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Howard ME, Cori JM. Time for sleep science to wake up to drowsy driver monitoring. Sleep 2024; 47:zsad324. [PMID: 38147022 PMCID: PMC10851863 DOI: 10.1093/sleep/zsad324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Indexed: 12/27/2023] Open
Affiliation(s)
- Mark E Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia
- Department of Medicine, University of Melbourne, Parkville, VIC, Australia
- Turner Institute of Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Jennifer M Cori
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia
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2
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Koopmans I, Doll RJ, van der Wall H, de Kam M, Groeneveld GJ, Cohen A, Zuiker R. Fit for purpose of on-the-road driving and simulated driving: A randomised crossover study using the effect of sleep deprivation. PLoS One 2023; 18:e0278300. [PMID: 36730178 PMCID: PMC9894419 DOI: 10.1371/journal.pone.0278300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 11/14/2022] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Drivers should be aware of possible impairing effects of alcohol, medicinal substance, or fatigue on driving performance. Such effects are assessed in clinical trials, including a driving task or related psychomotor tasks. However, a choice between predicting tasks must be made. Here, we compare driving performance with on-the-road driving, simulator driving, and psychomotor tasks using the effect of sleep deprivation. METHOD This two-way cross over study included 24 healthy men with a minimum driving experience of 3000km per year. Psychomotor tasks, simulated driving, and on-the-road driving were assessed in the morning and the afternoon after a well-rested night and in the morning after a sleep-deprived night. Driving behaviour was examined by calculating the Standard Deviation of Lateral Position (SDLP). RESULTS SDLP increased after sleep deprivation for simulated (10cm, 95%CI:6.7-13.3) and on-the-road driving (2.8cm, 95%CI:1.9-3.7). The psychomotor test battery detected effects of sleep deprivation in almost all tasks. Correlation between on-the-road tests and simulator SDLP after a well-rested night (0.63, p < .001) was not present after a night of sleep deprivation (0.31, p = .18). Regarding the effect of sleep deprivation on the psychomotor test battery, only adaptive tracking correlated with the SDLP of the driving simulator (-0.50, p = .02). Other significant correlations were related to subjective VAS scores. DISCUSSION The lack of apparent correlations and difference in sensitivity of performance of the psychomotor tasks, simulated driving and, on-the-road driving indicates that the tasks may not be interchangeable and may assess different aspects of driving behaviour.
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Affiliation(s)
- Ingrid Koopmans
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
- * E-mail:
| | | | | | | | - Geert Jan Groeneveld
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
| | - Adam Cohen
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
| | - Rob Zuiker
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
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3
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Cori JM, Downey LA, Sletten TL, Beatty CJ, Shiferaw BA, Soleimanloo SS, Turner S, Naqvi A, Barnes M, Kuo J, Lenné MG, Anderson C, Tucker AJ, Wolkow AP, Clark A, Rajaratnam SMW, Howard ME. The impact of 7-hour and 11-hour rest breaks between shifts on heavy vehicle truck drivers' sleep, alertness and naturalistic driving performance. ACCIDENT; ANALYSIS AND PREVENTION 2021; 159:106224. [PMID: 34192654 DOI: 10.1016/j.aap.2021.106224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/01/2021] [Accepted: 05/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND An inadequate rest break between shifts may contribute to driver sleepiness. This study assessed whether extending the major rest break between shifts from 7-hours (Australian industry standard) to 11-hours, improved drivers' sleep, alertness and naturalistic driving performance. METHODS 17 heavy vehicle drivers (16 male) were recruited to complete two conditions. Each condition comprised two 13-hour shifts, separated by either a 7- or 11-hour rest break. The initial 13-hour shift was the drivers' regular work. The rest break and following 13-hour shift were simulated. The simulated shift included 5-hours of naturalistic driving with measures of subjective sleepiness, physiological alertness (ocular and electroencephalogram) and performance (steering and lane departures). RESULTS 13 drivers provided useable data. Total sleep during the rest break was greater in the 11-hour than the 7-hour condition (median hours [25th to 75th percentile] 6.59 [6.23, 7.23] vs. 5.07 [4.46, 5.38], p = 0.008). During the simulated shift subjective sleepiness was marginally better for the 11-hour condition (mean Karolinska Sleepiness Scale [95th CI] = 4.52 [3.98, 5.07] vs. 5.12 [4.56, 5.68], p = 0.009). During the drive, ocular and vehicle metrics were improved for the 11-hour condition (p<0.05). Contrary to expectations, mean lane departures p/hour were increased during the 11-hour condition (1.34 [-0.38,3.07] vs. 0.63 [-0.2,1.47], p = 0.027). CONCLUSIONS Extending the major rest between shifts substantially increases sleep duration and has a modest positive impact on driver alertness and performance. Future work should replicate the study in a larger sample size to improve generalisability and assess the impact of consecutive 7-hour major rest breaks.
