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Philip P, Micoulaud-Franchi JA, Taillard J, Coelho J, Tisserand C, Dauvilliers Y, Sagaspe P. The Bordeaux Sleepiness Scale (BOSS): a new questionnaire to measure sleep-related driving risk. J Clin Sleep Med 2023; 19:957-965. [PMID: 36727504 PMCID: PMC10152350 DOI: 10.5664/jcsm.10470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 02/03/2023]
Abstract
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 sleep-related driving risk in patients with sleep disorders. METHODS The BOSS was designed by gathering data on sociodemographics, sleepiness, driving items, and traffic accident 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 and to self-reported episodes of severe sleepiness at the wheel. Receiver operating characteristic curves were computed. RESULTS The sensitivity and specificity of the BOSS (cutoff = 3) to predict sleep-related near-misses or accidents was, respectively, 82% and 74%, with an area under the receiver operating characteristic curve of 0.83. In a cohort of patients and a large population-based cohort, the area under the curve of the BOSS was significantly larger than that of the Epworth sleepiness scale (P < .001). Although the areas under the curve were equivalent between the BOSS and sleepiness at the wheel, 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 sleep-related driving risk. This short, specific questionnaire should be promoted as a first-line tool to evaluate the risk of traffic accidents in sleepy patients. CITATION Philip P, Micoulaud-Franchi J-A, Taillard J, et al. The Bordeaux Sleepiness Scale (BOSS): a new questionnaire to measure sleep-related driving risk. J Clin Sleep Med. 2023;19(5):957-965.
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Affiliation(s)
- Pierre Philip
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
- INSERM CIC1401, Université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Jacques Taillard
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Julien Coelho
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | | | - Yves Dauvilliers
- Reference National Center for Narcolepsy, Sleep Unit, CHU Montpellier, Montpellier, France
- PSNREC, University of Montpellier, INSERM, Montpellier, France
| | - Patricia Sagaspe
- Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
- CNRS, SANPSY, UMR 6033, Bordeaux, France
- CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
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Sprajcer M, Dawson D, Kosmadopoulos A, Sach EJ, Crowther ME, Sargent C, Roach GD. How Tired is Too Tired to Drive? A Systematic Review Assessing the Use of Prior Sleep Duration to Detect Driving Impairment. Nat Sci Sleep 2023; 15:175-206. [PMID: 37038440 PMCID: PMC10082604 DOI: 10.2147/nss.s392441] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/03/2023] [Indexed: 04/12/2023] Open
Abstract
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.
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Affiliation(s)
- Madeline Sprajcer
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
- Correspondence: Madeline Sprajcer, Central Queensland University, Appleton Institute, 44 Greenhill Road, Wayville, SA, 5034, Australia, Email
| | - Drew Dawson
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Anastasi Kosmadopoulos
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Edward J Sach
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Meagan E Crowther
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Charli Sargent
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
| | - Gregory D Roach
- Appleton Institute for Behavioural Sciences, Central Queensland University, Wayville, SA, Australia
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Pérez-Carbonell L, Mignot E, Leschziner G, Dauvilliers Y. Understanding and approaching excessive daytime sleepiness. Lancet 2022; 400:1033-1046. [PMID: 36115367 DOI: 10.1016/s0140-6736(22)01018-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/10/2022] [Accepted: 05/19/2022] [Indexed: 10/14/2022]
Abstract
Excessive daytime sleepiness (EDS) is a public health issue. However, it remains largely undervalued, scarcely diagnosed, and poorly supported. Variations in the definition of EDS and limitations in clinical assessment lead to difficulties in its epidemiological study, but the relevance of this symptom from a socioeconomic perspective is inarguable. EDS might be a consequence of several behavioural issues leading to insufficient or disrupted sleep, as well as a consequence of sleep disorders including sleep apnoea syndrome, circadian disorders, central hypersomnolence disorders (narcolepsy and idiopathic hypersomnia), other medical or psychiatric conditions, or medications. Furthermore, EDS can have implications for health as it is thought to act as a risk factor for other conditions, such as cardiovascular and neurodegenerative disorders. Because of the heterogeneous causes of EDS and the complexity of its pathophysiology, management will largely depend on the cause, with the final aim of making treatment specific to the individual using precision medicine and personalised medicine.
