Article

Driver sleepiness and risk of serious injury to car occupants: population based case control study

May 2002
BMJ (Compact Ed.) 324(7346):1125

DOI:10.1136/bmj.324.7346.1125

Authors:

Jennie L Connor

University of Otago

Robyn Norton

The University of Sydney

Shanthi Ameratunga

Middlemore Hospital

Elizabeth Robinson

University of Auckland

Show all 8 authorsHide

Objectives To estimate the contribution of driver sleepiness to the causes of car crash injuries. Design Population based case control study. Setting Auckland region of New Zealand, April 1998 to July 1999. Participants 571 car drivers involved in crashes where at least one occupant was admitted to hospital or killed (“injury crash”); 588 car drivers recruited while driving on public roads (controls), representative of all time spent driving in the study region during the study period. Main outcome measures Relative risk for injury crash associated with driver characteristics related to sleep, and the population attributable risk for driver sleepiness. Results There was a strong association between measures of acute sleepiness and the risk of an injury crash. After adjustment for major confounders significantly increased risk was associated with drivers who identified themselves as sleepy (Stanford sleepiness score 4-7 v 1-3; odds ratio 8.2, 95% confidence interval 3.4 to 19.7); with drivers who reported five hours or less of sleep in the previous 24 hours compared with more than five hours (2.7, 1.4 to 5.4); and with driving between 2 am and 5 am compared with other times of day (5.6, 1.4 to 22.7). No increase in risk was associated with measures of chronic sleepiness. The population attributable risk for driving with one or more of the acute sleepiness risk factors was 19% (15% to 25%). Conclusions Acute sleepiness in car drivers significantly increases the risk of a crash in which a car occupant is injured or killed. Reductions in road traffic injuries may be achieved if fewer people drive when they are sleepy or have been deprived of sleep or drive between 2 am and 5 am. What is already known on this topic What is already known on this topic Driver sleepiness is considered a potentially important risk factor for car crashes and related injuries but the association has not been reliably quantified Published estimates of the proportion of car crashes attributable to driver sleepiness vary from about 3% to 30% What this study adds What this study adds Driving while feeling sleepy, driving after five hours or less of sleep, and driving between 2 am and 5 am were associated with a substantial increase in the risk of a car crash resulting in serious injury or death Reduction in the prevalence of these three behaviours may reduce the incidence of injury crashes by up to 19%

Subjektiv eingeschätzter Beanspruchungszustand von im Schichtdienst tätigen Bus- und Straßenbahnfahrer*innen sowie Verwaltungsangestellten eines Verkehrsunternehmens

Article

Full-text available

May 2024

Zusammenfassung Hintergrund Berufskraftfahrer*innen im Personenverkehr sind bei ihrer Arbeit diversen Belastungen ausgesetzt. Dazu gehören neben dem Schichtdienst unter anderem die hohe Verantwortung gegenüber den Fahrgästen oder auch die Gewährleistung von Pünktlichkeit mit der Einhaltung von Fahrplänen. Ziel dieser Arbeit ist es, psychische Beanspruchungsfolgen bei Bus- und Straßenbahnfahrer*innen mit Schichtdienst zu identifizieren und deren Beanspruchungszustand und Schlafverhalten dem von Beschäftigten aus der Verwaltung des gleichen Unternehmens, jedoch ohne Schichtdienst, gegenüberzustellen. Methodik An der Studie nahmen 24 Bus- und Straßenbahnfahrer*innen mit Schichtdienst (Alter 46,3 ± 11,0 Jahre) und 29 Verwaltungsangestellte des gleichen Unternehmens ohne Schichtdienst (Alter 46,5 ± 10,5 Jahre) teil. Die subjektive Beanspruchung wurde mit Fragebögen (Pittsburgh Sleep Quality Index [PSQI], General-Health-Questionnaire [GHQ-12], Epworth Sleepiness Scale [ESS] und Erholungsunfähigkeit) erfasst. Ergebnisse Bus- und Straßenbahnfahrer*innen klagten über eine signifikant schlechtere Schlafqualität im Vergleich zu Verwaltungsangestellten (PSQI-Gesamtpunktzahl 7,0 ± 2,2 vs. 5,6 ± 3,3 Punkte; p = 0,038). Von den Fahrer*innen wurden 69 % als schlechte Schläfer im Vergleich zu 41 % der Verwaltungsangestellten eingestuft (pChi2

p_{\text{Chi}^2}

= 0,037). Die subjektiv eingeschätzte psychische Gesundheit, die Tagesschläfrigkeit und auch die Erholungsunfähigkeit unterschieden sich in beiden Gruppen nicht. Diskussion Aufgrund des hohen Anteils von Bus- und Straßenbahnfahrer*innen mit eingeschränkter Schlafqualität besteht in diesem Verkehrsunternehmen Handlungsbedarf zur Verbesserung des Schlafes in dieser Berufsgruppe.

How Tired is Too Tired to Drive? A Systematic Review Assessing the Use of Prior Sleep Duration to Detect Driving Impairment

Article

Full-text available

Apr 2023

Driver fatigue is a contributory factor in approximately 20% of vehicle crashes. While other causal factors (eg, drink-driving) have decreased in recent decades due to increased public education strategies and punitive measures, similar decreases have not been seen in fatigue-related crashes. Fatigued driving could be managed in a similar way to drink-driving, with an established point (ie, amount of prior sleep) after which drivers are “deemed impaired”. This systematic review aimed to provide an evidence-base for the concept of deemed impairment and to identify how much prior sleep may be required to drive safely. Four online databases were searched (PubMed, Web of Science, Scopus, Embase). Eligibility requirements included a) measurement of prior sleep duration and b) driving performance indicators (eg, lane deviation) and/or outcomes (eg, crash likelihood). After screening 1940 unique records, a total of 61 studies were included. Included studies were categorised as having experimental/quasi-experimental (n = 21), naturalistic (n = 3), longitudinal (n = 1), case–control (n = 11), or cross-sectional (n = 25) designs. Findings suggest that after either 6 or 7 hours of prior sleep, a modest level of impairment is generally seen compared with after ≥ 8 hours of prior sleep (ie, well rested), depending on the test used. Crash likelihood appears to be ~30% greater after 6 or 7 hours of prior sleep, as compared to individuals who are well rested. After one night of either 4 or 5 hours of sleep, there are large decrements to driving performance and approximately double the likelihood of a crash when compared with well-rested individuals. When considering the scientific evidence, it appears that there is a notable decrease in driving performance (and associated increase in crash likelihood) when less than 5h prior sleep is obtained. This is a critical first step in establishing community standards regarding the amount of sleep required to drive safely.

Possible effects of uberization on the quality of sleep of professional drivers

Article

Full-text available

Dec 2022
CHRONOBIOL INT

Uber and other on-demand business platforms drivers experience unparalleled flexibility in work hours, and many are using this model instead of working a fixed-hours job. The option of working more hours a day and, as a result, increasing the remuneration received is often chosen by drivers even at the expense of sleep. Due to their professional obligation, this population is at risk of excessive sleepiness due to sleep deprivation or poor sleep quality, increasing the risk of detrimental effects on health and the risk of car accidents. Considering that sleep is essential for general health, it is mandatory to create strategies to address these issues, such as limiting the maximum number of hours worked a day under the laws regulating labor rights and periodically assessing drivers' alertness.

Data Visualization of Traffic Violations in Maryland, U.S.

Article

Full-text available

Dec 2023

Nowadays, car use has become so common and inevitable that with a high approximation, it can be said that every family has at least one car. This study analyzes traffic violation data from Montgomery County, Maryland to identify patterns and factors influencing road safety. A dataset with over 1 million records on traffic stops was explored using R and Python. Analysis focused on the most frequent stop causes, seasonal and hourly distribution of stops, and the role of alcohol. Results indicate that failure to obey traffic devices was the top stop reason. Stops peaked in summer months and nighttime hours. The age group with the highest accident rate was young males in their 20s. While alcohol impaired driving is a major concern, the data did not show a significant link between alcohol use and fatalities or injuries. This research provides useful insights into road safety patterns and risk factors. The methodology of data mining and visualizing a large traffic violations dataset demonstrates an effective approach for uncovering actionable insights. Key findings on high-risk driver demographics and stop causes can inform policies to improve road safety.

Visual and non-visual responses of drivers to simulated LED headlights varying in correlated color temperature

Article

Nov 2023

This study aimed to investigate the impact of automotive headlights of different correlated colour temperatures (CCT) on the visual and non-visual performance of drivers. Forty drivers participated in the study, driving in a simulated night road for 45 min in three sessions. The LED headlights had CCTs of 3176 K, 4358 K and 6923 K, with an illuminance of 5 lx perpendicular to the participants' eyes. Heart rate variability (HRV), psychomotor vigilance task and Karolinska sleepiness scale were measured before and after driving. At the end of the trials, achromatic far and near visual acuity tests, as well as achromatic far and near contrast sensitivity tests, were conducted. The study revealed that CCT did not affect achromatic far and near visual acuity. However, CCT had an impact on achro-matic near and far contrast sensitivity, with higher CCT resulting in improved achromatic contrast sensitivity. As the CCT decreased, participants exhibited increased reaction time, made more errors, and reported higher sleepiness. The most significant physiological changes in HRV, including alterations in low frequency (LF), high frequency (HF) and LF/HF, were observed at lower CCT. The findings of this study suggest that both the visual and non-visual performance of drivers were enhanced when high CCTs were used for automotive LED headlights.

