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McCall CA. Moving towards a more naturalistic approach to evaluating drowsy driving risk. Sleep 2024; 47:zsae139. [PMID: 38908012 DOI: 10.1093/sleep/zsae139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Indexed: 06/24/2024] Open
Affiliation(s)
- Catherine A McCall
- Department of Pulmonary, Critical Care, and Sleep Medicine, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Department of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, WA, USA
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Okawara M, Tokutsu K, Hirashima K, Ishimaru T, Fujino Y. Presenteeism and Traffic Accident Among Taxi Drivers: A Prospective Cohort Study in Japan. Saf Health Work 2024; 15:208-212. [PMID: 39035792 PMCID: PMC11255960 DOI: 10.1016/j.shaw.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/12/2024] [Accepted: 04/15/2024] [Indexed: 07/23/2024] Open
Abstract
Background Traffic accidents involving professional drivers have serious societal repercussions. Unique occupational stressors and health risks exacerbate the likelihood of traffic accidents among professional drivers. This study explores the association between presenteeism-impaired work performance due to working while unwell-and traffic accident risk among professional taxi drivers in Japan. Methods A prospective cohort study was conducted from June 2022 to February 2023, involving taxi drivers from a single company in Fukuoka Prefecture, Japan. Presenteeism was assessed using the Work Functioning Impairment Scale (WFun). Primary outcome involved the number of self-reported minor traffic accidents. The incidence rate ratio (IRR) of minor traffic accident occurrences was estimated using a Poisson regression analysis, adjusted for confounders including sex, age, and driving experience. Results Of 838 targeted drivers, 435 were included in the analysis. Higher baseline work functioning impairment was associated with a significant trend of increasing IRR of minor traffic accidents (p for trend = 0.045). A dose-response relationship was seen between the degree of presenteeism and incidence rate of minor traffic accidents. Conclusion Higher levels of presenteeism were associated with an increased risk of traffic accidents among taxi drivers. The findings underscore the need for socio-economic support and prioritized health management to mitigate traffic accident risk among professional drivers. This study highlights the importance of managing non-critical health issues alongside serious health conditions for safer driving practices among professional drivers in Japan.
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Affiliation(s)
- Makoto Okawara
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan
| | - Kei Tokutsu
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Keiki Hirashima
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan
| | - Tomohiro Ishimaru
- Department of Medical Humanities, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan
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Kubala AG, Roma PG, Jameson JT, Sessoms PH, Chinoy ED, Rosado LR, Viboch TB, Schrom BJ, Rizeq HN, Gordy PS, Hirsch LDA, Biggs LAT, Russell DW, Markwald RR. Advancing a U.S. navy shipboard infrastructure for sleep monitoring with wearable technology. APPLIED ERGONOMICS 2024; 117:104225. [PMID: 38219375 DOI: 10.1016/j.apergo.2024.104225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/20/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
Development of fatigue management solutions is critical to U.S. Navy populations. This study explored the operational feasibility and acceptability of commercial wearable devices (Oura Ring and ReadiBand) in a warship environment with 845 Sailors across five ship cohorts during at-sea operations ranging from 10 to 31 days. Participants were required to wear both devices and check-in daily with research staff. Both devices functioned as designed in the environment and reliably collected sleep-wake data. Over 10,000 person-days at-sea, overall prevalence of Oura and ReadiBand use was 69% and 71%, respectively. Individual use rates were 71 ± 38% of days underway for Oura and 59 ± 34% for ReadiBand. Analysis of individual factors showed increasing device use and less device interference with age, and more men than women found the devices comfortable. This study provides initial support that commercial wearables can contribute to infrastructures for operational fatigue management in naval environments.
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Affiliation(s)
- Andrew G Kubala
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Peter G Roma
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Jason T Jameson
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Pinata H Sessoms
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA
| | - Evan D Chinoy
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA
| | - Luis R Rosado
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Trevor B Viboch
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Brandon J Schrom
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Hedaya N Rizeq
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | - Prayag S Gordy
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA; Military and Veterans Health Solutions, Leidos Inc., San Diego, CA, USA
| | | | - Lcdr Adam T Biggs
- Psychological Health and Resilience Department, Military Population Health Directorate, Naval Health Research Center, San Diego, CA, USA
| | - Dale W Russell
- Commander Naval Surface Force, U.S. Pacific Fleet, San Diego, CA, USA; Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Rachel R Markwald
- Warfighter Performance Department, Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA, USA.
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Mohd Yusoff H, Ismail KI, Ismail R, Khamis NK, Muhamad Robat R, Bryce JM. Development and evaluation of a scale to measure nurses' unsafe driving behaviour while commuting. Heliyon 2024; 10:e23735. [PMID: 38226263 PMCID: PMC10788452 DOI: 10.1016/j.heliyon.2023.e23735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 01/17/2024] Open
Abstract
Driving is the most prevalent form of commuting for most workers but is also perhaps the most hazardous mode of travel with unsafe driving contributing significantly to road traffic accidents. Despite nurses having been reported as being at higher risk of commuter-related accidents over the last three decades, little is known about unsafe driving behaviours among nurses while commuting, which is unique from other driving routines. Additionally, the lack of appropriate tools to measure such behaviours is apparent. This study aims i) to identify unsafe driving behaviours among nurses while commuting and ii) to develop a scale to assess nurses' unsafe commuting driving behaviours. The study employed a multiphase and multimethod approach to develop the scale, which was subject to stringent validation and evaluation. Themes were specified via the Nominal Group Technique (NGT). Six themes were identified namely: i) violations and reckless driving, ii) negative emotions, iii) drowsy driving iv) mind wandering, v) error and vi) carelessness. Content and face validity were sought through expert review. A total of 442 nurses' data were collected across multisite hospitals for evaluation. Exploratory factor analysis (EFA) resulted in recovered structure and was confirmed through Confirmatory Factor Analysis (CFA) with structural equation analyses being conducted to test predictive validity. All constructs met adequate validity and reliability. Nurses' unsafe driving behaviours while commuting were identified with a novel scale to assess them being both developed and validated. The resulting MyUDWC scale is a suitable tool for measuring nurses' unsafe driving behaviours while commuting.
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Affiliation(s)
- Hanizah Mohd Yusoff
- Jabatan Perubatan Kesihatan Awam, Fakulti Perubatan Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Khairil Idham Ismail
- Jabatan Perubatan Kesihatan Awam, Fakulti Perubatan Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
- Ministry of Health Malaysia, Federal Government Administrative Centre, 62590, Putrajaya, Malaysia
| | - Rosnah Ismail
- Jabatan Perubatan Kesihatan Awam, Fakulti Perubatan Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Nor Kamaliana Khamis
- Department of Mechanical and Manufacturing Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, UKM, Bangi 43600, Selangor, Malaysia
| | - Rosnawati Muhamad Robat
- Occupational and Environmental Health Unit, Selangor State Health Department, No 1, Wisma Sunway, Jalan Tengku Ampuan Zabedah C9/C, Seksyen 9, 40100, Shah Alam, Selangor, Malaysia
| | - Jonathan Michael Bryce
- INTI International University, Persiaran Perdana BBN Putra Nilai, 71800, Nilai, Malaysia
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Wu CS, Chen DHK, Ko YC, Bai CH, Chen PY, Liu WT, Lin YC. The firstly visited department affects the acceptance of CPAP in patients with obstructive sleep apnea: a cohort study. J Otolaryngol Head Neck Surg 2023; 52:71. [PMID: 37898803 PMCID: PMC10613393 DOI: 10.1186/s40463-023-00676-z] [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: 11/03/2022] [Accepted: 10/18/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Continuous positive airway pressure (CPAP) therapy is the first-line treatment for obstructive sleep apnea (OSA). However, the low acceptance rate of CPAP remains a challenging clinical issue. This study aimed to determine the factors that influence the acceptance rate of CPAP. METHODS This retrospective cohort study was conducted at the sleep center of Shuang-Ho Hospital. Initially, 1186 OSA patients who received CPAP therapy between December 2013 and December 2017 were selected, and finally, 1016 patients were analyzed. All patients with OSA received CPAP therapy for at least 1 week, and their acceptance to treatment was subsequently recorded. Outcome measures included patients' demographic and clinical characteristics (sex, age, BMI, comorbidities, history of smoking, and the medical specialist who prescribed CPAP treatment), polysomnography (PSG) results, and OSA surgical records. RESULTS Patients with a lower CPAP acceptance rate were referred from otolaryngologists (acceptance rate of otolaryngology vs. others: 49.6% vs. 56.6%, p = .015), in addition to having a lower apnea-hypopnea index (AHI) (acceptance vs. non-acceptance: 55.83 vs. 40.79, p = .003), rapid eye movement AHI (REM-AHI) (acceptance vs. non-acceptance: 51.21 vs. 44.92, p = .014), and arousal index (acceptance vs. non-acceptance: 36.80 vs. 28.75, p = .011). The multiple logistic regression model showed that patients referred from otolaryngology had a lower CPAP acceptance rate (odds ratio 0.707, p = .0216) even after adjusting for age, sex, BMI, AHI, REM-AHI, arousal index, comorbidities, and smoking status. CONCLUSIONS Before their initial consultation, patients may already have their preferred treatment of choice, which is strongly linked to the type of medical specialists they visit, and consequently, affects their rate of acceptance to CPAP therapy. Therefore, physicians should provide personalized care to patients by exploring and abiding by their preferred treatment choices.
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Affiliation(s)
- Chung-Sheng Wu
- Department of Primary Care Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - David Hsin-Kuang Chen
- Department of Medical Education, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yuan-Chun Ko
- Department of Primary Care Medicine, Wan-Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Chyi-Huey Bai
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Po-Yueh Chen
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Otolaryngology, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wen-Te Liu
- Sleep Center, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yi-Chih Lin
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Sleep Center, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
- Department of Otolaryngology, Shuang-Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe District, New Taipei City, 23561, Taiwan.
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Mesic A, Damsere-Derry J, Gyedu A, Mock C, Larley J, Opoku I, Wuaku DH, Kitali A, Osei-Ampofo M, Donkor P, Stewart B. Generating consensus on road safety issues and priorities in Ghana: A modified Delphi approach. Injury 2023; 54:110765. [PMID: 37193635 DOI: 10.1016/j.injury.2023.04.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/31/2023] [Accepted: 04/28/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Implementation of evidence-based approaches to reduce the substantial health, social, and financial burdens of road traffic injuries and deaths in Ghana and other low-and-middle-income countries (LMICs) is vitally important. Consensus from national stakeholders can provide insight into what evidence to generate and which interventions to prioritize for road safety. The main objective of this study was to elicit expert views on the barriers to reaching international and national road safety targets, the gaps in national-level research, implementation, and evaluation, and the future action priorities. MATERIALS AND METHODS We used an iterative three-round modified Delphi process to generate consensus among Ghanaian road safety stakeholders. We defined consensus as 70% or more stakeholders selecting a specific response in the survey. We defined partial consensus (termed "majority") as 50% or more stakeholders selecting a particular response. RESULTS Twenty-three stakeholders from different sectors participated. Experts generated consensus on barriers to road safety goals, including the poor regulation of commercial and public transport vehicles and limited use of technology to monitor and enforce traffic behaviors and laws. Stakeholders agreed that the impact of increasing motorcycle (2- and 3-wheel) use on road traffic injury burden is poorly understood and that it is a priority to evaluate road-user risk factors such as speed, helmet use, driving skills, and distracted driving. One emerging area was the impact of unattended/disabled vehicles along roadways. There was consensus on the need for additional research, implementation, and evaluation efforts of several interventions, including focused treatment of hazardous spots, driver training, road safety education as part of academic curricula, promotion of community involvement in first aid, development of strategically positioned trauma centers, and towing of disabled vehicles. CONCLUSION This modified Delphi process with stakeholders from Ghana generated consensus on road safety research, implementation, and evaluation priorities.
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Affiliation(s)
- Aldina Mesic
- Department of Global Health, University of Washington, Seattle, Washington, USA.
| | | | - Adam Gyedu
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Mock
- Department of Global Health, University of Washington, Seattle, Washington, USA; Department of Surgery, University of Washington, Seattle, Washington, USA; Harborview Injury Prevention and Research Center, Seattle, Washington, USA
| | | | - Irene Opoku
- Building and Road Research Institute, Kumasi, Ghana
| | | | | | | | - Peter Donkor
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Barclay Stewart
- Department of Surgery, University of Washington, Seattle, Washington, USA; Harborview Injury Prevention and Research Center, Seattle, Washington, USA
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Gibbings A, Ray LB, Gagnon S, Collin CA, Robillard R, Fogel SM. The EEG correlates and dangerous behavioral consequences of drowsy driving after a single night of mild sleep deprivation. Physiol Behav 2022; 252:113822. [PMID: 35469778 DOI: 10.1016/j.physbeh.2022.113822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/12/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Here, we investigated the behavioral, cognitive, and electrophysiological impact of mild, acute sleep loss via simultaneously recorded behavioral and electrophysiological measures of vigilance during a "real-world", simulated driving task. METHODS Participants (N = 34) visited the lab for two testing days where their brain activity and vigilance were simultaneously recorded during a driving simulator task. The driving task lasted approximately 70 mins and consisted of tailgating the lead car at high speed, which braked randomly, requiring participants to react quickly to avoid crashing. The night before testing, participants either slept from 12am-9am (Normally Rested), or 1am-6am (Sleep Restriction). RESULTS After a single night of mild sleep restriction, sleepiness was increased, participants took longer to brake, missed more braking events, and crashed more often. Brain activity showed more intense alpha burst activity and significant changes in EEG spectral power frequencies related to arousal (e.g., delta, theta, alpha). Importantly, increases in amplitude and number of alpha bursts predicted delays in reaction time when braking. CONCLUSIONS The findings of this study suggest that a single night of mild sleep loss has significant, negative consequences on driving performance and vigilance, and a clear impact on the physiology of the brain in ways that reflect reduced arousal. SIGNIFICANCE Understanding neural and cognitive changes associated with sleep loss may lead to important advancements in identifying and preventing potentially dangerous sleep-related lapses in vigilance.
