title: Maintenance of Wakefulness Test scores and driving performance in sleep disorder patients and controls.
abstract: OBJECTIVE
  Sleepiness at the wheel is a risk factor for traffic accidents. Past studies have demonstrated the validity of the Maintenance of Wakefulness Test (MWT) scores as a predictor of driving impairment in untreated patients with obstructive sleep apnea syndrome (OSAS), but there is limited information on the validity of the maintenance of wakefulness test by MWT in predicting driving impairment in patients with hypersomnias of central origin (narcolepsy or idiopathic hypersomnia). The aim of this study was to compare the MWT scores with driving performance in sleep disorder patients and controls.
  
  
  METHODS
  19 patients suffering from hypersomnias of central origin (9 narcoleptics and 10 idiopathic hypersomnia), 17 OSAS patients and 14 healthy controls performed a MWT (4×40-minute trials) and a 40-minute driving session on a real car driving simulator. Participants were divided into 4 groups defined by their MWT sleep latency scores. The groups were pathological (sleep latency 0-19 min), intermediate (20-33 min), alert (34-40 min) and control (>34 min). The main driving performance outcome was the number of inappropriate line crossings (ILCs) during the 40 minute drive test.
  
  
  RESULTS
  Patients with pathological MWT sleep latency scores (0-19 min) displayed statistically significantly more ILC than patients from the intermediate, alert and control groups (F (3, 46)=7.47, p<0.001).
  
  
  CONCLUSIONS
  Pathological sleep latencies on the MWT predicted driving impairment in patients suffering from hypersomnias of central origin as well as in OSAS patients. MWT is an objective measure of daytime sleepiness that appears to be useful in estimating the driving performance in sleepy patients.
authors.affiliation: Univ. de Bordeaux, Sommeil, Attention et Neuropsychiatrie, USR 3413, F-33000 Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000 Bordeaux, France; CHU Pellegrin, F-33076 Bordeaux, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Philip
authors.forename: Cyril
authors.initials: C
authors.lastname: Chaufton
authors.forename: Jacques
authors.initials: J
authors.lastname: Taillard
authors.forename: Patricia
authors.initials: P
authors.lastname: Sagaspe
authors.forename: Damien
authors.initials: D
authors.lastname: Léger
authors.forename: Monika
authors.initials: M
authors.lastname: Raimondi
authors.forename: Andrew
authors.initials: A
authors.lastname: Vakulin
authors.forename: Aurore
authors.initials: A
authors.lastname: Capelli
mesh_terms: D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation / Q000379:methods*; D017286:Polysomnography / Q000379:methods; D011597:Psychomotor Performance / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D014851:Wakefulness / Q000502:physiology*; D055815:Young Adult
keywords: Driving performance; Hypersomnias of central origin; Maintenance of Wakefulness Test; OSAS