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Maintenance of Wakefulness Test, obstructive sleep apnea syndrome, and driving risk
Author(s) -
Philip Pierre,
Sagaspe Patricia,
Taillard Jacques,
Chaumet Guillaume,
Bayon Virginie,
Coste Olivier,
Bioulac Bernard,
Guilleminault Christian
Publication year - 2008
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.21448
Subject(s) - epworth sleepiness scale , excessive daytime sleepiness , polysomnography , obstructive sleep apnea , medicine , apnea , psychology , physical therapy , insomnia , sleep disorder , psychiatry
Objective Sleepiness at the wheel is a major risk factor for traffic accidents. Because of the potential medical and legal implications, in this study, we evaluated the correlation between subjective and objective measures of sleepiness and driving performances in patients suffering from excessive daytime sleepiness. Methods Thirty‐eight untreated sleep apnea patients (mean age ± standard deviation, 51 ± 9 years; mean apnea–hypopnea index ± standard deviation, 41 ± 25), and 14 healthy control subjects (mean age ± standard deviation, 46 ± 9 years) were included in the study. Nocturnal polysomnography, mean sleep latency as measured by four 40‐minute Maintenance of Wakefulness Test (MWT) trials, Epworth Sleepiness Scale, Karolinska Sleepiness Scale, and the number of inappropriate line crossings during a 90‐minute real‐life driving session were analyzed. Results The number of inappropriate line crossings correlated with MWT scores (Spearman's P: r = −0.339; p < 0.05), Karolinska Sleepiness Scale scores measured at halfway in total driving distance (P: r = 0.367; p < 0.01), and Epworth Sleepiness Scale (P: r = 0.389; p < 0.01). We found a significant difference in the number of inappropriate line crossings among the four groups defined by MWT scores (very sleepy [0–19 minutes], sleepy [20–33 minutes], alert [34–40 minutes], and controls) (Kruskal–Wallis test: H = 11.319; p < 0.01). Very sleepy and sleepy patients had more inappropriate line crossings than the control drivers ( p < 0.05). Interpretation In addition to subjective sleepiness scales, the MWT can be used to assess driving ability in untreated sleep apnea patients. Ann Neurol 2008