Psychomotor Vigilance Test and Its Association With Daytime Sleepiness and Inflammation in Sleep Apnea: Clinical Implications

J Clin Sleep Med. 2017 Sep 15;13(9):1049-1056. doi: 10.5664/jcsm.6720.

Abstract

Study objectives: Excessive daytime sleepiness (EDS) is a key symptom of obstructive sleep apnea (OSA). The Psychomotor Vigilance Task (PVT) has been suggested as an objective easy-to-use, inexpensive alternative to the Multiple Sleep Latency Test (MSLT) to measure EDS. In patients with OSA, physiological sleepiness, but not subjective EDS (Epworth Sleepiness Scale [ESS]), has been associated with increased levels of the sleep- inducing proinflammatory cytokine interleukin-6 (IL-6). The goal of this study was to assess the association of PVT with objectively measured sleepiness (MSLT) and subjectively measured sleepiness (ESS) and IL-6 levels in patients with OSA.

Methods: We studied 58 untreated patients with OSA who underwent an 8-hour in-laboratory polysomnography for 4 consecutive nights. MSLT, PVT, and 24-hour serial profiles of IL-6 were assessed on the fourth day. PVT variables included number of lapses, mean reciprocal of the fastest 10% and slowest 10% reaction times, and median of 1/reaction time. ESS was assessed on day 1 of the study.

Results: Higher ESS scores were significantly associated with greater number of lapses (β = .34, P = .02) and lower values of 1/RT (β = -.36, P = .01) and slowest 10% RTs (β = -.30, P = .04). No significant association was observed between PVT and MSLT, nor PVT and IL-6 levels.

Conclusions: Our findings suggest that PVT is associated with subjectively assessed daytime sleepiness, but not with physiological sleepiness nor IL-6 levels in patients with OSA. It appears that ESS and PVT may be useful in predicting risks associated with impaired performance, such as traffic accidents, in patients with OSA.

Keywords: Psychomotor Vigilance Task; daytime sleepiness; objective daytime sleepiness; sleep apnea; subjective daytime sleepiness.

MeSH terms

  • Comorbidity
  • Disorders of Excessive Somnolence / epidemiology*
  • Disorders of Excessive Somnolence / physiopathology*
  • Female
  • Humans
  • Inflammation / epidemiology*
  • Inflammation / physiopathology
  • Male
  • Middle Aged
  • Pennsylvania / epidemiology
  • Psychomotor Performance / physiology*
  • Reaction Time / physiology
  • Sleep Apnea Syndromes / epidemiology*
  • Sleep Apnea Syndromes / physiopathology*