**3.2 Vigilance test** *Carda* **(Fig. 5)**

130 Sleep Disorders

Consequence of this reduced performance include an increased risk of accidents at work and in traffic and thus a higher socio-medical risk (e.g. Bradley et al. 1985, Podszus et al. In 1986, He et al. 1988, Mitler et al. 1988, Lamphere et al. 1989, Roehrs et al. 1989, Bédard et al. 1991, Kribbs et al. 1993a/b, Gerdesmeyer et al. 1997, Randerath et al. 1997, 1998, Weeß 1997,

To explore the difficult relationship between sleep, daytime fatigue and physical and mental performance is based mainly on three conditions (Johnson 1982, Weeß 1997, Weeß et al. 1998a/b). Thus, the three mentioned above parameters will be affecting through a variety of other variables, for example by the motivation of the healthy subjects or patients, or the daily and weekly rhythm. Furthermore, daytime fatigue and performance as well as their underlying attention-related processes are complex constructs. This analysis will be complicated also by the lack of standard term uses in the medical and psychological

There are, both in the medical and especially in sleep medicine research, a number of different research approaches and definitions regarding the attention and attention-driven processes (Rützel 1977, Rapp 1982, Brickenkamp & Karl 1986, Posner & Rafal, 1987, Säring 1988, Posner & Petersen, 1990, Posner 1995), which accentuate different characteristics and aspects of the daytime performance (James 1890, Head 1926, Mackworth JF 1956, Mackworth N 1958, Schmidtke 1965, Norman 1973, Bäumler 1974, Harnatt 1975, Rützel 1977, Brickenkamp & Karl 1986, Posner & Rafal, 1987, Säring 1988, Posner & Petersen, 1990,

Currently, in the sleep medicine literature, mainly the concept of Posner and Rafal (1987)

Also problematic are the very diverse conducted empirical analysis of attention and its components and the varying quality of the validation test procedures and instruments. Thus, inter alia vigilance covered by inappropriate (Stephan et al. 1991), too complex (Bédard et al. 1993) or timely too short (Bédard et al. 1991, 1993) test requirements (Weeß

To capture the tendency to fall asleep in Obstructive Sleep Apnea is conducted usually by the MSLT (Multiple Sleep Latency Test) (Poceta et al. 1992), because it correlated most strongly with the subjective state/mood of OSAS. However, through it the attention and

For this purpose researched Denzel et al. (1993) for more suitable methods and examined in this context, two computerized neuropsychological test procedures, a vigilance and a attention test, in which the attention test was checked under three experimental conditions (visual, auditory, combined). In both the dual-task-task as well as the vigilance testing was

Similar results – i.e. a significant improvement of vigilance under nCPAP – were found already by Kesper-Schwarzenberger et al. (1991), Cassel et al. (1991) and George et al. (1997;

As important criteria was found the standardization of experimental conditions (Horn et al. 1983, Denzel et al. 1993) and the design of the experimental setup (the author). Thus showed, inter alia, that an immediate auditory feedback about the correctness improved the occurred reactions improved the motivation of the patients, thereby obscuring the effects of sleep deprivation and their resulting poor performance (Wilkinson 1961, Steyvers &

found significant differences before and after nCPAP therapy (Denzel et al. 1993).

Weeß et al. 1998a/b, Büttner et al. 2000a/b, Büttner 2001).

literature (Johnson 1982, Weeß 1997, Weeß et al. 1998a/b).

will be used (Keller et al. 1993, Weeß 1997, Weeß et al. 1998a/b).

vigilance will be detected only indirectly (Denzel et al. 1993).

Gaillard 1993, Weeß 1997, Weeß et al. 1998a/b).

Rollet 1993, Schmöttke & Wiedl 1993).

1997, Weeß et al. 1998a/b).

*DADT*)

The Ambrock vigilance test "Carda" by Randerath et al. (1997) recorded the vigilance performance over a period of 30 minutes. The patient sits in a semi-darkened room in front of a black computer screen and look at the picture of a street with a running road median and the lateral lane boundaries. They are asked to respond within one second of a with a computer keyboard button on stimuli (white flashing rectangles), which occur in time and space for 20 ms randomly. In each 10-minute interval 100 stimuli appearing, in the total period 300 will be shown. After a brief instruction and a short practice the test is started via a menu driven DOS computer program.

Fig. 5. Driving Simulator *Carda* by Gerdesmeyer et al. 1997, Randerath et al. 1997, 1998
