Sleepy driver near-misses may predict accident risks. Sleep 30: 331-342

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: 4.59). 03/2007; 30(3):331-42.
Source: PubMed


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.

Download full-text


Available from: Rayleigh Ping-Ying Chiang,
    • "Additionally, sleepiness affects a multitude of cognitive tasks, including decision making and risk acceptance (Killgore et al., 2006) and, thus, if a sleepy driver ignores an earlier rumble strip hit, they could be prone to crashing in another manner other than running off the road. It is plausible to consider hitting a rumble strip as a proxy for a sleep-related close call or near-miss and, as such, the more close calls a driver experiences the greater the likelihood they will have a sleep-related crash (Powell et al., 2007). From a harm minimisation point of view, hitting a rumble strip should be regarded as a 'take a break signal', where the driver can implement more effective sleepiness countermeasures, such as napping or the consumption of caffeine (Horne and Reyner, 1996; Watling et al., 2014). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Driving while sleepy is associated with increased crash risk. Rumble strips are designed to alert a sleepy or inattentive driver when they deviate outside their driving lane. The current study sought to examine the effects of repeated rumble strip hits on levels of physiological and subjective sleepiness as well as simulated driving performance. In total, 36 regular shift workers drove a high-fidelity moving base simulator on a simulated road with rumble strips installed at the shoulder and centre line after a working a full night shift. The results show that, on average, the first rumble strip occurred after 20 min of driving, with subsequent hits occurring 10 min later, with the last three occurring approximately every 5 min thereafter. Specifically, it was found that the first rumble strip hit reduced physiological sleepiness; however, subsequent hits did not increase alertness. Moreover, the results also demonstrate that increased subjective sleepiness levels, via the Karolinska Sleepiness Scale, were associated with a greater probability of hitting a rumble strip. The present results suggest that sleepiness is very resilient to even strongly arousing stimuli, with physiological and subjective sleepiness increasing over the duration of the drive, despite the interference caused by rumble strips.
    Journal of Sleep Research 10/2015; DOI:10.1111/jsr.12359 · 3.35 Impact Factor
  • Source
    • "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]. "
    [Show abstract] [Hide abstract]
    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 · 3.15 Impact Factor
  • Source
    • "Powell et al. found an association between sleep disorders (narcolepsy, insomnia, and OSA) and accidents caused by sleepiness, as well as an association between sleepiness and near miss accidents.[53] Donjacour et al. concluded that untreated narcolepsy can impair driving performance and increase the risk of traffic accidents.[54] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Studies have shown that a large proportion of traffic accidents around the world are related to inadequate or disordered sleep. Recent surveys have linked driver fatigue to 16% to 20% of serious highway accidents in the UK, Australia, and Brazil. Fatigue as a result of sleep disorders (especially obstructive sleep apnea), excessive workload and lack of physical and mental rest, have been shown to be major contributing factors in motor vehicle accidents. A number of behavioral, physiological, and psychometric tests are being used increasingly to evaluate the impact of fatigue on driver performance. These include the oculography, polysomnography, actigraphy, the maintenance of wakefulness test, and others. Various strategies have been proposed for preventing or reducing the impact of fatigue on motor vehicle accidents. These have included: Educational programs emphasizing the importance of restorative sleep and the need for drivers to recognize the presence of fatigue symptoms, and to determine when to stop to sleep; The use of exercise to increase alertness and to promote restorative sleep; The use of substances or drugs to promote sleep or alertness (i.e. caffeine, modafinil, melatonin and others), as well as specific sleep disorders treatment; The use of CPAP therapy for reducing excessive sleepiness among drivers who have been diagnosed with obstructive sleep apnea. The evidence cited in this review justifies the call for all efforts to be undertaken that may increase awareness of inadequate sleep as a cause of traffic accidents. It is strongly recommended that, for the purpose of promoting highway safety and saving lives, all disorders that cause excessive sleepiness should be investigated and monitored.
    International journal of preventive medicine 03/2013; 4(3):246-57.
Show more