Sleep Disorders, Sleepiness, and Near-Miss Accidents Among Long-Distance Highway Drivers in the Summertime

Study Questions:

Is driver sleepiness associated with near-miss accidents during highway driving?

Methods:

Surveys were conducted on busy travel days at tollbooths for 1 month in France. Drivers were stopped at random and invited to participate. Only drivers at the wheel were interviewed. Data on demographics, sleep time, sleep needs, and sleep debt were collected. Subjective sleep complaints were assessed with the Epworth Sleepiness Scale, Basic Nordic Sleep Questionnaire, and Visual Analog Scale. Participants were also asked about near-miss sleepy accidents (NMSAs) in the past year or driving events due to sleepiness that caused no harm, but had potential to cause harm.

Results:

A total of 322,369 automobiles went through the tollbooths in July 2011. Of the random drivers approached, 3,051 agreed to participate (80%). Mean age was 46 ± 13 years, 75% were men, 85% of drivers were on vacation, and 61% were the only drivers in the vehicle. NMSAs during the current trip were reported by 2.9% of participants. Neither sleep time in the past 24 hours nor sleep debt correlated with near-miss accidents. The multivariate logistic regression model identified four significant independent risk factors for NMSA: NMSA in the past year (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.7-6.4), nonrestorative sleep in the past 3 months (OR, 1.9; 95% CI, 1.0-3.6), snoring in the past 3 months (OR, 2.0; 95% CI, 1.1-3.7), and sleepiness during the interview (OR, 1.4; 95% CI, 1.2-1.6).

Conclusions:

In this cross-sectional survey of highway drivers, sleepiness was not simply explained by acute sleep loss, but associated more with sleep-related breathing disorders.

Perspective:

Present controversy exists as to whether acute sleep loss or NMSA is the predominant predictor of car accidents. The authors concluded that sleep breathing disorders, such as snoring and nonrestorative sleep, were independently associated with a NMSA during the current highway trip. A weakness in this study is that drivers were surveyed only during daytime hours. Nighttime drivers were not interviewed. This study raises awareness and the association of sleepiness with road safety. More studies are needed to understand the role that sleep-disordered breathing plays in car accidents.

Keywords: France, Automobile Driving, Sleep Disorders


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