The association of schedule characteristics of heavy vehicle drivers with continuous eye-blink parameters of drowsiness

Article

Oct 2022
TRANSPORT RES F-TRAF

Study objectives While drowsiness contributes to 20% of heavy vehicle crashes, the impact of work schedules on heavy vehicle driver (HVD) drowsiness is unclear. This study explored the impact of work schedules on drowsiness (measured by infrared oculography) in HVDs. Method Work and drowsiness monitoring (Optalert, Australia) of ten HVDs, aged 37–62 years collected nearly 2430 h of work and 1068 h of oculography data during four weeks of naturalistic drives. Drowsiness events were defined as a John's Drowsiness Scores ≥ 2.6. Nine HVDs slept for 5.82 ± 1.37 h during five weeks of actigraphy. Association of driving schedule characteristics and drivers’ continuous eye-blink parameters were observed using logistic and mixed linear regression analyses. Results Combination of time of day (10 pm- 2 am), shift start time (2 pm-3 pm), hours into the shift (16–21 h), break duration (7–9 h), and sleep time (<6 h) increased the likelihood of drowsiness events when controlling for other covariates. A combination of night times (6 pm to 2 am), 18 to 21 h into the shift, shift start times (6 am to 7 am), shifts lengths (8 to15 h) and break times (<7 to 9 h) increased the hourly rate of drowsiness significantly when adjusting for other covariates. Conclusions The combination of prolonged work hours, night-time drives, early-morning shift starts and short breaks increase drowsiness rates in HVDs. Large datasets are needed to examine the interplay between sleep time, consecutive shifts and shift order and type with this combination.

Nigerians and their Adaptation to their Deadly Road Conditions: The Case of Fatigue-Related Road Accidents

Article

Full-text available

Sep 2024

The study aimed to investigate the consequences and negative impacts of the poor road conditions in Nigeria, focusing particularly on the lack of rest stops and their effects on drivers. A combination of quantitative and qualitative research methods was used to gather data and insights on current trends and realities. The study drew a comparison with guidelines from the National Highway Traffic Safety Administration (NHTSA) in the United States, which recommends that drivers take a break every two hours to prevent fatigue. However, using a structured questionnaire on long-distance drivers in southeast Nigeria, the survey results showed that the respondents often drive for an average of 6 hours and 12 minutes without a break, leading to severe fatigue, which causes lots of dangerous driving conditions. The study also revealed a negative perception among respondents towards the existing rest stops in Nigeria, indicating that these facilities do not meet their needs adequately. To address the issue of fatigue-related traffic accidents, the research suggests a comprehensive strategy that includes education on the dangers of driver fatigue, governmental interventions to improve road conditions, technological advancements to monitor driver fatigue, and organizational activities to enforce safety measures.

Prevalence of obstructive sleep apnea and its associated factors in primary health care in Morocco

Article

Full-text available

Jun 2024
SLEEP BREATH

Objective Obstructive sleep apnea is a common respiratory disorder that is still underdiagnosed in Morocco. This study aims to determine the prevalence of obstructive sleep apnea and its associated factors in primary healthcare. Methods In this cross-sectional study, 815 adults aged 18 years and older consulting in the primary health care services in Marrakech, Morocco, were included. We evaluated the risk of obstructive sleep apnea syndrome using the modified STOP-BANG questionnaire. Results The prevalence of the high risk of obstructive sleep apnea in our sample is 24.8% (CI 95%: 21.7 − 27.6%). The variables independently associated with the high suspicion of obstructive sleep apnea were: gender male (p = 0.001), age ≥ 45 years (p = 0.001), high blood pressure (p = 0.005), hyperlipidemia (p = 0.042), daytime sleepiness (p = 0.003), snoring (p = 0.001), tiredness (p = 0.001) and mandibular retrognathia (p = 0.025). Conclusion This survey revealed a significant prevalence of obstructive sleep apnea in Morocco. Therefore, we propose to generalize the screening of obstructive sleep apnea in hypertensive patients who report symptoms including daytime sleepiness, snoring, nocturnal choking, and tiredness that are unexplained by other known factors.

Association of Visual-Based Signals with Electroencephalography Patterns in Enhancing the Drowsiness Detection in Drivers with Obstructive Sleep Apnea

Article

Full-text available

Apr 2024
SENSORS-BASEL

Individuals with obstructive sleep apnea (OSA) face increased accident risks due to excessive daytime sleepiness. PERCLOS, a recognized drowsiness detection method, encounters challenges from image quality, eyewear interference, and lighting variations, impacting its performance, and requiring validation through physiological signals. We propose visual-based scoring using adaptive thresholding for eye aspect ratio with OpenCV for face detection and Dlib for eye detection from video recordings. This technique identified 453 drowsiness (PERCLOS ≥ 0.3 || CLOSDUR ≥ 2 s) and 474 wakefulness episodes (PERCLOS < 0.3 and CLOSDUR < 2 s) among fifty OSA drivers in a 50 min driving simulation while wearing six-channel EEG electrodes. Applying discrete wavelet transform, we derived ten EEG features, correlated them with visual-based episodes using various criteria, and assessed the sensitivity of brain regions and individual EEG channels. Among these features, theta–alpha-ratio exhibited robust mapping (94.7%) with visual-based scoring, followed by delta–alpha-ratio (87.2%) and delta–theta-ratio (86.7%). Frontal area (86.4%) and channel F4 (75.4%) aligned most episodes with theta–alpha-ratio, while frontal, and occipital regions, particularly channels F4 and O2, displayed superior alignment across multiple features. Adding frontal or occipital channels could correlate all episodes with EEG patterns, reducing hardware needs. Our work could potentially enhance real-time drowsiness detection reliability and assess fitness to drive in OSA drivers.

Sleep Disorders and Traffic Accidents: Unveiling the Hidden Risks

Article

Full-text available

Mar 2024

Patient: Male, 57-year-old Final Diagnosis: Obstructive sleep apnea Symptoms: Asleep • confusion • tired Clinical Procedure: — Specialty: Public Health • Pulmonology Objective Unusual clinical course Background Numerous countries, Vietnam included, have persistently high annual rates of traffic accidents. Despite concerted government efforts to reduce the annual traffic accident rate, the toll of fatalities and consequential injuries from these accidents rises each year. Various factors contribute to these incidents, notably including alcohol consumption while driving, inadequate awareness of traffic regulations, and substandard traffic infrastructure. However, an under-recognized risk in developing nations such as Vietnam is the prevalence of sleep disorders. Conditions such as obstructive sleep apnea syndrome and obesity hypoventilation syndrome, while prevalent, remain inadequately assessed and treated. These disorders represent significant yet largely unad-dressed contributors to the heightened risk of traffic accidents. Case Report We describe the case of a 55-year-old Vietnamese man hospitalized due to long-standing respiratory complications and profound daytime sleepiness. Over the past 2 years, the patient gained 10 kg. Consequently, he frequently experienced drowsiness, leading to 4 traffic accidents. Despite previous hospitalizations, this sleep disorder had gone undiagnosed and untreated. Diagnostic assessments confirmed concurrent obstructive sleep apnea and obesity hypoventilation syndrome through polysomnography and blood gas analyses. Treatment involving non-invasive positive airway pressure therapy notably alleviated symptoms and substantially improved his quality of life within a concise 3-month period. Conclusions Obstructive sleep apnea and obesity hypoventilation syndrome are contributory factors to excessive daytime somnolence, significantly increasing vulnerability to traffic accidents. Regrettably, this critical intersection remains inadequately addressed. Addressing these concerns comprehensively through dedicated research initiatives should be imperative before considering the universal issuance of driver’s licenses to all road users in Vietnam.

Psychophysiological models of hypovigilance detection: A scoping review

Article

Full-text available

Jun 2023
PSYCHOPHYSIOLOGY

Hypovigilance represents a major contributor to accidents. In operational contexts, the burden of monitoring/managing vigilance often rests on operators. Recent advances in sensing technologies allow for the development of psychophysiology-based (hypo)vigilance prediction models. Still, these models remain scarcely applied to operational situations and need better understanding. The current scoping review provides a state of knowledge regarding psychophysiological models of hypovigilance detection. Records evaluating vigilance measuring tools with gold standard comparisons and hypovigilance prediction performances were extracted from MEDLINE, PsychInfo, and Inspec. Exclusion criteria comprised aspects related to language, non-empirical papers, and sleep studies. The Quality Assessment tool for Diagnostic Accuracy Studies (QUADAS) and the Prediction model Risk Of Bias ASsessment Tool (PROBAST) were used for bias evaluation. Twenty-one records were reviewed. They were mainly characterized by participant selection and analysis biases. Papers predominantly focused on driving and employed several common psychophysiological techniques. Yet, prediction methods and gold standards varied widely. Overall, we outline the main strategies used to assess hypovigilance, their principal limitations, and we discuss applications of these models

Feeling sleepy? Stop Driving - Awareness of Fall Asleep Crashes

Article

Full-text available

May 2023
SLEEP

Study objectives: To examine whether drivers are aware of sleepiness and associated symptoms, and how subjective reports predict driving impairment and physiological drowsiness. Methods: Sixteen shift workers (19-65y; 9 women) drove an instrumented vehicle for 2-hours on a closed-loop track after a night of sleep and a night of work. Subjective sleepiness/symptoms were rated every 15-minutes. Severe and moderate driving impairment was defined by emergency brake manoeuvres and lane deviations, respectively. Physiological drowsiness was defined by eye closures (Johns Drowsiness Scores, JDS) and EEG-based microsleep events. Results: All subjective ratings increased post night-shift (p<0.001). No severe drive events occurred without noticeable symptoms beforehand. All subjective sleepiness ratings, and specific symptoms, predicted a severe driving event occurring in the next 15-minutes (OR: 1.76-2.4, AUC>0.81, p<0.009), except 'head dropping down'. KSS, ocular symptoms, difficulty keeping to center of the road, and nodding off to sleep, were associated with a lane deviation in the next 15-minutes (OR: 1.17-1.24, p<0.029), although accuracy was only 'fair' (AUC 0.59-0.65). All sleepiness ratings predicted severe ocular-based drowsiness (OR: 1.30-2.81, p<0.001), with very good-to-excellent accuracy (AUC>0.8), while moderate ocular-based drowsiness was predicted with fair-to-good accuracy (AUC>0.62). KSS, likelihood of falling asleep, ocular symptoms and 'nodding off' predicted microsleep events, with fair-to-good accuracy (AUC 0.65-0.73). Conclusions: Drivers are aware of sleepiness, and many self-reported sleepiness symptoms predicted subsequent driving impairment/physiological drowsiness. Drivers should self-assess a wide range of sleepiness symptoms and stop driving when these occur to reduce the escalating risk of road crashes due to drowsiness.