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Affiliation(s)
| | - Emmanuel Mignot
- Center for Narcolepsy, Stanford University, Palo Alto, CA, USA
| | - Guy Leschziner
- Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK; Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yves Dauvilliers
- Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Département de Neurologie, Hôpital Gui-de-Chauliac, Inserm INM, Université Montpellier, Montpellier, France
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4
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Chemical Characterization and Preliminary Evaluation of the Efficacy and Tolerability of a Food Supplement Based on Pomegranate Extract, B Vitamins, and Vitamin C against Prolonged Fatigue in Healthy Consumers. Processes (Basel) 2022. [DOI: 10.3390/pr10020208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Fatigue, characterized by periods of exhaustion that interfere with normal activities and negatively affect quality of life, can be classified as prolonged fatigue (or short-term fatigue, SF) or chronic fatigue. Vitamin deficiency and chronic inflammation seem to be possible causes of fatigue. Due to the unavailability of effective remedies that attenuate fatigue and provide consumer satisfaction, the aim of this investigation is to assess whether a commercial food supplement consisting of pomegranate extract with known anti-inflammatory activity, B vitamins, and vitamin C can help fight SF. To this end, the chemical composition of whole fruit pomegranate dry extract was determined through a RP-UHPLC–HRMS method, which indicated the presence of ellagitannins, gallotannins, and organic and phenolic acids. In a survey of consumers of food supplements aimed at reducing fatigue, 78 subjects (21 men and 57 women) were recruited for one month to evaluate the efficacy and tolerability of this food supplement through validated questionnaires for assessing fatigue level and quality of life. The consumers reported a significant improvement in their conditions without adverse effects over this time period. Although further studies are needed, these preliminary data suggest the capacity of a combination of pomegranate extract and hydrosoluble vitamins to alleviate SF.
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Sagaspe P, Micoulaud-Franchi JA, Bioulac S, Taillard J, Guichard K, Bonhomme E, Dauvilliers Y, Bastien CH, Philip P. Self-perceived sleep during the Maintenance of Wakefulness Test: how does it predict accidental risk in patients with sleep disorders? Sleep 2021; 44:6309942. [PMID: 34173829 DOI: 10.1093/sleep/zsab159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 05/17/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES To determine whether the feeling of having slept or not during the Maintenance of Wakefulness Test (MWT) is associated with the occurrence of self-reported sleep-related traffic near misses and accidents in patients with sleep disorders. METHODS This study was conducted in patients hospitalized in a French sleep center to perform a 4*40 min MWT. Relationship between mean sleep latency on the MWT, feeling of having slept or not during MWT trials and sleep-related near misses and accidents reported during the past year was analyzed. RESULTS 192 patients suffering from OSAS, idiopathic hypersomnia, narcolepsy, restless leg syndrome or insufficient sleep syndrome were included. 165 patients presented no or one misjudgment of feeling of having slept during MWT trials while 27 presented more than two misjudgments. Almost half of the latter (48.1%) reported a sleepiness-related traffic near miss or accident in the past year versus only one third (27.9%) for the former (P<.05). Multivariate logistic regression showed that patients with more than two misjudgments had a 2.52-fold (95% CI, 1.07-5.95, P<.05) increase in the risk of reporting a sleepiness-related near miss/accident. CONCLUSIONS Misjudgment in self-perceived sleep during the MWT is associated with the occurrence of self-reported sleepiness-related traffic near misses and accidents in the past year in patients suffering from sleep disorders. Asking about the perception of the occurrence of sleep during the MWT could be used to improve driving risk assessment in addition to sleep latencies.
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Affiliation(s)
- Patricia Sagaspe
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Stéphanie Bioulac
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Jacques Taillard
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Kelly Guichard
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Emilien Bonhomme
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France
| | - Yves Dauvilliers
- Reference National Center for Narcolepsy, Sleep Unit, CHU Montpellier, Montpellier, France.,PSNREC, University of Montpellier, INSERM, Montpellier, France
| | - Célyne H Bastien
- School of Psychology, Laval University, Quebec, Canada.,CERVO Research Centre, Beauport, Quebec, Canada
| | - Pierre Philip
- University of Bordeaux, Sleep, Addiction and Neuropsychiatry, USR, Bordeaux, France.,CNRS, SANPSY, USR, Bordeaux, France.,CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
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Sleepiness Behind the Wheel and the Implementation of European Driving Regulations. Sleep Med Clin 2021; 16:533-543. [PMID: 34325829 DOI: 10.1016/j.jsmc.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Sleep disturbance and sleepiness are established risk factors for driving accidents and obstructive sleep apnea (OSA) is the most prevalent medical disorder associated with excessive daytime sleepiness. Because effective treatment of OSA reduces accident risk, several jurisdictions have implemented regulations concerning the ability of patients with OSA to drive, unless effectively treated. This review provides a practical guide for clinicians who may be requested to certify a patient with OSA as fit to drive regarding the scope of the problem, the role of questionnaires and driving simulators to evaluate sleepiness, and the benefit of treatment on accident risk.