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Affiliation(s)
- A Gibbings
- Sleep Research Unit, The University of Ottawa's Institute of Mental Health Research at The Royal, Ottawa, K1Z 7K4, Canada; School of Psychology, University of Ottawa, Ottawa, K1N 6N5, Canada
| | - L B Ray
- Sleep Research Unit, The University of Ottawa's Institute of Mental Health Research at The Royal, Ottawa, K1Z 7K4, Canada
| | - S Gagnon
- School of Psychology, University of Ottawa, Ottawa, K1N 6N5, Canada
| | - C A Collin
- School of Psychology, University of Ottawa, Ottawa, K1N 6N5, Canada
| | - R Robillard
- Sleep Research Unit, The University of Ottawa's Institute of Mental Health Research at The Royal, Ottawa, K1Z 7K4, Canada; School of Psychology, University of Ottawa, Ottawa, K1N 6N5, Canada
| | - S M Fogel
- Sleep Research Unit, The University of Ottawa's Institute of Mental Health Research at The Royal, Ottawa, K1Z 7K4, Canada; School of Psychology, University of Ottawa, Ottawa, K1N 6N5, Canada; University of Ottawa Brain & Mind Research Institute, Ottawa, K1H 8M5, Canada.
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Akashiba T, Inoue Y, Uchimura N, Ohi M, Kasai T, Kawana F, Sakurai S, Takegami M, Tachikawa R, Tanigawa T, Chiba S, Chin K, Tsuiki S, Tonogi M, Nakamura H, Nakayama T, Narui K, Yagi T, Yamauchi M, Yamashiro Y, Yoshida M, Oga T, Tomita Y, Hamada S, Murase K, Mori H, Wada H, Uchiyama M, Ogawa H, Sato K, Nakata S, Mishima K, Momomura SI. Sleep Apnea Syndrome (SAS) Clinical Practice Guidelines 2020. Respir Investig 2022; 60:3-32. [PMID: 34986992 DOI: 10.1016/j.resinv.2021.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 11/25/2022]
Abstract
The prevalence of sleep disordered breathing (SDB) is reportedly very high. Among SDBs, the incidence of obstructive sleep apnea (OSA) is higher than previously believed, with patients having moderate-to-severe OSA accounting for approximately 20% of adult males and 10% of postmenopausal women not only in Western countries but also in Eastern countries, including Japan. Since 1998, when health insurance coverage became available, the number of patients using continuous positive airway pressure (CPAP) therapy for sleep apnea has increased sharply, with the number of patients about to exceed 500,000 in Japan. Although the "Guidelines for Diagnosis and Treatment of Sleep Apnea Syndrome (SAS) in Adults" was published in 2005, a new guideline was prepared in order to indicate the standard medical care based on the latest trends, as supervised by and in cooperation with the Japanese Respiratory Society and the "Survey and Research on Refractory Respiratory Diseases and Pulmonary Hypertension" Group, of Ministry of Health, Labor and Welfare and other related academic societies, including the Japanese Society of Sleep Research, in addition to referring to the previous guidelines. Because sleep apnea is an interdisciplinary field covering many areas, this guideline was prepared including 36 clinical questions (CQs). In the English version, therapies and managements for SAS, which were written from CQ16 to 36, were shown. The Japanese version was published in July 2020 and permitted as well as published as one of the Medical Information Network Distribution Service (Minds) clinical practice guidelines in Japan in July 2021.
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Affiliation(s)
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Motoharu Ohi
- Sleep Medical Center, Osaka Kaisei Hospital, Osaka, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Fusae Kawana
- Department of Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeru Sakurai
- Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Rho Tachikawa
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shintaro Chiba
- Ota Memorial Sleep Center, Ota General Hospital, Kanagawa, Japan
| | - Kazuo Chin
- Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine, Tokyo, Japan; Department of Human Disease Genomics, Center for Genomic Medicine, Graduate School Medicine, Kyoto University, Japan.
| | | | - Morio Tonogi
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, Tokyo, Japan
| | | | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Koji Narui
- Sleep Center, Toranomon Hospital, Tokyo, Japan
| | - Tomoko Yagi
- Ota Memorial Sleep Center, Ota General Hospital, Kanagawa, Japan
| | - Motoo Yamauchi
- Department of Respiratory Medicine, Nara Medical University, Nara, Japan
| | | | - Masahiro Yoshida
- Department of Hemodialysis and Surgery, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan
| | - Toru Oga
- Department of Respiratory Medicine, Kawasaki Medical School, Okayama, Japan
| | - Yasuhiro Tomita
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Satoshi Hamada
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroyuki Mori
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroo Wada
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Makoto Uchiyama
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Hiromasa Ogawa
- Department of Occupational Health, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kazumichi Sato
- Department of Dental and Oral Surgery, International University of Health and Welfare, Chiba, Japan
| | - Seiichi Nakata
- Department of Otorhinolaryngology, Second Hospital, Fujita Health University School of Medicine, Aichi, Japan
| | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Shin-Ichi Momomura
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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Cleper R, Hertz-Palmor N, Mosheva M, Hasson-Ohayon I, Kaplan R, Kreiss Y, Afek A, Pessach IM, Gothelf D, Gross R. Sleep Difficulties Among COVID-19 Frontline Healthcare Workers. Front Psychiatry 2022; 13:838825. [PMID: 35573372 PMCID: PMC9098971 DOI: 10.3389/fpsyt.2022.838825] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/28/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To identify COVID-19 work-related stressors and experiences associated with sleep difficulties in HCW, and to assess the role of depression and traumatic stress in this association. METHODS A cross-sectional study of HCW using self-report questionnaires, during the first peak of the pandemic in Israel (April 2020), conducted in a large tertiary medical center in Israel. Study population included 189 physicians and nurses working in designated COVID-19 wards and a comparison group of 643 HCW. Mean age of the total sample was 41.7 ± 11.1, 67% were female, 42.1% physicians, with overall mean number of years of professional experience 14.2 ± 20. The exposure was working in COVID-19 wards and related specific stressors and negative experiences. Primary outcome measurement was the Insomnia Severity Index (ISI). Secondary outcomes included the Primary Care-Post Traumatic Stress Disorder Screen (PC-PTSD-5); the Patient Health Questionnaire-9 (PHQ-9) for depression; the anxiety module of the Patient-Reported Outcomes Measurement Information System (PROMIS); Pandemic-Related Stress Factors (PRSF) and witnessing patient suffering and death. RESULTS Compared with non-COVID-19 HCW, COVID-19 HCW were more likely to be male (41.3% vs. 30.7%) and younger (36.91 ± 8.81 vs. 43.14 ± 11.35 years). COVID-19 HCW reported higher prevalence of sleep difficulties: 63% vs. 50.7% in the non-COVID group (OR 1.62, 95% CI 1.15-2.29, p = 0.006), mostly difficulty maintaining sleep: 26.5% vs. 18.5% (OR 1.65, 95% CI 1.11-2.44, p = 0.012). Negative COVID-19 work-related experiences, specifically witnessing patient physical suffering and death, partially explained the association. Although past psychological problems and current depression and PTSD were associated with difficulty maintaining sleep, the main association remained robust also after controlling for those conditions in the full model. CONCLUSION AND RELEVANCE COVID-19 frontline HCW were more likely to report sleep difficulties, mainly difficulty maintaining sleep, as compared with non-COVID-19 HCW working at the same hospital. Negative patient-care related experiences likely mediated the increased probability for those difficulties. Future research is needed to elucidate the long-term trajectories of sleep difficulties among HCW during large scale outbreaks, and to identify risk factors for their persistence.
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Affiliation(s)
- Rony Cleper
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nimrod Hertz-Palmor
- The Chaim Sheba Medical Center, Ramat Gan, Israel.,School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Mariela Mosheva
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Chaim Sheba Medical Center, Ramat Gan, Israel
| | | | | | - Yitshak Kreiss
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Itai M Pessach
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Doron Gothelf
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Raz Gross
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Chaim Sheba Medical Center, Ramat Gan, Israel
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10
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Akashiba T, Inoue Y, Uchimura N, Ohi M, Kasai T, Kawana F, Sakurai S, Takegami M, Tachikawa R, Tanigawa T, Chiba S, Chin K, Tsuiki S, Tonogi M, Nakamura H, Nakayama T, Narui K, Yagi T, Yamauchi M, Yamashiro Y, Yoshida M, Oga T, Tomita Y, Hamada S, Murase K, Mori H, Wada H, Uchiyama M, Ogawa H, Sato K, Nakata S, Mishima K, Momomura SI. Sleep Apnea Syndrome (SAS) Clinical Practice Guidelines 2020. Sleep Biol Rhythms 2022; 20:5-37. [PMID: 38469064 PMCID: PMC10900032 DOI: 10.1007/s41105-021-00353-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/28/2021] [Indexed: 12/17/2022]
Abstract
The prevalence of sleep-disordered breathing (SDB) is reportedly very high. Among SDBs, the incidence of obstructive sleep apnea (OSA) is higher than previously believed, with patients having moderate-to-severe OSA accounting for approximately 20% of adult males and 10% of postmenopausal women not only in Western countries but also in Eastern countries, including Japan. Since 1998, when health insurance coverage became available, the number of patients using continuous positive airway pressure (CPAP) therapy for sleep apnea has increased sharply, with the number of patients about to exceed 500,000 in Japan. Although the "Guidelines for Diagnosis and Treatment of Sleep Apnea Syndrome (SAS) in Adults" was published in 2005, a new guideline was prepared to indicate the standard medical care based on the latest trends, as supervised by and in cooperation with the Japanese Respiratory Society and the "Survey and Research on Refractory Respiratory Diseases and Pulmonary Hypertension" Group, of Ministry of Health, Labor and Welfare and other related academic societies, including the Japanese Society of Sleep Research, in addition to referring to the previous guidelines. Since sleep apnea is an interdisciplinary field covering many areas, this guideline was prepared including 36 clinical questions (CQs). In the English version, therapies and managements for SAS, which were written from CQ16 to 36, were shown. The Japanese version was published in July 2020 and permitted as well as published as one of the Medical Information Network Distribution Service (Minds) clinical practice guidelines in Japan in July 2021.
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Affiliation(s)
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Motoharu Ohi
- Sleep Medical Center, Osaka Kaisei Hospital, Osaka, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Fusae Kawana
- Department of Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeru Sakurai
- Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Ryo Tachikawa
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shintaro Chiba
- Ota Memorial Sleep Center, Ota General Hospital, Kanagawa, Japan
| | - Kazuo Chin
- Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, Tokyo, 173-8610 Japan
- Department of Human Disease Genomics, Center for Genomic Medicine, Graduate School Medicine, Kyoto University, Kyoto, Japan
| | | | - Morio Tonogi
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, Tokyo, Japan
| | | | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Koji Narui
- Sleep Center, Toranomon Hospital, Tokyo, Japan
| | - Tomoko Yagi
- Ota Memorial Sleep Center, Ota General Hospital, Kanagawa, Japan
| | - Motoo Yamauchi
- Department of Respiratory Medicine, Nara Medical University, Nara, Japan
| | | | - Masahiro Yoshida
- Department of Hemodialysis and Surgery, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan
| | - Toru Oga
- Department of Respiratory Medicine, Kawasaki Medical School, Okayama, Japan
| | - Yasuhiro Tomita
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Satoshi Hamada
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroyuki Mori
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroo Wada
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Uchiyama
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Hiromasa Ogawa
- Department of Occupational Health, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kazumichi Sato
- Department of Dental and Oral Surgery, International University of Health and Welfare, Chiba, Japan
| | - Seiichi Nakata
- Department of Otorhinolaryngology, Second Hospital, Fujita Health University School of Medicine, Aichi, Japan
| | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Shin-Ichi Momomura
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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11
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Association between sleep disturbance and occupational injury among Korean employees. Ann Occup Environ Med 2021; 33:e29. [PMID: 34868599 PMCID: PMC8602825 DOI: 10.35371/aoem.2021.33.e29] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/27/2021] [Accepted: 08/30/2021] [Indexed: 11/20/2022] Open
Abstract
Background Occupational injury has been a serious social problem steadily. Sleep disturbance is a risk factor for occupational injury. However, there were few researches studied on the linking between sleep disturbance and occupational injury in general working population of Korea. Therefore, we explored the association between sleep disturbance and occupational injury among Korean workers. Methods This study used data from the 5th Korean Working Conditions Survey. Occupational injury was assessed by asking work related injury for 12 months prior to the point of the survey. Sleep disturbance was assessed using the Minimal Insomnia Symptoms Scale (MISS). To analyze the association between sleep disturbance and occupational injury, multiple logistic regression analysis was conducted. Results The odds ratio (OR) of sleep disturbance group for occupational injury was 2.57 (95% confidence interval [CI]: 1.68–3.93) in the fully adjusted model. For the association between MISS score and occupational injury, it showed increasing trend that ORs increase from the 1st to the 4th quartiles. The OR of 2nd quartile was 1.10 (95% CI: 0.60–2.01), the OR of 3rd quartile was 2.27 (95% CI: 1.53–3.38) and the OR of 4th quartile was 2.80 (95% CI: 1.84–4.26). Conclusions Sleep disturbance was associated with occupational injury. In addition, increasing trend was observed between MISS score and occupational injury. These findings imply that developing of intervention programs to manage sleep disturbance and fatigue may be necessary to prevent occupational injury.
