Frontal Lobe Metabolic Decreases with Sleep Deprivation not Totally Reversed by Recovery Sleep
STUDY OBJECTIVES It has been suggested that the Maintenance of Wakefulness Test (MWT) may be clinically useful to assess fitness to drive, yet little is known about the actual relationship between sleep latency and driving performance. This study examined the ability of 2 MWT trials to predict driving-simulator performance in healthy individuals. DESIGN Experimental. SETTING NA. PATIENTS OR PARTICIPANTS Twenty healthy volunteers (mean age 22.8 years; 9 men). INTERVENTIONS NA. MEASUREMENTS AND RESULTS The MWT and driving-simulator performance were examined under 2 conditions-partial sleep deprivation and a combination of partial sleep deprivation and alcohol consumption. Each subject was studied a week apart, with the order randomly assigned. Subjects completed a nighttime 70-minute AusEd driving simulation task and two 40-minute MWT trials, 1 before (MWT1) and 1 after (MWT2) the driving task. In the sleep-deprived condition, the MWT1 sleep latency was inversely correlated with braking reaction time. During the partial sleep deprivation and alcohol condition, the number of microsleeps during the driving task, steering deviation, braking reaction time, and crashes all negatively correlated with the MWT1 sleep latency. Additionally, construction of a receiver-operator characteristic curve revealed that MWT1 sleep latency in the partial sleep deprivation plus alcohol condition significantly discriminated subjects who had a crash from those who did not. CONCLUSIONS These results indicate that sleep latency on the MWT is a reasonable predictor of driving simulator performance in sleepy, alcohol-impaired, normal subjects. Further research is needed to examine the relationship between daytime MWT results and driving simulator performance in sleepy patients (eg, those with obstructive sleep apnea) and in experimentally sleep-deprived normal subjects.