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Affiliation(s)
- Jennifer M Cori
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia.
| | - Luke A Downey
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia
| | - Tracey L Sletten
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia
| | - Caroline J Beatty
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Brook A Shiferaw
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia; Seeing Machines Ltd., 80 Mildura St., Fyshwick, ACT, Australia
| | - Shamsi Shekari Soleimanloo
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia; Institute for Social Science Research, The University of Queensland, Queensland, Australia
| | - Sophie Turner
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Aqsa Naqvi
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
| | - Maree Barnes
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Department of Medicine, University of Melbourne, Australia
| | - Jonny Kuo
- Seeing Machines Ltd., 80 Mildura St., Fyshwick, ACT, Australia
| | - Michael G Lenné
- Seeing Machines Ltd., 80 Mildura St., Fyshwick, ACT, Australia
| | - Clare Anderson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia
| | - Andrew J Tucker
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia
| | - Alexander P Wolkow
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia
| | - Anna Clark
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia
| | - Mark E Howard
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia; Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia; Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia; Department of Medicine, University of Melbourne, Australia
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4
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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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5
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Dunbar J, Gilbert JE, Lewis B. Exploring differences between self-report and electrophysiological indices of drowsy driving: A usability examination of a personal brain-computer interface device. JOURNAL OF SAFETY RESEARCH 2020; 74:27-34. [PMID: 32951791 DOI: 10.1016/j.jsr.2020.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 01/26/2020] [Accepted: 04/16/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Impaired driving has resulted in numerous accidents, fatalities, and costly damage. One particularly concerning type of impairment is driver drowsiness. Despite advancements, modern vehicle safety systems remain ineffective at keeping drowsy drivers alert and aware of their state, even temporarily. Until recently the use of user-centric brain-computer interface (BCI) devices to capture electrophysiological data relating to driver drowsiness has been limited. METHOD In this study, 25 participants drove on a simulated roadway under drowsy conditions. RESULTS Neither subjective nor electrophysiological measures differed between individuals who showed overt signs of drowsiness (prolonged eye closure) during the drive. However, the directionality and effect size estimates provided by the BCI device suggested the practicality and feasibility of its future implementation in vehicle safety systems. Practical applications: This research highlights opportunities for future BCI device research for use to assess the state of drowsy drivers in a real-world context.
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Affiliation(s)
- Jerone Dunbar
- Computer & Info. Science & Eng., University of Florida, USA.
| | - Juan E Gilbert
- Computer & Info. Science & Eng., University of Florida, USA.
| | - Ben Lewis
- Department of Psychiatry, University of Florida, Gainesville, FL, USA.
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6
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Huizinga CR, Zuiker RG, de Kam ML, Ziagkos D, Kuipers J, Mejia Y, van Gerven JM, Cohen AF. Evaluation of simulated driving in comparison to laboratory-based tests to assess the pharmacodynamics of alprazolam and alcohol. J Psychopharmacol 2019; 33:791-800. [PMID: 30912701 DOI: 10.1177/0269881119836198] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
RATIONALE Assessment of the effects of medicines on the risks of car driving must be derived from laboratory tests, simulated driving or real on-road driving tests. Relevance of tests is determined by their sensitivity and predictive ability for the probability of accidents or damage. This cannot be determined directly, but methods should be able to at least detect the effects of a positive control in dosage known to be clearly associated with increased risk. OBJECTIVES A driving simulator was evaluated in comparison with a battery of validated tests of CNS performance, the NeuroCart®. Alcohol in a concentration exactly at the legal limit (0.5 g L-1) and well above (1.0 g L-1) as well as alprazolam (1 mg) was used as positive control. METHODS This was a randomised, cross-over study using a double dummy blinded design in 24 healthy study subjects (12 M, 12 F) aged 20-43 years. Alcohol was infused intravenously using a validated clamping protocol to obtain concentrations of 0.5 g L-1 and on another occasion 1.0 g L-1. Alprazolam was given orally. Driving tests and lab tests were done at regular time intervals during a study day. RESULTS Alprazolam and alcohol significantly affected the main parameters of driving in the simulator and affected scores of safe driving and alprazolam increased the odds ratio of a virtual crash. Several laboratory measurements of psychomotor performance were affected by the reference substances as expected and correlated significantly with the driving performance. CONCLUSIONS The driving simulator can detect effects of reference substances at levels that are known to negatively affect driving.
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Affiliation(s)
| | - Rob G Zuiker
- 1 Centre for Human Drug Research, Leiden, The Netherlands
| | | | | | | | - Yuri Mejia
- 1 Centre for Human Drug Research, Leiden, The Netherlands
| | | | - Adam F Cohen
- 1 Centre for Human Drug Research, Leiden, The Netherlands
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7
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Sagaspe P, Micoulaud-Franchi JA, Coste O, Léger D, Espié S, Davenne D, Lopez R, Dauvilliers Y, Philip P. Maintenance of Wakefulness Test, real and simulated driving in patients with narcolepsy/hypersomnia. Sleep Med 2019; 55:1-5. [DOI: 10.1016/j.sleep.2018.02.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/29/2018] [Accepted: 02/21/2018] [Indexed: 11/16/2022]
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8
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Micallef J, Dupouey J, Jouve E, Truillet R, Lacarelle B, Taillard J, Daurat A, Authié C, Blin O, Rascol O, Philip P, Mestre D. Cannabis smoking impairs driving performance on the simulator and real driving: a randomized, double-blind, placebo-controlled, crossover trial. Fundam Clin Pharmacol 2018; 32:558-570. [DOI: 10.1111/fcp.12382] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 04/25/2018] [Accepted: 04/27/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Joëlle Micallef
