Applying maintenance of wakefulness test to medical evaluation of the flying personnel with obstructive sleep apnea
10.3760/cma.j.issn.1007-6239.2017.04.004
- VernacularTitle:清醒维持试验在飞行人员阻塞性睡眠呼吸暂停医学鉴定中的应用
- Author:
Li CUI
1
;
He GAO
1
;
Jun ZHENG
1
;
Xianrong XU
1
;
Jingjing GUO
1
;
Yan LI
1
;
Jianchang WANG
1
Author Information
1. 空军总医院,北京,100142
- Publication Type:Journal Article
- Keywords:
Sleep apnea,obstructive;
Eligibility determination;
Maintenance of wakefulness test;
Flying personnel
- From:
Chinese Journal of Aerospace Medicine
2017;28(4):260-265
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the possibility of using maintenance of wakefulness test (MWT) as an objective tool in waiver certification for the flying personnel suffering from obstructive sleep apnea (OSA).Methods Epworth sleepiness scale (ESS) was performed in 18 male flying personnel with OSA diagnosed by polysomnography (PSG).Then they were monitored by PSG for one night.The severity of OSA was defined by apnea hypopnea index (AHI) as:mild AHI (5-15 events/h),moderate AHI (≥15 events/h and ≤30 events/h) and severe AHI (＞30 events/h).The 40-min maintenance of wakefulness test (MWT) was conducted for 4 times next day.The flying personnel were grouped by the medical evaluation results as medical waiver group and temporarily/permanently grounded group.ESS score,PSG data and MWT results of flying personnel were compared between different groups.The relationships between MWT mean sleep latency and ESS score,PSG data were also analyzed.Results ①In 18 flying personnel,5 were with mild AHI,5 were with moderate and 8 were with severe.② Medical waiver group had 8 flying personnel while temporarily/permanently grounded group had 10.ESS score,AHI,arousal index and breathing events related arousal index of temporarily/permanently grounded group were significantly higher than those of medical waiver group (t =2.308-3.779,P＜0.05).③Mean sleep latency in MWT showed negative correlation to ESS score,AHI,apnea hypopnea index of rapid eye movement sleep,apnea hypopnea index of non-rapid eye movement sleep,supine apnea hypopnea index,arousal index and breathing events related arousal index (r =-0.635-0.481,P ＜ 0.05).④ The mean sleep latency in MWT of medical waiver group [(10.62 ± 3.91) min] was significantly shorter than that of temporarily/permanently grounded group [(37.80±6.22) min] (t =11.333,P＜0.05).Conclusions MWT is applicable as an objective and reliable tool to evaluate alertness of the flying personnel with OSA.Further studies on finding the correlation between abnormal MWT results and flight operational capacity are still needed for obtaining higher safety reliability.