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7
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Robin F, De Courson H, Roy M, Lemeux J, Philip P, Bioulac S, Nouette-Gaulain K. EQSAR: A national survey of sleep duration among French Anaesthesiologists and Intensivists. Anaesth Crit Care Pain Med 2020; 39:759-764. [DOI: 10.1016/j.accpm.2020.04.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/08/2020] [Accepted: 04/19/2020] [Indexed: 01/20/2023]
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Bonsignore MR, Randerath W, Schiza S, Verbraecken J, Elliott MW, Riha R, Barbe F, Bouloukaki I, Castrogiovanni A, Deleanu O, Goncalves M, Leger D, Marrone O, Penzel T, Ryan S, Smyth D, Teran-Santos J, Turino C, McNicholas WT. European Respiratory Society statement on sleep apnoea, sleepiness and driving risk. Eur Respir J 2020; 57:13993003.01272-2020. [DOI: 10.1183/13993003.01272-2020] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/25/2020] [Indexed: 12/22/2022]
Abstract
Obstructive sleep apnoea (OSA) is highly prevalent and is a recognised risk factor for motor vehicle accidents (MVA). Effective treatment with continuous positive airway pressure has been associated with a normalisation of this increased accident risk. Thus, many jurisdictions have introduced regulations restricting the ability of OSA patients from driving until effectively treated. However, uncertainty prevails regarding the relative importance of OSA severity determined by the apnoea–hypopnoea frequency per hour and the degree of sleepiness in determining accident risk. Furthermore, the identification of subjects at risk of OSA and/or accident risk remains elusive. The introduction of official European regulations regarding fitness to drive prompted the European Respiratory Society to establish a task force to address the topic of sleep apnoea, sleepiness and driving with a view to providing an overview to clinicians involved in treating patients with the disorder. The present report evaluates the epidemiology of MVA in patients with OSA; the mechanisms involved in this association; the role of screening questionnaires, driving simulators and other techniques to evaluate sleepiness and/or impaired vigilance; the impact of treatment on MVA risk in affected drivers; and highlights the evidence gaps regarding the identification of OSA patients at risk of MVA.
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Royant-Parola S, Kovess V, Brion A, Dagneaux S, Hartley S. Do hypnotics increase the risk of driving accidents or near miss accidents due to hypovigilance? The effects of sex, chronic sleepiness, sleep habits and sleep pathology. PLoS One 2020; 15:e0236404. [PMID: 32716956 PMCID: PMC7384619 DOI: 10.1371/journal.pone.0236404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 07/06/2020] [Indexed: 01/02/2023] Open
Abstract
Driving accidents due to hypovigilance are common but the role of hypnotics is unclear in patients suffering from sleep disorders. Our study examined factors influencing accidents and near miss accidents attributed to sleepiness at the wheel (ANMAS). Using data from an online questionnaire aimed at patients with sleep disorders, we analysed the associations between ANMAS, sociodemographic data, symptoms of sleep disorders, severity of insomnia (Insomnia Severity Index (ISI)) symptoms of anxiety and depression (Hospital Anxiety and Depression scale with depression (HADD) and anxiety (HADA) subscales), chronic sleepiness (Epworth sleepiness scale ESS), hypnotic use and information about sleep habits. Hypnotics were hierarchically grouped into Z-drugs, sedative medication, melatonin and over the counter (OTC) alternative treatments. Of 10802 participants; 9.1% reported ANMAS (Men 11.1% women 8.3%) and 24.4% took hypnotics (Z-drugs 8.5%, sedative medication 8%, melatonin 5.6% and alternative treatments 2.5%). Logistic regression analysis identified the following risk factors for ANMAS: moderate (OR 2.4; CI: 2.10-2.79) and severe sleepiness (ESS OR 5.66; CI: 4.74-6.77), depression (HADD OR 1.2; CI: 1.03-1.47), anxiety (HADA OR 1.2;CI: 1.01-1.47), and insufficient sleep (OR1.4; CI: 1.2-1.7). Hypnotics were not associated with an increased risk of ANMAS in patients suffering from insomnia. Risk factors varied according to sex: in females, sex (OR 0.; CI: 0.55-0.74), mild insomnia (OR 0.5; CI: 0.3-0.8) and use of alternative treatments (OR 0.455, CI:0.23-0.89) were protective factors and risk was increased by sleepiness, sleep debt, social jetlag, caffeine use, anxiety and depression. In men no protective factors were identified: sleepiness, sleep debt, and severe insomnia were associated with an increased risk of ANMAS. In clinical practice, all patients with daytime sleepiness and men with severe insomnia should be counselled concerning driving risk and encouraged to avoid sleep debt.