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Julien Dupouey
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Elisabeth Jouve
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Romain Truillet
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Bruno Lacarelle
- Laboratoire de Pharmacocinétique et Toxicologie; Assistance Publique Hôpitaux de Marseille; Marseille France
| | - Jacques Taillard
- Université de Bordeaux, CNRS, Sommeil Attention et Neuropsychiatrie, USR 3413; Bordeaux France
| | - Agnès Daurat
- Université Toulouse II, CNRS, EPHE, CLLE-LTC UMR 5263; Toulouse France
| | - Colas Authié
- Institut de la Vision, CNRS, UPMC, INSERM, UMR 7210; Paris France
| | - Olivier Blin
- Service de Pharmacologie Clinique et Pharmacovigilance & CIC-CPCET; Assistance Publique Hôpitaux de Marseille; 264 Rue Saint Pierre 13385 Marseille France
- Aix-Marseille Universite Faculté de Médecine; INS - Institut de Neurosciences des Systèmes INSERM UMR 1106 Marseille; Marseille France
| | - Olivier Rascol
- Department of Clinical Pharmacology and Neurosciences; Clinical Investigation Center INSERM CIC1436 and Clinique Spatiale MEDES; University Hospital and University of Toulouse3; Toulouse France
| | - Pierre Philip
- Université de Bordeaux, CNRS, Sommeil Attention et Neuropsychiatrie, USR 3413; Bordeaux France
| | - Daniel Mestre
- Aix-Marseille Université, CNRS, Institut des Sciences du Mouvement, UMR 7287; Marseille France
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9
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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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10
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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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11
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Weisgerber DM, Nikol M, Mistlberger RE. Driving home from the night shift: a bright light intervention study. Sleep Med 2017; 30:171-179. [DOI: 10.1016/j.sleep.2016.09.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/22/2016] [Accepted: 09/12/2016] [Indexed: 02/08/2023]
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12
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Meuleners L, Fraser ML, Govorko MH, Stevenson MR. Determinants of the occupational environment and heavy vehicle crashes in Western Australia: A case-control study. ACCIDENT; ANALYSIS AND PREVENTION 2017; 99:452-458. [PMID: 26643650 DOI: 10.1016/j.aap.2015.11.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 10/15/2015] [Accepted: 11/20/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To determine the association between a heavy vehicle driver's work environment, including fatigue-related characteristics, and the risk of a crash in Western Australia. METHODS This case-control study included 100 long-haul heavy vehicle drivers who were involved in a police-reported crash in WA and 100 long-haul heavy vehicle drivers recruited from WA truck stops, who were not involved in a crash in the previous 12 months. Driver demographics and driving details, work environment, vehicle and sleep-related characteristics were obtained using an interviewer-administered questionnaire. Drivers were tested for obstructive sleep apnoea using an overnight diagnostic device. Conditional multiple logistic regression analysis was undertaken to determine work environment-related factors associated with crash involvement. RESULTS After accounting for potential confounders, driving a heavy vehicle with an empty load was associated with almost a three-fold increased crash risk compared to carrying general freight (adjusted OR: 2.93, 95% CI: 1.17-7.34). Driving a rigid heavy vehicle was associated with a four-fold increased risk of crashing compared to articulated heavy vehicles (adjusted OR: 4.08, 95% CI: 1.13-14.68). The risk of crashing was almost five times higher when driving more than 50% of the trip between midnight and 5.59am (adjusted OR: 4.86, 95% CI: 1.47-16.07). Furthermore, the risk of crashing significantly increased if the time since the last break on the index trip was greater than 2h (adjusted OR: 2.18, 95% CI: 1.14-4.17). Drivers with more than 10 years driving experience were 52% less likely to be involved in a crash (adjusted OR: 0.48, 95% CI: 0.23-0.99). CONCLUSION The results provide support for an association between a driver's work environment, fatigue-related factors, and the risk of heavy vehicle crash involvement. Greater attention needs to be paid to the creation of a safer work environment for long distance heavy vehicle drivers.
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Affiliation(s)
- Lynn Meuleners
- Curtin-Monash Accident Research Centre (C-MARC), Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia.
| | - Michelle L Fraser
- Curtin-Monash Accident Research Centre (C-MARC), Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | - Matthew H Govorko
- Curtin-Monash Accident Research Centre (C-MARC), Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | - Mark R Stevenson
- Melbourne School of Design and Melbourne School of Engineering, The University of Melbourne, Melbourne, Victoria 3010, Australia
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Quera-Salva MA, Hartley S, Sauvagnac-Quera R, Sagaspe P, Taillard J, Contrand B, Micoulaud JA, Lagarde E, Barbot F, Philip P. Association between reported sleep need and sleepiness at the wheel: comparative study on French highways between 1996 and 2011. BMJ Open 2016; 6:e012382. [PMID: 28003284 PMCID: PMC5223720 DOI: 10.1136/bmjopen-2016-012382] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To investigate the evolution over 15 years of sleep schedules, sleepiness at the wheel and driving risk among highway drivers. METHODS Comparative survey including questions on usual sleep schedules and before the trip, sleepiness at the wheel, the Epworth sleepiness scale, Basic Nordic Sleep Questionnaire (BNSQ) and a travel questionnaire. RESULTS 80% of drivers stopped by the highway patrol agreed to participate in both studies with a total of 3545 drivers in 2011 and 2196 drivers in 1996 interviewed. After standardisation based on sex, age and mean annual driving distance, drivers in 2011 reported shorter sleep time on week days (p<0.0001), and week-ends (p<0.0001) and shorter optimal sleep time (p<0.0001) compared to 1996 drivers. There were more drivers sleepy at the wheel in 2011 than in 1996 (p<0.0001) and 2.5 times more drivers in 2011 than in 1996 had an Epworth sleepiness score >15 indicating severe sleepiness. CONCLUSIONS Even if drivers in 2011 reported good sleep hygiene prior to a highway journey, drivers have reduced their mean weekly sleep duration over 15 years and have a higher risk of sleepiness at the wheel. Sleep hygiene for automobile drivers remains an important concept to address.
