A Test for the Determination of Sustained Attention in Patients with Obstructive Sleep Apnea Syndrome

Abstract

Background and Objectives: To investigate the parameter daytime sleepiness in patients with the sleep apnea syndrome (SAS), a test for measurement of sustained attention was developed. The present studies were performed on volunteers undergoing preemployment medical examinations and SAS patients to determine the extent to which test results are in agreement with the symptoms of SAS and traffic accident reports, and also with daytime sleepiness, and whether learning or therapeutic effects can be seen with repeated tests prior to and following treatment with nasal continuous positive airway pressure (nCPAP). Methods: Participants: 125 healthy volunteers, and two groups of 28 SAS patients each. Design: Study A: The volunteers underwent a single attention test and completed a questionnaire concerned with traffic accidents and symptoms of sleep-related breathing disorders. Study B: SAS patients underwent two attention tests before treatment. Study C: SAS patients underwent one attention test before and one after nCPAP therapy. Results: Study A: The error rate in volunteers without symptoms of sleep-related breathing disorders (51 persons) was 4.7 ± 4.3% (number of errors 14.1 ± 12.9), 95% CI: 1.2 (number of errors 3.6). No dependence of the error rate on age, BMI or sex was found. In persons with a history of apneic events (n = 10), the error rate was 10.6 ± 10.0% (number of errors 31.8 ± 30), in those with more than two accidents during the last 5 years (n = 4), it was increased to 15.3 ± 9.7% (number of errors 45.9 ± 29.1). Study B: Among SAS patients, no significant learning effect was seen, and prolongation of the test duration beyond 30 min had no effect on the test results. Study C: The error rate improved significantly with nCPAP [10.6 ± 13.5 vs. 6.4 ± 8.9% (number of errors 31.8 ± 40.5 vs. 19.2 ± 26.7), p < 0.001]. Conclusions: The attention test can be helpful for the measurement of daytime sleepiness, and CPAP therapy can improve test performance.

Psychotherapy Improves Compliance with Tuberculosis Treatment

“…Psychological factors have been known to be important in various phases of respiratory illnesses including the stage of treatment[ 13, 14]. In this study, we examined the psychological factors in improving compliance among TB patients.…”

Drowsiness/alertness algorithm development and validation using synchronized EEG and cognitive performance to individualize a generalized model

“…The 3CVT developed by ABM incorporates features of the most common measures of sustained attention, such as the Continuous Performance Test (Weinstein, Silverstein et al 1999; Randerath, Gerdesmeyer et al 2000), Wilkinson Reaction Time (Wilkinson and Houghton 1982; Wilkinson 1990; Valencia-Flores, Bliwise et al 1996), and the PVT-192 (Dinges and Kribbs 1991; Dinges, Pack et al 1997), and it is designed to allow simultaneous monitoring and quantification of the EEG. These tasks are sensitive to changes in alertness as a result of acute sleep deprivation, cumulative sleep loss (Dinges, Pack et al 1997), daytime drowsiness in untreated sleep apnea in clinical populations (Dinges and Weaver 2003), and commercial truck drivers (Baulk, Biggs et al 2008).…”

Erfassung von Aufmerksamkeitsdefiziten bei Patienten mit obstruktivem Schlafapnoesyndrom mit unterschiedlichen Fahrsimulationsprogrammen

“…Bei diesem Daueraufmerksamkeitstest sind die Bedingungen eines eintönigen Reizhintergrundes sowohl zeitlich und örtlich nicht voraussagbarer Ereignisse integriert ( [24,39,40]; Abb. 1).…”

“…die Spurüberschrei-tung keine relevante Abhängigkeit zeigten. Allerdings wurde bei ausprägter Schläfrigkeit von OSAS-Patienten mit einem ESSScore > 13 mit Carda eine höhere Fehlerzahl erreicht[40].Unter der Testung mit Carsim lag die Anzahl der Patienten, die eine sichere pathologische Abweichung aufwiesen deutlich höher.Die komplexere Aufgabe der interaktiven Fahrsimulation erfasst Patienten mit eingeschränkter Leistungsfähigkeit bezüglich geteilter Aufmerksamkeit und interaktivem Handeln. Dies konnte an Personen, deren Fahrleistung nach Alkoholgabe mit einem Fahrsimulator überprüft wurde, nachgewiesen werden.…”