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12
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Bijlenga D, Urbanus B, van der Sluiszen NNJJM, Overeem S, Ramaekers JG, Vermeeren A, Lammers GJ. Comparing objective wakefulness and vigilance tests to on-the-road driving performance in narcolepsy and idiopathic hypersomnia. J Sleep Res 2021; 31:e13518. [PMID: 34755413 PMCID: PMC9286536 DOI: 10.1111/jsr.13518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/27/2022]
Abstract
Patients with narcolepsy or idiopathic hypersomnia (IH) are at increased risk of driving accidents. Both excessive daytime sleepiness, i.e. unwanted sleep episodes during the day, and disturbed vigilance are core features of these disorders. We tested on‐the‐road driving performance of patients with narcolepsy or IH coming in for a routine driving fitness evaluation and examined: (1) correlations between driving performance and the Maintenance of Wakefulness Test (MWT), Sustained Attention to Response Task (SART) and Psychomotor Vigilance Test (PVT) as objective tests; (2) the predictive power of the MWT and SART for increased risk of impaired driving; (3) the best set of objective predictors for increased risk of impaired driving. Participants were 44 patients (aged 18–75 years) with narcolepsy type 1 (NT1), type 2 (NT2) or IH. They completed the MWT, SART, PVT, a subjective sleepiness questionnaire, and a standardised on‐the‐road driving test. The standard deviation of the lateral position (SDLP) was used as outcome measure of driving performance. The MWT had low correlation with the SDLP (ρ = −0.41 to −0.49, p < 0.01). The SART and PVT had low correlations with SDLP (ρ = 0.30 and ρ = 0.39, respectively, both p < 0.05). The predictive power of MWT for an increased risk of impaired driving was significant, but low (area under the curve = 0.273, p = 0.012), and non‐significant for SART. We conclude that in our present group, none of the tests had adequate ability to predict impaired driving, questioning their use for clinical driving fitness evaluation in narcolepsy and IH. Real‐time monitoring of sleepiness while driving seems more promising in these patients.
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Affiliation(s)
- Denise Bijlenga
- Sleep-Wake Centre, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands.,Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Bram Urbanus
- Sleep-Wake Centre, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands
| | - Nick N J J M van der Sluiszen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Sebastiaan Overeem
- Centre for Sleep Medicine, Kempenhaeghe, Heeze, the Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Jan G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Annemiek Vermeeren
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Gert Jan Lammers
- Sleep-Wake Centre, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands.,Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
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13
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Genetics and Cognitive Vulnerability to Sleep Deprivation in Healthy Subjects: Interaction of ADORA2A, TNF-α and COMT Polymorphisms. Life (Basel) 2021; 11:life11101110. [PMID: 34685481 PMCID: PMC8540997 DOI: 10.3390/life11101110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/02/2021] [Accepted: 10/13/2021] [Indexed: 11/17/2022] Open
Abstract
Several genetic polymorphisms differentiate between healthy individuals who are more cognitively vulnerable or resistant during total sleep deprivation (TSD). Common metrics of cognitive functioning for classifying vulnerable and resilient individuals include the Psychomotor Vigilance Test (PVT), Go/noGo executive inhibition task, and subjective daytime sleepiness. We evaluated the influence of 14 single-nucleotide polymorphisms (SNPs) on cognitive responses during total sleep deprivation (continuous wakefulness for 38 h) in 47 healthy subjects (age 37.0 ± 1.1 years). SNPs selected after a literature review included SNPs of the adenosine-A2A receptor gene (including the most studied rs5751876), pro-inflammatory cytokines (TNF-α, IL1-β, IL-6), catechol-O-methyl-transferase (COMT), and PER3. Subjects performed a psychomotor vigilance test (PVT) and a Go/noGo-inhibition task, and completed the Karolinska Sleepiness Scale (KSS) every 6 h during TSD. For PVT lapses (reaction time >500 ms), an interaction between SNP and SDT (p < 0.05) was observed for ADORA2A (rs5751862 and rs2236624) and TNF-α (rs1800629). During TSD, carriers of the A allele for ADORA2A (rs5751862) and TNF-α were significantly more impaired for cognitive responses than their respective ancestral G/G genotypes. Carriers of the ancestral G/G genotype of ADORA2A rs5751862 were found to be very similar to the most resilient subjects for PVT lapses and Go/noGo commission errors. Carriers of the ancestral G/G genotype of COMT were close to the most vulnerable subjects. ADORA2A (rs5751862) was significantly associated with COMT (rs4680) (p = 0.001). In conclusion, we show that genetic polymorphisms in ADORA2A (rs5751862), TNF-α (rs1800629), and COMT (rs4680) are involved in creating profiles of high vulnerability or high resilience to sleep deprivation. (NCT03859882).
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14
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Molt F, Torres P, Flores V, Valladares C, Ibáñez JL, Cortés M. Trastornos del sueño en emergencias y desastres. REVISTA MÉDICA CLÍNICA LAS CONDES 2021. [PMCID: PMC8635449 DOI: 10.1016/j.rmclc.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Los trastornos del sueño son frecuentes en la población y una causa importante de morbilidad. El objetivo de esta revisión es evaluar las alteraciones del sueño en periodos de emergencia y desastres. A lo largo de la historia, la esfera biopsicosocial y el sueño de las personas ha sido abrumada por múltiples eventos a gran escala, tales como desastres naturales, tragedias provocadas por el hombre, conflictos bélicos, crisis sociales y pandemias, cuya experiencia puede derivar en problemas de salud a corto, mediano y/o largo plazo. En los estudios analizados, se ha observado el impacto negativo de las emergencias y desastres en el sueño, por lo que ha cobrado gran relevancia la difusión y promoción de medidas que incentiven el buen dormir. Debido a la llegada del COVID-19 y a la situación de confinamiento por periodos prolongados en el hogar para prevenir su propagación, han surgido importantes consecuencias a nivel social. Ciertos factores ocupacionales y características de los desastres se asocian a mayor comorbilidad, un alto riesgo de experimentar agotamiento físico, trastornos psicológicos e insomnio en grupos altamente vulnerables, como lo son los profesionales de la salud, rescatistas y socorristas. El insomnio es el trastorno de sueño más frecuente en la población general y su empeoramiento en el contexto de pandemia por COVID-19 representa un nuevo problema en salud pública. Es por ello, que es indispensable promover campañas de prevención de salud física y mental orientados a la pesquisa precoz y manejo de patologías de la esfera psicosocial, dentro de las posibilidades socioeconómicas.
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15
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Casale CE, Goel N. Genetic Markers of Differential Vulnerability to Sleep Loss in Adults. Genes (Basel) 2021; 12:1317. [PMID: 34573301 PMCID: PMC8464868 DOI: 10.3390/genes12091317] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 12/15/2022] Open
Abstract
In this review, we discuss reports of genotype-dependent interindividual differences in phenotypic neurobehavioral responses to total sleep deprivation or sleep restriction. We highlight the importance of using the candidate gene approach to further elucidate differential resilience and vulnerability to sleep deprivation in humans, although we acknowledge that other omics techniques and genome-wide association studies can also offer insights into biomarkers of such vulnerability. Specifically, we discuss polymorphisms in adenosinergic genes (ADA and ADORA2A), core circadian clock genes (BHLHE41/DEC2 and PER3), genes related to cognitive development and functioning (BDNF and COMT), dopaminergic genes (DRD2 and DAT), and immune and clearance genes (AQP4, DQB1*0602, and TNFα) as potential genetic indicators of differential vulnerability to deficits induced by sleep loss. Additionally, we review the efficacy of several countermeasures for the neurobehavioral impairments induced by sleep loss, including banking sleep, recovery sleep, caffeine, and naps. The discovery of reliable, novel genetic markers of differential vulnerability to sleep loss has critical implications for future research involving predictors, countermeasures, and treatments in the field of sleep and circadian science.
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Affiliation(s)
| | - Namni Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 425, Chicago, IL 60612, USA;
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16
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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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17
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Shin DS, Jeong BY, Park MH. Comparison of work-related traffic crashes between male taxi drivers aged ≥65 years and <65 years in South Korea. Work 2020; 67:369-380. [PMID: 33044217 DOI: 10.3233/wor-203286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The percentage of drivers aged ≥65 years among all Korean taxi drivers has risen sharply from 3.2% in 2006 to 22.0% in 2016. OBJECTIVE This study compared the characteristics of work-related traffic crashes between male taxi drivers aged ≥65 years and <65 years. METHODS Using the national compensation data of South Korea, 586 injured male taxi drivers were analyzed based on driver-related (work experience, company size, employment status, injured body part, and injury type) and crash-related factors (time and day of the crash, weather condition, road type, violation and drowsiness) by age group. RESULTS For the injured drivers aged ≥65, percentages of the crashes related to some factors were lower than those of the drivers aged <65 years: at night (55.2% vs. 64.0%), on rainy or snowy day (7.8% vs. 21.3%), on straight road (40.5% vs 50.9%) and on the expressway (6.9% vs. 13.0%). However, the percentage of the crashes related to a violation for the injured drivers aged ≥65 years (23.3%) was higher than that of the drivers aged <65 years (13.4%). Furthermore, the taxi drivers aged ≥65 years had a higher death rate (14.7%) than the drivers aged <65 years (8.5%). CONCLUSIONS The results can be useful for injury prevention policies and guidelines for elderly taxi drivers such as strengthened qualification tests for the aged drivers and improvement of the working environment.
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Affiliation(s)
- Dong Seok Shin
- Korea National Industrial Convergence Center, Korea Institute of Industrial Technology, Cheonan, Republic of Korea
| | - Byung Yong Jeong
- Department of Industrial & Management Engineering, Hansung University, Seoul, Republic of Korea
| | - Myoung Hwan Park
- Department of Industrial & Management Engineering, Hansung University, Seoul, Republic of Korea
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18
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Slikboer R, Muir SD, Silva SSM, Meyer D. A systematic review of statistical models and outcomes of predicting fatal and serious injury crashes from driver crash and offense history data. Syst Rev 2020; 9:220. [PMID: 32988410 PMCID: PMC7523043 DOI: 10.1186/s13643-020-01475-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/03/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Expenditure on driver-related behavioral interventions and road use policy is often justified by their impact on the frequency of fatal and serious injury crashes. Given the rarity of fatal and serious injury crashes, offense history, and crash history of drivers are sometimes used as an alternative measure of the impact of interventions and changes to policy. The primary purpose of this systematic review was to assess the rigor of statistical modeling used to predict fatal and serious crashes from offense history and crash history using a purpose-made quality assessment tool. A secondary purpose was to explore study outcomes. METHODS Only studies that used observational data and presented a statistical model of crash prediction from offense history or crash history were included. A quality assessment tool was developed for the systematic evaluation of statistical quality indicators across studies. The search was conducted in June 2019. RESULTS One thousand one hundred and five unique records were identified, 252 full texts were screened for inclusion, resulting in 20 studies being included in the review. The results indicate substantial and important limitations in the modeling methods used. Most studies demonstrated poor statistical rigor ranging from low to middle quality. There was a lack of confidence in published findings due to poor variable selection, poor adherence to statistical assumptions relating to multicollinearity, and lack of validation using new data. CONCLUSIONS It was concluded that future research should consider machine learning to overcome correlations in the data, use rigorous vetting procedures to identify predictor variables, and validate statistical models using new data to improve utility and generalizability of models. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019137081.
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Affiliation(s)
- Reneta Slikboer
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University of Technology, PO Box 218, Mail H31, John St, Hawthorn, Victoria, 3122, Australia.
| | - Samuel D Muir
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University of Technology, PO Box 218, Mail H31, John St, Hawthorn, Victoria, 3122, Australia
| | - S S M Silva
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University of Technology, PO Box 218, Mail H31, John St, Hawthorn, Victoria, 3122, Australia
| | - Denny Meyer
- Centre for Mental Health, Faculty of Health Arts and Design, Swinburne University of Technology, PO Box 218, Mail H31, John St, Hawthorn, Victoria, 3122, Australia
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19
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Bioulac S, Sagaspe P, Micoulaud-Franchi JA, Altena E, Taillard J, Schröder C, Bouvard MP, Fabrigoule C, Philip P. Objective Level of Alertness and Inhibitory Control Predict Highway Driving Impairment in Adults With ADHD. J Atten Disord 2020; 24:1475-1486. [PMID: 27009924 DOI: 10.1177/1087054716633751] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: It remains unclear whether daytime impairments in ADHD patients are better explained by an altered level of alertness and/or by cognitive deficits. The aim of this study was to determine the respective contribution of these factors on driving performance in ADHD adults. Method: ADHD adults (n = 39) and healthy controls (n = 18) underwent a nocturnal polysomnography (PSG) followed by a Maintenance of Wakefulness Test (MWT), a simulated driving task, and a neuropsychological evaluation. Results: ADHD patients had shorter mean sleep latency on the MWT and worse driving performance than controls. They also made more errors on attention and executive functioning tests. Logistic regression analyses showed that inhibition deficits and objective daytime sleepiness predicted highway driving performance in ADHD. Conclusion: Our study shows that not only inhibitory control deficits but also pathological level of alertness independently contribute to highway driving impairment in ADHD patients, providing a better understanding of the pathophysiological mechanisms involved in ADHD.