Convergent validity of video-based observer rating of drowsiness, against subjective, behavioral, and physiological measures

Article

Full-text available

May 2023
PLOS ONE

Driver drowsiness is a widely recognized cause of motor vehicle accidents. Therefore, a reduction in drowsy driving crashes is required. Many studies evaluating the crash risk of drowsy driving and developing drowsiness detection systems, have used observer rating of drowsiness (ORD) as a reference standard (i.e. ground truth) of drowsiness. ORD is a method of human raters evaluating the levels of driver drowsiness, by visually observing a driver. Despite the widespread use of ORD, concerns remain regarding its convergent validity, which is supported by the relationship between ORD and other drowsiness measures. The objective of the present study was to validate video-based ORD, by examining correlations between ORD levels and other drowsiness measures. Seventeen participants performed eight sessions of a simulated driving task, verbally responding to Karolinska sleepiness scale (KSS), while infra-red face video, lateral position of the participant’s car, eye closure, electrooculography (EOG), and electroencephalography (EEG) were recorded. Three experienced raters evaluated the ORD levels by observing facial videos. The results showed significant positive correlations between the ORD levels and all other drowsiness measures (i.e., KSS, standard deviation of the lateral position of the car, percentage of time occupied by slow eye movement calculated from EOG, EEG alpha power, and EEG theta power). The results support the convergent validity of video-based ORD as a measure of driver drowsiness. This suggests that ORD might be suitable as a ground truth for drowsiness.

Cognitive State Analysis, Understanding, and Decoding from the Perspective of Brain Connectivity

Chapter

Feb 2023

Cognitive states are involved in our daily life, which motivates us to explore them and understand them through a vast variety of perspectives. Among these perspectives, brain connectivity has been increasingly receiving attention in recent years. It is the right time to summarize the past achievements, serving as a cornerstone for the upcoming progress in the field. In this chapter, the definition of the cognitive state is first given, and the cognitive states that are frequently investigated are then outlined. The introduction of the methods for estimating connectivity strength and graph theoretical metrics follows. Subsequently, each cognitive state is separately described, and the progress in cognitive state investigation is summarized, including analysis, understanding, and decoding. We concentrate on the literature ascertaining macroscale representations of cognitive states from the perspective of brain connectivity and give an overview of achievements related to cognitive states to date, especially within the past 10 years. The discussions and future prospects are stated at the end of the chapter.

0168 Subjective and Objective Markers of Sleepiness in Drivers

Article

Full-text available

May 2022

Introduction Sleepiness is associated with a decrease in cognitive abilities with effects comparable to those of alcohol. It remains one of the main causes of fatal road accidents. Various tools are available to assess sleepiness subjectively and objectively, such as questionnaires and multiple sleep latency test. However, the former are subject to intra- and inter-individual variability, and the latter is only feasible in a sleep laboratory. The main objective of this study was to explore new potential markers (biological, neurocognitive) to assess sleepiness in drivers. In this perspective, the easy-to-use BLAST attention test allows the evaluation of micro-fluctuations in vigilance. In addition, salivary markers are good physiological markers, easily accessible and non-invasive to collect. Recent studies have suggested that salivary a-amylase and oxalate may be biomarkers of sleep pressure. Methods 185 drivers (median age 44 years, 72% male, 15% obese) were included during a break at a highway service area, in the morning, while on the road for vacation. Questionnaires on sleepiness, sleep the day before departure, an attention test and two salivary samples (alpha-amylase and oxalate) were taken. Associations between subjective and objective measures of sleepiness, sleep characteristics and salivary concentrations were tested using regression models adjusted for confounding factors. Results The night before departure, 57% of drivers reduced their sleep time and more than ¼ slept 5 hours or less. The higher the number of miles to drive, the shorter the sleep time. 16% of the drivers complained of poor sleep quality and difficulty falling asleep. At the time of the test, 46% of the drivers felt drowsy. Poor sleep quality or difficulty falling asleep the night before departure was associated with increased sleepiness as assessed by the Stanford Sleepiness Scale and decreased attentional ability as assessed by the BLAST. No association between salivary samples and sleepiness was observed. Conclusion Sleep characteristics on the day before departure were associated with sleepiness and attentional performance. The Stanford Sleepiness Scale and the BLAST could be used by individual drivers in a self-evaluation context. Support (If Any) This study was funded by the Vinci Foundation.

Ocena działania Inteligentnych Systemów Transportowych w zakresie poprawy bezpieczeństwa w wybranych miastach Polski / Evaluation of the operation of Intelligent Transport Systems in terms of improving safety in selected Polish cities

Chapter

Jan 2023

Zagadnienie bezpieczeństwa w ruchu drogowym jest bardzo ważne dla ogółu społeczeństwa. Dotyka zarówno osób pracujących na drogach, kierowców zawodowych, osób prywatnie korzystających z dróg publicznych, jak i pieszych. Według danych Głównego Urzędu Statystycznego w 2022 roku w Polsce doszło do 23 540 wypadków, w których zginęło 2491 osób [GUS, 2021]. Pokazuje to, jak ważne jest ciągłe poprawianie bezpieczeństwa w ruchu drogowym. Wsparcie w tym aspekcie w przypadku miast może nieść wprowadzenie systemów telematycznych, które pozwalają na efektywną poprawę poziomu bezpieczeństwa na drogach, a dodatkowo niosą ze sobą wiele innych korzyści. W ostatnich latach, w wielu wojewódzkich miastach wdrożono właśnie inteligentne systemy transportowe (ITS), których celem była między innymi poprawa bezpieczeństwa drogowego. Były one w dużej części finansowane ze środków Unii Europejskiej. Dzięki realizacji tych projektów w wielu miastach udało się zmniejszyć liczbę wypadków i co za tym idzie, podnieść bezpieczeństwo na drogach. Wprowadzenie ITS przyniosło także wiele innych korzyści. Dotyczą one upłynnienia ruchu, zmniejszenia czasu podróży i zapobieganie wypadkom. Systemy służą także użytkownikom transportu publicznego, pozwalając im na efektywniejsze i dokładniejsze planowanie podróży.

Stan infrastruktury i perspektywy rozwoju regionalnych portów lotniczych w Polsce

Chapter

Full-text available

Jan 2023

Transport to jeden z najważniejszych czynników warunkujących rozwój gospodarczy. Odpowiednio rozwinięta infrastruktura transportowa zwiększa spójność przestrzenną, społeczną oraz ekonomiczną państwa i przyczynia się do zwiększenia konkurencyjności gospodarki kraju. Nowoczesna infrastruktura i dynamicznie funkcjonujący system transportowy przyczyniają się do wzrostu gospodarczego kraju. Ponadto położenie państwa na międzynarodowych szlakach transportowych sprzyja jego konkurencyjności.

Szanse i perspektywy rozwoju transportu intermodalnego w Polsce

Chapter

Full-text available

Jan 2023

Szeroko pojęty transport od drugiej połowy XX wieku podlega nieustannym zmianom na rynku przewozów pasażerskich i towarowych. Przedsiębiorstwa transportowe, które chcą pozostać na rynku, powinny liczyć się z koniecznością zwiększenia wydajności transportu. Ciągła, krajowa lub międzynarodowa wy- miana handlowa i nierównomierne rozmieszczenie zasobów na ziemi wpływa na rozwój nowych technologii przewozu. Jedną z wykorzystywanych nowych metod jest transport intermodalny.

The Effect of Sleep Disorders and Fatigue on In-vehicle Traffic Accidents

Article

Full-text available

Dec 2022

Aim:Traffic accidents have been reported by the World Health Organization as a global problem affecting the whole world. Many studies have shown that the majority of traffic accidents are associated with inadequate and/or disturbed sleep. We aimed to define possible sleep disorders and chronic fatigue in people who had had an in-vehicle traffic accident with applicable scales and to take the necessary precautions.Materials and Methods:Our study included 104 people with a suitable general condition and physical examination, who had an in-vehicle traffic accident and applied to Pamukkale University Faculty of Medicine Emergency Service. For all patients, demographic data inquiries were made, and the ‘Epworth Sleepiness Scale (ESS)’, ‘Pittsburg Sleep Quality Index (PUKİ)’, ‘Berlin Questionnaire’ and ‘Fatigue Severity Scale’ were applied.Results:Increased daytime sleepiness was determined in 10 (9.62%) people according to the ESS, poor sleep quality in 15 (14.42%) people according to the PUKİ, high risk of Obstructive sleep apnea syndrome (OSAS) in 15 (14.42%) people according to the Berlin Questionnaire, and chronic fatigue in 30 (29.1%) people according to the Fatigue Severity Scale.Conclusion:In our study, we showed with scales that people who had an in-vehicle traffic accident could have various sleep disorders and chronic fatigue syndrome that had not been diagnosed before. However, contrary to what is mentioned in the literature, we found the prevalence of OSAS risk to be low. Necessary measures should be taken to minimize the risk of preventable accidents while driving. In case of suspicion of respiratory disorder, which is one of the sleep disorders we frequently see, gold standard tests such as polysomnography should be used before saying that there is no respiratory disorder in sleep with scales, especially in people who will be driving as a profession.