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Affiliation(s)
| | | | | | | | - Sarah Hartley
- Réseau Morphée, Garches, France
- EA 4047, APHP Hôpital Raymond Poincaré, Sleep Center, Université de Versailles Saint-Quentin en Yvelines, Garches, France
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Elliman TD, Schwalb ME, Adler AB. Sleep deprivation and hazardous unintended sleep in US army drill sergeants. Sleep Health 2020; 6:350-357. [DOI: 10.1016/j.sleh.2020.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/20/2020] [Accepted: 04/16/2020] [Indexed: 01/24/2023]
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11
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Lin YC, Chen TY, Chien WC, Chung CH, Chang HA, Kao YC, Tsai CS, Lin CS, Tzeng NS. Stimulants associated with reduced risk of hospitalization for motor vehicle accident injury in patients with obstructive sleep apnea-a nationwide cohort study. BMC Pulm Med 2020; 20:28. [PMID: 32013932 PMCID: PMC6998364 DOI: 10.1186/s12890-019-1041-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 12/24/2019] [Indexed: 02/07/2023] Open
Abstract
Background The risk of injury directly related to hospitalization for motor vehicle accidents (MVAs) in the obstructive sleep apnea (OSA) patients has not been thoroughly understood. Our study aimed to examine the association between the OSA and the hospitalization for an MVA injury. Methods This retrospective cohort study used Taiwan’s National Health Insurance Research Database (NHIRD) between 2000 and 2015. The OSA patients aged ≥20 years by age, sex, and index-year matched by non-OSA controls were enrolled (1:3). We used the Cox proportional regression model to evaluate the association between the OSA and the hospitalization for an MVA injury. Results The incidence rate of hospitalization for an MVA injury was higher in the OSA cohort (N = 3025) when compared with the non-OSA controls (N = 9075), as 575.3 and 372.0 per 100,000 person-years, respectively (p < 0.001). The Kaplan-Meier analysis showed that the OSA cohort had a significantly higher incidence of hospitalization for the MVA injury (log-rank test, p < 0.001). After adjusting for the covariates, the risk of hospitalization for the MVA injury among the OSA was significantly higher (hazard ratio [HR] =2.18; 95% confidence interval [CI] = 1.79–2.64; p < 0.001). Stimulants usage was associated with a nearly 20% decrease in the risk of an overall hospitalization for an MVA injury in the OSA patients. Conclusions This study provides evidence that patients with OSA are at a two-fold higher risk of developing hospitalization for an MVA injury, and the usage of modafinil and methylphenidate was associated with a lower risk of an overall hospitalization for the MVA injury.
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Affiliation(s)
- Yi-Chang Lin
- Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Biological Science and Technology, National Chiao Tung University, No.75, Po-Ai Street, Hsinchu, 30068, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan.,Department of Psychiatry, Tri-Service General Hospital, Keelung Branch, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan.,Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan
| | - Chien-Sung Tsai
- Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Sheng Lin
- Department of Biological Science and Technology, National Chiao Tung University, No.75, Po-Ai Street, Hsinchu, 30068, Taiwan.
| | - Nian-Shen Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan. .,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan.
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13
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Tzeng NS, Hsing SC, Chung CH, Chang HA, Kao YC, Mao WC, Yang CCH, Kuo TBJ, Chen TY, Chien WC. The Risk of Hospitalization for Motor Vehicle Accident Injury in Narcolepsy and the Benefits of Stimulant Use: A Nationwide Cohort Study in Taiwan. J Clin Sleep Med 2019; 15:881-889. [PMID: 31138389 DOI: 10.5664/jcsm.7842] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/21/2019] [Indexed: 12/20/2022]
Abstract
STUDY OBJECTIVES To examine the risk of hospitalization for motor vehicle accident injury (MVAI) in patients with narcolepsy and the effects of stimulant use on MVAI occurrence in patients with narcolepsy. METHODS This is a population-based, retrospective cohort study using Taiwan's National Health Insurance Research Database between 2000 and 2013. We included patients with narcolepsy based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, 347. The case and matched control participants were selected in a ratio of 1:3, and the traffic accident (ICD-9-CM codes: E810-E819) plus injury codes (ICD-9-CM codes: 800.xx-999.xx) due to MVAI following hospitalization were used for the study outcome. The type of injury, causes, intentionality, and the effects of stimulant use on patients with narcolepsy were also assessed. RESULTS A total of 1,316 participants were enrolled, including 329 participants with narcolepsy and 987 participants without narcolepsy. During a 14-year follow-up period, a total of 104 participants had MVAI, of whom 47 (1,559.54 per 100,000 person-years) belonged to the narcolepsy cohort and 57 (556.21 per 100,000 person-years) to the non-narcolepsy cohort. After adjusting for covariates, the risk of hospitalization for MVAI among participants with narcolepsy was still significantly higher than those without narcolepsy (adjusted hazard ratio = 6.725; 95% confidence interval = 4.421-10.231; P < .001). The use of modafinil or methylphenidate, as monotherapy or combined treatment, was associated with a lower risk of MVAI in the narcolepsy cohort. CONCLUSIONS Patients with narcolepsy may have a higher risk of hospitalization for MVAI and stimulant use could mitigate such risk.