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Affiliation(s)
- Stéphanie Bioulac
- Pôle Universitaire Psychiatrie Enfants et Adolescents, Bordeaux, France.,Université de Bordeaux, France.,Unité de Service et de Recherche du Centre National de la Recherche Scientifique 3413 (USR CNRS 3413), Sommeil, Attention et Neuropsychiatrie (SANPSY), Bordeaux, France
| | - Patricia Sagaspe
- Université de Bordeaux, France.,Unité de Service et de Recherche du Centre National de la Recherche Scientifique 3413 (USR CNRS 3413), Sommeil, Attention et Neuropsychiatrie (SANPSY), Bordeaux, France.,Centre Hospitalier Universitaire (CHU) Pellegrin, Clinique du Sommeil, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Université de Bordeaux, France.,Unité de Service et de Recherche du Centre National de la Recherche Scientifique 3413 (USR CNRS 3413), Sommeil, Attention et Neuropsychiatrie (SANPSY), Bordeaux, France.,Centre Hospitalier Universitaire (CHU) Pellegrin, Clinique du Sommeil, Bordeaux, France
| | - Ellemarije Altena
- Université de Bordeaux, France.,Unité de Service et de Recherche du Centre National de la Recherche Scientifique 3413 (USR CNRS 3413), Sommeil, Attention et Neuropsychiatrie (SANPSY), Bordeaux, France
| | - Jacques Taillard
- Université de Bordeaux, France.,Unité de Service et de Recherche du Centre National de la Recherche Scientifique 3413 (USR CNRS 3413), Sommeil, Attention et Neuropsychiatrie (SANPSY), Bordeaux, France.,Centre Hospitalier Universitaire (CHU) Pellegrin, Clinique du Sommeil, Bordeaux, France
| | - Carmen Schröder
- University of Strasbourg, France.,Institute for Cellular and Integrative Neuroscience, Strasbourg, France
| | | | - Colette Fabrigoule
- Université de Bordeaux, France.,Unité de Service et de Recherche du Centre National de la Recherche Scientifique 3413 (USR CNRS 3413), Sommeil, Attention et Neuropsychiatrie (SANPSY), Bordeaux, France
| | - Pierre Philip
- Université de Bordeaux, France.,Unité de Service et de Recherche du Centre National de la Recherche Scientifique 3413 (USR CNRS 3413), Sommeil, Attention et Neuropsychiatrie (SANPSY), Bordeaux, France.,Centre Hospitalier Universitaire (CHU) Pellegrin, Clinique du Sommeil, Bordeaux, France
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20
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Crichton T, Singh R, Abosi-Appeadu K, Dennis G. Excessive daytime sleepiness after traumatic brain injury. Brain Inj 2020; 34:1525-1531. [DOI: 10.1080/02699052.2020.1810316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Thomas Crichton
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Rajiv Singh
- Department of Neuroscience, University of Sheffield, Sheffield, UK
- Osborn Neurorehabilitation Unit, Department of Rehabilitation Medicine, Sheffield Teaching Hospitals, Sheffield, UK
| | | | - Gary Dennis
- Department of Neuroscience, University of Sheffield, Sheffield, UK
- Department of Neurology, Sheffield Teaching Hospitals, Sheffield, UK
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21
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McElroy SF, Olney A, Hunt C, Glennon C. Shift work and hospital employees: A descriptive multi-site study. Int J Nurs Stud 2020; 112:103746. [PMID: 32928504 DOI: 10.1016/j.ijnurstu.2020.103746] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hospitals staff with 12-hour and other shift work patterns to account for daily and seasonal workload requirements. Research in healthcare and industries requiring shift work suggests there may be negative health consequences to the workers related to fatigue and other factors. Due to the 24/7 nature of healthcare, it is important to understand the impact of shift work on employees. OBJECTIVES The objectives of this study were to investigate how shift work impacts satisfaction with time for social and home activities, based on the Social and Domestic Survey, and chronic fatigue. In addition, an exploration of drowsy driving was undertaken. DESIGN AND SETTING This study was a multi-site, descriptive survey study, conducted in 4 acute care hospitals in one metropolitan area in the central United States. PARTICIPANTS Participants included healthcare workers in five 24/7 departments: nursing, respiratory therapy, laboratory, radiology and pharmacy. METHODS Measures included demographics, work characteristics, and scales including the: Social and Domestic Survey, Circadian Type Inventory, and Chronic Fatigue Scale along with data regarding drowsy driving and automobile accidents/near misses. Data were analyzed using descriptive statistics for sample characteristics. An exploratory factor analysis was conducted on the Social and Domestic Survey. Group differences were tested using Mann-Whitney U tests and regression analyses. RESULTS The sample included 1563 subjects (24% RR). The mean age was 40 years. Nursing comprised 77% of the sample, 88% were female, 85% were in a direct patient care role, 67% worked day shift, and 49% worked 12-hour shifts. Pay was important for working night shift, but home life was important for day shift. Night shift (p<0.001) and 12-hour shift workers (p<0.001) had higher chronic fatigue. However, after controlling for other factors, working night shift remained a significant predictor of chronic fatigue and lower satisfaction with time for daily tasks and family/social life, whereas working 12-hour shifts predicted higher satisfaction with daily tasks and periodic life activities. Thirty-five percent of workers reported altering their driving behavior at least half the time due to drowsy driving and 19% had an automobile accident or near miss due to drowsy driving. CONCLUSIONS Findings suggest that night and long shifts can have negative effects on fatigue, family, and social life. Drowsy driving and accidents/near misses frequently occur due to drowsy driving. Leaders should continue to study the 24/7 work environment and test measures to improve the safety of shift workers.
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Affiliation(s)
- Susan F McElroy
- Children's Mercy - Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA.
| | - Adrienne Olney
- Children's Mercy - Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA.
| | - Cheri Hunt
- Children's Mercy - Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA.
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22
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Forest K, Valdenaire G, Lorendeau JP, Sagaspe P, Contrand B, Durand-Teyssier C, Sakr D, Gil-Jardine C, Boutreux S, Lagarde E, Peyrouzet H, Lassalle R, Moore N, Philip P, Girodet PO. Factors associated with serious vehicular accidents: A cross-sectional study in hospital emergency rooms. Br J Clin Pharmacol 2020; 87:612-621. [PMID: 32530532 DOI: 10.1111/bcp.14427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/28/2020] [Accepted: 05/28/2020] [Indexed: 11/30/2022] Open
Abstract
AIMS Pictograms on medicine boxes warn of potential drug-related driving hazard; we studied their association with serious accidents. METHODS Prospective study in emergency departments of the hospitals in Bordeaux and Périgueux (France), of drivers with serious (admitted at least 24 hours) or nonserious vehicular accidents. Minors, passengers, pedestrians or subjects incapable of answering an interview were excluded. Interviews ascertained driver and accident characteristics, use of drugs with or without pictograms, use of alcohol and abuse substances, sleepiness, distractions, and mind wandering at the time of the accident, RESULTS: Between 18 October 2016 and 26 December 2018, 1200 of the 6212 drivers admitted to the hospital emergency rooms, 741 nonserious, 459 serious, were interviewed. Serious accidents were associated with male sex (odds ratio 1.89, 95% confidence interval [1.36-2.64]), age above 60 years (3.64 [2.21-6.00]), driving on local roads (3.34 [2.34-4.76]), driving a motorcycle (3.39 [2.29-5.00]), having drunk alcohol within 6 hours (2.89 [1.85-4.51]) and using a drug with a pictogram during the 24 hours previous to the accident (1.57 [1.06-2.32]). From 207 police reports, 101 drivers were not responsible, and 106 were responsible, associated with age below 40 years, driving in overcast or rainy weather (2.62 [1.29-5.33]), on local roads (3.89 [1.90-7.95]), and use of at least 1 pictogram drug in the previous week (3.12 [1.31-7.41]). CONCLUSION The known risks of alcohol and pictogram drugs, of riding motorcycles and using local roads were confirmed. As measured, behavioural sleepiness did not predict accidents.
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Affiliation(s)
- Karelle Forest
- Bordeaux INSERM CIC1401, CHU de Bordeaux - Université de Bordeaux 33076, Bordeaux, France
| | | | | | | | - Benjamin Contrand
- Injury Epidemiology, transport, occupation (University of Bordeaux), Bordeaux, France
| | | | - Dunia Sakr
- Bordeaux INSERM CIC1401, CHU de Bordeaux - Université de Bordeaux 33076, Bordeaux, France
| | | | | | - Emmanuel Lagarde
- Injury Epidemiology, transport, occupation (University of Bordeaux), Bordeaux, France
| | - Hélène Peyrouzet
- Bordeaux INSERM CIC1401, CHU de Bordeaux - Université de Bordeaux 33076, Bordeaux, France
| | - Régis Lassalle
- Bordeaux INSERM CIC1401, CHU de Bordeaux - Université de Bordeaux 33076, Bordeaux, France
| | - Nicholas Moore
- Bordeaux INSERM CIC1401, CHU de Bordeaux - Université de Bordeaux 33076, Bordeaux, France
| | | | - Pierre-Olivier Girodet
- Bordeaux INSERM CIC1401, CHU de Bordeaux - Université de Bordeaux 33076, Bordeaux, France
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23
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Mahajan K, Velaga NR. Effects of Partial Sleep Deprivation on Braking Response of Drivers in Hazard Scenarios. ACCIDENT; ANALYSIS AND PREVENTION 2020; 142:105545. [PMID: 32380239 DOI: 10.1016/j.aap.2020.105545] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/31/2020] [Accepted: 04/05/2020] [Indexed: 06/11/2023]
Abstract
This study aimed at modeling the Response Time (RT) and Total Braking Time (TBT) of drivers under Partial Sleep Deprivation (PSD). Fifty male participants drove the driving simulator in three experimental conditions: two test sessions and a baseline. The two test sessions were conducted after one and two nights of PSD (sleep = 4.25 ± 0.5 h), respectively. Sleep reduction was recorded using a wrist-worn Actiwatch. The baseline session was conducted after full rest (7-8 h sleep/day for a week). The order of test sessions and baseline was randomized. Each test included two hazard events: 1) pedestrians crossing a road and 2) parked vehicles merging into a roadway. Karolinska Sleepiness Scale (KSS) and Sleepiness Symptoms Questionnaire (SSQ) ratings were also recorded during each drive. Four separate models using parametric accelerated failure time (AFT) with Weibull distribution were developed for RT and TBT in the two events. The models were chosen with clustered heterogeneity to account for intra-group heterogeneity due to repeated measures across tests. In the case of pedestrians crossing event, RT increased by 10% in the first test session and no significant effect observed on RT in the second test session. The overall TBT reduced by 25% and 28% during the first and second PSD sessions, respectively. In the case of vehicle merging event, both response time and total braking time delayed by 44% and 17% respectively after PSD. Other factors such as age, experience, work-rest hours, KSS and SSQ rating, often exercising, approaching speed and braking force were also found significant in the analysis. The parametric AFT approach adopted in this study showed the change in 'response time' and 'total braking time' concerning the type of hazard scenario and partial sleep-deprivation.
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Affiliation(s)
- Kirti Mahajan
- Transportation Systems Engineering, Department of Civil Engineering, Indian Institute of Technology (IIT) Bombay, Powai, Mumbai 400 076, India
| | - Nagendra R Velaga
- Transportation Systems Engineering, Department of Civil Engineering, Indian Institute of Technology (IIT) Bombay, Powai, Mumbai 400 076, India.
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24
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Philip P, Guichard K, Strauss M, Léger D, Pepin E, Arnulf I, Sagaspe P, Barateau L, Lopez R, Taillard J, Micoulaud-Franchi JA, Dauvilliers Y. Maintenance of wakefulness test: how does it predict accident risk in patients with sleep disorders? Sleep Med 2020; 77:249-255. [PMID: 32778442 DOI: 10.1016/j.sleep.2020.04.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
Abstract
STUDY OBJECTIVE To determine whether the objective level of alertness measured by the Maintenance of Wakefulness Test (MWT) is associated with the occurrence of self-reported sleepiness-related traffic near misses and accidents related to sleepiness in patients with sleep disorders. METHODS This case-control study was conducted over a three-year period in four French sleep centers during a 4∗40 min MWT in patients driving more than 5000 Km/year. Relationship between mean sleep latency on the MWT (MWT latency) and age, sex, driving, sleepiness-related near misses and accidents reported during the previous year, and sleep disorder characteristics was analyzed. RESULTS Of 377 patients suffering from OSAS, idiopathic hypersomnia, narcolepsy, restless leg syndrome or insufficient sleep syndrome, 176 were included. 74 cases reported an accident or near miss related to sleepiness at the wheel in the past year, and 102 reported no accident/near miss (control patients). Thirty-one (37.8 %) cases and 9 (8.8 %) controls reported being sleepy at the wheel more than once a week (p < 0.0001). After adjusted regression analyses, patients with MWT latency between 19 and 33 minutes had a 3.2- (CI 95%[1.5; 6.8], p < 0.0001) fold increase in risk of reporting a near miss/ accident and patients with MWT latency <19 min had a 5.5- (CI 95%[2.2; 13.8], p = 0.003) fold increase in this risk, compared to the referent group (MWT latency>33 min). CONCLUSIONS MWT latency is associated with self-reported, sleepiness-related near misses and accidents related to sleepiness in the past year in patients routinely investigated in sleep clinics. The MWT could be used to assess driving risk together with clinical interviews assessing sleepiness at the wheel.
