Assessment of driving impairment due to excessive daytime sleepiness using psychophysiologic and performance variables in a simulation paradigm

Excessive daytime sleepiness can be a serious and life-threatening cause of driving impairment. Medical professionals are frequently placed in the difficult role of making objective assessments of driving safety in their patients, with decisions carrying significant medicolegal weight. Yet, assessment of driving competency also relates to a patient's own perception of wellbeing and sensorimotor functioning, cognitive functioning and level of insight into deficits.; The focus of this thesis concerns a synthesis of convergent behavioural data derived from subjective reports, neurophysiologic recording and a number of performance variables collected via a computerized simulation assessment device in real-time during a standardized driving task. The methodological intent of this research has been to develop a diagnostic paradigm in an analogous fashion to previously established daytime tests of pathological somnolence with potentially greater sensitivity, specificity and ecological validity.; Factors impacting on results are discussed, ranging from psychological, circadian, neurological and cybernetic research perspectives.