Medical Resident Driving Simulator Performance Following a Night on Call

Ware, J. Catesby; Risser, Matthew R.; Manser, Thomas; Karlson, Karl H.

doi:10.1207/s15402010bsm0401_1

Cited by 50 publications

(37 citation statements)

References 23 publications

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“…Also, SWS at baseline tended to correlate with lesser deterioration and better improvement in median reaction time in women only. These results are also consistent with previous findings that women appear more resilient to the sleep-disturbing effects of the blood drawing procedures (6) and suffer less performance decrements after a night of sleep loss (43). These potential gender differences should be explored further in future studies.…”

Section: Discussionsupporting

confidence: 92%

Effects of recovery sleep after one work week of mild sleep restriction on interleukin-6 and cortisol secretion and daytime sleepiness and performance

Pejovic

Basta

Vgontzas

et al. 2013

American Journal of Physiology-Endocrinology and Metabolism

143

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-One workweek of mild sleep restriction adversely impacts sleepiness, performance, and proinflammatory cytokines. Many individuals try to overcome these adverse effects by extending their sleep on weekends. To assess whether extended recovery sleep reverses the effects of mild sleep restriction on sleepiness/alertness, inflammation, and stress hormones, 30 healthy young men and women (mean age Ϯ SD, 24.7 Ϯ 3.5 yr; mean body mass index Ϯ SD, 23.6 Ϯ 2.4 kg/m 2 ) participated in a sleep laboratory experiment of 13 nights [4 baseline nights (8 h/night), followed by 6 sleep restriction nights (6 h/night) and 3 recovery nights (10 h/night)]. Twenty-four-hour profiles of circulating IL-6 and cortisol, objective and subjective daytime sleepiness (Multiple Sleep Latency Test and Stanford Sleepiness Scale), and performance (Psychomotor Vigilance Task) were assessed on days 4 (baseline), 10 (after 1 wk of sleep restriction), and 13 (after 2 nights of recovery sleep). Serial 24-h IL-6 plasma levels increased significantly during sleep restriction and returned to baseline after recovery sleep. Serial 24-h cortisol levels during restriction did not change compared with baseline, but after recovery they were significantly lower. Subjective and objective sleepiness increased significantly after restriction and returned to baseline after recovery. In contrast, performance deteriorated significantly after restriction and did not improve after recovery. Extended recovery sleep over the weekend reverses the impact of one work week of mild sleep restriction on daytime sleepiness, fatigue, and IL-6 levels, reduces cortisol levels, but does not correct performance deficits. The long-term effects of a repeated sleep restriction/sleep recovery weekly cycle in humans remain unknown. recovery sleep; sleep restriction; alertness; cortisol; Il-6 IN MODERN SOCIETIES, increasing work demands and lifestyle changes have resulted in adults sleeping considerably less than the seven hours per night considered to be the average sleep time necessary to sustain optimal daytime functioning (8, 23). Experimental studies in healthy young adults have consistently demonstrated that chronic sleep restriction results in a number of abnormal physiological changes, including increased inflammatory markers (15,22,39) and impaired blood glucose regulation (33), which may be the mechanisms through which chronic sleep curtailment may affect health and longevity. A recent U.S. National Sleep Foundation survey showed that about 25% of the population do not get enough sleep during the weekdays due to the work demands, whereas about 40% sleep longer during the weekend trying to "catch up" for the shorter weekdays' sleep duration (23). Although it is commonly believed that sleep loss accumulated during the week can be compensated for by extending sleep over the weekend, it is not known whether recovery sleep adequately reverses the adverse effects of sleep loss. Most studies on the effects of recovery sleep after short-term sleep restriction are focused on psychomotor...

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Section: Discussionsupporting

confidence: 92%

Effects of recovery sleep after one work week of mild sleep restriction on interleukin-6 and cortisol secretion and daytime sleepiness and performance

Pejovic

Basta

Vgontzas

et al. 2013

American Journal of Physiology-Endocrinology and Metabolism

143

View full text Add to dashboard Cite

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“…Similarly, problematic substance use is e ndorsed by a greater number of OIF/OEF veterans with P TSD compared with those without PTSD [40,50]. Given that insufficient sleep is known to im pair driving abil ity [51][52][53][54] and problematic drinking has been linked to even greater risk for collisions [55], it seems likely that both problems could also be contributing to the driving difficulties noted in our sample. Alth ough patients in the presen t study were not systematically evaluated for any type of sleep problems or substance abuse, future studies are needed to examine the impact of these conditions on driving safety in individuals with PTSD.…”

Section: Role Of Sleep Disturbance and Substance Abuse In Ptsd And Drmentioning

confidence: 74%

Prevalence and characteristics of driving difficulties in Operation Iraqi Freedom/Operation Enduring Freedom combat returnees

Lew¹,

Kraft²,

Pogoda³

et al. 2011

JRRD

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Abstract-We studied the prevalence and characteristics of selfreported driving difficulties and examined their association with traumatic brain injury (TBI) and/or posttraumatic stress disorder (PTSD) in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans who were seen at a Department of Veterans Affairs outpatient polytrauma clinic. In this study, we used a brief driving questionnaire and chart reviews to assess the prevalence and characteristics of driving difficulties in the following four groups of patients: TBI only, PTSD only, TBI + PTSD, and Neither (neither TBI nor PTSD). Compared with before deployment, 93% o f OIF/OEF veterans seen in the po lytrauma clinic reported more di fficulties with driving in at least one domai n, with the most common areas of d ifficulty being (1) problems with anger or impatience (82%), (2) general driving difficulties (65%), and (3) experiences with near misses (57%). Patients with PTSD (with or without TBI) reported the most significant driving impairments, whereas respondents with a history of only TBI endorsed driving difficulties similar to veterans without either diagnosis. Qualitative an alysis of veterans' co mments also revealed similar patterns. Self-reported driving problems were common among OIF/OEF returnees. Respondents who had a diagnosis of PTSD (with or without TBI) reported the most severe driving difficulties since returning from deployment. The association between PTSD and driving problems warrants further investigation.

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“…6,7 The software and hardware simulation setup used has been previously validated in numerous studies. 18,20,22,25,35 Specifically, automobile components of the driving simulator included brake and accelerator pedals connected to a brake cylinder and force transducer, an adjustable steering column, and an adjustable car seat. The pedal assembly is connected to an analog-to-digital converter that transmits positional information to the computer.…”

Section: Methodsmentioning

confidence: 99%

“…To our knowledge, there is no well-defined, validated model with measurable end points that can truly evaluate upper extremity function in the context of driving performance. However, our position has been that through the use of a validated driving simulator, which has been used in a variety of studies both in the medical and in the orthopedic literature, 6,7,18,20,22,25,35 we have been able to create a customized driving circuit that directly tests upper extremity function in the context of driving by minimizing confounding variables such as variability in speed and braking, particularly in worst-case scenario situations that require coordinated evasive maneuvering.…”

Section: Collisionsmentioning

confidence: 99%