| Cataplexy, a sudden loss of voluntary muscle control, is a hallmark symptom of narcolepsy, a sleep disorder believed to affect 1 in 1000. Cataplexy is usually triggered by emotions such as laughter, surprise, fear or anger, and is more common in times of stress. Reliably inducing cataplexy in a clinical setting is hampered by the social and ethical concerns surrounding purposeful evocation of strong emotions as well as defense mechanisms patients commonly develop to resist such emotions.
The Mayo Sleep Disorders Unit feels the interactive display technology known as "virtual reality" may have potential for reliably inducing cataplexy in a clinical setting. The perceived advantages of the technology are its immersive nature (that may help bypass patient defenses) and its game-like unreality that allows the introduction of surprising, threatening, or humorous elements with little risk of offending patients.
We have developed a simulation-based scenario that makes use of existing simulation software and VR hardware currently in the BIR. We have modified an existing automobile driving simulation to allow the introduction of humorous, surprising, or stress-inducing occurrences and objects into the simulation as the patient attempts to navigate his simulated vehicle through a virtual town.
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The patient will wear a stereoscopic head-mounted display, through which he will view the virtual town through the windows of his simulated vehicle. The vehicle is be controlled via a driving simulator steering wheel and pedal cluster. The patient will be instructed to drive his vehicle to another location in town, given initial directions and street signs. As he attempts to accomplish the task, several options may be made available:
- Other vehicles travel the roads, are in the sky,vehicles can morph into other things (animals, buildings), buildings can/may move or morph
- Audio cues occur: music plays (the car has a radio), jokes are told, horns sound, instructions and announcements (correct and anomalous) are made
- There can be progressive/reversible steering failure and or other control failure
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