The validity of the pupillographic sleepiness test at shorter task durations
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The validity of the pupillographic sleepiness test at shorter task durations Jessica E. Manousakis 1
&
Jordan Maccora 1 & Clare Anderson 1
Accepted: 4 November 2020 # The Psychonomic Society, Inc. 2020
Abstract The pupillographic sleepiness test (PST) is an accurate predictor of alertness failure and performance impairment across sleep deprivation. At 11 min in duration, the task is considered too long to be used in occupational or roadside settings. We therefore investigated the predictive capacity of the PST at seven shortened test durations. Eighteen healthy young adults (aged 21.4 ± 3.2 years, 10 men) underwent 40 h of continuous wakefulness, completing an 11-min PST and a 10-min psychomotor vigilance task (PVT) every 2 h. Waking electroencephalography was recorded and scored for microsleeps during PVTs. The PST was divided into eight equal 82-s blocks and the predictive capacity of the pupillary unrest index (PUI) calculated at descending PST durations by systematically removing blocks. PUI increased significantly with time awake for all test durations (p < .0001), with a similar amplitude of PUI observed for test durations of 5.5 min and longer. While all test durations accurately predicted PVT impairment (AUC: 0.72–0.86, p < .001) and microsleep (AUC: 0.74–0.84, p < .0001), 5.5 min was the shortest duration where accuracy remained high across level and type of impairment (AUC: 0.79–0.86). For the 5.5-min duration, the positive predictive value (PPV) and negative predictive value (NPV) were on average 50.1% and 89.4%, respectively, and were comparable to the full 11min task (PPV: 49.2%; NPV: 91%). The PST can be shortened to 5.5 min without compromising accuracy in detecting performance impairment or physiological drowsiness. The PST is an ideal candidate for fitness-for-duty or fitness-to-drive testing, and future studies should examine its predictive capacity, at shorter durations, against operationally relevant outcomes. Keywords Pupillary instability . Fitness for duty . Alertness . Sustained attention . Vigilance . Drowsiness . Sleepiness . Fatigue
Introduction Drowsiness is a leading cause of motor vehicle crashes (MVCs), alongside alcohol intoxication and speeding (Australian Transport Council, 2011; Connor et al., 2002). Worldwide estimates suggest approximately 20% of serious MVCs are caused by drowsiness (Blanco, Biever, Gallagher, & Dingus, 2006; Connor et al., 2002), with insufficient sleep resulting in a two- to fifteen-fold increase in crash risk (Tefft, 2018). Occupations that require individuals to work shifts, particularly night shifts, are of major concern due to the synergistic impact of sleep loss and circadian misalignment on alertness (Anderson et al., 2012). Accordingly, shift workers are at a heightened risk of drowsiness-related MVCs
* Clare Anderson [email protected] 1
Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria 3800, Australia
(Crummy, Cameron, Swann, Kossmann, & Naughton, 2008; Lee et al., 2016
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