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Psychomotor Vigilance Testing of Professional Drivers in the Occupational Health Clinic: A Potential Objective Screen for Daytime Sleepiness

Zhang, Chunbai MD, MPH; Varvarigou, Vasileia MD; Parks, Philip D. MD, MPH; Gautam, Shiva PhD; Bueno, Antonio Vela MD; Malhotra, Atul MD; Kales, Stefanos N. MD, MPH, FACOEM

Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e318223d3d6
Original Articles

Objective: Psychomotor vigilance testing (PVT) rapidly assesses attention, reaction time (RT), and abnormal vigilance. Thus, PVT may be an adjunct to screening drivers for high-risk obstructive sleep apnea (OSA)/excess daytime sleepiness (EDS).

Methods: Commercial drivers and emergency responders undergoing occupational examinations took a 10-minute PVT and were instructed to achieve their fastest possible RTs. Participants with maximum RT >5 seconds or ≥2 “super lapses” (RT ≥1000 ms) were categorized as “microsleepers.”

Results: Among 193 male participants, the 15 microsleepers (8%) were significantly more obese, but not different on age or Epworth Sleepiness Score. Time of day had no effect on RT.

Conclusion: PVT is suitable to occupational clinics and can identify otherwise unrecognized, impaired vigilance. Further studies must validate the PVT abnormalities most predictive of OSA/EDS and vehicular crashes, compared to adiposity measures alone.

Author Information

From the Division of Sleep Medicine, Department of Medicine (Drs Zhang and Malhotra), Brigham and Women's Hospital, Boston, Mass; Department of Environmental and Occupational Medicine & Epidemiology (Drs Zhang, Varvarigou, and Kales), Harvard School of Public Health, Boston, Mass; Department of Medicine (Drs Varvarigou, Parks, and Kales), Occupational Medicine, Cambridge Health Alliance, Cambridge; Beth Israel Deaconess Medical Center (Dr Gautam), Boston, Mass; and Universidad Autonoma (Dr Bueno), Madrid, Spain.

Address correspondence to: Stefanos N. Kales, MD, MPH, The Cambridge Health Alliance, Employee & Industrial Medicine, 1493 Cambridge Street, Macht Building, Suite 427, Cambridge, MA 02139; E-mail:;

Disclosure: The authors declare no conflict of interest.

©2012The American College of Occupational and Environmental Medicine