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Affiliation(s)
- M A Quera-Salva
- Sleep Unit, EA4047, Department of Physical Medicine and Rehabilitation, Assistance Publique des Hôpitaux de Paris (AP-HP), Raymond Poincare Hospital, Garches, France
- INSERM CIC1429, APHP, Hôpital Raymond Poincaré, Garches, France
| | - S Hartley
- Sleep Unit, EA4047, Department of Physical Medicine and Rehabilitation, Assistance Publique des Hôpitaux de Paris (AP-HP), Raymond Poincare Hospital, Garches, France
| | - R Sauvagnac-Quera
- Department of Pediatrics Physical Medicine and Rehabilitation, AP-HP, Raymond Poincare Hospital, Garches, France
| | - P Sagaspe
- CNRS USR 3413 SANPSY “ Sommeil, Attention et Neuropsychiatrie ”, Bordeaux, France
| | - J Taillard
- CNRS USR 3413 SANPSY “ Sommeil, Attention et Neuropsychiatrie ”, Bordeaux, France
| | - B Contrand
- ISPED, Bordeaux Population Health Research Centre INSERM U1219-, University of Bordeaux, Bordeaux, France
- Injury Epidemiology, Transport, Occupation, Bordeaux Population Health Research Centre INSERM U1219-, Bordeaux, France
| | - J A Micoulaud
- ISPED, Bordeaux Population Health Research Centre INSERM U1219-, University of Bordeaux, Bordeaux, France
| | - E Lagarde
- ISPED, Bordeaux Population Health Research Centre INSERM U1219-, University of Bordeaux, Bordeaux, France
- Injury Epidemiology, Transport, Occupation, Bordeaux Population Health Research Centre INSERM U1219-, Bordeaux, France
| | - F Barbot
- INSERM CIC1429, APHP, Hôpital Raymond Poincaré, Garches, France
| | - P Philip
- CNRS USR 3413 SANPSY “ Sommeil, Attention et Neuropsychiatrie ”, Bordeaux, France
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Perrier J, Jongen S, Vuurman E, Bocca M, Ramaekers J, Vermeeren A. Driving performance and EEG fluctuations during on-the-road driving following sleep deprivation. Biol Psychol 2016; 121:1-11. [DOI: 10.1016/j.biopsycho.2016.09.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 08/08/2016] [Accepted: 09/28/2016] [Indexed: 01/20/2023]
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Trouble Sleeping Associated With Lower Work Performance and Greater Health Care Costs: Longitudinal Data From Kansas State Employee Wellness Program. J Occup Environ Med 2016; 57:1031-8. [PMID: 26461857 DOI: 10.1097/jom.0000000000000534] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the relationships between employees' trouble sleeping and absenteeism, work performance, and health care expenditures over a 2-year period. METHODS Utilizing the Kansas State employee wellness program (EWP) data set from 2008 to 2009, multinomial logistic regression analyses were conducted with trouble sleeping as the predictor and absenteeism, work performance, and health care costs as the outcomes. RESULTS EWP participants (N = 11,698 in 2008; 5636 followed up in 2009) who had higher levels of sleep disturbance were more likely to be absent from work (all P < 0.0005), have lower work performance ratings (all P < 0.0005), and have higher health care costs (P < 0.0005). Longitudinally, more trouble sleeping was significantly related to negative changes in all outcomes. CONCLUSIONS Employees' trouble sleeping, even at a subclinical level, negatively impacts on work attendance, work performance, and health care costs.
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Al Reesi H, Al Maniri A, Adawi SA, Davey J, Armstrong K, Edwards J. Prevalence and characteristics of road traffic injuries among young drivers in Oman, 2009-2011. TRAFFIC INJURY PREVENTION 2016; 17:480-487. [PMID: 26506986 DOI: 10.1080/15389588.2015.1107679] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 10/09/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Studies from different parts of the world have indicated that the impact of road traffic incidents disproportionally affects young adults. Few known studies have been forthcoming from Arabian Gulf countries. Within Oman, a high proportion of the population is under the age of 20. Coupled with the drastic increase in motorization in recent years, there is a need to understand the state of road safety among young people in Oman. The current research aimed to explore the prevalence and characteristics of road traffic injuries among young drivers aged 17-25 years. METHODS Crash data from 2009 to 2011 were extracted from the Directorate General of Traffic, Royal Oman Police (ROP) database in Oman. The data were analyzed to explore the impact of road crashes on young people (17-25 years), the characteristics of young driver crashes, and how these differ from older drivers and to identify key predictors of fatalities in young driver crashes. RESULTS Overall, young people were overrepresented in injuries and fatalities within the sample time period. Though it is true that many young people in crashes were driving at the time, it was also evident that young people were often victims in a crash caused by someone else. Thus, to reduce the impact of road crashes on young people, there is a need to generally address road safety within Oman. When young drivers were involved in crashes they were predominantly male. The types of crashes these drivers have can be broadly attributed to risk taking and inexperience. Speeding and nighttime driving were the key risk factors for fatalities. CONCLUSION The results highlight the need to address young driver safety in Oman. From these findings, the introduction of a graduated driver licensing system with nighttime driving restrictions could significantly improve young driver safety.
