高的 ESS 评分与较长的反应时间和更多的错误（p<.01）相关。主要结果，总错误，在一天中的不同时间没有差异。反应时间和遗漏错误受到影响（p<.05）。
SART 量化了警觉性障碍，这是嗜睡障碍的一个重要维度。结果表明，抑郁症状不会影响 SART 结果。建议进行练习。在解释结果时应考虑测试时间。我们得出结论，SART 不能区分中枢性嗜睡障碍。它可能是这些疾病的标准诊断评估和监测的有用补充。
