Sleep-Disordered Breathing and Psychomotor Vigilance in a Community-Based Sample

Abstract

, LEADING TO nocturnal arousals, unrefreshing sleep, and daytime sleepiness. SDB has been shown to be a contributing factor in diminished neurocognitive functioning. [1][2][3][4] Specifically, within the spectrum of neurocognitive deficits, vigilance impairment or inability to sustain attention is a frequent complaint of patients with SDB. Vigilance lapses have been shown to be associated with sleepiness-regardless of the cause-as well as with fatigue and alcohol impairment, 5-7 and the lapses have been found to be tightly coupled to slow eyelid closures, 8 which increase in frequency with drowsy driving 9 and contribute to motor vehicle crashes and occupation-related accidents. 10Significant associations between SDB and impaired vigilance have been shown in patient-based studies.3,11-13 Because these studies were based on patients who may have been more likely to be have been referred to a sleep clinic if they experienced impaired vigilance, the association between SDB and impaired vigilance may be overstated and may not be applicable to SDB in the community-based population.In contrast with the results from patient-based studies, no significant relationships between SDB and vigilance impairment have been reported in samples of older community-dwelling adults selected independently of sleep complaints.14,15 Although the data suggest that SDB in older people may not be associated with impairment, it is possible that methodologic differences, restricted age range, selection bias, or small sample size may explain the discrepancies in the findings between these and the findings from the patient-based studies.SDB is common and the range of SDB severity is wide, but no studies on the association between SDB and vigilance in the community population based on a large sample have been reported that span the full range of SDB severity and age range in adults.In a large community-based sample of middle-aged and older adults, we assessed the independent association between SDB and vigilance impairment as assessed by the psychomotor vigilance task (PVT), an instrument that is widely used in assessing the maintenance of alertness related to sleep deprivation and sleep disorders.7 In addition, data on self-reported and polysomnographically determined sleepiness provided the opportunity to assess whether sleepiness mediates the associations of SDB with vigilance impairments and the impact of sleepiness on vigilance performance in a nonclinical population. Study Objective: Sleep-disordered breathing (SDB) has been associated with impaired psychomotor vigilance performance in patients with sleep apnea patients. A bias toward greater referral of sleep apnea patients with severely impaired performance could explain these findings. Furthermore, no studies on the association between SDB and vigilance performance in a large community-based sample have been reported that encompasses the full spectrum of SDB severity. This study investigated the association between SDB and psychomotor vigilance with cross-sectional data from the Wiscon...

Multiple Sclerosis Fatigue is Associated with Reduced Psychomotor Vigilance

“…The mean reaction time on the PVT was 315.0 (+65.1) with 90% of subjects demonstrating reaction times exceeding the 19 The mean number of lapses was 3.98 (+5.24) with 59% exceeding the mean (1.96) for an age-and sex-matched control (p=0.001). 19 The Figure, a scatter plot of MFIS score against PVT reaction time, demonstrates the correlation between reaction times and fatigue scores.…”

“…For example, in other studies age has been shown to affect PVT performance, and in this study, gender was a significant contributor. 19 However, these observations also illustrate the drawback of traditional fatigue rating scales, which encompass several distinct parameters -short-term attention, exercise tolerance, sustained concentration capabilities -under the umbrella of fatigue. Perhaps it will be fruitful in the future to research MS fatigue by differentiating this entity into several, smaller, objectively defined components, including alertness.…”

“…19 The Figure, a scatter plot of MFIS score against PVT reaction time, demonstrates the correlation between reaction times and fatigue scores. The Pearson correlation coefficient was 0.38.…”

“…Mean reaction times in the general population have been previously published, by gender and by age group. 19 The mean reaction time for a general population sample with the same gender and age distribution as the study population was estimated from these data. Self-reporting of fatigue was assessed using the Modified Fatigue Impact Scale (MFIS), an instrument that consists of 21 questions measuring social, physical, and cognitive aspects of fatigue.…”

“…The PVT is a reaction-time task that has been validated in laboratory, clinical, and field studies investigating sleep, respiratory, and neurological disorders. [18][19][20] The PVT has been demonstrated to be highly sensitive to sleep loss and can easily be used in a clinical setting. We also assessed other factors, including demographics, disability, pain, mood, and sleep quality, to assess their relative contribution to psychomotor vigilance performance in this population.…”