title: The effect of partial sleep deprivation on computer-based measures of fitness to drive.
abstract: OBJECTIVE
  Using a partial sleep deprivation paradigm, the aim of the study was to investigate the sensitivity of a computer-based test battery of fitness to drive to detect impairments related to sleepiness.
  
  
  METHODS
  Forty-seven healthy subjects (34 females, mean age 26.0 ± 6.8 years) participated in a counterbalanced within-subject design of two conditions: (i) normal night sleep and (ii) partial sleep deprivation (PSD) with 4 h time in bed. For the assessment of fitness to drive, we used a validated traffic psychological test battery. Moreover, well-established measures of sleepiness highly responsive to sleep deprivation were applied: the Karolinska Sleepiness Scale (KSS), pupillography (Pupil Unrest Index (PUI) as physiological sleepiness indicator) and two sustained attention tasks (psychomotor Vigilance Task and Mackworth Clock Test).
  
  
  RESULTS
  Subjective and physiological sleepiness were significantly increased after PSD, accompanied by large (d > 1.50 for KSS) and medium (d = 0.55 for PUI) effect sizes. Sleepiness-related performance decrements were found in both sustained attention tasks (d = 0.59-0.77). Assessing driving-related ability, PSD induced decrements only in the test domain Reaction Test (reaction time d = 0.54 and motor time d = 0.45). All other subtests-as well as the overall judgement of fitness to drive-were not significantly affected by PSD.
  
  
  CONCLUSIONS
  In contrast to established tests of sustained attention and subjective sleepiness, computer-based test batteries of fitness to drive might lack sensitivity to core aspects of sleepiness as they mainly consist of short and stimulating subtests. Therefore, tasks that require sustained attention should be an essential part of traffic psychological test batteries when sleepiness is a potential issue.
authors.affiliation: Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany.|Department of Psychology, Stockholm University, Stockholm, Sweden.|Stress Research Institute, Stockholm University, Stockholm, Sweden.
authors.forename: Johanna F A
authors.initials: JF
authors.lastname: Schwarz
authors.affiliation: Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Geisler
authors.affiliation: Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany.|Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social Foundation Bamberg, Bamberg, Germany.
authors.forename: Göran
authors.initials: G
authors.lastname: Hajak
authors.affiliation: Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Zulley
authors.affiliation: Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Rupprecht
authors.affiliation: Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Wetter
authors.affiliation: Department of Psychiatry and Psychotherapy, Center of Sleep Medicine, University of Regensburg, Universitätsstrasse 84, 93053, Regensburg, Germany. roland.popp@medbo.de.
authors.forename: Roland F J
authors.initials: RF
authors.lastname: Popp
mesh_terms: D000328:Adult; D001143:Arousal; D001288:Attention; D001333:Automobile Driver Examination; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011930:Reaction Time; D012892:Sleep Deprivation; D014851:Wakefulness; D055815:Young Adult
keywords: Daytime sleepiness; Fitness to drive; Partial sleep deprivation; Sustained attention