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Affiliation(s)
- Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Chun Hsing
- Center for Healthcare Quality Management, Cheng Hsin General Hospital.,Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Heath Sciences
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Chung Mao
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
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14
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Baiardi S, La Morgia C, Sciamanna L, Gerosa A, Cirignotta F, Mondini S. Is the Epworth Sleepiness Scale a useful tool for screening excessive daytime sleepiness in commercial drivers? ACCIDENT; ANALYSIS AND PREVENTION 2018; 110:187-189. [PMID: 29074223 DOI: 10.1016/j.aap.2017.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 10/10/2017] [Indexed: 06/07/2023]
Abstract
The significant social and economic impact of excessive daytime sleepiness makes sleep evaluation a primary medical need in commercial drivers. However, the best screening tool is still matter of debate. In our cohort of 221 commercial drivers, only ten (4.5%) had Epworth Sleepiness Scale scores indicative of excessive daytime sleepiness. These findings and the lack of concordance in estimating excessive daytime sleepiness among commercial drivers in previous studies using the same psychometric measure indicate that the Epworth Sleepiness Scale is not a reliable tool. This may be due to the low internal consistency of the scale in non-clinical samples and the possible intentional underscoring of sleepiness due to a perceived threat of driver's license suspension. Moreover, the reliability of the Epworth Sleepiness Scale results may be strongly influenced by the administration setting. The clinical application of inexpensive less time-consuming new tools like performance tests should be considered for the objective evaluation of excessive daytime sleepiness in commercial drivers.
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Affiliation(s)
- Simone Baiardi
- Neurology Unit, Sant'Orsola-Malpighi University Hospital, Bologna, Italy.
| | - Chiara La Morgia
- Neurology Unit, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
| | - Lucia Sciamanna
- Neurology Unit, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
| | - Alberto Gerosa
- Mountain Workplace Prevention and Safety Unit, Local Health Trust, Bologna, Italy
| | - Fabio Cirignotta
- Neurology Unit, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
| | - Susanna Mondini
- Neurology Unit, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
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15
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Xu H, Wang H, Guan J, Yi H, Qian Y, Zou J, Xia Y, Fu Y, Li X, Jiao X, Huang H, Dong P, Yu Z, Yang J, Xiang M, Li J, Chen Y, Wang P, Sun Y, Li Y, Zheng X, Jia W, Yin S. Effects of continuous positive airway pressure on neurocognitive architecture and function in patients with obstructive sleep apnoea: study protocol for a multicentre randomised controlled trial. BMJ Open 2017; 7:e014932. [PMID: 28550021 PMCID: PMC5729992 DOI: 10.1136/bmjopen-2016-014932] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Many clinical studies have indicated that obstructive sleep apnoea (OSA), the most common chronic sleep disorder, may affect neurocognitive function, and that treatment for continuous positive airway pressure (CPAP) has some neurocognitive protective effects against the adverse effects of OSA. However, the effects of CPAP treatment on neurocognitive architecture and function remain unclear. Therefore, this multicentre trial was designed to investigate whether and when neurocognitive architecture and function in patients with OSA can be improved by CPAP treatment and to explore the role of gut microbiota in improving neurocognitive function during treatment. METHODS/DESIGN This study will be a multicentre, randomised, controlled trial with allocation concealment and assessor blinding. A total of 148 eligible patients with moderate to severe OSA will be enrolled from five sleep centres and randomised to receive CPAP with best supportive care (BSC) intervention or BSC intervention alone. Cognitive function, structure and function of brain regions, gut microbiota, metabolites, biochemical variables, electrocardiography, echocardiography, pulmonary function and arterial stiffness will be assessed at baseline before randomisation and at 3, 6 and 12 months. ETHICS AND DISSEMINATION This study has been approved by the Medical Ethics Committee of Shanghai Jiao Tong University Affiliated Sixth People's Hospital (approval number 2015-79). The results from this study will be published in peer-reviewed journals and at relevant conferences. TRIAL REGISTRATION NUMBER NCT02886156; pre-results.
