Blink duration as an indicator of driver sleepiness in professional bus drivers.

This study focused on eyeblink duration as a measure of sleepiness in on-road driving and on the driving performance of professional bus drivers with polysomnographically confirmed mild obstructive Sleep Apnea Syndrome (OSAS). Ten bus drivers with OSAS and their matched controls participated in the study. The Maintenance of Wakefulness Test (MWT) and a monotonous on-road driving task were completed. Eyeblink duration and frequency and speed control were measured while driving. Lane-keeping was evaluated by the supervisor in the car. Subsequent to these tasks, drivers with OSAS received continuous positive airway pressure treatment (nasal CPAP). After nine weeks of treatment, the tasks were repeated. Prior to treatment the average blink duration in the driving task was significantly longer and sleep latency in the MWT was significantly shorter for bus drivers with OSAS than for controls (mean blink duration 82.3 ms; 51.9 ms and mean sleep latency 23.2 min; 35.4 min), indicating increased daytime sleepiness. Subsequent to treatment both measures in drivers with OSAS decreased to the level of the controls. Treatment effects in MWT and blink duration in on-road driving also correlated significantly. No significant differences between the groups appeared in average blink frequency or driving performance in terms of maintenance of speed. No significant lane drifting appeared either. These results support earlier findings on blink duration as an indicator of increased sleepiness and have important implications for those involved in the transport technological industry. The findings also suggest that nasal CPAP treatment is effective in reducing excessive daytime sleepiness.