Comparison of driving simulator performance and neuropsychological testing in Narcolepsy

Kotterba, Sylvia; Mueller, Nicole; Leidag, M.; Widdig, W.; Rasche, Kurt; Malin, J.‐P.; Schultze‐Werninghaus, G.; Orth, M.

doi:10.1016/j.clineuro.2003.12.003

Cited by 49 publications

(38 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…may be exacerbated by fear of accidents, concerns about their employment, and functional limitations such as difficulty obtaining driving licensure. 5,[34][35][36][37][38][39] It seems likely that in patients with a diagnosis of narcolepsy, psychiatric conditions develop at least partly in response to, or as a comorbid component of, the condition and, as a result, these patients are not fully functional at work and have reduced quality of life. Moreover, they seek medical help from general and specialist physicians, and are admitted to inpatient and outpatient services in response to their condition and its comorbidities.…”

Section: Discussionmentioning

confidence: 99%

The Humanistic and Economic Burden of Narcolepsy

Flores

Villa

Black

et al. 2016

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

Study Objectives: To evaluate the burden of narcolepsy--with respect to psychiatric comorbidities, Health-Related Quality of Life (HRQoL), direct costs for healthcare resource utilization, and indirect costs for reported work loss-through comparison of patients to matched controls. Methods: This analysis was conducted on data from the NHWS n = 75,000, 2012 NHWS n = 71,157, and 2013. Patients who reported a narcolepsy diagnosis (n = 437) were matched 1:2 with controls (n = 874) on age, sex, race/ethnicity, marital status, education, household income, body mass index, smoking status, alcohol use, exercise, and physical comorbidity. Chi-square tests and one-way analyses of variance were used to assess whether the narcolepsy and control groups differed on psychiatric comorbidities, HRQoL, labor force participation, work productivity, and healthcare resource utilization. Results: Patients with narcolepsy, in comparison to matched controls, reported substantially (two to four times) greater psychiatric comorbidity, HRQoL impairment, prevalence of long-term disability, absenteeism, and presenteeism, and greater resource use in the past 6 mo as indicated by higher mean number of hospitalizations, emergency department visits, traditional healthcare professional visits, neurologist visits, and psychiatrist visits (each p < 0.05). Conclusions: These population-based data suggest that a narcolepsy diagnosis is associated with substantial adverse impact on mental health, HRQoL, and key economic burdens that include work impairment, resource use, and both direct and indirect costs. Although this study is cross-sectional, the results highlight the magnitude of the potential opportunity to improve mental health, lower costs, and augment work-related productivity through effective assessment and treatment of narcolepsy. I NTRO DUCTI O NNarcolepsy is a chronic disorder characterized by excessive daytime sleepiness that can be associated with significant effect on quality of life and disability. Narcolepsy is also associated with obesity, nighttime sleep disturbances, and functional impairment.1,2 Narcolepsy typically presents during teenage years or young adulthood and persists through adulthood. Prevalence estimates range between 25 and 50 per 100,000 people. 3,4 Numerous studies have found health-related quality of life (HRQoL) among narcolepsy patients to be significantly impaired in comparison with healthy controls or the general population. [5][6][7][8][9][10][11][12][13][14] Patients are impaired on several domains of HRQoL including mood, psychopathology, and other areas such as marital and work problems.5-14 Narcolepsy has been associated with a negative impact on work productivity including increased unemployment, 15

show abstract

Section: Discussionmentioning

confidence: 99%

The Humanistic and Economic Burden of Narcolepsy

Flores

Villa

Black

et al. 2016

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

show abstract

“…According to the above-mentioned problems of choosing the adequate off-road test, patients were investigated with a driving simulator, which has been used for driving evaluation in other diseases in our hospital [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Driving after cerebral ischemia – a driving simulator investigation

Kotterba

Widdig

Brylak

et al. 2005

Wien Med Wochenschr

Self Cite

View full text Add to dashboard Cite

All patients had only mild deficits and stated themselves able to drive. We could demonstrate the need to focus on driving skills especially in patients with MCA-infarctions. The driving simulator assesses various physical and neuropsychological functions influencing driving. It may especially be used for expert opinions regarding driving licence. It can also serve as a pre-driver evaluation before on road driving tests.

show abstract

“…31 [Level 3] In a recent driver simulator study, the reaction time was the only correlation with accident rate. 32 [Level 3] Naps have often been recommended in the management of excessive daytime sleepiness (EDS) associated with narcolepsy-cataplexy. This simple behavioral management strategy has proven to increase daytime functioning in narcoleptic patients.…”

Section: Supporting Evidence and Rationalementioning

confidence: 99%

Quality Measures for the Care of Patients with Narcolepsy

Krahn

Hershner

Loeding

et al. 2015

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

The American Academy of Sleep Medicine (AASM) commissioned a Workgroup to develop quality measures for the care of patients with narcolepsy. Following a comprehensive literature search, 306 publications were found addressing quality care or measures. Strength of association was graded between proposed process measures and desired outcomes. Following the AASM process for quality measure development, we identifi ed three outcomes (including one outcome measure) and seven process measures. The fi rst desired outcome was to reduce excessive daytime sleepiness by employing two process measures: quantifying sleepiness and initiating treatment. The second outcome was to improve the accuracy of diagnosis by employing the two process measures: completing both a comprehensive sleep history and an objective sleep assessment. The third outcome was to reduce adverse events through three steps: ensuring treatment follow-up, documenting medical comorbidities, and documenting safety measures counseling. All narcolepsy measures described in this report were developed by the Narcolepsy Quality Measures Workgroup and approved by the AASM Quality Measures Task Force and the AASM Board of Directors. The AASM recommends the use of these measures as part of quality improvement programs that will enhance the ability to improve care for patients with narcolepsy. N arcolepsy is one of the most intriguing causes of excessive daytime sleepiness. Narcolepsy (with cataplexy) affects approximately 25-50 per 100,000 people in the US. 1 The prevalence of narcolepsy without cataplexy is higher still, yet the disorder remains under-recognized and under-diagnosed. Presently, narcolepsy treatment varies due to a heterogeneous presentation of symptoms and severity of disease among patients. Although narcolepsy is uncommon compared to other sleep disorders, the American Academy of Sleep Medicine (AASM) included it in the quality measure process because it is a disorder that generally results in signifi cant daily dysfunction when not appropriately treated. The quality measures described in this position paper include children and adolescents in the targeted patient population, as 40% to 50% of adult patients report onset of symptoms before age 15 years. 2,3 However, the Workgroup notes limitations in diagnostic testing and lack of level 1 evidence-based treatment studies in the pediatric population. Because of the paucity of clinical trials and FDA-approved treatments for narcolepsy for both pediatric and adult patients, the Workgroup believed that it was imperative to include off-label options in treatment plans.The International Classifi cation of Sleep Disorders, Third Edition (ICSD-3) was used as the narcolepsy diagnostic reference. The ICSD-3 subdivides narcolepsy into type 1 and 2, with type 1 characterized by excessive daytime sleepiness, hypocretin defi ciency syndrome, and signs of REM-sleep dissociation (e.g., cataplexy, hypnagogic and hypnopompic hallucinations, sleep paralysis) and type 2 characterized by excessive daytime sleepiness and ...

show abstract

Comparison of driving simulator performance and neuropsychological testing in Narcolepsy

Cited by 49 publications

References 18 publications

The Humanistic and Economic Burden of Narcolepsy

The Humanistic and Economic Burden of Narcolepsy

Driving after cerebral ischemia – a driving simulator investigation

Quality Measures for the Care of Patients with Narcolepsy

Contact Info

Product

Resources

About