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Affiliation(s)
- Huajun Xu
- Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wang
- Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Guan
- Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongliang Yi
- Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingjun Qian
- Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianyin Zou
- Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunyan Xia
- Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiqun Fu
- Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyi Li
- Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao Jiao
- Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hengye Huang
- Department of Epidemiology, School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Pin Dong
- Department of Otorhinolaryngology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Ziwei Yu
- Department of Otorhinolaryngology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Yang
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Mingliang Xiang
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiping Li
- Department of Otorhinolaryngology Head and Neck Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yanqing Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Peihua Wang
- Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yizhou Sun
- Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuehua Li
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xiaojian Zheng
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Wei Jia
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Shankai Yin
- Department of Otolaryngology Head and Neck Surgery and Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Otolaryngological Institute of Shanghai Jiao Tong University, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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16
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Quera-Salva MA, Hartley S, Sauvagnac-Quera R, Sagaspe P, Taillard J, Contrand B, Micoulaud JA, Lagarde E, Barbot F, Philip P. Association between reported sleep need and sleepiness at the wheel: comparative study on French highways between 1996 and 2011. BMJ Open 2016; 6:e012382. [PMID: 28003284 PMCID: PMC5223720 DOI: 10.1136/bmjopen-2016-012382] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To investigate the evolution over 15 years of sleep schedules, sleepiness at the wheel and driving risk among highway drivers. METHODS Comparative survey including questions on usual sleep schedules and before the trip, sleepiness at the wheel, the Epworth sleepiness scale, Basic Nordic Sleep Questionnaire (BNSQ) and a travel questionnaire. RESULTS 80% of drivers stopped by the highway patrol agreed to participate in both studies with a total of 3545 drivers in 2011 and 2196 drivers in 1996 interviewed. After standardisation based on sex, age and mean annual driving distance, drivers in 2011 reported shorter sleep time on week days (p<0.0001), and week-ends (p<0.0001) and shorter optimal sleep time (p<0.0001) compared to 1996 drivers. There were more drivers sleepy at the wheel in 2011 than in 1996 (p<0.0001) and 2.5 times more drivers in 2011 than in 1996 had an Epworth sleepiness score >15 indicating severe sleepiness. CONCLUSIONS Even if drivers in 2011 reported good sleep hygiene prior to a highway journey, drivers have reduced their mean weekly sleep duration over 15 years and have a higher risk of sleepiness at the wheel. Sleep hygiene for automobile drivers remains an important concept to address.
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Affiliation(s)
- M A Quera-Salva
- Sleep Unit, EA4047, Department of Physical Medicine and Rehabilitation, Assistance Publique des Hôpitaux de Paris (AP-HP), Raymond Poincare Hospital, Garches, France
- INSERM CIC1429, APHP, Hôpital Raymond Poincaré, Garches, France
| | - S Hartley
- Sleep Unit, EA4047, Department of Physical Medicine and Rehabilitation, Assistance Publique des Hôpitaux de Paris (AP-HP), Raymond Poincare Hospital, Garches, France
| | - R Sauvagnac-Quera
- Department of Pediatrics Physical Medicine and Rehabilitation, AP-HP, Raymond Poincare Hospital, Garches, France
| | - P Sagaspe
- CNRS USR 3413 SANPSY “ Sommeil, Attention et Neuropsychiatrie ”, Bordeaux, France
| | - J Taillard
- CNRS USR 3413 SANPSY “ Sommeil, Attention et Neuropsychiatrie ”, Bordeaux, France
| | - B Contrand
- ISPED, Bordeaux Population Health Research Centre INSERM U1219-, University of Bordeaux, Bordeaux, France
- Injury Epidemiology, Transport, Occupation, Bordeaux Population Health Research Centre INSERM U1219-, Bordeaux, France
| | - J A Micoulaud
- ISPED, Bordeaux Population Health Research Centre INSERM U1219-, University of Bordeaux, Bordeaux, France
| | - E Lagarde
- ISPED, Bordeaux Population Health Research Centre INSERM U1219-, University of Bordeaux, Bordeaux, France
- Injury Epidemiology, Transport, Occupation, Bordeaux Population Health Research Centre INSERM U1219-, Bordeaux, France
| | - F Barbot
- INSERM CIC1429, APHP, Hôpital Raymond Poincaré, Garches, France
| | - P Philip
- CNRS USR 3413 SANPSY “ Sommeil, Attention et Neuropsychiatrie ”, Bordeaux, France
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17
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Garbarino S, Durando P, Guglielmi O, Dini G, Bersi F, Fornarino S, Toletone A, Chiorri C, Magnavita N. Sleep Apnea, Sleep Debt and Daytime Sleepiness Are Independently Associated with Road Accidents. A Cross-Sectional Study on Truck Drivers. PLoS One 2016; 11:e0166262. [PMID: 27902703 PMCID: PMC5130193 DOI: 10.1371/journal.pone.0166262] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 10/25/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Recent research has found evidence of an association between motor vehicle accidents (MVAs) or near miss accidents (NMAs), and excessive daytime sleepiness (EDS) or its main medical cause, Obstructive Sleep Apnea (OSA). However, EDS can also be due to non-medical factors, such as sleep debt (SD), which is common among professional truck drivers. On the opposite side, rest breaks and naps are known to protect against accidents. STUDY OBJECTIVES To investigate the association of OSA, SD, EDS, rest breaks and naps, with the occurrence of MVAs and NMAs in a large sample of truck drivers. METHODS 949 male truck drivers took part in a cross-sectional medical examination and were asked to complete a questionnaire about sleep and waking habits, risk factors for OSA and EDS. RESULTS MVAs and NMAs were reported by 34.8% and 9.2% of participants, respectively. MVAs were significantly predicted by OSA (OR = 2.32 CI95% = 1.68-3.20), SD (OR = 1.45 CI95% = 1.29-1.63), EDS (OR = 1.73 CI95% = 1.15-2.61) and prevented by naps (OR = 0.59 CI95% = 0.44-0.79) or rest breaks (OR = 0.63 CI95% = 0.45-0.89). NMAs were significantly predicted by OSA (OR = 2.39 CI95% = 1.47-3.87) and SD (OR = 1.49 CI95% = 1.27-1.76) and prevented by naps (OR = 0.52 CI95% = 0.32-0.85) or rest breaks (OR = 0.49 CI95% = 0.29-0.82). CONCLUSIONS When OSA, SD or EDS are present, the risk of MVAs or NMAs in truck drivers is severely increased. Taking a rest break or a nap appear to be protective against accidents.