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Affiliation(s)
- Pierre Philip
- Université de Bordeaux, Sommeil, Addiction et Neuropsychiatrie, USR 3413, Bordeaux, France; CNRS, SANPSY, USR 3413, Bordeaux, France; CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France.
| | - Kelly Guichard
- Université de Bordeaux, Sommeil, Addiction et Neuropsychiatrie, USR 3413, Bordeaux, France; CNRS, SANPSY, USR 3413, Bordeaux, France; CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Mélanie Strauss
- Neuropsychology and Functional Imaging Research Group, Center for Research in Cognition and Neurosciences, Université Libre de Bruxelles, Brussels, Belgium; Department of Neurology and Psychiatry, Erasme Hospital, Cliniques Universitaires de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium; Université de Paris, VIFASOM (Vigilance, Fatigue, Sommeil et Santé Publique), EA 7330, Paris, France; APHP, Hôtel-Dieu de Paris, Centre du Sommeil et de la Vigilance, France
| | - Damien Léger
- Université de Paris, VIFASOM (Vigilance, Fatigue, Sommeil et Santé Publique), EA 7330, Paris, France; APHP, Hôtel-Dieu de Paris, Centre du Sommeil et de la Vigilance, France
| | - Emilie Pepin
- Université de Paris, VIFASOM (Vigilance, Fatigue, Sommeil et Santé Publique), EA 7330, Paris, France; APHP, Hôtel-Dieu de Paris, Centre du Sommeil et de la Vigilance, France
| | - Isabelle Arnulf
- Sleep Disorder Unit, Pitié-Salpêtrière University Hospital (APHP), Paris, France
| | - Patricia Sagaspe
- Université de Bordeaux, Sommeil, Addiction et Neuropsychiatrie, USR 3413, Bordeaux, France; CNRS, SANPSY, USR 3413, Bordeaux, France; CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Lucie Barateau
- Reference National Center for Narcolepsy, Sleep Unit, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, Montpellier, France
| | - Régis Lopez
- Reference National Center for Narcolepsy, Sleep Unit, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, Montpellier, France
| | - Jacques Taillard
- Université de Bordeaux, Sommeil, Addiction et Neuropsychiatrie, USR 3413, Bordeaux, France; CNRS, SANPSY, USR 3413, Bordeaux, France; CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Université de Bordeaux, Sommeil, Addiction et Neuropsychiatrie, USR 3413, Bordeaux, France; CNRS, SANPSY, USR 3413, Bordeaux, France; CHU Bordeaux, Centre Hypersomnies Rares, Bordeaux, France
| | - Yves Dauvilliers
- Reference National Center for Narcolepsy, Sleep Unit, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, Montpellier, France
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25
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Filomeno R, Ikeda A, Maruyama K, Wada H, Tanigawa T. Excessive daytime sleepiness and alcohol consumption among commercial drivers. Occup Med (Lond) 2020; 69:406-411. [PMID: 31263899 DOI: 10.1093/occmed/kqz091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Commercial drivers suffering from excessive daytime sleepiness (EDS) have been identified as a major cause of road traffic accidents. Alcohol usage directly affects sleep, adversely affecting next-day alertness and performance. AIMS To examine the relationship between alcohol consumption and EDS among commercial truck drivers in Japan and the implications of this on public health. METHODS All participants in this cross-sectional study were commercial motor vehicle drivers from Tokyo and Niigata Prefecture. Participants completed a self-administered questionnaire with details of their age, body mass index, alcohol consumption, Epworth Sleepiness Scale (ESS) score and tobacco usage. Participants' oxygen desaturation index was determined by a pulse oximetry device that participants took home. RESULTS A total of 1422 males registered with the Japan Trucking Association and aged 20-69 years participated. The multivariate-adjusted odds ratio (OR) of EDS among participants aged <43 years was 0.81 (95% confidence interval (CI) 0.47-1.40) for light drinkers, 0.93 (95% CI 0.51-1.70) for moderate drinkers and 0.61 (95% CI 0.21-1.79) for heavy drinkers, compared to non-drinkers. The multivariate-adjusted OR among participants aged ≥43 years was 1.42 (95% CI 0.59-3.45) for light drinkers, 1.53 (95% CI 0.63-3.75) for moderate drinkers and 3.37 (95% CI 1.14-9.96) for heavy drinkers (P for interaction = 0.05). CONCLUSION We found that the association between ESS and alcohol intake was more evident among those aged ≥43 years, who reported higher levels of EDS with increased alcohol consumption.
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Affiliation(s)
- R Filomeno
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - A Ikeda
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Maruyama
- Department of Bioscience, Ehime University Graduate School of Agriculture, Ehime, Japan
| | - H Wada
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Crain TL, Brossoit RM, Robles-Saenz F, Tran M. Fighting fatigue: A conceptual model of driver sleep in the gig economy. Sleep Health 2020; 6:358-365. [PMID: 32205095 DOI: 10.1016/j.sleh.2020.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 01/23/2020] [Accepted: 02/03/2020] [Indexed: 01/09/2023]
Abstract
The purpose of this paper was to integrate the sleep science, occupational health, and organizational psychology literature to develop a conceptual model of driver sleep and fatigue in the gig economy. We develop an integrative framework, which proposes that aspects of the on-demand driving context influence driver sleep health and fatigue. Driver outcomes include safety incidents, injuries, health, job attitudes, interpersonal behavior, and performance. In addition, moderators, such as driver demographics and health conditions, can interact with aspects of the driver context. A number of practical implications are provided, addressing the ways in which occupational health researchers, online labor platform companies, and drivers can improve sleep health. This is the first paper to provide a broad understanding of how scientists, through both research and practice, can help improve sleep, a primary issue in the ridesharing industry.
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Affiliation(s)
- Tori L Crain
- Department of Psychology, Colorado State University, 1876 Campus Delivery, Fort Collins, CO 80523-1876.
| | - Rebecca M Brossoit
- Department of Psychology, Colorado State University, 1876 Campus Delivery, Fort Collins, CO 80523-1876
| | - Faviola Robles-Saenz
- Department of Psychology, Colorado State University, 1876 Campus Delivery, Fort Collins, CO 80523-1876
| | - Molly Tran
- Department of Nursing and Health Sciences, Elmhurst College, 190 Prospect Avenue, Elmhurst, IL 60126
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27
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Knott M, Classen S, Krasniuk S, Tippett M, Alvarez L. Insufficient sleep and fitness to drive in shift workers: A systematic literature review. ACCIDENT; ANALYSIS AND PREVENTION 2020; 134:105234. [PMID: 31443915 DOI: 10.1016/j.aap.2019.07.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 07/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Insufficient sleep, <6.5 h per night, majorly affects shift workers, placing them at higher risk for motor vehicle crash related injury or fatality. While systematic reviews (SLRs) examine the effects of insufficient sleep and driving, to date, no SLR focuses on driver fitness or performance in shift workers. OBJECTIVES Determine the class of evidence (Class I-highest to Class IV-lowest), and level of confidence (Level A-high, to Level U-insufficient) in the determinants of driver fitness and performance in shift workers. Next, consider evidence-based recommendations for clinical practice, research, and policy. METHODS A protocol was registered on PROSPERO (#CRD42018052905) using an established SLR methodology: a comprehensive electronic database search, study selection, data extraction, critical appraisal, analysis, and interpretation using published guidelines. RESULTS Searches identified 1226 unique records with 11(2 on-road, 9 simulator) meeting final inclusion criteria. Class III to IV evidence identified that exposure to overnight shift work possibly predicts (Level C confidence) drivers at risk for adverse on-road outcomes and likely predicts (Level B) drivers at risk for adverse driving simulator outcomes. Higher ratings of subjective sleepiness and extended time driving possibly predict (Level C) drivers at risk for adverse driving simulator outcomes. CONCLUSIONS This study demonstrates a low to moderate level of confidence in the determinants of driving in shift workers. A critical need exists for gold-standard on-road assessments integrating complex driving environments representative of real-world demands, targeting tactical and strategic outcomes in a broad spectrum of shift workers.
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Affiliation(s)
- Melissa Knott
- Faculty of Health Sciences, Western University, London, Ontario, Canada.
| | - Sherrilene Classen
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA.
| | - Sarah Krasniuk
- Faculty of Health Sciences, Western University, London, Ontario, Canada.
| | - Marisa Tippett
- Western Libraries, Western University, London, Ontario, Canada.
| | - Liliana Alvarez
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada.
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28
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Astell-Burt T, Feng X. Does sleep grow on trees? A longitudinal study to investigate potential prevention of insufficient sleep with different types of urban green space. SSM Popul Health 2019; 10:100497. [PMID: 32025565 PMCID: PMC6996010 DOI: 10.1016/j.ssmph.2019.100497] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/04/2019] [Accepted: 10/06/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction To investigate association between urban green space and prevalent and incident cases of insufficient sleep (<6 h sleep per day). Methods This longitudinal study examined the odds of prevalent and incident insufficient sleep in relation to indicators of total green space, tree canopy, open grass and other low-lying vegetation in the Sax Institute's 45 and Up Study (baseline 2006–2009; follow-up 2012–2015). Association between green space within 1.6 km road distances and insufficient sleep among 38,982 participants living in Sydney, Wollongong or Newcastle were analysed using multilevel logistic regressions adjusted for confounding. Results Participants with more total green space had lower odds of prevalent insufficient sleep (e.g. ≥30% compared with 0-4% total green space odds ratio (OR) = 0.68, 95% credible interval (95%CI) = 0.53, 0.85). The odds of prevalent insufficient sleep were lower among participants with more tree canopy (e.g. ≥30% compared with 0-9% tree canopy OR = 0.78, 95%CI 0.69, 0.88). The odds of incident insufficient sleep were also lower with more tree canopy (e.g. ≥30% compared with 0-9% tree canopy OR = 0.87, 95%CI = 0.75, 0.99). There were no statistically significant associations between prevalent or incident insufficient sleep with open grass or other low-lying vegetation, nor incident sufficient sleep with total green space. Conclusions Prioritising restoration and protection of urban tree canopy may help to promote population-wide prevention of insufficient sleep in middle-to-older aged adults. 4 cross-sectional studies have previously linked sleep duration with green space. This longitudinal study examined prevalence and incidence of short sleep (<6 h). We found lower odds of prevalent and incident short sleep with more tree canopy.
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Affiliation(s)
- Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia
- Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales Australia
- School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- Corresponding author. Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
- Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales Australia
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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29
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Philip P, Taillard J, Micoulaud-Franchi JA. Sleep Restriction, Sleep Hygiene, and Driving Safety: The Importance of Situational Sleepiness. Sleep Med Clin 2019; 14:407-412. [PMID: 31640868 DOI: 10.1016/j.jsmc.2019.07.002] [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] [Indexed: 12/31/2022]
Abstract
Sleep-related accidents are a frequent cause of death and injury in the world. Poor sleep hygiene is responsible for sleep deprivation, which is clearly associated with an increased risk of accidents. Evidence shows that self-reported sleepiness at the wheel and reporting of inappropriate line-crossings are strong predictors of accident risk. Although the Epworth sleepiness scale is widely used in clinical practice, it is not the best to evaluate driving risks. Simple questions on the occurrence of near misses and sleepiness at the wheel should be asked systematically to address the issue of fitness to drive.
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Affiliation(s)
- Pierre Philip
- USR CNRS 3413 SANPSY Sommeil, Addiction et NeuroPSYchiatrie, Bordeaux, France; SANPSY, USR 3413, Université Bordeaux, CHU de Bordeaux, Place Amelie Raba Leon, Bordeaux 33000, France; Sleep Clinic, CHU de Bordeaux, Pôle Neurosciences Cliniques, Bordeaux, France.
| | - Jacques Taillard
- USR CNRS 3413 SANPSY Sommeil, Addiction et NeuroPSYchiatrie, Bordeaux, France; SANPSY, USR 3413, Université Bordeaux, CHU de Bordeaux, Place Amelie Raba Leon, Bordeaux 33000, France
| | - Jean-Arthur Micoulaud-Franchi
- USR CNRS 3413 SANPSY Sommeil, Addiction et NeuroPSYchiatrie, Bordeaux, France; SANPSY, USR 3413, Université Bordeaux, CHU de Bordeaux, Place Amelie Raba Leon, Bordeaux 33000, France; Sleep Clinic, CHU de Bordeaux, Pôle Neurosciences Cliniques, Bordeaux, France
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30
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Herzog-Krzywoszanska R, Krzywoszanski L. Bedtime Procrastination, Sleep-Related Behaviors, and Demographic Factors in an Online Survey on a Polish Sample. Front Neurosci 2019; 13:963. [PMID: 31619947 PMCID: PMC6759770 DOI: 10.3389/fnins.2019.00963] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/28/2019] [Indexed: 01/17/2023] Open
Abstract
The sufficient length and good quality of night sleep play a vital role in maintaining health, well-being and effective functioning. Nevertheless, an increase in the prevalence of sleep deprivation can be observed recently. The concept of bedtime procrastination, defined as going to bed later than intended, has been proposed to explain one of the psychological determinants of sleep deficiency. To investigate the prevalence of bedtime procrastination among Poles we carried out a Polish adaptation of the Bedtime Procrastination Scale (BPS), a self-report questionnaire for measuring the tendency to voluntarily postpone going to bed in the absence of any external circumstances for doing so. The aim of the research was to determine the main psychometric properties of the Polish version of the BPS. We also aimed to identify the relationships between bedtime procrastination and selected demographic variables in the Polish sample, and to examine the impact of bedtime procrastination on self-reported sleep outcomes. The data obtained from online surveys conducted on two Polish samples were analyzed, including demographic factors, self-reported sleep outcomes, and responses to items of the BPS. The Polish version of the BPS has a unifactorial structure like the original version. It also exhibits satisfactory internal consistency and moderate temporal stability in a 10-week retest study. BPS scores were not significantly related to the place of residence, the highest completed level of education, living with a spouse or partner, and living with children. Scores in BPS slightly decreased with age and females scored higher on BPS than males. Higher BPS scores were obtained for a group of students in comparison to a group of subjects who were not students, and lower BPS scores were found in working respondents in comparison to respondents who were not working. BPS scores correlate negatively with sleep length on workdays and a feeling of sleep sufficiency, and positively with sleep length on weekdays relative to workdays, sleeping later than one would like, and a feeling of fatigue. Several relationships between self-reported sleep outcomes and demographic variables were also identified.
