Article

Sleepy driver near-misses may predict accident risks

Department of Otolaryngology Head and Neck Surgery and Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, Stanford, CA, USA.
Sleep (Impact Factor: 5.06). 03/2007; 30(3):331-42.
Source: PubMed

ABSTRACT To quantify the prevalence of self-reported near-miss sleepy driving accidents and their association with self-reported actual driving accidents.
A prospective cross-sectional internet-linked survey on driving behaviors.
Dateline NBC News website.
Results are given on 35,217 (88% of sample) individuals with a mean age of 37.2 +/- 13 years, 54.8% women, and 87% white. The risk of at least one accident increased monotonically from 23.2% if there were no near-miss sleepy accidents to 44.5% if there were > or = 4 near-miss sleepy accidents (P < 0.0001). After covariate adjustments, subjects who reported at least one near-miss sleepy accident were 1.13 (95% CI, 1.10 to 1.16) times as likely to have reported at least one actual accident as subjects reporting no near-miss sleepy accidents (P < 0.0001). The odds of reporting at least one actual accident in those reporting > or = 4 near-miss sleepy accidents as compared to those reporting no near-miss sleepy accidents was 1.87 (95% CI, 1.64 to 2.14). Furthermore, after adjustments, the summary Epworth Sleepiness Scale (ESS) score had an independent association with having a near-miss or actual accident. An increase of 1 unit of ESS was associated with a covariate adjusted 4.4% increase of having at least one accident (P < 0.0001).
A statistically significant dose-response was seen between the numbers of self-reported sleepy near-miss accidents and an actual accident. These findings suggest that sleepy near-misses may be dangerous precursors to an actual accident.

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    • "ILCs have been reported in epidemiologic studies as near-miss sleepy accidents (NMSA). Importantly the occurrence of several NMSA strongly predicts sleep-related accidents in the same year [6] [15]. "
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    ABSTRACT: We aimed to investigate sleepiness, sleep hygiene, sleep disorders, and driving risk among highway drivers. We collected data using cross-sectional surveys, including the Epworth Sleepiness Scale (ESS) questionnaire, Basic Nordic Sleep Questionnaire (BNSQ), and a travel questionnaire; we also obtained sleep data from the past 24h and information on usual sleep schedules. Police officers invited automobile drivers to participate. There were 3051 drivers (mean age, 46±13y; 75% men) who completed the survey (80% participation rate). Eighty-seven (2.9%) drivers reported near-miss sleepy accidents (NMSA) during the trip; 8.5% of NMSA occurred during the past year and 2.3% reported sleepiness-related accidents occurring in the past year. Mean driving time was 181±109min and mean sleep duration in the past 24h was 480±104min; mean sleep duration during workweeks was 468±74min. Significant risk factors for NMSA during the trip were NMSA in the past year, nonrestorative sleep and snoring in the past 3months, and sleepiness during the interview. Neither sleep time in the past 24h nor acute sleep debt (sleep time difference between workweeks and the past 24h) correlated with the occurrence of near misses. Unlike previous studies, acute sleep loss no longer explains sleepiness at the wheel. Sleep-related breathing disorders or nonrestorative sleep help to explain NMSA more adequately than acute sleep loss.
    Sleep Medicine 09/2013; 15(1). DOI:10.1016/j.sleep.2013.06.018 · 3.10 Impact Factor
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    • "Further, participants who reported four or more fatigue/sleep-related near-miss incidents had twice the risk of involvement in a fatigue/sleep-related RTI than those who had no-near miss events. The authors of this study argue that fatigue/sleep-related near-misses can serve as a metric to predict drivers at risk of a fatigue/sleep-related crash (Powell et al., 2007). An earlier study focusing on the experiences of drivers with a sleep disorder (Engleman, Asgari-Jirhandeh, McLeod, Ramsay, & Deary, 1996) noted that following an intervention, near-misses decreased in line with the observed reduction of actual RTIs, providing further support for the premise that fatigue/sleepy near missevents are precursors to an actual incident. "
    Transportation Research Part F Traffic Psychology and Behaviour 01/2013; 21:242. · 1.99 Impact Factor
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    • "However, near misses have been shown to be good indicators of drivers at higher risk of being implicated in accidents. If a person experiences drowsiness, near-misses are 14 times more common than actual accidents [8]. In terms of concentration, inattention of drivers plays a major role in road accidents for the general population. "
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    ABSTRACT: Introduction. After a mild traumatic brain injury (mTBI), individuals quickly resume driving. However, relatively little is known about the impact of mTBI on driving ability and, notably, on the perceived influence of postconcussive symptoms on driving. Hence, the objective of this study was to document the perception of driving abilities in individuals with mTBI. Method. Twenty-seven drivers with mTBI were interviewed to document their perception regarding their driving abilities. Both driving-related difficulties and compensatory strategies used to increase driving safety were documented. A mixed quantitative and qualitative analysis of the data was completed. Results. 93% of participants reported at least one difficulty perceived as having an impact on everyday activities. Most frequently named problems affecting driving were fatigue and reduced concentration. In addition, 74% of participants had adapted their driving or developed strategies to compensate for driving difficulties. Discussion/Conclusion. Postconcussive symptoms have repercussions on driving ability. However, people with mTBI tend to be aware of their difficulties and develop, over time, adaptive strategies. Preventive measures are thus warranted to increase health care professionals' awareness of the potential consequences of mTBI on driving ability and to promote guidelines for the safe resumption of driving after injury.
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