Obstructive sleep apnea and psychomotor vigilance task performance

Abstract

BackgroundObstructive sleep apnea (OSA) is a highly prevalent disorder with considerable morbidity and mortality. Vigilance and attentiveness are often impaired in OSA patients. In occupational medicine settings, subjective reports of sleepiness are notoriously inaccurate, making the identification of objective measures of vigilance potentially important for risk assessments of fitness for duty. In order to evaluate the effects of OSA on attentiveness and vigilance, we conducted a cross-sectional study to examine the association between OSA and psychomotor vigilance task (PVT) performance.MethodsPatients attending sleep clinics for evaluation of possible sleep apnea were recruited. The subjects underwent either a standard overnight laboratory polysomnography or home sleep study. Subjective daytime sleepiness was assessed by Epworth sleepiness scale, and vigilance was tested using a portable device. The participants were asked to respond to the PVT signals using their dominant hand. Each PVT administration lasted 10 minutes, with stimuli signals appearing randomly at variable intervals of 2–10 seconds.ResultsMean age of the participants was 46±15 years, and mean body mass index was 34.3±9.8 kg/m2. Participants with higher Epworth scores had worse PVT performance (P<0.05). In multivariate analyses, age, body mass index, and poor sleep efficiency (measured by Pittsburgh sleep quality index score) were associated with worse PVT performance (P<0.05). In contrast, PVT performance did not differ significantly across categories of apnea hypopnea index severity. Subgroup analysis demonstrated that women had worse performance on all PVT measures (P<0.05).ConclusionPVT performance can be utilized for risk assessments of sleepiness and may be particularly useful among populations where subjective reports are unreliable.

Psychomotor vigilance performance predicted by Epworth Sleepiness Scale scores in an operational setting with the United States Navy

“…In contrast to ESS, the PVT is sensitive to both acute (Doran et al ., ) and chronic partial sleep deprivation (Dinges et al ., ). Therefore, while our results are consistent with other data in clinical settings (Batool‐Anwar et al ., ), ESS may not predict acute situational compromises in persons who are acutely sleep deprived, but not chronically so. This problem is ameliorated by the findings of multiple operational studies though, showing that military populations are chronically sleep deprived (Miller et al ., , , ).…”

Rest but busy: Aberrant resting‐state functional connectivity of triple network model in insomnia

“…PVT is one of the leading assays of sustained attention in the sleep‐related research and is highly sensitive to the effect of sleep loss (Deurveilher, Bush, Rusak, Eskes, & Semba, ). Studies in rats of chronic sleep restriction or sleep deprivation and in patients with sleep–wake disorders or obstructive sleep apnea showed that poorer PVT performance was associated with more sleep loss and excessive daytime sleepiness (Batool‐Anwar et al., ; Deurveilher et al., ; Dinges et al., ; Doran, Van Dongen, & Dinges, ; Oonk, Davis, Krueger, Wisor, & Van Dongen, ; Thomann, Baumann, Landolt, & Werth, ). Insomniacs often complain about insufficient sleep and sleepiness in the daytime that make daytime alertness and sustained attention impaired.…”

Psychomotor Vigilance Test and Its Association With Daytime Sleepiness and Inflammation in Sleep Apnea: Clinical Implications

“…[8][9][10][11][12][13][14][15] It has been shown that sleepiness, as a result of chronic sleep restriction or total sleep deprivation, is associated in a dose-response manner with impaired PVT performance. 13 Dinges and colleagues reported that sleep restriction to 4 to 5 hours per night for 1 week resulted in significantly elevated subjective daytime sleepiness (as measured by the Stanford Sleepiness Scale) and progressive deterioration of PVT performance across the days of restricted sleep.…”