Erfassung von Aufmerksamkeitsdefiziten bei Patienten mit obstruktivem Schlafapnoesyndrom mit unterschiedlichen Fahrsimulationsprogrammen

Abstract

Patients with obstructive sleep apnea syndrome suffer from reduced continuous attention due to neuropsychological deficits. Among other means, driving simulator programs are employed for registration and objectification as well as observation of the course of therapy. While Steer Clear by Findley et al. and the driving simulator Carda (Randerath et al.) represent pure continuous attention tests, the new driving simulator test Carsim, measures attention interactively and continuously. This way, more complex functions are recorded. We therefore investigated Carda and the program Carsim to study the various features of both methods. For this purpose, 105 OSAS patients were tested on both driving simulators concerning the mistake rate in Carda and the time of tracking deviations in Carsim. We defined the normal range by using the mean value +/- 2 standard deviations from our earlier publications in healthy persons without sleep disorders. With Carda the mistake rate exceeded in 10 of 105 patients (9.5%) the normal range and with Carsim the frequency of tracking deviations exceeded in 49 of 105 patients (46.7%) the normal range. The incidence of deviation from normal was significantly higher with Carsim testing. By additionally testing the number of pathological cases is with Carda increased from 46.7% to 51.4%. The tests characterize different components of neuropsychological deficits. Driving simulators with tracking tasks describe neuropsychological deficits in comparison with those measuring only components of reaction in a higher percentage.

The Effects of Sleep-Related Breathing Disorders on Waking Performance

“…1-5% of the population is affected by it (men are about ten times more affected than women). In particular, patients with OSAS suffer in addition to their symptoms often also on a multitude of sequelae, including excessive daytime sleepiness (Büttner et al 2004e), vigilance decrease (Büttner et al 2003b(Büttner et al , 2004c) and memory disorders (Büttner et al 2003c/d). These performance restrictions or impairments affect the affected subjects, both professionally and in their ability to drive motor vehicles (Findley et al 1988a/b, 1989b, 1995, Mitler et al In 1988, Cassel et al 1991a/b, 1993, 1996, ATS 1994, Gerdesmeyer et al 1997, Krieger et al 1997, Randerath et al 1997, 1998, Weeß 1997, Weeß et al 1998a/b, Büttner et al 2000a/b, Büttner 2001).…”