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Affiliation(s)
- Hamed Al Reesi
- a Department of Health Information and Studies , Directorate General of Health Services, North Batinah Governorate, Ministry of Health , Liwa , Sultanate of Oman
- b Department of Family Medicine and Public Health , College of Medicine and Health Sciences, Sultan Qaboos University , Muscat , Sultanate of Oman
| | - Abdullah Al Maniri
- c Road safety Research Program, The Research Council , Muscat , Sultanate of Oman
| | - Samir Al Adawi
- d Department of Behavioral Medicine , College of Medicine and Health Sciences, Sultan Qaboos University , Muscat , Sultanate of Oman
| | - Jeremy Davey
- e Centre for Accident Research and Road Safety-Queensland, Queensland University of Technology , Brisbane , Australia
| | - Kerry Armstrong
- e Centre for Accident Research and Road Safety-Queensland, Queensland University of Technology , Brisbane , Australia
| | - Jason Edwards
- e Centre for Accident Research and Road Safety-Queensland, Queensland University of Technology , Brisbane , Australia
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17
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Czeisler CA, Wickwire EM, Barger LK, Dement WC, Gamble K, Hartenbaum N, Ohayon MM, Pelayo R, Phillips B, Strohl K, Tefft B, Rajaratnam SMW, Malhotra R, Whiton K, Hirshkowitz M. Sleep-deprived motor vehicle operators are unfit to drive: a multidisciplinary expert consensus statement on drowsy driving. Sleep Health 2016; 2:94-99. [PMID: 28923267 DOI: 10.1016/j.sleh.2016.04.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 04/13/2016] [Accepted: 04/13/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVES This article presents the consensus findings of the National Sleep Foundation Drowsy Driving Consensus Working Group, which was an expert panel assembled to establish a consensus statement regarding sleep-related driving impairment. METHODS The National Sleep Foundation assembled a expert panel comprised of experts from the sleep community and experts appointed by stakeholder organizations. A systematic literature review identified 346 studies that were abstracted and provided to the panelists for review. A modified Delphi RAND/UCLA Appropriateness Method with 2 rounds of voting was used to reach consensus. RESULTS A final consensus was reached that sleep deprivation renders motorists unfit to drive a motor vehicle. After reviewing growing evidence of impairment and increased crash risk among drivers who obtained less than optimal sleep duration in the preceding 24 hours, the panelists recognized the need for public policy guidance as to when it is certainly unsafe to drive. Toward this end, the panelists agreed upon the following expert consensus statement: "Drivers who have slept for two hours or less in the preceding 24 hours are not fit to operate a motor vehicle." Panelists further agreed that most healthy drivers would likely be impaired with only 3 to 5 hours of sleep during the prior 24 hours. CONCLUSIONS There is consensus among experts that healthy individuals who have slept for 2 hours or less in the preceding 24 hours are too impaired to safely operate a motor vehicle. Prevention of drowsy driving will require sustained and collaborative effort from multiple stakeholders. Implications and limitations of the consensus recommendations are discussed.
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Affiliation(s)
- Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, and Sleep Health Institute, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
| | - Emerson M Wickwire
- Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Laura K Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, and Sleep Health Institute, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Karen Gamble
- Division of Behavioral Neurobiology, Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Maurice M Ohayon
- Division of Public Mental Health and Population Sciences, Department of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
| | - Rafael Pelayo
- Stanford Sleep Medicine Clinic, Stanford University School of Medicine, Redwood City, CA, USA
| | - Barbara Phillips
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, KY, USA
| | - Kingman Strohl
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Brian Tefft
- AAA Foundation for Traffic Safety, Washington, DC, USA
| | - Shantha M W Rajaratnam
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Notting Hill, VIC, Australia
| | - Raman Malhotra
- SLUCare Sleep Disorders Center, Saint Louis University, St Louis, MO, USA; Department of Neurology, Saint Louis University, St Louis, MO, USA
| | | | - Max Hirshkowitz
- Division of Public Mental Health and Population Sciences, School of Medicine, Stanford University, Stanford, CA, USA; Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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18
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Sleepiness, attention and risk of accidents in powered two-wheelers. Sleep Med Rev 2016; 25:40-51. [DOI: 10.1016/j.smrv.2015.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 01/20/2015] [Accepted: 01/21/2015] [Indexed: 11/18/2022]
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19
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Drowsiness detection using heart rate variability. Med Biol Eng Comput 2016; 54:927-37. [DOI: 10.1007/s11517-015-1448-7] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 12/19/2015] [Indexed: 11/25/2022]
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20
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Lee ML, Howard ME, Horrey WJ, Liang Y, Anderson C, Shreeve MS, O'Brien CS, Czeisler CA. High risk of near-crash driving events following night-shift work. Proc Natl Acad Sci U S A 2016; 113:176-81. [PMID: 26699470 PMCID: PMC4711869 DOI: 10.1073/pnas.1510383112] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Night-shift workers are at high risk of drowsiness-related motor vehicle crashes as a result of circadian disruption and sleep restriction. However, the impact of actual night-shift work on measures of drowsiness and driving performance while operating a real motor vehicle remains unknown. Sixteen night-shift workers completed two 2-h daytime driving sessions on a closed driving track at the Liberty Mutual Research Institute for Safety: (i) a postsleep baseline driving session after an average of 7.6 ± 2.4 h sleep the previous night with no night-shift work, and (ii) a postnight-shift driving session following night-shift work. Physiological measures of drowsiness were collected, including infrared reflectance oculography, electroencephalography, and electrooculography. Driving performance measures included lane excursions, near-crash events, and drives terminated because of failure to maintain control of the vehicle. Eleven near-crashes occurred in 6 of 16 postnight-shift drives (37.5%), and 7 of 16 postnight-shift drives (43.8%) were terminated early for safety reasons, compared with zero near-crashes or early drive terminations during 16 postsleep drives (Fishers exact: P = 0.0088 and P = 0.0034, respectively). Participants had a significantly higher rate of lane excursions, average Johns Drowsiness Scale, blink duration, and number of slow eye movements during postnight-shift drives compared with postsleep drives (3.09/min vs. 1.49/min; 1.71 vs. 0.97; 125 ms vs. 100 ms; 35.8 vs. 19.1; respectively, P < 0.05 for all). Night-shift work increases driver drowsiness, degrading driving performance and increasing the risk of near-crash drive events. With more than 9.5 million Americans working overnight or rotating shifts and one-third of United States commutes exceeding 30 min, these results have implications for traffic and occupational safety.
