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Study finds that using wakefulness tests to detect daytime sleepiness in drivers may be unreliable
Date:2/14/2009

Westchester, Ill. A study in the Feb. 15 issue of the Journal of Clinical Sleep Medicine shows that a 40 minute protocol for the Maintenance of Wakefulness Test (MWT40) is superior to a 20-minute protocol (MWT20) at detecting excessive daytime sleepiness (EDS) in adults who may be unable to maintain wakefulness while driving. Yet results also suggest that the test may not be completely reliable when the strong motivation to keep a driver's license enables individuals to overcome sleepiness during the test.

Forty-one out of the 164 subjects in the study (25 percent) fell asleep in one or more of the MWT40 trials; 10 participants (6.1 percent) fell asleep in all four trials. Out of 39 subjects with severe obstructive sleep apnea (OSA), 19 (48.7 percent) fell asleep in at least one of the trials. In a previous study of the MTW20 protocol, only five out of 54 subjects (9.2 percent) fell asleep in any of the trials.

According to the principal investigator Giora Pillar, M.D, Ph.D, with the Sleep Laboratory at Rambam Medical Center in Haifa, Israel, it is very difficult to objectively assess and quantify the capability of an individual to remain vigilant. Many of the study's participants may have been highly motivated to overcome their sleepiness during the test in order to prevent their license from being revoked.

"It could be expected that the MWT40 will be superior to MWT20, but it is somewhat surprising that despite a strong drive to sleep, as in cases of severe apnea, people could pass the test by remaining awake in all trials," said Pillar. "It emphasizes the strong effect of motivation."

The study included 164 consecutive subjects with an average age of 50, who were referred to the Technion Sleep Lab between June 2006 and January 2007 by the Medical Institute for Driving Safety of the Ministry of Transportation. Participants who were suspected of suffering from EDS were referred for evaluation for their abi
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Contact: Kelly Wagner
kwagner@aasmnet.org
708-492-0930
American Academy of Sleep Medicine
Source:Eurekalert

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