Maintenance of Wakefulness Test, obstructive sleep apnea syndrome, and driving risk
Corresponding Author
Pierre Philip MD, PhD
Université Bordeaux 2, Paris, France
CNRS UMR-5227, Paris, France
Groupe d'Etude Neuro-Psycho-Pharmacolgique du Sommeil et de la Somnolence, Paris, France
Clinique du Sommeil, CHU Pellegrin, Bordeaux, Paris, France
Université Bordeaux 2; CNRS UMR-5227; CHU (GENPPHASS), Place Amélie Raba-Léon, 33076 Bordeaux Cedex, FranceSearch for more papers by this authorPatricia Sagaspe PhD
Groupe d'Etude Neuro-Psycho-Pharmacolgique du Sommeil et de la Somnolence, Paris, France
INRETS, Paris, France
Search for more papers by this authorJacques Taillard PhD
CNRS UMR-5227, Paris, France
Groupe d'Etude Neuro-Psycho-Pharmacolgique du Sommeil et de la Somnolence, Paris, France
Search for more papers by this authorGuillaume Chaumet M.S.
Université Bordeaux 2, Paris, France
Groupe d'Etude Neuro-Psycho-Pharmacolgique du Sommeil et de la Somnolence, Paris, France
Search for more papers by this authorOlivier Coste MD
Clinique du Sommeil, CHU Pellegrin, Bordeaux, Paris, France
Search for more papers by this authorBernard Bioulac MD, PhD
Université Bordeaux 2, Paris, France
CNRS UMR-5227, Paris, France
Clinique du Sommeil, CHU Pellegrin, Bordeaux, Paris, France
Search for more papers by this authorChristian Guilleminault MD, PhD
Stanford University Sleep Disorders Center, Stanford, CA
Search for more papers by this authorCorresponding Author
Pierre Philip MD, PhD
Université Bordeaux 2, Paris, France
CNRS UMR-5227, Paris, France
Groupe d'Etude Neuro-Psycho-Pharmacolgique du Sommeil et de la Somnolence, Paris, France
Clinique du Sommeil, CHU Pellegrin, Bordeaux, Paris, France
Université Bordeaux 2; CNRS UMR-5227; CHU (GENPPHASS), Place Amélie Raba-Léon, 33076 Bordeaux Cedex, FranceSearch for more papers by this authorPatricia Sagaspe PhD
Groupe d'Etude Neuro-Psycho-Pharmacolgique du Sommeil et de la Somnolence, Paris, France
INRETS, Paris, France
Search for more papers by this authorJacques Taillard PhD
CNRS UMR-5227, Paris, France
Groupe d'Etude Neuro-Psycho-Pharmacolgique du Sommeil et de la Somnolence, Paris, France
Search for more papers by this authorGuillaume Chaumet M.S.
Université Bordeaux 2, Paris, France
Groupe d'Etude Neuro-Psycho-Pharmacolgique du Sommeil et de la Somnolence, Paris, France
Search for more papers by this authorOlivier Coste MD
Clinique du Sommeil, CHU Pellegrin, Bordeaux, Paris, France
Search for more papers by this authorBernard Bioulac MD, PhD
Université Bordeaux 2, Paris, France
CNRS UMR-5227, Paris, France
Clinique du Sommeil, CHU Pellegrin, Bordeaux, Paris, France
Search for more papers by this authorChristian Guilleminault MD, PhD
Stanford University Sleep Disorders Center, Stanford, CA
Search for more papers by this authorAbstract
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
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