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Affiliation(s)
- Michael L Lee
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115
| | - Mark E Howard
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115; Department of Respiratory & Sleep Medicine, Institute for Breathing & Sleep, Austin Health, Heidelberg, VIC 3084, Australia
| | - William J Horrey
- Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748
| | - Yulan Liang
- Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748
| | - Clare Anderson
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115; Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3800, Australia
| | - Michael S Shreeve
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115
| | - Conor S O'Brien
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115;
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21
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Perrier J, Leufkens T, Bulla J, Jongen S, Bocca M, Ramaekers J, Vermeeren A. Electroencephalography during on-the-road driving in older untreated insomnia patients and normal sleepers. Biol Psychol 2015; 109:20-8. [DOI: 10.1016/j.biopsycho.2015.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 03/20/2015] [Accepted: 04/02/2015] [Indexed: 11/26/2022]
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Affiliation(s)
- Clifford B Saper
- Department of Neurology, Beth Israel Deaconess Medical Center Harvard Medical School, Boston, MA
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Crundall D, Stedmon AW, Crundall E, Saikayasit R. The role of experience and advanced training on performance in a motorcycle simulator. ACCIDENT; ANALYSIS AND PREVENTION 2014; 73:81-90. [PMID: 25180786 DOI: 10.1016/j.aap.2014.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 07/22/2014] [Accepted: 08/08/2014] [Indexed: 06/03/2023]
Abstract
Motorcyclists are over-represented in collision statistics. While many collisions may be the direct fault of another road user, a considerable number of fatalities and injuries are due to the actions of the rider. While increased riding experience may improve skills, advanced training courses may be required to evoke the safest riding behaviours. The current research assessed the impact of experience and advanced training on rider behaviour using a motorcycle simulator. Novice riders, experienced riders and riders with advanced training traversed a virtual world through varying speed limits and roadways of different curvature. Speed and lane position were monitored. In a comparison of 60 mph and 40 mph zones, advanced riders rode more slowly in the 40 mph zones, and had greater variation in lane position than the other two groups. In the 60 mph zones, both advanced and experienced riders had greater lane variation than novices. Across the whole ride, novices tended to position themselves closer to the kerb. In a second analysis across four classifications of curvature (straight, slight, medium, tight) advanced and experienced riders varied their lateral position more so than novices, though advanced riders had greater variation in lane position than even experienced riders in some conditions. The results suggest that experience and advanced training lead to changes in behaviour compared to novice riders which can be interpreted as having a potentially positive impact on road safety.
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Affiliation(s)
- David Crundall
- Division of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK.
| | - Alex W Stedmon
- Human Systems Integration Group, Faculty of Engineering and Computing, Coventry University, Coventry, UK
| | - Elizabeth Crundall
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - Rossukorn Saikayasit
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, Nottingham, UK
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Stevenson MR, Elkington J, Sharwood L, Meuleners L, Ivers R, Boufous S, Williamson A, Haworth N, Quinlan M, Grunstein R, Norton R, Wong K. The role of sleepiness, sleep disorders, and the work environment on heavy-vehicle crashes in 2 Australian states. Am J Epidemiol 2014; 179:594-601. [PMID: 24352592 DOI: 10.1093/aje/kwt305] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Heavy-vehicle driving involves a challenging work environment and a high crash rate. We investigated the associations of sleepiness, sleep disorders, and work environment (including truck characteristics) with the risk of crashing between 2008 and 2011 in the Australian states of New South Wales and Western Australia. We conducted a case-control study of 530 heavy-vehicle drivers who had recently crashed and 517 heavy-vehicle drivers who had not. Drivers' crash histories, truck details, driving schedules, payment rates, sleep patterns, and measures of health were collected. Subjects wore a nasal flow monitor for 1 night to assess for obstructive sleep apnea. Driving schedules that included the period between midnight and 5:59 am were associated with increased likelihood of crashing (odds ratio = 3.42, 95% confidence interval: 2.04, 5.74), as were having an empty load (odds ratio = 2.61, 95% confidence interval: 1.72, 3.97) and being a less experienced driver (odds ratio = 3.25, 95% confidence interval: 2.37, 4.46). Not taking regular breaks and the lack of vehicle safety devices were also associated with increased crash risk. Despite the high prevalence of obstructive sleep apnea, it was not associated with the risk of a heavy-vehicle nonfatal, nonsevere crash. Scheduling of driving to avoid midnight-to-dawn driving and the use of more frequent rest breaks are likely to reduce the risk of heavy-vehicle nonfatal, nonsevere crashes by 2-3 times.