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Affiliation(s)
- Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
- Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, IRCCS AOU San Martino IST, Genoa, Italy
| | - Paolo Durando
- Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, IRCCS AOU San Martino IST, Genoa, Italy
| | - Ottavia Guglielmi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - Guglielmo Dini
- Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, IRCCS AOU San Martino IST, Genoa, Italy
| | - Francesca Bersi
- Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, IRCCS AOU San Martino IST, Genoa, Italy
| | - Stefania Fornarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - Alessandra Toletone
- Department of Health Sciences, Postgraduate School in Occupational Medicine, University of Genoa and Occupational Medicine Unit, IRCCS AOU San Martino IST, Genoa, Italy
| | - Carlo Chiorri
- Department of Educational Sciences, University of Genoa, Genoa, Italy
| | - Nicola Magnavita
- Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- * E-mail:
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18
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Garbarino S, Guglielmi O, Campus C, Mascialino B, Pizzorni D, Nobili L, Mancardi GL, Ferini-Strambi L. Screening, diagnosis, and management of obstructive sleep apnea in dangerous-goods truck drivers: to be aware or not? Sleep Med 2016; 25:98-104. [DOI: 10.1016/j.sleep.2016.05.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 03/22/2016] [Accepted: 05/16/2016] [Indexed: 11/25/2022]
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19
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Smith AP. A UK survey of driving behaviour, fatigue, risk taking and road traffic accidents. BMJ Open 2016; 6:e011461. [PMID: 27540100 PMCID: PMC5013464 DOI: 10.1136/bmjopen-2016-011461] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/16/2016] [Accepted: 07/05/2016] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of the present research was to examine associations between poor driving behaviour (DB), driving when fatigued (DF), risk taking (RT) and road traffic accidents (RTAs). DESIGN The study involved a cross-sectional online survey of clients of an insurance company. The survey measured DB (speeding, distraction, lapses of attention and aggression), RT and frequency of driving when fatigued (DF, driving late at night, prolonged driving, driving after a demanding working day and driving with a cold). Demographic, lifestyle, job characteristics and psychosocial factors were also measured and used as covariates. SETTING Cardiff, UK. SAMPLE 3000 clients of an insurance company agreed to participate in the study, and 2856 completed the survey (68% woman, 32% man; mean age: 34 years, range 18-74 years). MAIN OUTCOME MEASURES The outcomes were RTAs (requiring medical attention; not requiring medical attention), where the person was the driver. RESULTS Factor analyses showed that DB, RT and fatigue loaded on independent factors. Logistic regressions showed that poor DB, frequently DF and taking risks predicted medical and non-medical RTAs. These effects were additive and those who reported poor DB, driving when fatigue and taking risks were twice as likely to have an RTA. These effects remained significant when demographic, lifestyle, medical, driving, work and psychosocial factors were covaried. CONCLUSIONS Poor DB, DF and RT predict RTAs. There are now short measuring instruments that can assess these, and driver education programmes must increase awareness of these risk factors.
