Performance and cardiovascular measures in normal adults with extreme MSLT scores and subjective sleepiness levels.

STUDY OBJECTIVES The purpose of this study was to determine the relationship of subjective and objective sleepiness across several nights. Extreme groups were chosen based upon both Multiple Sleep Latency Test (MSLT) findings and report of characteristic subjective sleepiness, and groups were compared across sleep, demographic, performance, and physiologic variables. DESIGN AND SETTING Subjects spent 3 baseline nights and the following days in the laboratory. Standard polysomnographic recordings were made on each night. On each day, subjects had an MSLT, performance testing, and metabolic and heart rate observation periods. PARTICIPANTS Participants were 50 adult normal sleepers. INTERVENTIONS None. MEASUREMENT AND RESULTS Those subjects with sleep latencies on the MSLT of more than 10 minutes following the adaptation night (Alert) were compared with 2 groups of subjects with sleep latencies on the MSLT of less than 7 minutes following the adaptation night. Subjects with MSLT < 7 were divided into those who reported subjective sleepiness during the day (subjective sleepiness > 1 SD above the mean for the entire group-Sleepy-Sleepy) and those who did not report subjective sleepiness (subjective sleepiness < 1 SD above the mean for the entire group--Sleepy-Alert). The Alert group maintained longer sleep latencies than the other groups and had improved performance on vigilance compared to the Sleepy-Sleepy group on all days and on some days compared to the Sleepy-Alert group. Vigilance was improved in the Sleepy-Alert group compared with the Sleepy-Sleepy group on all days. The Alert group had higher heart rate and increased low/high spectral heart rate power compared to both sleepy groups, and the Sleepy-Alert group had higher heart rate and increased low/high spectral heart rate power compared to the Sleepy-Sleepy group at some points. CONCLUSIONS It was concluded that normal adults with short MSLT latencies differ from those with longer latencies on both cardiac and performance variables. Also, those individuals with short latencies can be divided into subgroups claiming subjective sleepiness or denying sleepiness. Those denying sleepiness have improved vigilance performance and greater heart rate and low/high spectral heart rate power compared to those with subjective sleepiness. Both the MSLT group differences and the subjective group differences imply that ability to maintain wakefulness and performance in sedentary situations may be related to innate ability to maintain physiologic arousal.