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Howard ME, Jackson ML, Swann P, Berlowitz DJ, Grunstein RR, Pierce RJ. Deterioration in driving performance during sleep deprivation is similar in professional and nonprofessional drivers. TRAFFIC INJURY PREVENTION 2014; 15:132-137. [PMID: 24345014 DOI: 10.1080/15389588.2013.800637] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE There is some suggestion in the literature that professional drivers might self-select to be more resistant to the effects of sleep deprivation; however, this question has not been directly examined. The current laboratory study aimed to compare performance changes during acute sleep deprivation between professional and nonprofessional drivers. METHODS Twenty volunteer male professional drivers and 20 nonprofessional drivers performed a simulated driving task (AusEd) and the Psychomotor Vigilance Task (PVT) during 24 hours of continuous wakefulness. Ratings of subjective sleepiness were also examined. RESULTS There was a progressive and significant increase in lateral lane position and speed variability on the simulated driving task and an increase in PVT reaction times and lapses after participants had been awake for 17 to 24 hours (Ps < .01). There was no difference in performance changes between the professional and nonprofessional drivers. CONCLUSIONS Professional drivers in this study had the same susceptibility to sleep deprivation as nonprofessional drivers. This finding does not support the concept that professional drivers are resistant to sleep loss.
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Affiliation(s)
- Mark E Howard
- a Institute for Breathing and Sleep, Austin Health , Heidelberg , Victoria , Australia
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Quera Salva MA, Barbot F, Hartley S, Sauvagnac R, Vaugier I, Lofaso F, Philip P. Sleep disorders, sleepiness, and near-miss accidents among long-distance highway drivers in the summertime. Sleep Med 2014; 15:23-6. [DOI: 10.1016/j.sleep.2013.06.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 05/27/2013] [Accepted: 06/28/2013] [Indexed: 11/25/2022]
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Daurat A, Sagaspe P, Moták L, Taillard J, Bayssac L, Huet N, Authié C, Mestre D, Philip P. Lorazepam impairs highway driving performance more than heavy alcohol consumption. ACCIDENT; ANALYSIS AND PREVENTION 2013; 60:31-34. [PMID: 24007754 DOI: 10.1016/j.aap.2013.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 07/26/2013] [Accepted: 08/10/2013] [Indexed: 06/02/2023]
Abstract
While research indicates that benzodiazepine (BZD)-like drugs impair driving performance, it remains unclear (i) how far BZDs affect lane-keeping performance, compared with alcohol and (ii) to what extent this impact can realistically be measured in a simulated environment. To clarify these issues, 16 healthy male drivers who had never previously taken BZDs underwent a randomized, crossover, double-blind, placebo-controlled driving paradigm (with the BZD lorazepam) in both real-world and simulated settings. Two lane-keeping variables, namely inappropriate line crossings (ILCs) and standard deviation of lateral position (SDLP), were recorded during the driving sessions. Analyses revealed that (i) a single lorazepam dose (2 mg given by mouth) caused higher SDLP increases than a blood alcohol concentration of above 0.05%, and that (ii) this BZD effect was amplified in the simulated driving setting, mainly for ILCs. As a consequence, we recommend that physicians be made more aware of BZD-related risks and that researchers make a clear distinction between the effects of BZD intake per se and the impact of simulated driving settings.
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Affiliation(s)
- Agnès Daurat
- UMR 5263 CNRS - EPHE - Toulouse II University, "CLLE-LTC" Laboratory, Toulouse, France.
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Williamson A, Friswell R. Fatigue in the workplace: causes and countermeasures. FATIGUE-BIOMEDICINE HEALTH AND BEHAVIOR 2013. [DOI: 10.1080/21641846.2012.744581] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Fraser M, Conduit R, Phillips JG. Effects of sleep deprivation on decisional support utilisation. ERGONOMICS 2013; 56:235-245. [PMID: 23419086 DOI: 10.1080/00140139.2012.760754] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED To inform development of decisional support systems for the sleep deprived, this study examined the effect of sleep debt, time pressure and risk on the ability to use a decision aid. A total of 19 participants were tested when well rested and sleep deprived. Participants played computerised forms of Blackjack, which varied a 1- or 4-second response deadline, at two levels of risk, and could be supplied with online advice. Mean bets served as indications of confidence. Although confidence was less when play was fast or higher risk participants did not bet significantly less when sleep deprived, suggesting an impaired calibration of judgement that was supported by evidence of rallying. This failure to adjust confidence was accompanied by slower responses at low risk when sleep deprived. Sleep-deprived participants were less able to use decisional support under time pressure and made more errors without advice and time pressure. PRACTITIONER SUMMARY Decisional support is becoming more pervasive. To inform development of decisional support systems to assist the sleep deprived, an experiment considered the use of decisional support as a function of time pressure and risk. Advisory systems require processing and will be less efficacious under time pressure when sleep deprived.
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Affiliation(s)
- Maxwell Fraser
- Department of Psychology, Monash University, Clayton, 3800, Australia.
