[Accidents caused by sleepiness--prediction by neurophysiologic/psychologic testing and simulated driving studies]

Vigilance monitoring – review and practical aspects

Vigilance monitoring is increasingly important in the industrialised world because working tasks are becoming increasingly monotonous and less physically exhausting, resulting in a high risk of falling asleep unintentionally. Among existing tests for the assessment of vigilance, objectiveness plays the most important role in preventing volitional influence by the test subject. In addition, the tests should be simple so that a monotonous situation will emerge. This review gives an overview of important vigilance monitoring systems that are currently in use for research purposes and industrial application. The tests presented are the Mackworth clock test, the VIGIMAR, the Karolinska drowsiness test, tests based on blood pressure and heart rate changes, the psychomotor vigilance test, and experimental tests relying on pupillography and electrodermal activity.

Begutachtung der Tagesschläfrigkeit bei neurologischen Erkrankungen und dem obstruktiven Schlafapnoesyndrom (OSAS)

Patients with increased daytime sleepiness are impaired in all areas of their social environment. Expert opinions are recommended for pension proceedings, regarding driving licenses as well as for restrictions at the workplace. All possibilities should be considered in the differential diagnosis of sleep disorders, which have to be treated before an expert opinion is submitted. Statutory regulations on evaluation of sleepiness are contained in the guidelines for assessing a patient's fitness to drive. The importance of daytime sleepiness in other occupations should be assessed according to the respective workplace. The patient should be informed of the appraisal with regard to career choice and workplace design. The expert thus has the responsible task of carrying out interdisciplinary differential diagnosis of pathological sleepiness and monitoring treatment success with appropriate test methods. In the present paper the legal guidelines in Germany and available test methods are presented.