
DATE: Thursday, September 25, 1997          TAG: 9709250329

SECTION: LOCAL                   PAGE: B1   EDITION: FINAL 
SOURCE: BY MARIE JOYCE, STAFF WRITER 
DATELINE: NORFOLK                           LENGTH:  154 lines

A WAKE-UP TEST SIMULATOR GIVES RESEARCHERS CLUES ON WHY SOME FALL ASLEEP AT THE WHEEL.

In a darkened closet, Joseph Hunnicutt sits in a blue bucket seat, gripping a steering wheel salvaged from a junkyard. A computer screen in front of him makes it appear as if he's cruising the slow, winding curves of a cartoon highway, triangle trees passing on his right and left. A small speaker provides the soothing purr of a well-tuned engine.

Hunnicutt has come to Sentara Norfolk General Hospital's Sleep Disorders Center, a joint project with Eastern Virginia Medical School, to prove a point: He can stay awake behind the wheel.

This is a personal issue for Hunnicutt, who wants to be a truck driver but fears he won't get a job because he has been treated for a sleep disorder.

Wakefulness at the wheel is also becoming a social issue, as government regulators and transport companies grow increasingly concerned about the safety problem caused by sleepy drivers.

With the new computer driving simulator, the Sleep Disorders Center staff hopes to be part of the solution. The simulator has two purposes: providing information for studies of how, why and when people fall asleep behind the wheel; and capturing a growing market by testing would-be professional drivers and pilots.

The landscape looks more like a cartoon than a video image of a real road. But studies comparing this type of set-up with more expensive and realistic arrangements have shown it's just as effective in testing drivers, said Dr. Virgil D. Wooten, a professor of internal medicine and psychiatry at EVMS.

The machine was set up and is run by Matt Risser, a study coordinator for the EVMS sleep center who is finishing his master's degree in psychology. The project, completed this summer, cost the center about $50,000, including labor. Risser went to a junkyard and picked out a big bucket seat, since patients with the most common sleep disorder, sleep apnea, tend to be overweight.

The simulator is designed to respond to the wheel and to brake and accelerator pedals in the floor. If the ``driver'' slams the brakes or takes a curve too fast, the speaker squeals.

Yet little happens if the driver drifts off the road or into the oncoming traffic, as he would if he fell asleep.

Rather than crashing into a virtual ditch or making some horrendous noise, the program silently records an accident and repositions the car in the middle of the lane.

That's because a crash would jar the patient awake and keep him awake. Some patients nod off, have accidents and never know it.

It's normal to see some decrease in alertness after about 45 minutes, Risser said. Nevertheless, a driver who isn't deprived of sleep should be able to stay awake for a longer time than the test - at least from Norfolk to Richmond, for example, Wooten said.

Before the test, electrodes are glued to Hunnicutt's skull to measure brain waves; on his chin to see if his jaw relaxes; and below his eyes to measure blinking and eye movements.

The road he'll drive on is designed to be lulling - a 55-mile-per-hour trip on a relatively straight two-lane road, with a few curves and an occasional oncoming car.

``It's real boring,'' Risser said with a laugh. ``It's meant to be that way.

``Basically, the less stuff you have going on, the more driving performance is going to decrease. You have less to attend to, and you start losing attention.''

After a brief test drive to make sure he can operate the machine, Hunnicutt is shut into the dark, carpeted room with no radio, no windows to roll down, no cup holder. Just the road.

If Hunnicutt makes it through the hour with no problems, he will show the test to potential employers in the trucking industry.

Driving a truck has been his dream since he was a boy, when he and his cousins used to pretend that their bicycles were tractor-trailers. But family came first, and while his children were young, he worked as a machinist at Newport News Shipbuilding.

When the shift ended and he shuffled out with thousands of others, he felt like a cow in a herd. He grew to hate even going to crowded shopping malls. He dreamed of the solitude - just him and his journal and the great American landscape.

Now that his ``baby'' is 15, he is going to start training. But when he called a trucking company to ask a supervisor about a job, he told the guy he had been treated for sleep apnea.

``He said, `Oop, can't hire you.' I was discriminated against right from the get-go,'' Hunnicutt said.

This condition causes the throat muscles to go slack during the night, cutting off air. A sufferer typically snores loudly and wakes up many times during the night. The periods of waking are so short that the person may not even notice them, but the constant sleep deprivation causes other health problems and makes it almost impossible for him to stay awake during the day.

Hunnicutt now uses a sort of respirator while he sleeps. The machine creates just enough air pressure to keep his airway open. Hunnicutt's energy skyrocketed once treatment started, and he no longer suffers the constant sleepiness that once dogged him, he said.

But Hunnicutt is looking for a job at a time of growing awareness of safety problems caused by sleepy drivers.

Wooten, who is certified as a medical examiner by the Federal Aviation Administration, said the government and shipping companies will be looking for ways to improve their drivers' performance and to prove their employees can stay awake.

Currently, he said, truckers and pilots get physicals. But there is no way to diagnose sleep apnea in a simple physical, unless the patient or a spouse tells the doctor about snoring and difficulty staying awake.

``All our measures now of sleepiness are very indirect,'' Wooten said.

The FAA requires pilots to take a ``multiple wakefulness test,'' in which they sit in a well-lit room for 20-minute intervals while someone monitors their brain-wave patterns.

``We would prefer to see a more direct measure like this,'' Wooten said. ``I think this is better than anything else that's available.''

A few other sleep centers in the country have a similar driving simulator. One day, Wooten believes, a test like this will become standard for professionals.

Hunnicutt fidgets in his seat and adjusts his glasses. In the next room, the needles on the machine attached to the electrodes jump wildly. By the time he reaches the first curve in the road - about five minutes into the test - he has realized just how dull this ride will be.

But the needles monitoring his progress record normal brain waves and eye movements. At 44 minutes, the machine starts to show spikes caused by alpha waves - a sign that he is closing his eyes longer than a blink, said Risser. And his speed drops suddenly, from 57 to 52 miles per hour. But this is perfectly normal - even a well-rested driver will experience this.

He passes the test with no accidents. Later, Risser will analyze some of the variables recorded by the computer, but it's pretty clear that Hunnicutt did OK.

``Did I crash and burn?'' Hunnicutt asks when Risser opens the door and turns on the light.

``No, I don't think you did,'' Risser replies. ``How did it feel?''

``Boring,'' Hunnicutt says. And as he heads out to have his electrodes removed, he adds with a grin, ``I don't believe a person who hasn't got any sleep problems could take it.'' ILLUSTRATION: Photo

BETH BERGMAN photos/The Virginian-Pilot

Technician Ronnie Gill, left, prepares Joseph Hunnicutt for the

driving test at the Sleep Disorders Center. Hunnicutt wants to prove

he can handle long-distance truck driving despite having sleep

apnea.

This is the computer monitor that Joseph Hunnicutt sees as he

operates the new driving simulator at the Sleep Disorders Center.

After some practice, he takes a one-hour drive on the device during

which his brain is monitored for sleep activity.

Color Photo

BETH BERGMAN/The Virginian-Pilot

Joseph Hunnicutt begins a practice run on the driving simulator at