Feigning daytime sleepiness: potential effects on the psychomotor vigilance test.
Feigning daytime sleepiness: potential effects on the psychomotor vigilance test.
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假装白天困倦：对精神运动警惕性测试的潜在影响。
DOI：
10.1093/sleep/zsad203
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发表时间：
2023
期刊：
影响因子：
5.6
通讯作者：
Trotti,LynnMarie
中科院分区：
文献类型：
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作者：
Mariano,Christianna;Moron,Danielle;Maness,Caroline;Olvera,Victoria;Saini,Prabhjyot;Rye,DavidB;Bliwise,DonaldL;Trotti,LynnMarie
白天过度嗜睡（EDS）是一个多方面的结构，可以通过各种自我报告问卷和客观测试来量化。验证患者对EDS的主观报告的常规方法涉及客观测量，诸如多次睡眠潜伏期测试（MPEST）或保持清醒测试（MWT）。虽然这些测试经常提供嗜睡的确证证据，但它们可能昂贵，耗时，难以执行，并且具有较差的重测可靠性[1，2]。此外，几乎所有旨在量化EDS的工具都有一个共同的局限性，即它们的有效性依赖于患者的认真合作。有动机缩短或延长其睡眠潜伏期的参与者可以通过MPEG4或MWT来缩短或延长睡眠潜伏期[3，4]。鉴于日间嗜睡客观评估的这些问题，心理警觉测试（PVT）[5]的临床应用出现了激增，这是一种相对简短的程序，在实验方案中得到了充分验证[6，7]。迄今为止的研究表明，PVT可用于描述嗜睡患者的认知功能受损[7-9]。具体而言，嗜睡患者在平均和中位反应时间、反应时间倒数（RRT）、至少500毫秒的失误以及最快和最慢10%反应的RRT方面的表现明显差于非嗜睡对照组[7]。此外，RRT随时间的斜率（即试验分钟RRT的线性回归斜率）显示嗜睡组的任务时间恶化显著高于对照组[7]。在这份简短的报告中，我们探讨了在何种程度上PVT的性能配置文件可能有助于区分嗜睡患者与正常受试者指示假装困倦。为了反映我们中心CDH患者临床人群的年龄分布，我们从社区招募了健康的年轻人（n= 16）作为对照。指导他们使用10分钟手持式PVT器械，并在测试前进行1分钟的实践演示。然后，他们被告知尝试使他们的PVT结果看起来好像他们很困，没有任何关于如何实现这一点的进一步说明。所有参与者均进行了PVT
Excessive daytime sleepiness (EDS) is a multi-faceted construct that can be quantified with a variety of self-report questionnaires and objective tests. The conventional approach to validate a patient’s subjective report of EDS involves an objective measure such as the Multiple Sleep Latency Test (MSLT) or Maintenance of Wakefulness Test (MWT). While these tests often provide corroborating evidence of sleepiness, they may be expensive, time-consuming, difficult to perform, and have poor test–retest reliability [1, 2]. Additionally, a shared limitation of nearly all tools that aim to quantify EDS is that their validity is reliant on earnest cooperation on the part of the patient. Participants motivated to shorten or lengthen their sleep latency on MSLT or MWT may be able to do so [3, 4].In view of these issues with objective assessment of daytime sleepiness, there has been an upsurge in the clinical application of the Psychomotor Vigilance Test (PVT)[5], a relatively brief procedure well-validated in experimental protocols [6, 7]. Studies to date suggest that PVT has utility in characterizing impaired cognitive performance in hypersomnolent patients [7–9]. Specifically, hypersomnolent patients perform significantly worse than nonsleepy controls on measures of mean and median reaction time, reciprocal of reaction time (RRT), lapses of at least 500 milliseconds, and RRT of the fastest and slowest 10% of responses [7]. Additionally, the slope of RRT over time (ie linear regression slope of RRT on trial minute) shows significantly more time-ontask worsening for the hypersomnolent group than for controls [7]. In this brief report, we explored to what extent a PVT performance profile might serve to differentiate hypersomnolent patients from normal subjects instructed to feign drowsiness. In order to mirror the age distribution of the clinical population of CDH patients presenting at our center, we recruited healthy young adults (n= 16) from the community to serve as controls. They were instructed on the use of the 10-minute, handheld PVT device, and performed a 1-minute practice demonstration prior to testing. They were then told to try to make their PVT results appear as though they were sleepy, without any further instructions on how to achieve this. All participants performed the PVT