title: Impaired driving simulation in patients with Periodic Limb Movement Disorder and patients with Obstructive Sleep Apnea Syndrome.
abstract: BACKGROUND
  Excessive daytime sleepiness (EDS) is considered to be responsible for increased collision rate and impaired driving simulator performance in Obstructive Sleep Apnea Syndrome (OSAS) patients. Periodic Limb Movement Disorder (PLMD) patients also frequently report EDS and may also have impaired driving capacities.
  
  
  METHODS
  PLMD patients (n=16), OSAS patients (n=18), and controls (n=16) performed a monotonous 25-min driving simulation task. Parameters for driving capacity were the slope of the standard deviation of the lane position, lapses of attention (LOA), and structural deviations. The severity of sleep disruption and the degree of subjective sleepiness were measured.
  
  
  RESULTS
  Slope and LOA were significantly higher in patients than controls, pointing to a decreased driving performance. At start patients and controls had similar driving capacity. The PLMD and OSAS groups did not differ on any scale or simulation performance, although OSAS patients generally performed worse. Subjective sleepiness was higher in patients than controls, and correlated positively with driving simulator parameters. Severity of the disorder and performance were uncorrelated.
  
  
  CONCLUSIONS
  PLMD and OSAS patients showed impaired performance in a simulated monotonous driving task. At start, patients and controls performed similarly, but patient performance decreased clearly with time, suggesting that decreased vigilance as a result of disturbed sleep is an important component of deteriorated simulated and, possibly, real driving performance.
authors.affiliation: Department of Neurology, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. e.w.gieteling@umcg.nl
authors.forename: Esther W
authors.initials: EW
authors.lastname: Gieteling
authors.forename: Marije S
authors.initials: MS
authors.lastname: Bakker
authors.forename: Aarnoud
authors.initials: A
authors.lastname: Hoekema
authors.forename: Natasha M
authors.initials: NM
authors.lastname: Maurits
authors.forename: Wiebo H
authors.initials: WH
authors.lastname: Brouwer
authors.forename: Johannes H
authors.initials: JH
authors.lastname: van der Hoeven
mesh_terms: D001288:Attention / Q000502:physiology; D001334:Automobile Driving / Q000523:psychology*; D016022:Case-Control Studies; D003198:Computer Simulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000503:physiopathology / Q000523:psychology*; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000523:psychology*; D013997:Time Factors