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Taillard J, Capelli A, Sagaspe P, Anund A, Akerstedt T, Philip P. In-car nocturnal blue light exposure improves motorway driving: a randomized controlled trial. PLoS One 2012; 7:e46750. [PMID: 23094031 PMCID: PMC3477137 DOI: 10.1371/journal.pone.0046750] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 09/04/2012] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED Prolonged wakefulness greatly decreases nocturnal driving performance. The development of in-car countermeasures is a future challenge to prevent sleep-related accidents. The aim of this study is to determine whether continuous exposure to monochromatic light in the short wavelengths (blue light), placed on the dashboard, improves night-time driving performance. In this randomized, double-blind, placebo-controlled, cross-over study, 48 healthy male participants (aged 20-50 years) drove 400 km (250 miles) on motorway during night-time. They randomly and consecutively received either continuous blue light exposure (GOLite, Philips, 468 nm) during driving or 2*200 mg of caffeine or placebo of caffeine before and during the break. Treatments were separated by at least 1 week. The outcomes were number of inappropriate line crossings (ILC) and mean standard deviation of the lateral position (SDLP). Eight participants (17%) complained about dazzle during blue light exposure and were removed from the analysis. Results from the 40 remaining participants (mean age ± SD: 32.9±11.1) showed that countermeasures reduced the number of inappropriate line crossings (ILC) (F(2,91.11) = 6.64; p<0.05). Indeed, ILC were lower with coffee (12.51 [95% CI, 5.86 to 19.66], p = 0.001) and blue light (14.58 [CI, 8.75 to 22.58], p = 0.003) than with placebo (26.42 [CI, 19.90 to 33.71]). Similar results were found for SDLP. Treatments did not modify the quality, quantity and timing of 3 subsequent nocturnal sleep episodes. Despite a lesser tolerance, a non-inferior efficacy of continuous nocturnal blue light exposure compared with caffeine suggests that this in-car countermeasure, used occasionally, could be used to fight nocturnal sleepiness at the wheel in blue light-tolerant drivers, whatever their age. More studies are needed to determine the reproducibility of data and to verify if it can be generalized to women. TRIAL REGISTRATION ClinicalTrials.gov NCT01070004.
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Affiliation(s)
- Jacques Taillard
- University of Bordeaux, Sommeil, Attention et Neuropsychiatrie, USR 3413, Bordeaux, France.
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Van Dongen HPA, Belenky G, Vila BJ. The efficacy of a restart break for recycling with optimal performance depends critically on circadian timing. Sleep 2011; 34:917-29. [PMID: 21731142 DOI: 10.5665/sleep.1128] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Under simulated shift-work conditions, we investigated the efficacy of a restart break for maintaining neurobehavioral functioning across consecutive duty cycles, as a function of the circadian timing of the duty periods. DESIGN As part of a 14-day experiment, subjects underwent two cycles of five simulated daytime or nighttime duty days, separated by a 34-hour restart break. Cognitive functioning and high-fidelity driving simulator performance were tested 4 times per day during the two duty cycles. Lapses on a psychomotor vigilance test (PVT) served as the primary outcome variable. Selected sleep periods were recorded polysomnographically. SETTING The experiment was conducted under standardized, controlled laboratory conditions with continuous monitoring. PARTICIPANTS Twenty-seven healthy adults (13 men, 14 women; aged 22-39 years) participated in the study. INTERVENTIONS Subjects were randomly assigned to a nighttime duty (experimental) condition or a daytime duty (control) condition. The efficacy of the 34-hour restart break for maintaining neurobehavioral functioning from the pre-restart duty cycle to the post-restart duty cycle was compared between these two conditions. RESULTS Relative to the daytime duty condition, the nighttime duty condition was associated with reduced amounts of sleep, whereas sleep latencies were shortened and slow-wave sleep appeared to be conserved. Neurobehavioral performance measures ranging from lapses of attention on the PVT to calculated fuel consumption on the driving simulators remained optimal across time of day in the daytime duty schedule, but degraded across time of night in the nighttime duty schedule. The 34-hour restart break was efficacious for maintaining PVT performance and other objective neurobehavioral functioning profiles from one duty cycle to the next in the daytime duty condition, but not in the nighttime duty condition. Subjective sleepiness did not reliably track objective neurobehavioral deficits. CONCLUSIONS The 34-hour restart break was adequate for maintaining performance in the case of optimal circadian placement of sleep and duty periods (control condition) but was inadequate (and perhaps even detrimental) for maintaining performance in a simulated nighttime duty schedule (experimental condition). Current US transportation hours-of-service regulations mandate time off duty but do not consider the circadian aspects of shift scheduling. Reinforcing a recent trend of applying sleep science to inform policymaking for duty and rest times, our findings indicate that restart provisions in hours-of-service regulations could be improved by taking the circadian timing of the duty schedules into account.
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Affiliation(s)
- Hans P A Van Dongen
- Sleep and Performance Research Center, Washington State University Spokane, PO Box 1495, Spokane, WA 99210-1495, USA.
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Verster JC, Roth T. Standard operation procedures for conducting the on-the-road driving test, and measurement of the standard deviation of lateral position (SDLP). Int J Gen Med 2011; 4:359-71. [PMID: 21625472 PMCID: PMC3100218 DOI: 10.2147/ijgm.s19639] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Indexed: 11/28/2022] Open
Abstract
This review discusses the methodology of the standardized on-the-road driving test and standard operation procedures to conduct the test and analyze the data. The on-the-road driving test has proven to be a sensitive and reliable method to examine driving ability after administration of central nervous system (CNS) drugs. The test is performed on a public highway in normal traffic. Subjects are instructed to drive with a steady lateral position and constant speed. Its primary parameter, the standard deviation of lateral position (SDLP), ie, an index of ‘weaving’, is a stable measure of driving performance with high test–retest reliability. SDLP differences from placebo are dose-dependent, and do not depend on the subject’s baseline driving skills (placebo SDLP). It is important that standard operation procedures are applied to conduct the test and analyze the data in order to allow comparisons between studies from different sites.
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Affiliation(s)
- Joris C Verster
- Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacology, Utrecht University, Utrecht, The Netherlands
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