Psychomotor Vigilance Testing of Professional Drivers in the Occupational Health Clinic

Zhang, Chunbai; Varvarigou, Vasileia; Parks, Philip D.; Gautam, Shiva; Bueno, Antonio Vela; Malhotra, Atul; Kales, Stefanos N.

doi:10.1097/jom.0b013e318223d3d6

Cited by 35 publications

(21 citation statements)

References 30 publications

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“…Our study extends the results of previously published studies demonstrating decrements in PVT performance with high BMI 7,24,25. Obesity has also been shown to increase the risk of motor vehicle crashes 26,27.…”

Section: Discussionsupporting

confidence: 90%

Obstructive sleep apnea and psychomotor vigilance task performance

Batool-Anwar¹,

Kales²,

Patel³

et al. 2014

NSS

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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.

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Section: Discussionsupporting

confidence: 90%

Obstructive sleep apnea and psychomotor vigilance task performance

Batool-Anwar¹,

Kales²,

Patel³

et al. 2014

NSS

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“…These tests evaluate several domains of executive function (working memory, response inhibition) while also employing attention and psychomotor speed resources 18 . The ICT has been shown to correlate with driving abnormalities in cirrhotics and mirrors findings seen in non-cirrhotic OSA driving studies 19, 20 . This cognitive dysfunction was compounded in cirrhotics who were further impaired on digit symbol and both number connection tests, highlighting the continuum of attention-centered cognitive impairments with increasing co-morbidities 12 .…”

Section: Discussionsupporting

confidence: 57%

Effects of Obstructive Sleep Apnea on Sleep Quality, Cognition, and Driving Performance in Patients With Cirrhosis

Bajaj

Thacker

Leszczyszyn

et al. 2015

Clinical Gastroenterology and Hepatology

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Background & Aims: In patients with cirrhosis, sleep disturbances are assumed to result from hepatic encephalopathy (HE). The effects of obstructive sleep apnea (OSA) on cognition, sleep parameters, or driving in patients with cirrhosis are unclear. Methods: We performed a cross-sectional, prospective study of 118 subjects. Subjects were assigned to 1 of 4 groups: those with OSA and cirrhosis (without HE or ascites, n=34), those with only cirrhosis (n=30), those with only OSA only (n=29), and those without OSA or cirrhosis (controls, n=25). None of OSA patients were receiving continuous positive airway pressure (CPAP) therapy. Subjects underwent cognitive testing (paper–pencil tests for psychomotor speed and attention, as well as executive function tests), sleep assessment (daytime sleepiness and night-time sleep quality) and a monotonous driving simulation (worsening lane deviations over time indicate poor performance). We also tested patients with OSA, with cirrhosis (n=10) and without cirrhosis (n=7), before and after CPAP therapy. Results: Daytime sleepiness and sleep quality were worse in subjects in the OSA groups (with or without cirrhosis) than subjects with cirrhosis alone or controls. Of subjects with only OSA, 36% had impaired psychomotor speed and attention, compared to >60% of subjects in both cirrhosis groups. In contrast, executive function was uniformly worse in subjects with OSA, with or without cirrhosis, than groups without OSA. Simulator performance (lane deviations) worsened over time in both OSA groups. CPAP therapy significantly increased executive function and sleep quality, and reduced simulator lane deviations and sleepiness, in subjects with and without cirrhosis. After CPAP therapy, performance on the paper–pencil test performance improved significantly only in subjects with OSA without cirrhosis. Conclusion: OSA should be considered in evaluating sleep impairment in patients with cirrhosis. In patients with cirrhosis and OSA, psychomotor speed and attention issues are likely related to the cirrhosis, whereas executive function and simulator performance are affected by the OSA. CPAP therapy improves executive function and simulator performance in patients with OSA, regardless of cirrhosis.

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“…These may include psychomotor vigilance testing, driving simulators, and eye movement sensors. 21–26 …”

Section: Discussionmentioning

confidence: 99%

Association of Sleep Habits With Accidents and Near Misses in United States Transportation Operators

Johnson

Patel

Baur

et al. 2014

Journal of Occupational &Amp; Environmental Medicine

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Objective To explore sleep risk factors and their association with adverse events in transportation operators. Methods Self-reported sleep-related behaviors were analyzed in transportation operators (drivers, pilots, and rail operators) aged 26 to 78 years who completed the National Sleep Foundation’s 2012 “Planes, Trains, Automobiles, and Sleep” survey. Regression analyses were used to assess the associations of various sleep-related variables with the combined outcome of self-reported accidents and near misses. Results Age- and body mass–adjusted predictors of accidents/near misses included an accident while commuting (odds ratio [OR] = 4.6; confidence interval [CI], 2.1 to 9.8), driving drowsy (OR = 4.1; CI, 2.5 to 6.7), and Sheehan Disability Scale score greater than 15 (OR = 3.5; CI, 2.2 to 5.5). Sleeping more than 7 hours nightly was protective for accident/near misses (OR = 0.6; CI, 0.4 to 0.9). Conclusion Recognized risk factors for poor sleep or excessive daytime sleepiness were significantly associated with self-reported near misses and/or accidents in transportation operators.

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Psychomotor Vigilance Testing of Professional Drivers in the Occupational Health Clinic

Cited by 35 publications

References 30 publications

Obstructive sleep apnea and psychomotor vigilance task performance

Obstructive sleep apnea and psychomotor vigilance task performance

Effects of Obstructive Sleep Apnea on Sleep Quality, Cognition, and Driving Performance in Patients With Cirrhosis

Association of Sleep Habits With Accidents and Near Misses in United States Transportation Operators

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