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Affiliation(s)
- Andrew P Smith
- Centre for Occupational and Health Psychology, School of Psychology, Cardiff University, Cardiff, UK
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20
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Feng S, Li Z, Ci Y, Zhang G. Risk factors affecting fatal bus accident severity: Their impact on different types of bus drivers. ACCIDENT; ANALYSIS AND PREVENTION 2016; 86:29-39. [PMID: 26513334 DOI: 10.1016/j.aap.2015.09.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 09/04/2015] [Accepted: 09/30/2015] [Indexed: 06/05/2023]
Abstract
While the bus is generally considered to be a relatively safe means of transportation, the property losses and casualties caused by bus accidents, especially fatal ones, are far from negligible. The reasons for a driver to incur fatalities are different in each case, and it is essential to discover the underlying risk factors of bus fatality severity for different types of drivers in order to improve bus safety. The current study investigates the underlying risk factors of fatal bus accident severity to different types of drivers in the U.S. by estimating an ordered logistic model. Data for the analysis are retrieved from the Buses Involved in Fatal Accidents (BIFA) database from the USA for the years 2006-2010. Accidents are divided into three levels by counting their equivalent fatalities, and the drivers are classified into three clusters by the K-means cluster analysis. The analysis shows that some risk factors have the same impact on different types of drivers, they are: (a) season; (b) day of week; (c) time period; (d) number of vehicles involved; (e) land use; (f) manner of collision; (g) speed limit; (h) snow or ice surface condition; (i) school bus; (j) bus type and seating capacity; (k) driver's age; (l) driver's gender; (m) risky behaviors; and (n) restraint system. Results also show that some risk factors only have impact on the "young and elder drivers with history of traffic violations", they are: (a) section type; (b) number of lanes per direction; (c) roadway profile; (d) wet road surface; and (e) cyclist-bus accident. Notably, history of traffic violations has different impact on different types of bus drivers.
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Affiliation(s)
- Shumin Feng
- School of Transportation Science and Engineering, Harbin Institute of Technology, Harbin 150090, China
| | - Zhenning Li
- School of Transportation Science and Engineering, Harbin Institute of Technology, Harbin 150090, China
| | - Yusheng Ci
- School of Transportation Science and Engineering, Harbin Institute of Technology, Harbin 150090, China.
| | - Guohui Zhang
- Department of Civil Engineering, University of New Mexico, Albuquerque 87131, USA
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21
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Léger D, Ement P. Somnolence et risque accidentel. Presse Med 2015; 44:1022-8. [DOI: 10.1016/j.lpm.2015.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 04/03/2015] [Accepted: 04/10/2015] [Indexed: 11/30/2022] Open
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22
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Watling CN, Armstrong KA, Smith SS, Wilson A. The on-road experiences and awareness of sleepiness in a sample of Australian highway drivers: A roadside driver sleepiness study. TRAFFIC INJURY PREVENTION 2015; 17:24-30. [PMID: 25834934 DOI: 10.1080/15389588.2015.1033690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Driver sleepiness contributes substantially to road crash incidents. Simulator and on-road studies clearly reveal an impairing effect from sleepiness on driving ability. However, the degree to which drivers appreciate the dangerousness of driving while sleepy is somewhat unclear. This study sought to determine drivers' on-road experiences of sleepiness, their prior sleep habits, and personal awareness of the signs of sleepiness. METHODS Participants were a random selection of 92 drivers traveling on a major highway in the state of Queensland, Australia, who were stopped by police as part of routine drink driving operations. Participants completed a brief questionnaire that included demographic information, sleepy driving experiences (signs of sleepiness and on-road experiences of sleepiness), and prior sleep habits. A modified version of the Karolinska Sleepiness Scale (KSS) was used to assess subjective sleepiness in the 15 min prior to being stopped by police. RESULTS Participants' ratings of subjective sleepiness were quite low, with 90% reporting being alert to extremely alert on the KSS. Participants were reasonably aware of the signs of sleepiness, with many signs of sleepiness associated with on-road experiences of sleepiness. Additionally, the number of hours spent driving was positively correlated with the drivers' level of sleep debt. CONCLUSIONS The results suggest that participants had moderate experiences of driving while sleepy and many were aware of the signs of sleepiness. The relationship between driving long distances and increased sleep debt is a concern for road safety. Increased education regarding the dangers of sleepy driving seems warranted.
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Affiliation(s)
- Christopher N Watling
- a Centre for Accident Research and Road Safety-Queensland , Institute of Health and Biomedical Innovation , Queensland University of Technology , Brisbane , Queensland , Australia
- b Stress Research Institute , Stockholm University , Stockholm , Sweden
| | - Kerry A Armstrong
- a Centre for Accident Research and Road Safety-Queensland , Institute of Health and Biomedical Innovation , Queensland University of Technology , Brisbane , Queensland , Australia
| | - Simon S Smith
- a Centre for Accident Research and Road Safety-Queensland , Institute of Health and Biomedical Innovation , Queensland University of Technology , Brisbane , Queensland , Australia
| | - Adrian Wilson
- a Centre for Accident Research and Road Safety-Queensland , Institute of Health and Biomedical Innovation , Queensland University of Technology , Brisbane , Queensland , Australia
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