Abstract
ObjectiveTo assess drug induced driving impairment, initial screening is needed. However, no consensus has been reached about which initial screening tools have to be used. The present study aims to determine the ability of a battery of psychometric tests to detect performance impairing effects of clinically relevant levels of drowsiness as induced by one night of sleep deprivation.MethodsTwenty four healthy volunteers participated in a 2-period crossover study in which the highway driving test was conducted twice: once after normal sleep and once after one night of sleep deprivation. The psychometric tests were conducted on 4 occasions: once after normal sleep (at 11 am) and three times during a single night of sleep deprivation (at 1 am, 5 am, and 11 am).ResultsOn-the-road driving performance was significantly impaired after sleep deprivation, as measured by an increase in Standard Deviation of Lateral Position (SDLP) of 3.1 cm compared to performance after a normal night of sleep. At 5 am, performance in most psychometric tests showed significant impairment. As expected, largest effect sizes were found on performance in the Psychomotor Vigilance Test (PVT). Large effects sizes were also found in the Divided Attention Test (DAT), the Attention Network Test (ANT), and the test for Useful Field of View (UFOV) at 5 and 11 am during sleep deprivation. Effects of sleep deprivation on SDLP correlated significantly with performance changes in the PVT and the DAT, but not with performance changes in the UFOV.ConclusionFrom the psychometric tests used in this study, the PVT and DAT seem most promising for initial evaluation of drug impairment based on sensitivity and correlations with driving impairment. Further studies are needed to assess the sensitivity and validity of these psychometric tests after benchmark sedative drug use.
Highlights
Medicinal and illicit drugs can have detrimental side effects, such as sedation and reduced alertness, which can cause driving impairment possibly leading to traffic accidents (e.g. [1], [2], [3], [4], [5])
On-the-road driving performance was significantly impaired after sleep deprivation, as measured by an increase in Standard Deviation of Lateral Position (SDLP) of 3.1 cm compared to performance after a normal night of sleep
Largest effect sizes were found on performance in the Psychomotor Vigilance Test (PVT)
Summary
Medicinal and illicit drugs can have detrimental side effects, such as sedation and reduced alertness, which can cause driving impairment possibly leading to traffic accidents (e.g. [1], [2], [3], [4], [5]). Medicinal and illicit drugs can have detrimental side effects, such as sedation and reduced alertness, which can cause driving impairment possibly leading to traffic accidents Performance testing should be applied to provide meaningful precautions for users and prescribers regarding the impact of particular drugs on driving, either as part of the drug registration process Methodological guidelines for experimental studies assessing the effects of drugs on driving indicate that relatively simple laboratory tests can be used as a first step in screening a drug’s impairing potential as they often provide the earliest evidence of impairment on driving performance [8], and that more sophisticated procedures (e.g. driving simulators, on-the-road testing) should be included in a later stage [9], [10], [11], [12]. No consensus has been reached about which specific initial screening tools are best to be used [10], as the link between test outcomes and clinical relevance is often unclear
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