Dynamic simulation on eye exposure of in-vehicle daylighting in urban environments of China

Article

Full-text available

Dec 2022

Light has a profound non-visual impact on the human body. It affects people’s mood, alertness, endocrine and circadian rhythm. Most non-visual effects studies focus on built environment. Yet, the non-visual effects of in-vehicle lighting have rarely drawn scholarly attention. Theoretically, by changing the transmittance and reflectance of the windshield, or adjusting the luminaires in vehicles, the physiological and mental state of the driver and the passengers can be intervened. The paper carries out series of dynamic daylight simulations in multiple categories of urban environments in China, summarizes the eye exposure characteristics of in-vehicle daylighting, and proposes new suggestions regarding the lighting design in vehicles. The main results can be summarized as follows: (1) The M/P Ratio of the in-vehicle daylighting has an average of 1.12 for clear sky, while 1.07 for overcast sky. (2) The back seat passengers receives significant lower eye exposure compares with the driver and front seat passenger when looking ahead. However, if the back seat passengers look outside the side windshield, the eye exposure they receive is mostly higher than that the driver and front seat passenger receive. (3) The floor area ratio (FAR) of the urban environment has an impact on the eye exposure of in-vehicle daylighting. The higher the FAR, the lower the non-visual effects. (4) The in-vehicle daylighting eye exposure differs significantly throughout China. Of all the seven typical cities selected in the study, Shenzhen > Lhasa > Kunming > Beijing > Shanghai > Harbin > Chongqing.

Meta-analytic study on substance intake and work-related accidents calls for attention to bio-psycho-social factors

Article

Full-text available

Dec 2022
NEUROSCI BIOBEHAV R

Accidents at work are a major concern because of their social and economic impact. The causes are highly variable and often linked to risk behaviors that could be avoided, of which substance use is a prime example. The aim of this paper was to meta-analytically review the scientific literature on substance intake and its link to work-related accidents. From an initial pool of 19954 papers, we considered a final sample of 27 clustered in three groups according to substances class (alcohol, recreational drugs, medicines). Despite different pharmacological effects, substances consumed for recreational purposes significantly increased the risk of work-related accidents (odds ratio: alcohol 1.78, recreational drugs 1.47), whereas medicines did not: however, these results require caution due to the heterogeneity of the included studies and suspected publication bias. While bio-psycho-social factors could have helped to understand this association, selected studies neglected both the variegated effects and the root causes of recreational substance consumption. Future studies and interventions should consider these complexity factors to transcend the mere description of the phenomenon.

Que nous disent les outils de mesure sur la somnolence et l’hypersomnolence chez l’adulte ? Approches historiques et perspectives futures

Article

Full-text available

Oct 2022

Résumé Malgré son rôle central dans la sémiologie et les classifications nosologiques des troubles du sommeil et de l’éveil, il n’existe pas, actuellement, de consensus sur la définition de la somnolence et de l’hypersomnolence qui restent des concepts complexes et multidimensionnels. Dans un article publié dans ce numéro de Médecine du Sommeil, Lopez et al. proposent des définitions de l’hypersomnolence et de ses différentes sous-dimensions, selon une approche basée sur une connaissance experte, organisant les construits selon les connaissances et l’expérience des auteurs. Dans cet article, nous présentons une approche complémentaire, consistant à faire émerger les différentes sous-dimensions de la somnolence et de l’hypersomnolence en partant des outils conçus pour les mesurer chez l’adulte. Une analyse systématique des outils de mesures, avec le minimum d’a priori possible, est réalisée afin de proposer une organisation hybride basée, à la fois, sur le savoir expertal et sur une approche historique des évolutions et ajustements successifs des construits mesurés par les outils de mesure. Nous avons ensuite identifié trois enjeux actuels de recherche autour de la mesure de l’hypersomnolence : i) la standardisation des protocoles ; ii) la mise au point de questionnaires mesurant les différentes dimensions de l’hypersomnolence chez l’adulte ; et iii) les nouveaux critères de mesure sur la base des protocoles « classiques ». Nous proposons, enfin, des perspectives à l’interface des apports de la médecine de précision et de la médecine stratifiée pour l’approche clinique et de recherche de la somnolence et de l’hypersomnolence en médecine du sommeil.

The impact of break duration, time of break onset, and prior shift duration on the amount of sleep between shifts in heavy vehicle drivers

Article

Oct 2022
J SLEEP RES

This study aimed to examine the impact of break duration between consecutive shifts, time of break onset, and prior shift duration on total sleep time (TST) between shifts in heavy vehicle drivers (HVDs), and to assess the interaction between break duration and time of break onset. The sleep (actigraphy and sleep diaries) and work shifts (work diaries) of 27 HVDs were monitored during their usual work schedule for up to 9 weeks. Differences in TST between consecutive shifts and days off were assessed. Linear mixed models (followed by pairwise comparisons) assessed whether break duration, prior shift duration, time of break onset, and the interaction between break duration and break onset were related to TST between shifts. Investigators found TST between consecutive shifts (mean [SD] 6.38 [1.38] h) was significantly less than on days off (mean [SD] 7.63 [1.93] h; p < 0.001). Breaks starting between 12:01 and 8:00 a.m. led to shorter sleep (p < 0.05) compared to breaks starting between 4:01 and 8:00 p.m. Break durations up to 7, 9, and 11 h (Australian and European minimum break durations) resulted in a mean (SD) of 4.76 (1.06), 5.66 (0.77), and 6.41 (1.06) h of sleep, respectively. The impact of shift duration prior to the break and the interaction between break duration and time of break were not significant. HVDs’ sleep between workdays is influenced independently by break duration and time of break onset. This naturalistic study provides evidence that current break regulations prevent sufficient sleep duration in this industry. Work regulations should evaluate appropriate break durations and break onset times to allow longer sleep opportunities for HVDs.

Risk assessment of road traffic accidents related to sleepiness during driving: a systematic review

Article

Full-text available

Sep 2022

Shehzad Saleem

Background: Injuries due to accidental crash are the 8th leading cause of death worldwide. Sleepiness results in disrupted neurological function and is a major risk factor for road traffic accidents. Aims: This systematic review assessed the relationship between sleepiness during driving and road traffic accidents. Methods: A systematic review was conducted using online databases such as Wiley Online Library, JSTOR, Medline, and PubMed. Full-text, English language articles published between May 2000 and November 2020 were retrieved. Road traffic accident was set as the outcome of interest and sleepiness during driving as the exposure. The review included studies containing adjusted risk estimates (95% confidence interval). Ten cross-sectional studies (N = 55,945), 5 case-control studies (N = 3821), and 2 cohort studies (N =16,875) were included. Results: Over 50% of the participants in the different studies experienced sleep deprivation ranging from 3.5% to 67.3%. Abe et al. reported the highest (58%) frequency of sleepiness during driving in their cross-sectional study in Japan, and Nabi et al. reported the lowest (1.1%) in their cohort study in France. Conclusion: Sleepiness and sleep deprivation were related to road traffic accidents; and sleep deprivation was the main contributor to drowsiness while driving.

Weakened Sustained Attention and Increased Cognitive Effort after Total Sleep Deprivation: A Virtual Reality Ecological Study

Article

Full-text available

Sep 2022
INT J HUM-COMPUT INT

Total sleep deprivation (TSD) has a major impact on sustained attention as reported by previous studies that have investigated effects of TSD, however by using classical neuropsychological tests that lack ecological validity. To study the effects of TSD on daily-life activities, we carried out an ecological evaluation of sustained attention using a virtual reality task requiring driving along an unpredictable path. We enrolled 30 volunteers who underwent two experimental sessions: baseline (after normal sleep night) and after 36 h of total TSD. We assessed changes in sustained attentional performance by analysing the series of visuomotor adjustments while driving. After TSD, we found greater inaccuracy and longer attentional lapses. Furthermore, the visuomotor adjustments series exhibited higher long-range correlations (self-similarity) which has been associated with greater cognitive efforts. Sustained attention assessed by the ecological task requiring visuomotor coordination gets worse after 36 h of total TSD together with greater cognitive effort.

Sleep Deficiency in Adolescents: The School Start Time Debate

Article

Dec 2024

A qualitative study investigating fatigue among Indonesian freight-train drivers

Article

Full-text available

Nov 2024

Fatigue among Indonesian coal freight train drivers is a risk factor that has never been investigated. This studyevaluated fatigue among these train drivers and sought to determine work- and non work-related factorscontributing to fatigue. The objectives were achieved by conducting a field observation and semi-structuredinterviews (SSI) with 21 freight train drivers. Using a thematic analysis, four groups of factors (themes) wereidentified: 1) work demand, 2) management support, 3) quality of work and rest facilities, and 4) organizationalissues. Findings of this study demonstrated that fatigue among the drivers was unnecessarily excessive. Severalimportant causes of fatigue included extended period of duty duration (exceeding company policy), adverseworking physical environment, and the difficulty in obtaining good quality of rest, particularly at the destination(transit) station. Rest period between shifts was deemed inadequate, and back-to-back duties (separated with lessthan 8 h of rest) were often unavoidable. Satisfactory personnel scheduling and assignments were challenging,due to the complex nature of the external coal company operating environment, in addition to the freight trainlowest track priority that resulted in services backlogs, delays, and frequent stops along the routes. While furtherstudies were needed, short-term interventions could be done, including more ergonomic locomotive cabin andimproving rest facilities at the transit station. Long-term initiatives might include better coordination andcommunication with the coal company, especially in developing more accurate departure and arrival estimatesand train timetables.