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Affiliation(s)
| | - Lukasz Krzywoszanski
- Neurocognitive Psychology Unit, Chair of Psychology, Faculty of Pedagogy, Pedagogical University of Kraków , Poland
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31
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Barfield R, Wang H, Liu Y, Brody JA, Swenson B, Li R, Bartz TM, Sotoodehnia N, Chen YDI, Cade BE, Chen H, Patel SR, Zhu X, Gharib SA, Johnson WC, Rotter JI, Saxena R, Purcell S, Lin X, Redline S, Sofer T. Epigenome-wide association analysis of daytime sleepiness in the Multi-Ethnic Study of Atherosclerosis reveals African-American-specific associations. Sleep 2019; 42:zsz101. [PMID: 31139831 PMCID: PMC6685317 DOI: 10.1093/sleep/zsz101] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 03/27/2019] [Indexed: 02/07/2023] Open
Abstract
STUDY OBJECTIVES Daytime sleepiness is a consequence of inadequate sleep, sleep-wake control disorder, or other medical conditions. Population variability in prevalence of daytime sleepiness is likely due to genetic and biological factors as well as social and environmental influences. DNA methylation (DNAm) potentially influences multiple health outcomes. Here, we explored the association between DNAm and daytime sleepiness quantified by the Epworth Sleepiness Scale (ESS). METHODS We performed multi-ethnic and ethnic-specific epigenome-wide association studies for DNAm and ESS in the Multi-Ethnic Study of Atherosclerosis (MESA; n = 619) and the Cardiovascular Health Study (n = 483), with cross-study replication and meta-analysis. Genetic variants near ESS-associated DNAm were analyzed for methylation quantitative trait loci and followed with replication of genotype-sleepiness associations in the UK Biobank. RESULTS In MESA only, we detected four DNAm-ESS associations: one across all race/ethnic groups; three in African-Americans (AA) only. Two of the MESA AA associations, in genes KCTD5 and RXRA, nominally replicated in CHS (p-value < 0.05). In the AA meta-analysis, we detected 14 DNAm-ESS associations (FDR q-value < 0.05, top association p-value = 4.26 × 10-8). Three DNAm sites mapped to genes (CPLX3, GFAP, and C7orf50) with biological relevance. We also found evidence for associations with DNAm sites in RAI1, a gene associated with sleep and circadian phenotypes. UK Biobank follow-up analyses detected SNPs in RAI1, RXRA, and CPLX3 with nominal sleepiness associations. CONCLUSIONS We identified methylation sites in multiple genes possibly implicated in daytime sleepiness. Most significant DNAm-ESS associations were specific to AA. Future work is needed to identify mechanisms driving ancestry-specific methylation effects.
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Affiliation(s)
- Richard Barfield
- Department of Epidemiology, University of Washington, Seattle, WA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Heming Wang
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA
| | - Brenton Swenson
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA
- Institute for Public Health Genetics, University of Washington, Seattle, WA
| | - Ruitong Li
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA
- Institute for Public Health Genetics, University of Washington, Seattle, WA
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA
| | - Yii-der I Chen
- The Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Brian E Cade
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Han Chen
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX
- Center for Precision Health, School of Public Health & School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX
| | - Sanjay R Patel
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Xiaofeng Zhu
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Sina A Gharib
- Computational Medicine Core, Center for Lung Biology, University of Washington Medicine Sleep Center, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, WA
| | - W Craig Johnson
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Richa Saxena
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
- Center for Genomic Medicine and Department of Anesthesia, Pain, and Critical Care Medicine, Massachusetts General Hospital, Boston, MA
| | - Shaun Purcell
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
- Department of Psychiatry, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA
| | - Xihong Lin
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA
- Department of Statistics, Harvard University, Cambridge, MA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA
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32
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Facer-Childs ER, Middleton B, Skene DJ, Bagshaw AP. Resetting the late timing of 'night owls' has a positive impact on mental health and performance. Sleep Med 2019; 60:236-247. [PMID: 31202686 DOI: 10.1016/j.sleep.2019.05.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND There is conflict between living according to our endogenous biological rhythms and our external environment, with disruptions resulting in negative consequences to health and performance. This is often documented in shift work and jet lag, but 'societal norms' (eg, typical working hours) can create profound issues for 'night owls', people whose internal biological timing predisposes them to follow an unusually late sleep-wake cycle. Night owls have also been associated with health issues, mood disturbances, poorer performance and increased mortality rates. METHODS This study used a randomized control trial design aimed to shift the late timing of night owls to an earlier time (phase advance), using non-pharmacological, practical interventions in a real-world setting. These interventions targeted light exposure (through earlier wake up/sleep times), fixed meals times, caffeine intake and exercise. RESULTS Overall, participants demonstrated a significant advance of ∼2 h in sleep/wake timings as measured by actigraphy and circadian phase markers (dim light melatonin onset and peak time of the cortisol awakening response), whilst having no adverse effect on sleep duration. Notably, the phase advance was accompanied by significant improvements to self-reported depression and stress, as well as improved cognitive (reaction time) and physical (grip strength) performance measures during the typical 'suboptimal' morning hours. CONCLUSIONS Our findings propose a novel strategy for shifting clock timing towards a pattern that is more aligned to societal demands that could significantly improve elements of performance, mental health and sleep timing in the real world.
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Affiliation(s)
- Elise R Facer-Childs
- School of Biosciences, University of Birmingham, Birmingham, B15 2TT, UK; Centre for Human Brain Health, University of Birmingham, Birmingham, B15 2TT, UK; School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Benita Middleton
- Faculty of Health & Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Debra J Skene
- Faculty of Health & Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Andrew P Bagshaw
- Centre for Human Brain Health, University of Birmingham, Birmingham, B15 2TT, UK; School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
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Lee DW, Kim SJ, Shin NY, Lee WJ, Lee D, Jang JH, Choi SH, Kang DH. Sleeping, sleeping environments, and human errors in South Korean male train drivers. J Occup Health 2019; 61:358-367. [PMID: 31050123 PMCID: PMC6718836 DOI: 10.1002/1348-9585.12059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/06/2019] [Accepted: 04/04/2019] [Indexed: 11/17/2022] Open
Abstract
Objectives Reducing human errors caused by daytime sleepiness among train drivers is important to prevent train accidents. Our purpose of the study was to investigate the association among sleep, workplace sleeping environments, and human errors. Methods We recruited 144 South Korean train drivers belongs to the Korean Railroad Corporation. This cross‐sectional data was analyzed to investigate the association of insomnia (insomnia severity index), sleep quality (Pittsburgh sleep quality index), obstructive sleep apnea (Berlin questionnaire), and daytime sleepiness (Epworth scale) with human error and near‐miss experiences. We examined whether human error and near‐miss events were associated with various sleeping environments at work and at home after adjusting for the sleep indices. Results The experience of human errors was associated with insomnia and daytime sleepiness, and near‐miss events were associated with insomnia among South Korean drivers. Sleeping environments including cold temperature and odor were related to both human errors and near‐miss events among South Korean train drivers, after adjusted for age, working years, shiftwork, obesity, smoking, binge drinking, regular exercise, caffeine consumption, sleep quality, severity of insomnia, obstructive sleep apnea, and daytime sleepiness. Conclusions The train drivers’ workplace sleeping environment is significantly associated with human error events and near‐miss events after adjusting for sleep quality, insomnia, obstructive sleep apnea, and daytime sleepiness. To prevent train accidents caused by human errors, more attention is necessary for improving workplace sleeping environments.
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Affiliation(s)
- Dong-Wook Lee
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Na Young Shin
- College of Liberal Arts and Interdisciplinary Studies, Kyonggi University, Suwon, Republic of Korea
| | - Won Joon Lee
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Dasom Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Joon Hwan Jang
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Hee Choi
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatry and Institute of Human Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Do-Hyung Kang
- Emotional Information and Communication Technology Association, Seoul, Republic of Korea
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Vogelpohl T, Kühn M, Hummel T, Vollrath M. Asleep at the automated wheel-Sleepiness and fatigue during highly automated driving. ACCIDENT; ANALYSIS AND PREVENTION 2019; 126:70-84. [PMID: 29571975 DOI: 10.1016/j.aap.2018.03.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 03/11/2018] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
Due to the lack of active involvement in the driving situation and due to monotonous driving environments drivers with automation may be prone to become fatigued faster than manual drivers (e.g. Schömig et al., 2015). However, little is known about the progression of fatigue during automated driving and its effects on the ability to take back manual control after a take-over request. In this driving simulator study with Nö=ö60 drivers we used a three factorial 2ö×ö2ö×ö12 mixed design to analyze the progression (12ö×ö5ömin; within subjects) of driver fatigue in drivers with automation compared to manual drivers (between subjects). Driver fatigue was induced as either mainly sleep related or mainly task related fatigue (between subjects). Additionally, we investigated the drivers' reactions to a take-over request in a critical driving scenario to gain insights into the ability of fatigued drivers to regain manual control and situation awareness after automated driving. Drivers in the automated driving condition exhibited facial indicators of fatigue after 15 to 35ömin of driving. Manual drivers only showed similar indicators of fatigue if they suffered from a lack of sleep and then only after a longer period of driving (approx. 40ömin). Several drivers in the automated condition closed their eyes for extended periods of time. In the driving with automation condition mean automation deactivation times after a take-over request were slower for a certain percentage (about 30%) of the drivers with a lack of sleep (Mö=ö3.2; SDö=ö2.1ös) compared to the reaction times after a long drive (Mö=ö2.4; SDö=ö0.9ös). Drivers with automation also took longer than manual drivers to first glance at the speed display after a take-over request and were more likely to stay behind a braking lead vehicle instead of overtaking it. Drivers are unable to stay alert during extended periods of automated driving without non-driving related tasks. Fatigued drivers could pose a serious hazard in complex take-over situations where situation awareness is required to prepare for threats. Driver fatigue monitoring or controllable distraction through non-driving tasks could be necessary to ensure alertness and availability during highly automated driving.
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Affiliation(s)
- Tobias Vogelpohl
- Technische Universität Braunschweig, Gaußstraße 23, 38106 Braunschweig, Germany.
| | - Matthias Kühn
- Unfallforschung der Versicherer, Wilhelmstraße 43/43G, 10117 Berlin, Germany.
| | - Thomas Hummel
- Unfallforschung der Versicherer, Wilhelmstraße 43/43G, 10117 Berlin, Germany.
| | - Mark Vollrath
- Technische Universität Braunschweig, Gaußstraße 23, 38106 Braunschweig, Germany.
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35
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Owens JA, Dearth-Wesley T, Herman AN, Whitaker RC. Drowsy Driving, Sleep Duration, and Chronotype in Adolescents. J Pediatr 2019; 205:224-229. [PMID: 30392873 DOI: 10.1016/j.jpeds.2018.09.072] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/05/2018] [Accepted: 09/28/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To determine whether self-reported drowsy driving was associated with an evening chronotype, a biologically-based difference in circadian sleep-wake timing, and shorter school-night sleep duration in a sample of high school drivers. STUDY DESIGN Cross-sectional observational data were obtained from an online survey in spring 2015 of 431 drivers, age 15.5-18.7 years, attending Fairfax County (Virginia) Public schools. Drowsy driving was defined as having ever "driven a car or motor vehicle while feeling drowsy" in the last year. School-night sleep duration was calculated from school-night bedtime and wake time. Those with scores in the lower and upper tertiles of the Morningness-Eveningness Scale for Children were designated as having an evening or morning chronotype, respectively. RESULTS Among survey respondents, 63.1% drove at least several times a week and 47.6% reported drowsy driving. The covariate-adjusted prevalence of drowsy driving was 13.9% (95% CI 3.0%-24.9%) higher in students who slept <7 hours on school-nights than in those who slept 8 or more hours. Compared with those with a morning chronotype, the adjusted prevalence of drowsy driving was 15.2% (95% CI 4.5%-25.9%) higher among those with an evening chronotype. CONCLUSION Among adolescent drivers, both an evening chronotype and shorter school-night sleep duration were associated with more frequent reports of drowsy driving. Interventions to improve the timing and duration of nighttime sleep in adolescents may reduce the occurrence of drowsy driving.
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Affiliation(s)
- Judith A Owens
- Division of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Tracy Dearth-Wesley
- Columbia-Bassett Program and Bassett Research Institute, Bassett Medical Center, Cooperstown, NY
| | - Allison N Herman
- Columbia-Bassett Program and Bassett Research Institute, Bassett Medical Center, Cooperstown, NY
| | - Robert C Whitaker
- Columbia-Bassett Program and Bassett Research Institute, Bassett Medical Center, Cooperstown, NY.
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Knott M, Classen S, Krasniuk S, Tippett M, Alvarez L. Insufficient sleep and fitness to drive in shift workers: a systematic literature review protocol. Inj Prev 2018; 25:589-594. [PMID: 30554167 DOI: 10.1136/injuryprev-2018-042972] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND The majority of shift workers experience insufficient sleep as a result of their employment. Insufficient sleep is associated with impaired neurocognitive functioning, affecting key skills required for driving, resulting in shift workers experiencing a disproportionate burden of RTC injuries and fatalities. Yet, to our knowledge, no systematic literature review (SLR) exists to critically appraise and synthesise evidence on the determinants of fitness to drive (assessed on-road) and driving performance (assessed in a driving simulator) in shift workers with insufficient sleep. OBJECTIVES A SLR protocol is established to conduct analysis and synthesis of the level of evidence and confidence in the determinants of fitness to drive and driving performance, among shift workers with insufficient sleep. METHODS This study follows Cooper and Hedges' established SLR methodology: formulate the problem, locate and select studies, collect data, appraise critically, analyse and present data, interpret results and disseminate information. Critical appraisal and analysis follows the 2017 American Academy of Neurology guidelines determining the level of evidence and the level of confidence for each determinant identified in the literature. Protocol and results reporting adhere to the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols guidelines. CONCLUSIONS This SLR contributes to research evidence examining the impact of insufficient sleep and driver sleepiness on fitness to drive and driving performance. Analysis of the level of evidence and level of confidence in the existing literature will advance evidence-informed prevention strategies and critical decision-making, to mitigate adverse effects of insufficient sleep for improving road safety.
