On-the-road driving performance of patients with central disorders of hypersomnolence

Nick van der Sluiszen, Bram Urbanus, Gert Jan Lammers, Sebastiaan Overeem, J.G. Ramaekers, Annemiek Vermeeren*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)

Abstract

Introduction
Excessive Daytime Sleepiness is a core symptom of narcolepsy and idiopathic hypersomnia, which impairs driving performance. Adequate treatment improves daytime alertness, but it is unclear whether driving performance completely normalizes. This study compares driving performance of patients with narcolepsy and idiopathic hypersomnia receiving treatment to that of healthy controls.

Methods
Patients diagnosed with narcolepsy type 1 (NT1, n = 33), narcolepsy type 2 (NT2, n = 7), or idiopathic hypersomnia (IH, n = 6) performed a standardized one-hour on-the-road driving test, measuring standard deviation of lateral position (SDLP).

Results
Results showed that mean SDLP in patients did not differ significantly from controls, but the 95%CI of the mean difference (+1.02 cm) was wide (-0.72 to +2.76 cm). Analysis of subgroups, however, showed that mean SDLP in NT1 patients was significantly increased by 1.90 cm as compared to controls, indicating impairment. Moreover, four NT1 patients requested to stop the test prematurely due to self-reported somnolence, and two NT1 patients were stopped by the driving instructor for similar complaints.

Conclusion
Driving performance of NT1 patients may still be impaired, despite receiving treatment. No conclusions can be drawn for NT2 and IH patients due to the low sample sizes of these subgroups. In clinical practice, determination of fitness to drive for these patients should be based on an individual assessment in which also coping strategies are taken into account.
Original languageEnglish
Pages (from-to)120-126
Number of pages7
JournalTraffic Injury Prevention
Volume22
Issue number2
Early online date19 Dec 2020
DOIs
Publication statusPublished - 17 Feb 2021

Keywords

  • Daytime sleepiness
  • vehicle control
  • vigilance
  • real-world driving
  • pharmacological treatment
  • standard deviation of lateral position

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