Easy listening or driving distraction? The relationship between audiobook complexity level and driving performance on simple routes

Article

Nov 2024
TRANSPORT RES F-TRAF

The role of microsleeps to estimate sleepiness at the wheel and near-miss accidents in obstructive sleep apnea

Article

Sep 2024

Study Objectives:Obstructive sleep apnea (OSA) is considered a risk factor for sleepiness at the wheel (SW) and near-miss accidents (NMA). To date, there are subjective and objective methods such as the Maintenance of Wakefulness Test (MWT) to investigate sleepiness. However, these methods have limitations. Therefore, a new analysis of the MWT was introduced based on the identification of microsleeps (MS). So, we tested MS analysis to improve the discriminative ability of MWT in recognizing individuals at risk for SW and NMA in a population with OSA. Methods:The study was conducted on 100 naïve patients with suspected OSA referred to our Sleep Medicine Unit. All patients performed a full-standard polysomnography and MWT. The MWT was analyzed according to standard criteria, and the presence of MS episodes, the mean MS latency and the MS density (the mean absolute or relative number of MS) were assessed. Results:Microsleeps were observed in 100% of alert or sleepy patients and 47% of the fully alert (P <0.0001). Almost 90% of patients reporting NMA showed episodes of MS during MWT. The occurrence of NMA was related to EDS, MS latency and MS density (P <0.001). The discriminative power for the NMA of MS density measures was higher than that derived from latency analysis, particularly in patients without EDS and with a simultaneous mean sleep latency >33 minutes. Conclusions:MS analysis provides objective evidence of sleepiness and, therefore, could improve the discriminative ability of the MWT in recognizing individuals at high risk for accidents.

Road Traffic Injuries

Chapter

Jan 2024

Driver Distraction Detection based on Deep Learning Techniques using Images

Conference Paper

May 2024

Analysis of Real-Time Cognitive Fatigue Detection Systems for Driver Safety

Conference Paper

Apr 2024

Repeated electrical vestibular nerve stimulation (VeNS) reduces severity in moderate to severe insomnia; a randomized, sham-controlled trial; The Modius Sleep Study

Article

May 2024
BRAIN STIMUL

Die Rolle des Schlafes für anstrengende Leistung und Soziabilität

Chapter

Mar 2024

SPARK: A High-Efficiency Black-Box Domain Adaptation Framework for Source Privacy-Preserving Drowsiness Detection

Article

Mar 2024

Developing an effective and efficient electroencephalography (EEG)-based drowsiness monitoring system is crucial for enhancing road safety and reducing the risk of accidents. For general usage, cross-subject evaluation is indispensable. Despite progress in unsupervised domain adaptation (UDA) and source-free domain adaptation (SFDA) methods, these often rely on the availability of labeled source data or white-box source models, posing potential privacy risks. This study explores a more challenging setting of UDA for EEG-based drowsiness detection, termed black-box domain adaptation (BBDA). In BBDA, adaptation in the target domain relies solely on a black-box source model, without access to the source data or parameters of the source model. Specifically, we propose a framework called Self-distillation and Pseudo-labelling for Ensemble Deep Random Vector Functional Link (edRVFL)-based Black-box Knowledge Adaptation (SPARK). SPARK employs entropy-based selection of high-confidence samples, which are then pseudo-labeled to train a student edRVFL network. Subsequently, ensemble self-distillation is performed to extract knowledge by training the edRVFL using refined labels introduced by ensemble learning. This process further improves the robustness of the student edRVFL network. The features of the edRVFL are beneficial for improving the computational efficiency of the framework, making it more suitable for tasks involving small datasets. The proposed SPARK framework is evaluated on two publicly available driver drowsiness datasets. Experimental results demonstrate its superior performance over strong baselines, while significantly reducing training time. These findings underscore the potential for practical integration of the proposed framework into drowsiness monitoring systems, thereby contributing substantially to the privacy preservation of source subjects.

Reducing crash risk for young drivers: Protocol for a pragmatic randomised controlled trial to improve young driver sleep

Article

Mar 2024

Background Road trauma is a leading cause of death and disability for young Australians (15–24 years). Young adults are overrepresented in crashes due to sleepiness, with two-thirds of their fatal crashes attributed to sleepy driving. This trial aims to examine the effectiveness of a sleep extension and education program for improved road safety in young adults. Methods Young adults aged 18–24 years (n = 210) will be recruited for a pragmatic randomised controlled trial employing a placebo-controlled, parallel-groups design. The intervention group will undergo sleep extension and receive education on sleep, whereas the placebo control group will be provided with information about diet and nutrition. The primary outcomes of habitual sleep and on-road driving performance will be assessed via actigraphy and in-vehicle accelerometery. A range of secondary outcomes including driving behaviours (driving simulator), sleep (diaries and questionnaire) and socio-emotional measures will be assessed. Discussion Sleep is a modifiable factor that may reduce the risk of sleepiness-related crashes. Modifying sleep behaviour could potentially help to reduce the risk of young driver sleepiness-related crashes. This randomised control trial will objectively assess the efficacy of implementing sleep behaviour manipulation and education on reducing crash risk in young adult drivers.

Levels of Evidence in Transport Research

Conference Paper

Feb 2024

This article is an attempt to analyze the issue of the level of scientific evidence presented in broadly understood transport research. Various classifications of levels of evidence (LOE) have been formalized in the scientific literature and are reviewed in this article. They help assess the importance (rank) and quality of publicly presented scientific studies. On their basis, the recipient of scientific content forms an opinion on its usefulness and credibility. Not all LOEs are used in transportation studies. Those that are used are used with different frequencies. In this article, the authors analyze the problem of why more and less popular methods can be observed in scientific research in transport. The article tries to explain why transport research is currently being conducted in this way and, above all, whether it is possible to change the observed state of affairs in this matter.

Identifying multilayer differential core networks and effective discriminant features for driver fatigue detection

Article

Apr 2024
BIOMED SIGNAL PROCES

Driver fatigue detection based on EEG has received a lot of attention. In this paper, from the initial brain functional networks of EEG, we first identify multilayer differential core networks based on node and edge discrepancy between different states to capture more discriminant information for the task. Then, the discriminant features are constructed from the resulting multilayer core networks by tensor decomposition and feature selection. The resulting discriminant features contain not only structural information about the network of individual frequency bands, but also additional relational information between the networks of different frequency bands. Our method has the strong ability of information extraction and anti-interference, which can be directly applied to the initial network to identify and utilize weak links with discriminative power. The classification results on the publicly available dataset show that the average accuracy of our method is 9.5% higher than that of the baseline method. When applied to the initial functional network without any pre-processing, the proposed method of this paper can achieve a classification accuracy of 91.14%, which is higher than the results of state-of-the-art related studies on the same dataset. These results indicate that the proposed method is effective and reliable for detecting driver fatigue from EEG.

In-vehicle fragrance administration as a countermeasure for driver fatigue

Article

Dec 2023

Improving Road Safety with Ensemble Learning: Detecting Driver Anomalies Using Vehicle Inbuilt Cameras

Article

Nov 2023

15. Sleep Behaviors and Disorders

Chapter

Oct 2023

Current challenges and opportunities in global sleep medicine

Chapter

Jan 2023

Human being spends around one third of life in sleep, so normal sleep characteristics and its disorders have been the focus of attention of many scientists and physicians since long ago. The historical art works and scientific documents about sleep are the proof of this reality. However, modern sleep medicine with its own diagnostic procedures, therapeutic strategies, and sleep monitoring techniques is a new branch of medicine that has been introduced to the world not more than half a decade ago, primarily in the second half of the 20th century. Physicians and scientists in any branch of medicine have encountered challenges and obstacles while taking their primary steps. It is not surprising that we, as sleep specialists and scientists, may encounter many problems during the process of developing this new branch of medicine in our country. Although these problems differ in many aspects among various countries, there are some similarities. Since the development of sleep medicine, many professional sleep societies have evolved, many exclusive sleep journals have been published, guideline for accreditation of centers have been developed and also formalized fellowship training programs in medical universities all over the world have been established. Such developments have been helpful in reaching some milestones in overcoming some obstacles and challenges, although there is still a long way to reach the peak. Sharing the information regarding the situation of sleep medicine practice and training as well as challenges that each of us face in our daily practice and research can help us continue to improve global sleep health. While writing this chapter we connected to the major sleep scientists and physicians all over the world and asked for sharing their knowledge of development of sleep medicine in their countries. We discovered extremely valuable resources of what is going on in the practice of sleep medicine each country. In this chapter we will discuss the topic of sleep medicine in a couple of countries including China, Iran, South Korea, Russia, India, Saudi Arabia, Vietnam, Egypt, Armenia, Turkey, Nigeria and Morroco. For each country, we will first give some general information about the countries, their health care systems, sleep medicine practices, training, fellowship programs, and sleep medicine societies. Finally, we will discuss the costs of practicing sleep medicine and go through the challenges of practicing in this new field of medicine in each country.