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Affiliation(s)
- Melissa Knott
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Sherrilene Classen
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Sarah Krasniuk
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Marisa Tippett
- Education Library, Althouse College, Western University, London, Ontario, Canada
| | - Liliana Alvarez
- Faculty of Health Sciences, Western University, London, Ontario, Canada
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Irregular work schedule and sleep disturbance in occupational drivers-A nationwide cross-sectional study. PLoS One 2018; 13:e0207154. [PMID: 30439972 PMCID: PMC6237347 DOI: 10.1371/journal.pone.0207154] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 10/25/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The objective of this study was to investigate the relationship between irregular work schedules and sleep disturbance and compare the impacts of work schedule on sleep disturbance between occupational drivers and office workers. METHODS Using data from the 3rd and 4th Korean Working Conditions Survey, 3,070 occupational drivers and 9,898 office workers were included in this study. The subjects' days of night work, evening work, and subjective complaints of sleep disturbance were investigated along with other covariates. RESULTS In the multivariate logistic regression analyses, occupational drivers (odds ratio [OR], 95% confidence interval [CI]: 1.51, 1.11-2.05), workers who were engaged in more night work (2.49, 1.84-3.38 for 1-15 days, and 3.80, 2.67-5.41 for 16-30 days) and evening work (2.22, 1.66-2.97 for 1-15 days, and 1.76, 1.26-2.45) were more likely to report sleep disturbance. Moreover, occupational driving showed significant interaction effects with both night and evening work on sleep disturbance, and therefore, showed higher ORs for sleep disturbance in the 16-30 days night (5.38, 3.40-8.52) and evening (3.13, 1.97-4.98) compared to no night and evening working office workers. CONCLUSIONS Occupational drivers who are exposed to night work and evening work are at higher risks for sleep disturbance. Therefore, for the public and drivers' safety, optimal work schedules for minimising sleep disturbance should be developed.
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Li H, Shao Y, Xing Z, Li Y, Wang S, Zhang M, Ying J, Shi Y, Sun J. Napping on night-shifts among nursing staff: A mixed-methods systematic review. J Adv Nurs 2018; 75:291-312. [DOI: 10.1111/jan.13859] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 08/05/2018] [Accepted: 09/04/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Huanhuan Li
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Yanping Shao
- Department of Obstetrics and Gynecology; The Second Hospital of Jilin University; Changchun Jilin China
| | - Zhuangjie Xing
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Yuan Li
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Shouqi Wang
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Meiling Zhang
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Jie Ying
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Ying Shi
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
| | - Jiao Sun
- Basic Nursing Department; School of Nursing; Jilin University; Changchun Jilin China
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Zou X, Yue WL, Vu HL. Visualization and analysis of mapping knowledge domain of road safety studies. ACCIDENT; ANALYSIS AND PREVENTION 2018; 118:131-145. [PMID: 29958121 DOI: 10.1016/j.aap.2018.06.010] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 06/12/2018] [Accepted: 06/15/2018] [Indexed: 06/08/2023]
Abstract
Mapping knowledge domain (MKD) is an important application of visualization technology in Bibliometrics, which has been extensively applied in psychology, medicine, and information science. In this paper we conduct a systematic analysis of the development trend on road safety studies based on the Science Citation Index Expanded (SCIE) and Social Sciences Citation Index (SSCI) articles published between 2000 and 2018 using the MKD software tools VOSviewer and Sci2 Tool. Based on our analysis, we first present the annual numbers of articles, origin countries, main research organizations and groups as well as the source journals on road safety studies. We then report the collaborations among the main research organizations and groups using co-authorship analysis. Furthermore, we adopt the document co-citation analysis, keywords co-occurrence analysis, and burst detection analysis to visually explore the knowledge bases, topic distribution, research fronts and research trends on road safety studies. The proposed approach based on the visualized analysis of MKD can be used to establish a reference information and research basis for the application and development of methods in the domain of road safety studies. In particular, our results show that the knowledge bases (classical documents) of road safety studies in the last two decades have focused on five major areas of "Crash Frequency Data Analysis", "Driver Behavior Questionnaire", "Safety in Numbers for Walkers and Bicyclists", "Road Traffic Injury and Prevention", and "Driving Speed and Road Crashes". Among the research topics, the five dominant clusters are "Causation and Injury Severity Analysis of Road Accidents", "Epidemiologic Study and Prevention of Road Traffic Injury", "Intelligent Transportation System and Active Safety", "Young drivers' driving behavior and psychology", and "Older drivers' psychological and physiological characteristics". Finally, the burst keywords in research trends include Cycling, Intelligent Transportation Systems, and Distraction.
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Affiliation(s)
- Xin Zou
- School of Natural and Built Environments, University of South Australia, Mawson Lakes, SA, 5095, Australia.
| | - Wen Long Yue
- Australian Road Research Board, Port Melbourne, VIC, 3207, Australia
| | - Hai Le Vu
- Institute of Transport Studies, Monash University, Clayton, VIC, 3800, Australia
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40
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Wu WT, Tsai SS, Liao HY, Lin YJ, Lin MH, Wu TN, Shih TS, Liou SH. Usefulness of overnight pulse oximeter as the sleep assessment tool to assess the 6-year risk of road traffic collision: evidence from the Taiwan Bus Driver Cohort Study. Int J Epidemiol 2018; 46:266-277. [PMID: 27477030 DOI: 10.1093/ije/dyw141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 11/13/2022] Open
Abstract
Background In order to support health service organizations in arranging a system for prevention of road traffic collisions (RTC), it is important to study the usefulness of sleep assessment tools. A cohort study was used to evaluate the effectiveness of subjective and objective sleep assessment tools to assess for the 6-year risk of both first RTC event only and recurrent RTC events. Methods The Taiwan Bus Driver Cohort Study (TBDCS) recruited 1650 professional drivers from a large bus company in Taiwan in 2005. The subjects were interviewed in person, completed the sleep assessment questionnaires and had an overnight pulse oximeter survey. Moreover, this cohort of drivers was linked to the National Traffic Accident Database (NTAD) and researchers found 139 new RTC events from 2005 to 2010. Primary outcomes were traffic collisions from NTAD, nocturnal oxygen desaturation index (ODI) from pulse oximeter, Pittsburg sleeping quality score, Epworth daytime sleepiness score, Snore Outcomes Survey score and working patterns from questionnaires. A Cox proportional hazards model and an extended Cox regression model for repeated events were performed to estimate the hazard ratio for RTC. Results The RTC drivers had increased ODI4 levels (5.77 ± 4.72 vs 4.99 ± 6.68 events/h; P = 0.008) and ODI3 levels (8.68 ± 6.79 vs 7.42 ± 7.94 events/h; P = 0.007) in comparison with non-RTC drivers. These results were consistent regardless of whether ODI was evaluated as a continuous or a categorical variable. ODI4 and ODI3 levels increased the 6-year RTC risks among professional drivers even after adjusting for age, education, history of cardiovascular disease, caffeine intake, sleeping pills used, bus driving experience and shift modes. Moreover, there was an increased trend for ODI between the stratification of the number of RTCs in comparison with the non-RTC group. In the extended Cox regression models for repeated RTC events with the Anderson and Gill intensity model and Prentice-Williams-Petersen model, measurement of ODI increased hazards of the subsequent RTC events. Conclusion This study showed that an increase in the 6-year risk of RTC was associated with objective measurement of ODI for a sign of sleep-disordered breathing (SDB), but was not associated with self-reported sleeping quality or daytime sleepiness. Therefore, the overnight pulse oximeter is an effective sleep assessment tool for assessing the risk of RTC. Further research should be conducted regarding measures to prevent against SDB among professional drivers.
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Affiliation(s)
- Wei-Te Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Su-Shan Tsai
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Hui-Yi Liao
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Yu-Jen Lin
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan
| | - Ming-Hsiu Lin
- Institute of Labor, Occupational Safety and Health, Ministry of Labor, New Taipei, Taiwan
| | - Trong-Neng Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.,Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Tung-Sheng Shih
- Institute of Labor, Occupational Safety and Health, Ministry of Labor, New Taipei, Taiwan
| | - Saou-Hsing Liou
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.,Department of Occupational Safety and Health, China Medical University, Taichung, Taiwan.,Department of Public Health, National Defense Medical Center, Taipei, Taiwan
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41
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Gottlieb DJ, Ellenbogen JM, Bianchi MT, Czeisler CA. Sleep deficiency and motor vehicle crash risk in the general population: a prospective cohort study. BMC Med 2018; 16:44. [PMID: 29554902 PMCID: PMC5859531 DOI: 10.1186/s12916-018-1025-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 02/12/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Insufficient sleep duration and obstructive sleep apnea, two common causes of sleep deficiency in adults, can result in excessive sleepiness, a well-recognized cause of motor vehicle crashes, although their contribution to crash risk in the general population remains uncertain. The objective of this study was to evaluate the relation of sleep apnea, sleep duration, and excessive sleepiness to crash risk in a community-dwelling population. METHODS This was a prospective observational cohort study nested within the Sleep Heart Health Study, a community-based study of the health consequences of sleep apnea. The participants were 1745 men and 1456 women aged 40-89 years. Sleep apnea was measured by home polysomnography and questionnaires were used to assess usual sleep duration and daytime sleepiness. A follow-up questionnaire 2 years after baseline ascertained driving habits and motor vehicle crash history. Logistic regression analysis was used to examine the relation of sleep apnea and sleep duration at baseline to the occurrence of motor vehicle crashes during the year preceding the follow-up visit, adjusting for relevant covariates. The population-attributable fraction of motor vehicle crashes was estimated from the sample proportion of motor vehicle crashes and the adjusted odds ratios for motor vehicle crash within each exposure category. RESULTS Among 3201 evaluable participants, 222 (6.9%) reported at least one motor vehicle crash during the prior year. A higher apnea-hypopnea index (p < 0.01), fewer hours of sleep (p = 0.04), and self-reported excessive sleepiness (p < 0.01) were each significantly associated with crash risk. Severe sleep apnea was associated with a 123% increased crash risk, compared to no sleep apnea. Sleeping 6 hours per night was associated with a 33% increased crash risk, compared to sleeping 7 or 8 hours per night. These associations were present even in those who did not report excessive sleepiness. The population-attributable fraction of motor vehicle crashes was 10% due to sleep apnea and 9% due to sleep duration less than 7 hours. CONCLUSIONS Sleep deficiency due to either sleep apnea or insufficient sleep duration is strongly associated with motor vehicle crashes in the general population, independent of self-reported excessive sleepiness.
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Affiliation(s)
- Daniel J Gottlieb
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, 221 Longwood Ave, BLI 225E, Boston, MA, 02115, USA.
- VA Boston Healthcare System, Boston, MA, USA.
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
| | - Jeffrey M Ellenbogen
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Matt T Bianchi
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham & Women's Hospital, 221 Longwood Ave, BLI 225E, Boston, MA, 02115, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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42
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Liu SY, Perez MA, Lau N. The impact of sleep disorders on driving safety—findings from the Second Strategic Highway Research Program naturalistic driving study. Sleep 2018; 41:4835112. [DOI: 10.1093/sleep/zsy023] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
- Shu-Yuan Liu
- The Grado Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA
| | | | - Nathan Lau
- The Grado Department of Industrial and Systems Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA
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43
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Breen JM, Naess PA, Gjerde H, Gaarder C, Stray-Pedersen A. The significance of preexisting medical conditions, alcohol/drug use and suicidal behavior for drivers in fatal motor vehicle crashes: a retrospective autopsy study. Forensic Sci Med Pathol 2017; 14:4-17. [PMID: 29185214 DOI: 10.1007/s12024-017-9934-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 11/25/2022]
Abstract
Driver fatalities in motor vehicle collisions (MVCs) encompass accidents, suicides, and natural deaths when driving. The objective of this study was to determine the significance of pathology and other autopsy findings for drivers in fatal MVCs. Forensic autopsy records of driver fatalities in southeast Norway between 2000 and 2014 were studied retrospectively. Data from individual police and collision investigation reports were also collected and analyzed. In 406 driver fatalities, the male/female ratio was 340/66; 9% died from natural causes, 9% were suicides, 65% were culpable accidental deaths, 14% were nonculpable deaths, and 3% were undetermined deaths. Head injuries and thoracic injuries were the most common causes of death. A seatbelt had been worn in 50% of the fatalities, and its prevalence did not differ between accidental deaths and suicides. Blood levels of alcohol and/or drugs that indicated impairment at the time of the collision were found in 40% (105/262) of all culpable accidental deaths but in 50% (64/127) of drivers aged up to 35 years. Pathology (most often cardiovascular disease) suggestive of sudden incapacitation before the collision was present in 24% (62/264) of drivers who were culpable in the accident and in 70% (46/66) of culpable drivers older than 55 years. A substantial proportion of drivers are killed in accidental collisions that may have occurred as a result of either alcohol/drug impairment or preexisting disease. Suicides and natural deaths both constitute significant proportions of MVC fatalities and may be misclassified unless a full inquest including an autopsy is performed.
