- •
Chronic sleep restriction impacts drivers in developed countries.
- •
Sleepiness at the wheel is a better predictor of accident risk than the Epworth sleepiness scale.
- •
Inappropriate line crossings are strong warnings of future sleep-related accidents.
- •
Road safety campaigns should address not only acute but also chronic sleep deprivation all year long.
Sleep Restriction, Sleep Hygiene, and Driving Safety: The Importance of Situational Sleepiness
Section snippets
Key points
Physiologic factors modulating sleepiness
Sleepiness is a complex symptom that may be confused with fatigue. Technically, sleepiness occurs when chronobiological or homeostatic sleep pressure increases to force the brain to go from a state of arousal to a state of sleep. Alerting systems are then stimulated and somewhat prevent the occurrence of sleep.
The first and most common factor involved in sleepiness is extended wakefulness or sleep deprivation, which significantly increases homeostatic pressure and generates excessive daytime
Quantifying sleepiness: differences between neutral and “at risk” sleepiness
Sleepiness can be defined as a subjective perception or as an objective measure via electrophysiological measurements. The Stanford Sleepiness Scale (SSS)10 and the Karolinska Scale11 have been used in many sleep deprivation protocols and in healthy subjects. They measure instantaneous sleepiness via straightforward questions. Because they focus on a short period of time, they hardly reflect the mean level of sleepiness over days or weeks; yet these data are required to quantify the impact of
Nonprofessional drivers
In the 1990s, Philip and colleagues17 conducted a series of studies investigating the role of sleep deprivation and sleepiness at the wheel among large populations of highway drivers. At that time when air conditioning was not widespread in automobiles in Europe, public health campaigns recommended leaving early in the morning or late at night to avoid heat and traffic jams. A first study demonstrated that time of departure was closely related to sleep restriction and that sleep-related
Future considerations
Although much has already been done in this field, many questions remain unanswered. At the diagnostic level there is still no simple objective measure to quantify the risk to drivers, unlike other accident risk factors that can be easily assessed, such as by using a breathalyzer for alcohol testing. Ideally, one need a somnotest to quantify the driving risk, but up to now driving simulators or electroencephalogram (EEG) measures have provided only indirect and variable estimations of the
References (34)
- et al.
The role of driver sleepiness in car crashes: a systematic review of epidemiological studies
Accid Anal Prev
(2001) - et al.
Sleep disorders and accidental risk in a large group of regular registered highway drivers
Sleep Med
(2010) Ultrashort sleep-waking schedule. III. "Gates" and "forbidden zones" for sleep
Electroencephalogr Clin Neurophysiol
(1986)- et al.
Determinants of sleepiness in automobile drivers
J Psychosom Res
(1996) Road accidents caused by drivers falling asleep
Accid Anal Prev
(1999)- et al.
Maintenance of wakefulness test scores and driving performance in sleep disorder patients and controls
Int J Psychophysiol
(2013) Black times: temporal determinants of transport safety
Accid Anal Prev
(1997)Road traffic injury is an escalating burden in Africa and deserves proportionate research efforts
PLoS Med
(2007)- et al.
High risk of near-crash driving events following night-shift work
Proc Natl Acad Sci U S A
(2016) - et al.
A functional genetic variation of adenosine deaminase affects the duration and intensity of deep sleep in humans
Proc Natl Acad Sci U S A
(2005)
Adenosinergic mechanisms contribute to individual differences in sleep deprivation-induced changes in neurobehavioral function and brain rhythmic activity
J Neurosci
Human sleep: its duration and organization depend on its circadian phase
Science
Time course of neurobehavioral alertness during extended wakefulness in morning- and evening-type healthy sleepers
Chronobiol Int
The development and use of the Stanford sleepiness scale (SSS)
Psychophysiology
Relations between performance and subjective ratings of sleepiness during a night awake
Sleep
A new method for measuring daytime sleepiness: the Epworth sleepiness scale
Sleep
Driver sleepiness and risk of serious injury to car occupants: population based case control study
BMJ
Cited by (16)
Healthy sleep: basic sleep tips
2023, Encyclopedia of Sleep and Circadian Rhythms: Volume 1-6, Second EditionAcute sleep deprivation in humans
2023, Encyclopedia of Sleep and Circadian Rhythms: Volume 1-6, Second EditionThe effects of non-invasive brain stimulation on sleep disturbances among different neurological and neuropsychiatric conditions: A systematic review
2021, Sleep Medicine ReviewsCitation Excerpt :The lack of sleep and poor sleep quality can impair cognition, decision making, psychomotor function, mood, and immune function among others [8,9]. Moreover, sleep disturbances are considered risk factors for cardiovascular diseases, dementia, obesity, diabetes, depression, pain, cancer, driving accidents, and overall mortality [10–16]. Insomnia is the most common sleep disorder [17,18].
The effect of physical activity on sleep disturbance in various populations: a scoping review of randomized clinical trials
2023, International Journal of Behavioral Nutrition and Physical Activity
Disclosure Statement: None to declared.