A Study on Safety Measures with reference to Human Resource Management

Article

Full-text available

Apr 2023

Harshal Padwal

Employee‘s safety is that the major aspect of the organization. Safety may be measures or techniques implemented to scale back the chance of injury, loss and danger to persons, property or the environment in any facility or place involving the manufacturing, producing and processing of products or merchandise. The result reveals that the employees are feeling satisfied about the protection policies available within the company. Therefore the organization can increase the attention of the staff regarding the security policies by conducting orientation and safety programs.

Metabolomics-based Sleepiness Markers for Risk Prevention and Traffic Safety (ME-SMART): a monocentric, controlled, randomized, crossover trial

Article

Full-text available

Feb 2023
TRIALS

Background Too little sleep and the consequences thereof are a heavy burden in modern societies. In contrast to alcohol or illicit drug use, there are no quick roadside or workplace tests for objective biomarkers for sleepiness. We hypothesize that changes in physiological functions (such as sleep–wake regulation) are reflected in changes of endogenous metabolism and should therefore be detectable as a change in metabolic profiles. This study will allow for creating a reliable and objective panel of candidate biomarkers being indicative for sleepiness and its behavioral outcomes. Methods This is a monocentric, controlled, randomized, crossover, clinical study to detect potential biomarkers. Each of the anticipated 24 participants will be allocated in randomized order to each of the three study arms (control, sleep restriction, and sleep deprivation). These only differ in the amount of hours slept per night. In the control condition, participants will adhere to a 16/8 h wake/sleep regime. In both sleep restriction and sleep deprivation conditions, participants will accumulate a total sleep deficit of 8 h, achieved by different wake/sleep regimes that simulate real-life scenarios. The primary outcome is changes in the metabolic profile (i.e., metabolome) in oral fluid. Secondary outcome measures will include driving performance, psychomotor vigilance test, d2 Test of Attention, visual attention test, subjective (situational) sleepiness, electroencephalographic changes, behavioral markers of sleepiness, changes in metabolite concentrations in exhaled breath and finger sweat, and correlation of metabolic changes among biological matrices. Discussion This is the first trial of its kind that investigates complete metabolic profiles combined with performance monitoring in humans over a multi-day period involving different sleep–wake schedules. Hereby, we aim to establish a candidate biomarker panel being indicative for sleepiness and its behavioral outcomes. To date, there are no robust and easily accessible biomarkers for the detection of sleepiness, even though the vast damage on society is well known. Thus, our findings will be of high value for many related disciplines. Trial registration ClinicalTrials.gov Identifier NCT05585515, released on 18.10.2022; Swiss National Clinical Trial Portal SNCTP000005089, registered on 12 August 2022.

Driver Drowsiness Detection Using AI

Research

Full-text available

Aug 2022

Drowsiness and fatigue are one of the main causes leading to road accidents. They can be prevented by taking effort to get enough sleep before driving, drink coffee or energy drink, or have a rest when the signs of drowsiness occur. The popular drowsiness detection method uses complex methods, such as EEG and ECG. This method has high accuracy for its measurement but it need to use contact measurement and it has many limitations on driver fatigue and drowsiness monitor. Thus, it is not comfortable to be used in real time driving. This paper proposes a way to detect the drowsiness signs among drivers by measuring the eye closing rate and yawning. This project describes on how to detect the eyes and mouth in a video recorded from the experiment conducted by AIROS (American Institute of Road Safety). In the video, a participant will drive the driving simulation system and a webcam will be place in front of the driving simulator. The video will be recorded using the webcam to see the transition from awake to fatigue and finally, drowsy. The designed system deals with detecting the face area of the image captured from the video. The purpose of using the face area so it can narrow down to detect eyes and mouth within the face area. Once the face is found, the eyes and mouth are found by creating the eye for left and right eye detection and also mouth detection. A computer vision based thoughts have been used for the creation of a Drowsy Driver Detection System. The little camera has been utilized by framework that concentrates straight towards the essence of driver and checks the driver's eyes with a particular ultimate objective to perceive weakness. A notice sign is issued to alert the driver, in such circumstance when exhaustion is perceived. The framework oversees using information picked up for the picture to find the facial tourist spots, which gets the area where the eyes of an individual may exist. On the off chance that the eyes of driver are discovered close for a specific measure of casings, the proposed framework accept that the driver is falling asleep and an alarm of caution has been issued. The structure can work just when the eye are found, and works in encompassing lighting conditions too.

Cognitive State Analysis, Understanding, and Decoding from the Perspective of Brain Connectivity

Chapter

Jun 2021

The Bordeaux Sleepiness Scale (BOSS): a new questionnaire to measure sleep-related driving risk

Article

Feb 2023

Study objectives: Sleepiness is a well-known risk factor for traffic accidents. Our study presents a new questionnaire, the Bordeaux Sleepiness Scale (BOSS), specifically designed to evaluate the sleep-related driving risk in patients with sleep disorders. Methods: The BOSS was designed by gathering data on the socio-demographics, sleepiness, driving items and traffic accidental exposure (kilometers driven) in the past year of 293 patients followed for sleep disorders at a French sleep clinic. It was then validated on data from a large population-based cohort of 7,296 highway drivers. Its performance was compared to the Epworth Sleepiness Scale (ESS) and to self-reported episodes of severe sleepiness at the wheel (SAW). Receiver Operating Characteristic (ROC) curves were computed. Results: The sensitivity and specificity of the BOSS (cut-off = 3) to predict sleep-related near-misses or accidents was respectively 82% and 74%, with an area under the ROC curve of 0.83. In a patients cohort and in a large population-based cohort, the area under the curve of the BOSS was significantly larger than that of the ESS (P<.001). Although the areas under the curve were equivalent between the BOSS and SAW, the specificity of the BOSS was higher. Conclusions: The BOSS scale combining exposure (kilometers driven) and self-perception of situational sleepiness provides a simple and reliable evaluation of the sleep-related driving risk. This short specific questionnaire should be promoted as first line to evaluate the risk of traffic accidents in sleepy patients.

Determinanty bezpieczeństwa transportu drogowego towarów w krajach Unii Europejskiej / Determinants of road freight transport safety in European Union countries

Chapter

Dec 2022

PL Poprawa bezpieczeństwa ruchu drogowego jest jednym z zasadniczych celów Wspólnoty Europejskiej oraz poszczególnych jej państw członkowskich. Wypadki drogowe niosą za sobą ogromne koszty zarówno dla państwa, przedsiębiorstw, jak i indywidulanych użytkowników dróg. Jak wynika z raportu Komisji Europejskiej (KE), koszty ludzkiego życia wycenione na podstawie wartości statystycznego życia (VSL) wynoszą 3,5 mln Euro. W niniejszym rozdziale przedstawiono zależności pomiędzy liczbą ofiar wypadków drogowych powodowanych przez pojazdy ciężarowe a wybranymi czynnikami je determinującymi w poszczególnych krajach EU. Przeprowadzone badania pozwalają na stwierdzenie, że udział pojazdów ciężarowych w liczbie ofiar wypadków drogowych nie jest duży. Jednak sam wypadek drogowy z udziałem tego typu pojazdów powoduje wiele negatywnych następstw dla przedsiębiorstwa transportowego. Analiza pojedynczych czynników takich, jak liczba pojazdów w danym kraju, dopuszczalna prędkość czy średni wiek pojazdów nie pozwala wskazać jednoznacznie, że jeden z badanych czynników ma zasadniczy wpływ na liczbę ofiar śmiertelnych w wypadkach drogowych. Uznać zatem należy, że wypadki drogowe z udziałem ofiar śmiertelnych są wypadkową wielu czynników, ale biorąc pod uwagę podejście systemowe należy te czynniki rozpatrywać z punktu widzenia działania człowieka, otoczenia i pojazdu. EN Road safety is one of the fundamental objectives of the European Community authorities and of the individual Member States. Road accidents entail huge costs, both for the state, businesses and individual road users. According to the report of the European Commission (EC), the cost of human life valued on the basis of the value of a statistical life (VSL) is 3.5 million Euros. This chapter presents the relationship between the number of victims of road accidents caused by heavy goods vehicles and selected factors that determine them in different countries of the EU. The research carried out allows us to state that the share of heavy goods vehicles in the number of road accident fatalities is not high. However, a road accident involving this type of vehicle has many negative consequences for transport company. The analysis of single factors, such as the number of vehicles in a given country, the permissible speed limit or the average age of vehicles does not allow us to clearly indicate that one of the examined factors has a major impact on the number of fatalities in road accidents. It should therefore be acknowledged that road accidents involving fatalities are the result of many factors, but, taking account systemic approach, these factors should be considered from the point of view of human, environmental and vehicle performance.

An analysis of collision avoidance manoeuvres in emergency traffic situations

Article

Full-text available

Jun 2016

Rafał Stanisław Jurecki

This paper provides an overview of the research into the driver behaviour in simulated near collision situations. The aim of such investigations is to determine various parameters characterising the driver performance, e.g. driver response time. The driver response time is a very important parameter used, for example, to analyse road accidents. The results presented in this paper come from a study performed for two different emergency traffic situations using some predefined procedures (scenarios). The tests included situations in which a person driving a subject vehicle on a test track was to respond to obstacle mock-ups on a conflicting path (intrusion of a pedestrian from the left or from the right and intrusion of a vehicle from the right). The test data was used to determine the parameters describing the driver behaviour, i.e. the braking response time (braking manoeuvre), the steering response time (steering manoeuvre) and the intensity of the two manoeuvres. This paper compares the values of the driver response time for two scenarios, each with two variants. The average values of the braking response time and the steering response time were determined on a closed track in relation to the Time-To-Collision (TTC) in the range 0,6÷3s, characterising a near collision situation. Another parameter describing the driver behaviour discussed in this paper is the intensity of an avoidance manoeuvre. In the case of braking, the relative brake pedal displacement was analysed, while in the steering manoeuvre, the steering angle was taken into account. The average values of the braking displacement and the steering angle were presented in the function of the TTC. This paper looks at the relationship between the intensity of the driver response (braking, steering), the driver response time and the TTC.