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Affiliation(s)
- Jan Mario Breen
- Department of Forensic Sciences, Section of Pediatric Forensic Medicine, Oslo University Hospital, P.O. Box 4950 Nydalen, 0424, Oslo, Norway. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318, Oslo, Norway.
| | - Paal Aksel Naess
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318, Oslo, Norway.,Department of Traumatology, Oslo University Hospital, P.O. 4956 Nydalen, 0424, Oslo, Norway
| | - Hallvard Gjerde
- Department of Forensic Sciences, Section of Drug Abuse Research, Oslo University Hospital, P.O. Box 4950 Nydalen, 0424, Oslo, Norway
| | - Christine Gaarder
- Department of Traumatology, Oslo University Hospital, P.O. 4956 Nydalen, 0424, Oslo, Norway
| | - Arne Stray-Pedersen
- Department of Forensic Sciences, Section of Pediatric Forensic Medicine, Oslo University Hospital, P.O. Box 4950 Nydalen, 0424, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318, Oslo, Norway
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44
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Bioulac S, Micoulaud-Franchi JA, Arnaud M, Sagaspe P, Moore N, Salvo F, Philip P. Risk of Motor Vehicle Accidents Related to Sleepiness at the Wheel: A Systematic Review and Meta-Analysis. Sleep 2017; 40:4049536. [PMID: 28958002 DOI: 10.1093/sleep/zsx134] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Study Objectives Sleepiness at the wheel is widely believed to be a cause of motor vehicle accidents. Nevertheless, a systematic review of studies investigating this relationship has not yet been published. The objective of this study was to quantify the relationship between sleepiness at the wheel and motor vehicle accidents. Methods A systematic review was performed using Medline, Scopus, and ISI Web of Science. The outcome measure of interest was motor vehicle accident defined as involving four- or two-wheeled vehicles in road traffic, professional and nonprofessional drivers, with or without objective consequences. The exposure was sleepiness at the wheel defined as self-reported sleepiness at the wheel. Studies were included if they provided adjusted risk estimates of motor vehicle accidents related to sleepiness at the wheel. Risk estimates and 95% confidence intervals (95% CIs) were extracted and pooled as odds ratios (ORs) using a random-effect model. Heterogeneity was quantified using Q statistics and the I2 index. The potential causes of heterogeneity were investigated using meta-regressions. Results Ten cross-sectional studies (51,520 participants), six case-control studies (4904 participants), and one cohort study (13,674 participants) were included. Sleepiness at the wheel was associated with an increased risk of motor vehicle accidents (pooled OR 2.51 [95% CI 1.87; 3.39]). A significant heterogeneity was found between the individual risk estimates (Q = 93.21; I2 = 83%). Conclusions Sleepiness at the wheel increases the risk of motor vehicle accidents and should be considered when investigating fitness to drive. Further studies are required to explore the nature of this relationship. Systematic review registration number PROSPERO 2015 CRD42015024805.
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Affiliation(s)
- Stéphanie Bioulac
- University of Bordeaux, SANPSY, Bordeaux, France
- CNRS, SANPSY, Bordeaux, France
- CHU Pellegrin, Clinique du Sommeil, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- University of Bordeaux, SANPSY, Bordeaux, France
- CNRS, SANPSY, Bordeaux, France
- CHU Pellegrin, Clinique du Sommeil, Bordeaux, France
| | | | - Patricia Sagaspe
- University of Bordeaux, SANPSY, Bordeaux, France
- CNRS, SANPSY, Bordeaux, France
| | - Nicholas Moore
- University of Bordeaux, INSERM U657, Bordeaux, France
- CHU Bordeaux, Bordeaux, France
- CIC Bordeaux, Bordeaux, France
| | - Francesco Salvo
- University of Bordeaux, INSERM U657, Bordeaux, France
- CHU Bordeaux, Bordeaux, France
| | - Pierre Philip
- University of Bordeaux, SANPSY, Bordeaux, France
- CNRS, SANPSY, Bordeaux, France
- CHU Pellegrin, Clinique du Sommeil, Bordeaux, France
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45
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Shekari Soleimanloo S, White MJ, Garcia-Hansen V, Smith SS. The effects of sleep loss on young drivers' performance: A systematic review. PLoS One 2017; 12:e0184002. [PMID: 28859144 PMCID: PMC5578645 DOI: 10.1371/journal.pone.0184002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 08/14/2017] [Indexed: 12/14/2022] Open
Abstract
Young drivers (18-24 years) are over-represented in sleep-related crashes (comprising one in five fatal crashes in developed countries) primarily due to decreased sleep opportunity, lower tolerance for sleep loss, and ongoing maturation of brain areas associated with driving-related decision making. Impaired driving performance is the proximal reason for most car crashes. There is still a limited body of evidence examining the effects of sleep loss on young drivers' performance, with discrepancies in the methodologies used, and in the definition of outcomes. This study aimed to identify the direction and magnitude of the effects of sleep loss on young drivers' performance, and to appraise the quality of current evidence via a systematic review. Based on the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) approach, 16 eligible studies were selected for review, and their findings summarised. Next, critical elements of these studies were identified, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines augmented to rate those elements. Using those criteria, the quality of individual papers was calculated and the overall body of evidence for each driving outcome were assigned a quality ranking (from 'very low' to 'high-quality'). Two metrics, the standard deviation of lateral position and number of line crossings, were commonly reported outcomes (although in an overall 'low-quality' body of evidence), with significant impairments after sleep loss identified in 50% of studies. While speed-related outcomes and crash events (also with very low- quality evidence) both increased under chronic sleep loss, discrepant findings were reported under conditions of acute total sleep deprivation. It is crucial to obtain more reliable data about the effects of sleep loss on young drivers' performance by using higher quality experimental designs, adopting common protocols, and the use of consistent metrics and reporting of findings based on GRADE criteria and the PRISMA statement. Key words: Young drivers, sleep loss, driving performance, PRISMA, the GRADE, systematic review.
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Affiliation(s)
- Shamsi Shekari Soleimanloo
- Centre for Accident Research and Road Safety, Queensland University of Technology, Brisbane, Queensland, Australia
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
- * E-mail: ,
| | - Melanie J. White
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Simon S. Smith
- Recover Injury Research Centre, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
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46
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Grüner M, Ansorge U. Mobile Eye Tracking During Real-World Night Driving: A Selective Review of Findings and Recommendations for Future Research. J Eye Mov Res 2017; 10. [PMID: 33828651 PMCID: PMC7141062 DOI: 10.16910/jemr.10.2.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We exhaustively review the published research on eye movements during real-world night driving, which is an important field of research as fatal road traffic accidents at night out-number fatal accidents during the daytime. Eye tracking provides a unique window into the underlying cognitive processes. The studies were interpreted and evaluated against the back-ground of two descriptions of the driving task: Gibson and Crooks’ description of driving as the visually guided selection of a driving path through the unobstructed field of safe travel; and Endsley’s situation awareness model, highlighting the influence of drivers’ interpreta-tions and mental capacities (e.g., cognitive load, memory capacity, etc.) for successful task performance. Our review unveiled that drivers show expedient looking behavior, directed to the boundaries of the field of safe travel and other road users. Thus, the results indicated that controlled (intended) eye movements supervened, but some results could have also reflected automatic gaze attraction by salient but task-irrelevant distractors. Also, it is not entirely certain whether a wider dispersion of eye fixations during daytime driving (compared to night driving) reflected controlled and beneficial strategies, or whether it was (partly) due to distraction by stimuli unrelated to driving. We concluded by proposing a more fine-grained description of the driving task, in which the contribution of eye movements to three different subtasks is detailed. This model could help filling an existing gap in the reviewed research: Most studies did not relate eye movements to other driving performance measurements for the evaluation of real-world night driving performance.
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47
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Sadeghniiat-Haghighi K, Yazdi Z, Moradinia M, Aminian O, Esmaili A. Traffic crash accidents in Tehran, Iran: Its relation with circadian rhythm of sleepiness. Chin J Traumatol 2017; 18:13-7. [PMID: 26169088 DOI: 10.1016/j.cjtee.2014.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Road traffic accidents are one of main problems in Iran. Multiple factors cause traffic accidents and the most important one is sleepiness. This factor, however, is given less attention in our country. Road traffic accidents relevant to sleepiness are studied. METHODS In this cross-sectional study, all road traffic accidents relevant to sleepiness, which were reported by police, were studied in Tehran province in 2009. RESULTS The risk of road traffic accidents due to sleepiness was increased by more than sevenfold (odds ratio = 7.33) in low alertness hours (0:00-6:00) compared to other time of day. The risk of road traffic accidents due to sleepiness was decreased by 0.15-fold (odds ratio = 0.15) in hours with maximum of alertness (18:00-22:00) of circadian rhythm compared to other time of day. CONCLUSION The occurrence of road traffic accidents due to sleepiness has significant statistical relations with driving during lowest point of alertness of circadian rhythm.
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48
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Leisure-Time Physical Activity and Sedentary Behavior and Their Cross-Sectional Associations with Excessive Daytime Sleepiness in the French SU.VI.MAX-2 Study. Int J Behav Med 2016; 23:143-52. [PMID: 26249724 DOI: 10.1007/s12529-015-9501-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The potential benefit of physical activity in terms of decreasing excessive daytime sleepiness (EDS) prevalence is unclear, especially in aging adults. PURPOSE We aimed to elucidate the associations among physical activity, sedentariness, and EDS in middle-aged and older adults. METHODS We conducted a cross-sectional analysis using data from a subsample of participants in the SU.VI.MAX-2 observational study (2007-2009; N = 4179; mean age = 61.9 years). EDS was defined as a score >10 on the Epworth Sleepiness Scale. Leisure-time physical activity and different types of sedentary behavior were assessed with the Modifiable Activity Questionnaire. The associations were examined with multivariable logistic regression models. RESULTS In the adjusted multivariable model, total leisure-time physical activity (modeled in quartiles, Q) was significantly, inversely associated with EDS (odds ratios (OR)Q4 vs Q1 = 0.70, 95 % confidence interval (CI) = 0.54-0.89). The association persisted in analyses restricted to individuals not taking sleep medication (ORQ4 vs Q1 = 0.72, 95 % CI = 0.54-0.95). In turn, time spent watching television and time spent reading appeared protective against EDS (ORQ4 vs Q1 = 0.73, 95 % CI = 0.57-0.94; ORQ4 vs Q1 = 0.76, 95 % CI = 0.60-0.97, respectively), whereas time spent on a computer appeared to confer an increased risk for EDS (ORQ4 vs Q1 = 1.30, 95 % CI = 1.05-1.62). When physical activity and sedentariness were modeled jointly, using WHO recommendation-based cutoffs for high/low levels, no significant associations were observed in the fully adjusted models. CONCLUSIONS The findings reinforce public health recommendations promoting behavior modification and specifically moderate-intensity exercise in middle-aged and older adults. The association of high physical activity/low sedentariness with EDS, which was not supported by the data, merits further investigation before firm conclusions could be drawn.
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49
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Lee CJ, Geiger-Brown J, Beck KH. Intentions and willingness to drive while drowsy among university students: An application of an extended theory of planned behavior model. ACCIDENT; ANALYSIS AND PREVENTION 2016; 93:113-123. [PMID: 27180286 DOI: 10.1016/j.aap.2016.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 03/05/2016] [Accepted: 05/02/2016] [Indexed: 06/05/2023]
Abstract
A web-based questionnaire was used to assess the utility of constructs from the Theory of Planned Behavior (TPB) and the Prototype Willingness Model (PWM) to predict intentions and willingness to engage in drowsy driving in a sample of 450 university students. Those students who reported more favorable attitudes and subjective norm and greater perceived control and willingness in relation to drowsy driving behavior were more likely to report stronger intentions to engage in drowsy driving behavior. Augmenting the TPB constructs with the PWM construct of willingness significantly explained up to an additional 8 percent of the variance in drowsy driving intention. Perceived behavioral control and willingness were consistently the strongest predictors of drowsy driving intention in the augmented model, which together with the control (personal) variables explained up to 70 percent of the variance in intention. Thus, the Theory of Planned Behavior and the Prototype Willingness Model may be useful for understanding motivational influences on drowsy driving behavior in young people and present promising theoretical frameworks for designing more effective interventions against drowsy driving in this population.
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Affiliation(s)
- Clark J Lee
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD 20742, USA; Center for Health Outcomes Research, University of Maryland, Baltimore, 655 West Lombard Street, Baltimore, MD 21201, USA; Center for Health and Homeland Security, University of Maryland, Baltimore, 500 West Baltimore Street, Baltimore, MD 21201, USA.
| | - Jeanne Geiger-Brown
- Center for Health Outcomes Research, University of Maryland, Baltimore, 655 West Lombard Street, Baltimore, MD 21201, USA
| | - Kenneth H Beck
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD 20742, USA
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50
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Rodrigues TM, Castro Caldas A, Ferreira JJ. Pharmacological interventions for daytime sleepiness and sleep disorders in Parkinson's disease: Systematic review and meta-analysis. Parkinsonism Relat Disord 2016; 27:25-34. [PMID: 27010071 DOI: 10.1016/j.parkreldis.2016.03.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 02/11/2016] [Accepted: 03/03/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Daytime sleepiness and sleep disorders are frequently reported in Parkinson's disease (PD). However, their impact on quality of life has been underestimated and few clinical trials have been performed. OBJECTIVES We aimed to assess the efficacy and safety of pharmacological interventions for daytime sleepiness and sleep disorders in PD. METHODS Systematic review of randomized controlled trials comparing any pharmacological intervention with no intervention or placebo for the treatment of daytime sleepiness and sleep problems in PD patients. RESULTS Ten studies (n = 338 patients) were included. Four trials addressed interventions for excessive daytime sleepiness. Meta-analysis of the three trials evaluating modafinil showed a significant reduction in sleepiness, as assessed by the Epworth Sleepiness Scale (ESS) (- 2.24 points, 95% CI - 3.90 to - 0.57, p < 0.05). In one study, treatment with caffeine was associated with a non-significant improvement of 1.71 points in ESS (95% CI, - 3.57 to 0.13). The six remaining trials assessed interventions for insomnia and REM sleep Behaviour Disorder (RBD). Single study results suggest that doxepin and YXQN granules might be efficacious, while pergolide may be deleterious for insomnia and that rivastigmine may be used to treat RBD in PD patients. However, there is insufficient evidence to support or refute the efficacy of any of these interventions. No relevant side effects were reported. CONCLUSIONS Whilst providing recommendations, this systematic review depicts the lack of a body of evidence regarding the treatment of sleep disorders in PD patients; hence, further studies are warranted.
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Affiliation(s)
- Tiago Martins Rodrigues
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Portugal; Institute of Pharmacology and Neurosciences, Faculty of Medicine, University of Lisbon, Portugal; Unit of Neurosciences, Instituto de Medicina Molecular, Lisbon, Portugal
| | - Ana Castro Caldas
- Department of Neurosciences, Hospital de Santa Maria, Lisbon, Portugal
| | - Joaquim J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Portugal; Department of Neurosciences, Hospital de Santa Maria, Lisbon, Portugal; Clinical Pharmacology Unit, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Portugal.
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