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首頁> 外文學(xué)位 >Self-report sleepiness measures, objective sleepiness measures and simulated driving performance in controls and patients with obstructive sleep apnea.
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Self-report sleepiness measures, objective sleepiness measures and simulated driving performance in controls and patients with obstructive sleep apnea.

機(jī)譯：對照和患有阻塞性睡眠呼吸暫停的患者的自我報(bào)告嗜睡測量，客觀嗜睡測量和模擬駕駛表現(xiàn)。

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The ability of self-report and objective measures of sleepiness to predict performance on the York Driving Simulator was evaluated using two experimental protocols. The first study involved one night of prolonged wakefulness in 16 female participants, aged 18 to 19, who were tested at 2300, 0130, 0400 and 0630 hrs. Each test session consisted of the Stanford Sleepiness Scale, Multiple Sleep Latency Test, Repeated Test of Sustained Wakefulness, Alpha Attenuation Test, Four Choice Reaction Time Test, and a 30-minute simulated driving task during which continuous self-appraisals of sleepiness/alertness were made. As wakefulness was prolonged, participants showed signs of increasing sleepiness on each of the sleepiness measures, and progressive impairments in simulated driving performance. The group of objective sleepiness measures and the group of self-report sleepiness were equally effective predictors of simulated driving ability (R2 = 0.59 and R2 = 0.52, respectively). Further exploration of the association between each individual sleepiness measure and simulated driving ability showed that, although the Repeated Test of Sustained Wakefulness was generally the highest ranked predictor of simulated driving ability, its superiority was matched by self-report sleepiness measures (particularly the online self-appraisal of sleepiness/alertness) and the Multiple Sleep Latency Test. The self-awareness of sleepiness appears to be comparable to measures of physiological sleep tendency in predicting impairments in driving ability. The second study consisted of a pre/post treatment design in 18 patients, aged 28 to 78, who were diagnosed with obstructive sleep apnea. Study 2 was carried out in collaboration with Dr. Michael Fitzpatrick of the Sleep Disorders Laboratory at Kingston General Hospital, who was interested in comparing CPAP treatment outcomes when patients were treated with a laboratory-determined fixed pressure level compared with self-adjusted pressure levels. A randomized crossover design was used, consisting of two 5-week treatment limbs (fixed CPAP and self-adjusted CPAP) separated by a 1-week wash-out period. Patients were tested on four occasions, before and after each treatment limb, with each testing day consisting of the Epworth Sleepiness Scale, Stanford Sleepiness Scale, Maintenance of Wakefulness Test, Alpha Attenuation Test, and a 45-minute simulated driving task during which continuous self-appraisals of sleepiness/alertness were made. Treatment outcome (measured by self-reported sleepiness, physiological sleepiness, and simulated driving performance) did not differ significantly between the fixed versus self-adjusted CPAP limbs. The strongest predictors of simulated driving performance were the Maintenance of Wakefulness Test and the self-assessment of sleepiness/alertness while driving. However, there were no significant differences between the predictive ability of the self-report sleepiness measures and the objective sleepiness measures. The findings suggest that (1) self-titrated CPAP can produce treatment outcomes at least as good as those associated with traditional polysomnographic methods, (2) in patients with sleep apnea, simulated driving ability is predicted by both the Maintenance of Wakefulness Test and the self-assessment of sleepiness while driving.
機(jī)譯：使用兩個實(shí)驗(yàn)方案評估了自我報(bào)告的能力和客觀的嗜睡性指標(biāo)來預(yù)測約克駕駛模擬器的性能。第一項(xiàng)研究涉及18位至19歲的16位女性參與者的一整夜的長時(shí)間覺醒，他們在2300、0130、0400和0630小時(shí)進(jìn)行了測試。每個測試環(huán)節(jié)包括斯坦福嗜睡量表，多次睡眠潛伏期測驗(yàn)，持續(xù)清醒的重復(fù)測驗(yàn)，阿爾法衰減測試，四項(xiàng)選擇反應(yīng)時(shí)間測驗(yàn)以及一個30分鐘的模擬駕駛?cè)蝿?wù)，在此過程中，我們對嗜睡/警覺性進(jìn)行了持續(xù)的自我評估。制作。隨著覺醒時(shí)間的延長，參與者在每種困倦措施中都表現(xiàn)出嗜睡增加的跡象，并且在模擬駕駛性能方面逐漸受到損害?？陀^困倦測量組和自我報(bào)告困倦組是模擬駕駛能力的有效預(yù)測指標(biāo)（分別為R2 = 0.59和R2 = 0.52）。進(jìn)一步研究每個嗜睡指標(biāo)與模擬駕駛能力之間的關(guān)系表明，盡管“持續(xù)清醒的重復(fù)測試”通常是模擬駕駛能力的最高預(yù)測指標(biāo)，但其優(yōu)越性與自我報(bào)告的嗜睡衡量指標(biāo)（尤其是在線自我）相匹配。 -嗜睡/警覺性評估）和多次睡眠潛伏期測試。在預(yù)測駕駛能力受損時(shí)，嗜睡的自我意識似乎可以與生理睡眠趨勢的測量結(jié)果相提并論。第二項(xiàng)研究包括對18位年齡在28至78歲，被診斷為阻塞性睡眠呼吸暫停的患者進(jìn)行治療前/治療后設(shè)計(jì)。研究2與金斯敦綜合醫(yī)院睡眠障礙實(shí)驗(yàn)室的邁克爾·菲茨帕特里克（Michael Fitzpatrick）博士合作進(jìn)行，他對將患者接受實(shí)驗(yàn)室確定的固定壓力水平與自行調(diào)節(jié)的壓力水平進(jìn)行比較時(shí)的CPAP治療結(jié)果感興趣。使用隨機(jī)交叉設(shè)計(jì)，由兩個5周的治療肢體（固定的CPAP和自行調(diào)節(jié)的CPAP）組成，相隔1周的清除期。在每個治療肢體前后，對患者進(jìn)行了四次測試，每個測試日包括愛潑華嗜睡量表，斯坦福嗜睡量表，維持覺醒測試，阿爾法衰減測試和45分鐘的模擬駕駛?cè)蝿?wù)，在此過程中持續(xù)自我-進(jìn)行困倦/警覺性評估。固定和自行調(diào)整的CPAP肢體的治療結(jié)果（通過自我報(bào)告的嗜睡，生理性嗜睡和模擬駕駛表現(xiàn)來衡量）沒有顯著差異。模擬駕駛性能的最強(qiáng)預(yù)測指標(biāo)是維持清醒測試和駕駛時(shí)的嗜睡/警覺性自我評估。然而，自我報(bào)告困倦措施的預(yù)測能力與客觀困倦措施的預(yù)測能力之間沒有顯著差異。研究結(jié)果表明（1）自行調(diào)節(jié)的CPAP所產(chǎn)生的治療效果至少與傳統(tǒng)的多導(dǎo)睡眠監(jiān)測方法相近;（2）在睡眠呼吸暫?；颊咧?，通過維持清醒測試和保持睡眠狀態(tài)可預(yù)測模擬駕駛能力駕駛時(shí)對困倦的自我評估。

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