Hazard perception performance and visual scanning behaviours: The effect of sleepiness

Article

Oct 2022
TRANSPORT RES F-TRAF

Driver sleepiness accounts for a substantial proportion of crashes in Australia and Worldwide. Young adults are overrepresented in sleep-related crashes and are more susceptible to sleepiness, resulting in impaired attention and driving performance. Visual scanning behaviour can affect the role between attention and information acquisition from the driver's environment. Thus, if attention is impaired, visual scanning behaviours are likely to show decrements as well. Overall, 32 young adults aged between 20 and 25 years completed a 60-minute hazard perception task to examine the effect of sleepiness and time-on-task on hazard perception performance, visual scanning behaviours, subjective sleepiness scores, and psychomotor vigilance test performance. The main outcomes include decrements in hazard perception performance and a restriction in horizontal and vertical eye scanning ranges across the 60-minute session, but with a more pronounced effect when sleep-restricted. These outcomes were consistent with increases in subjective sleepiness and behavioural metrics of sleepiness assessed via the PVT. Reductions in scanning range could limit opportunities to attend to hazards and other critical safety events. The current study outcomes provide an important contribution regarding the risks associated with sleepy driving performance.

A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale

Article

Full-text available

Jan 1992

Murray Johns

The development and use of a new scale, the Epworth sleepiness scale (ESS), is described. This is a simple, self-administered questionnaire which is shown to provide a measurement of the subject's general level of daytime sleepiness. One hundred and eighty adults answered the ESS, including 30 normal men and women as controls and 150 patients with a range of sleep disorders. They rated the chances that they would doze off or fall asleep when in eight different situations commonly encountered in daily life. Total ESS scores significantly distinguished normal subjects from patients in various diagnostic groups including obstructive sleep apnea syndrome, narcolepsy and idiopathic hypersomnia. ESS scores were significantly correlated with sleep latency measured during the multiple sleep latency test and during overnight polysomnography. In patients with obstructive sleep apnea syndrome ESS scores were significantly correlated with the respiratory disturbance index and the minimum SaO2 recorded overnight. ESS scores of patients who simply snored did not differ from controls.

The Cost of Sleep-Related Accidents: A Report for the National Commission on Sleep Disorders Research

Article

Full-text available

Mar 1994

Damien Leger

This report, prepared for the National Commission on Sleep Disorders Research, explores the economic implications of sleepiness in relation to accidents. In Part One, I describe the frequency of accidents in the United States and explain a method for estimating the economic cost of these of accidents. Accidents are the fourth leading cause of mortality in the United States, and motor-vehicle accidents represent 51% of total deaths caused by accidents. The method used for calculating the cost of accidents is called "the human capital approach". It is based on the principle that "one person produces a sum of output during his/her life-time, which can be approximated by his/her earnings". It is necessary to understand that this estimate of human value is not intended to reduce human beings to a sum of earnings during his/her lifetime. It does, however, serve as a useful indicator in making decisions regarding public health policy for the country. The results of the total cost of accidents and the relative costs for work-related, home-based and public accidents in 1988 are discussed. In Part Two, I explore the role sleepiness plays in contributing to the total number of accidents. The difficulty of researching this subject is compounded by the fact that reports of rates of accidents related to sleepiness differ significantly from author to author. This is true both for drivers with sleep disorders and those without. We have calculated two different rates for estimating the number of motor-vehicle accidents caused by sleepiness.(ABSTRACT TRUNCATED AT 250 WORDS)

Pilcher JJ, Huffcutt AI. Effects of sleep deprivation on performance: a meta-analysis. Sleep 19: 318-326

Article

Full-text available

Jun 1996

To quantitatively describe the effects of sleep loss, we used meta-analysis, a technique relatively new to the sleep research field, to mathematically summarize data from 19 original research studies. Results of our analysis of 143 study coefficients and a total sample size of 1.932 suggest that overall sleep deprivation strongly impairs human functioning. Moreover, we found that mood is more affected by sleep deprivation than either cognitive or motor performance and that partial sleep deprivation has a more profound effect on functioning than either long-term or short-term sleep deprivation. In general, these results indicate that the effects of sleep deprivation may be underestimated in some narrative reviews, particularly those concerning the effects of partial sleep deprivation.

The Association between Sleep Apnea and the Risk of Traffic Accidents

Article

Full-text available

Apr 1999

Drowsiness and lack of concentration may contribute to traffic accidents. We conducted a case-control study of the relation between sleep apnea and the risk of traffic accidents. The case patients were 102 drivers who received emergency treatment at hospitals in Burgos or Santander, Spain, after highway traffic accidents between April and December 1995. The controls were 152 patients randomly selected from primary care centers in the same cities and matched with the case patients for age and sex. Respiratory polygraphy was used to screen the patients for sleep apnea at home, and conventional polysomnography was used to confirm the diagnosis. The apnea-hypopnea index (the total number of episodes of apnea and hypopnea divided by the number of hours of sleep) was calculated for each participant. The mean age of the participants was 44 years; 77 percent were men. As compared with those without sleep apnea, patients with an apnea-hypopnea index of 10 or higher had an odds ratio of 6.3 (95 percent confidence interval, 2.4 to 16.2) for having a traffic accident. This relation remained significant after adjustment for potential confounders, such as alcohol consumption, visual-refraction disorders, body-mass index, years of driving, age, history with respect to traffic accidents, use of medications causing drowsiness, and sleep schedule. Among subjects with an apnea-hypopnea index of 10 or more, the risk of an accident was higher among those who had consumed alcohol on the day of the accident than among those who had not. There is a strong association between sleep apnea, as measured by the apnea-hypopnea index, and the risk of traffic accidents.

Long Distance Driving and Self–Induced Sleep Deprivation among Automobile Drivers

Article

Full-text available

Jun 1999

To evaluate the sleep hygiene and prevalence of sleep deprivation among a large sample of automobile drivers. From the 15th of June to the 4th of August 1996, with the help of the French highway patrol, we randomly stopped automobile drivers at the toll booths of Bordeaux and Biarritz. All subjects completed a validated questionnaire on sleep/wake habits during the year. After answering the questionnaire, subjects completed a graphic travel and sleep log of the three days preceding the interview. We randomly stopped 2196 automobile drivers. Ninety-one percent of the sample (mean age 43 +/- 13 years) agreed to participate in the survey. Fifty percent of the drivers decreased their total sleep time in the 24 hours before the interview compared with their regular self-reported sleep time. 12.5% presented a sleep debt > 180 minutes, and 2.7% presented a sleep debt > 300 minutes. Being young, commuting to work, driving long distances, starting the trip at night, being an "evening" person, being a long sleeper during the week, and sleeping in on the week-end were risk factors significantly associated with sleep debt. The results of the study highlight variables (long-distance driving, youth, sleep restriction) that are frequently associated with sleep-related accidents.

Fatigue, alcohol, and serious road crashes in France: Factorial study of national data

Article

Full-text available

May 2001

France has a high rate of road traffic crashes but the importance of the driver fatigue factor has not been investigated, nor have comparisons been made with alcohol related crashes. This study investigated the role of fatigue in serious road crashes using the French national database. Four categories of crash were identified: alcohol related; fatigue related; alcohol and fatigue related; no alcohol or fatigue. A table summarises the results, looking at times of day, numbers of crashes, numbers of deaths, and numbers with severely injured victims. Daytime crashes, physical handicap, driver distraction and weekend versus weekday variables were also analysed. Fatigue, especially when combined with alcohol presents a particularly high risk of road crashes resulting in death or serious injury.

Principles and Practice of Sleep Medicine

Book

Jan 2005

This authoritative guide to sleep medicine is also available as an e-dition, book (ISBN: 1416003207) plus updated online reference! The new edition of this definitive resource has been completely revised and updated to provide all of the latest scientific and clinical advances. Drs. Kryger, Roth, and Dementand over 170 international expertsdiscuss the most recent data, management guidelines, and treatments for a full range of sleep problems. Representing a wide variety of specialties, including pulmonary, neurology, psychiatry, cardiology, internal medicine, otolaryngology, and primary care, this whos who of experts delivers the most compelling, readable, and scientifically accurate source of sleep medicine available today. Includes user-friendly synopses of important background information before all basic science chapters. Provides expert coverage of narcolepsy * movement disorders * breathing disorders * gastrointestinal problems * neurological conditions * psychiatric disturbances * substance abuse * and more. Discusses hot topics such as the genetic mechanisms of circadian rhythms * the relationship between obesity, hormones, and sleep apnea * sleep apnea and arterial hypertension * and more. Includes a new section on Cardiovascular Disorders that examines the links between sleep breathing disorders and cardiovascular abnormalities, as well as the use of sleep related therapies for congestive heart failure. Provides a new section on Womens Health and Sleep Disorders that includes information on the effects of hormonal changes during pregnancy and menopause on sleep. Features the fresh perspectives of 4 new section editors. Employs a more consistent chapter organization for better readability and easier navigation.

