Psychomotor vigilance test and its association with daytime sleepiness and inflammation in sleep apnea: Clinical implications

Yun Li, Alexandros Vgontzas, Ilia Kritikou, Julio Fernandez-Mendoza, Maria Basta, Slobodanka Pejovic, Jordan Gaines, Edward O. Bixler

Research output: Contribution to journalArticlepeer-review

42 Scopus citations


Study Objectives: Excessive daytime sleepiness (EDS) is a key symptom of obstructive sleep apnea (OSA). The Psychomotor Vigilance Task (PVT) has been suggested as an objective easy-to-use, inexpensive alternative to the Multiple Sleep Latency Test (MSLT) to measure EDS. In patients with OSA, physiological sleepiness, but not subjective EDS (Epworth Sleepiness Scale [ESS]), has been associated with increased levels of the sleep- inducing proinflammatory cytokine interleukin-6 (IL-6). The goal of this study was to assess the association of PVT with objectively measured sleepiness (MSLT) and subjectively measured sleepiness (ESS) and IL-6 levels in patients with OSA. Methods: We studied 58 untreated patients with OSA who underwent an 8-hour in-laboratory polysomnography for 4 consecutive nights. MSLT, PVT, and 24-hour serial profiles of IL-6 were assessed on the fourth day. PVT variables included number of lapses, mean reciprocal of the fastest 10% and slowest 10% reaction times, and median of 1/reaction time. ESS was assessed on day 1 of the study. Results: Higher ESS scores were significantly associated with greater number of lapses (β = .34, P = .02) and lower values of 1/RT (β = −.36, P = .01) and slowest 10% RTs (β = −.30, P = .04). No significant association was observed between PVT and MSLT, nor PVT and IL-6 levels. Conclusions: Our findings suggest that PVT is associated with subjectively assessed daytime sleepiness, but not with physiological sleepiness nor IL-6 levels in patients with OSA. It appears that ESS and PVT may be useful in predicting risks associated with impaired performance, such as traffic accidents, in patients with OSA.

Original languageEnglish (US)
Pages (from-to)1049-1056
Number of pages8
JournalJournal of Clinical Sleep Medicine
Issue number9
StatePublished - 2017

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology


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