title: Daytime sleepiness and driving performance in patients with obstructive sleep apnea: comparison of the MSLT, the MWT, and a simulated driving task.
abstract: OBJECTIVE
  To test the reliability of a driving-simulation test for the objective measurement of daytime alertness compared with the Multiple Sleep Latency Test (MSLT) and with the Maintenance of Wakefulness Test (MWT), and to test the ability to drive safely, in comparison with on-road history, in the clinical setting of untreated severe obstructive sleep apnea.
  
  
  METHODS
  N/A.
  
  
  METHODS
  Sleep laboratory.
  
  
  METHODS
  Twenty-four patients with severe obstructive sleep apnea and reported daytime sleepiness varying in severity (as measured by the Epworth Sleepiness Scale).
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Patients underwent MSLT and MWT coupled with 4 sessions of driving-simulation test on 2 different days randomly distributed 1 week apart. Simulated-driving performance (in terms of lane-position variability and crash occurrence) was correlated with sleep latency on the MSLT and more significantly on the MWT, showing a predictive validity toward the detection of sleepy versus alert patients with obstructive sleep apnea. In addition, patients reporting excessive daytime sleepiness or a history of car crashes showed poorer performances on the driving simulator.
  
  
  CONCLUSIONS
  A simulated driving test is a suitable tool for objective measurement of daytime alertness in patients with obstructive sleep apnea. Further studies are needed to clarify the association between simulated-driving performance and on-road crash risk of patients with sleep disordered breathing.
authors.affiliation: Unit of Neurology, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Pizza
authors.forename: Sara
authors.initials: S
authors.lastname: Contardi
authors.forename: Susanna
authors.initials: S
authors.lastname: Mondini
authors.forename: Lino
authors.initials: L
authors.lastname: Trentin
authors.forename: Fabio
authors.initials: F
authors.lastname: Cirignotta
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control; D000328:Adult; D000368:Aged; D001143:Arousal; D001288:Attention; D001334:Automobile Driving / Q000523:psychology*; D003198:Computer Simulation; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009949:Orientation; D011214:Practice, Psychological; D011597:Psychomotor Performance; D011930:Reaction Time; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000523:psychology; D014584:User-Computer Interface; D014851:Wakefulness