Daytime Sleepiness and Alertness. Principles and Practice of Sleep Medicine

Article

Jan 2000

Use of Clinical Tools and Tests In Sleep Medicine

Chapter

Dec 2005

Ronald D Chervin

Driver Sleepiness as a Factor in Car and Heavy Ground Vehicle Accidents

Book

Jan 1995

G Maycock

Sleepiness, Driving, and Motor Vehicle Crashes

Article

Jun 1998

Objective. - To assess the contribution of driver sleepiness to highway crashes and review recent recommendations to change federal hours-of-service regulations for commercial motor vehicle drivers. Data Sources. - Information was derived from a search on the MEDLINE, Transportation Research Information Service (TRIS), and Bibliographic Electronic Databases of Sleep (BEDS) databases from 1975 through 1997 and from manual review of the reference lists in relevant journal articles, government publications, conference proceedings, and textbooks. Data Synthesis. - Driver sleepiness is a causative factor in 1% to 3% of all US motor vehicle crashes. Surveys of the prevalence of sleepy behavior in drivers suggest that sleepiness may be a more common cause of highway crashes than is reflected in these estimates. About 96% of sleep-related crashes involve passenger vehicle drivers and 3% involve drivers of large trucks. Risk factors include youth, shift work, alcohol and other drug use, over-the-counter and prescription medications, and sleep disorders. Conclusions. - Increased awareness of the relationship between sleepiness and motor vehicle crashes will promote the health and safety of drivers and highway users. Physicians can contribute by encouraging good sleep habits, recognizing and treating sleep-related problems, and counseling patients about the risks of driving while sleepy. To protect public health and safety, the American Medical Association recommends continued research on devices and technologies to detect signs of sleepiness and prevent the deterioration of driver alertness and performance. Educational programs about the risks of falling asleep while driving are needed for physicians, the public, and commercial truck drivers.

Performing while sleepy: Effects of experimentally induced sleepiness

Chapter

Jan 1991

Work hours, sleepiness and the underlying mechanisms

Article

Dec 1995
J SLEEP RES

Torbjörn Åkerstedt

Severe subjective and physiological sleepiness occur in night work, afflict almost all individuals and are associated with a performance impairment severe enough to explain night-work accident data. The alertness deficit is caused by the displacement of work to the circadian phase which is least conducive to alert behaviour, by extension of the time spent awake and by the reduction of sleep length (due to circadian interference with sleep). Sleepiness will be extreme when the three causes are operative simultaneously. The three factors may be used quantitatively to predict sleepiness.

Methods of adjustment for estimating the attributable risk in case-control studies: A review

Article

Nov 1991

Jacques Bénichou

In the 1980's, progress was made in adjusting estimates of the attributable risk (AR) for confounding factors and in calculating associated confidence intervals. In this paper, methods of adjustment for estimation of the AR in case-control studies are reviewed. The limitations and problems associated with two methods based on stratification, the weighted-sum approach and the Mantel-Haenszel approach, are discussed. They include small-sample bias with the weighted-sum approach and the difficulty of taking interaction into account with the Mantel-Haenszel approach. A third method based on logistic regression is reviewed. It is argued that this latter method has the greatest generality and flexibility, and includes the two other approaches as special cases. Throughout the paper, an example of a case-control study of oesophageal cancer illustrates the use of the methods described.

Modeling and Variable Selection in Epidemiologic Analysis

Article

Apr 1989

Sander Greenland

This paper provides an overview of problems in multivariate modeling of epidemiologic data, and examines some proposed solutions. Special attention is given to the task of model selection, which involves selection of the model form, selection of the variables to enter the model, and selection of the form of these variables in the model. Several conclusions are drawn, among them: a) model and variable forms should be selected based on regression diagnostic procedures, in addition to goodness-of-fit tests; b) variable-selection algorithms in current packaged programs, such as conventional stepwise regression, can easily lead to invalid estimates and tests of effect; and c) variable selection is better approached by direct estimation of the degree of confounding produced by each variable than by significance-testing algorithms. As a general rule, before using a model to estimate effects, one should evaluate the assumptions implied by the model against both the data and prior information.

Quantification of Sleepiness: A New Approach

Article

Aug 1973

Investigated whether the Stanford Sleepiness Scale (SSS), a self-rating scale used to quantify progressive steps in sleepiness, cross-validates with performance on mental tasks and whether the SSS demonstrates changes in sleepiness with sleep loss. 5 undergraduates were given a brief test of memory and the Wilkinson Addition Test in 2 test sessions and the Wilkinson Vigilance Test in 2 other sessions spaced throughout a 16-hr day for 6 days. Ss made SSS ratings every 15 min during their waking activities. On Night 4, Ss underwent all-night sleep deprivation. On all other nights, Ss were allowed only 8 hrs in bed. Mean SSS ratings correlated r = .68 with performance on the Wilkinson tests. Discrete SSS ratings correlated r = .47 with performance on the memory test. Moreover, mean baseline SSS ratings were found to be significantly lower than corresponding ratings of the deprivation period. (PsycINFO Database Record (c) 2005 APA, all rights reserved)

Attributable Risk Estimation in Case-Control Studies

Article

Feb 1994

Driver sleepiness: Occupational screening and the physician's role

Article

Nov 1999
Aust New Zeal J Med

R J Pierce

The role of driver sleepiness in car crashes: A systematic review of epidemiological studies

Article

Feb 2001
ACCIDENT ANAL PREV

To assess the available evidence for a causal role of driver sleepiness in car crashes or car crash injury, and to quantify the effect, a systematic review of the international literature was conducted. The review included all studies with a fatigue-related exposure measure, a crash or crash injury outcome measure and a comparison group, regardless of publication status, language or date of the study. Eighteen cross-sectional studies and one case-control study fulfilled the inclusion criteria. The fatigue-related exposures investigated in these studies were sleep disorders (n = 14), shift work (n = 2), sleep deprivation/fragmentation (n = 1), and excessive daytime sleepiness (n = 2). Only one study used an injury outcome measure. Studies were limited in their ability to establish a causal relationship by their design, by biases, and in many cases, by small sample sizes. The better quality cross-sectional studies were suggestive of a positive relationship between fatigue and crash risk, but could not provide reliable estimates of the strength of the association. The case-control study provided moderately strong evidence for an association between sleep apnoea and risk of driver injury, with an adjusted odds ratio of 7.2 (95% confidence interval 2.4-21.8). We conclude that the direct epidemiological evidence for a causal role of fatigue in car crashes is weak, but suggestive of an effect. To estimate the burden of injury due to fatigue-related crashes in the population, information is required from well-designed observational epidemiological studies about the prevalence of fatigue in the car driving population and the size of the risk this confers.

Prevalence of Driver Sleepiness in a Random Population-based Sample of Car Driving

Article

Sep 2001

To obtain reliable estimates of the prevalence of driver sleepiness. A two-stage cluster sampling technique was employed to obtain a sample of car drivers representative of time spent driving on public roads in a geographically defined region. Data were collected by interviewer-administered questionnaire, and analysed in accordance with the sampling design. The Auckland region of New Zealand, between April 1998 and July 1999. 588 drivers of cars and other light vehicles recruited at 69 roadside survey sites. Of 746 eligible participants, 79% were interviewed, 12% refused, 8% were untraceable, and 1% were unable to give informed consent. From this sample we estimated that 58.7% of driving was undertaken by men. The vast majority of driving (90.8%) was undertaken by drivers with Epworth Sleepiness scores in the normal range (<10), but a significant minority was undertaken by drivers with one or more characteristics likely to impair alertness. 3.1% had < or = 5 hours sleep in the previous 24 hours, and 21.9% had < or = 4 full nights sleep in the previous week. The triad of symptoms associated with sleep apnea (snoring, choking, and breathing pauses while sleeping) was present in 1.6%; and 8.1% worked a pattern of shifts likely to interfere with normal sleep. The prevalence of sleepiness amongst a random sample of New Zealand car driving was low, and less than suggested by previous studies.

Drowsiness, counter-measures to drowsiness, and the risk of a motor vehicle crash

Article

Oct 2001

Knowledge of how different indicators of drowsiness affect crash risk might be useful to drivers. This study sought to estimate how drowsiness related factors, and factors that might counteract drowsiness, are related to the risk of a crash. Drivers on major highways in a rural Washington county were studied using a matched case-control design. Control (n=199) drivers were matched to drivers in crashes (n=200) on driving location, travel direction, hour, and day of the week. Crash risk was greater among drivers who felt they were falling asleep (adjusted relative risk (aRR) 14.2, 95% confidence interval (CI) 1.4 to 147) and those who drove longer distances (aRR 2.2 for each additional 100 miles, 95% CI 1.4 to 3.3). Risk was also greater among drivers who had slept nine or fewer hours in the previous 48 hours, compared with those who had slept 12 hours. Crash risk was less for drivers who used a highway rest stop (aRR 0.5, 95% CI 0.3 to 1.0), drank coffee within the last two hours (aRR 0.5, 95% CI 0.3 to 0.9), or played a radio while driving (aRR 0.6, 95% CI .4 to 1.0). Drivers may be able to decrease their risk of crashing if they: (1) stop driving if they feel they are falling asleep; (2) use highway rest stops; (3) drink coffee; (4) turn on a radio; (5) get at least nine hours sleep in the 48 hours before a trip; and (6) avoid driving long distances by sharing the driving or interrupting the trip.

Principles and practice of sleep medicine

Jan 2000

M Bonnet

Bonnet M. Sleep deprivation. In: Kryger M, Roth T, Dement W, ed. Principles and practice of sleep medicine. 3rd ed. Philadelphia, PA: WB Saunders, 2000.

Driver sleepiness and risk of serious injury to car occupants: population based case control study

Abstract

No full-text available

Recommended publications

Driver sleepiness and risk of serious injury to car occupants: Population based case control study