Awareness of sleepiness when driving

Horne, Jim; Baulk, Stuart D.

doi:10.1046/j.1469-8986.2003.00130.x

Cited by 181 publications

(105 citation statements)

References 13 publications

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“…This level of self-awareness of increasing sleepiness when driving is similar to what we have found with a group of healthy drivers of a similar age (mean age 66.6y [52-74y]) having undergone sleep restriction [11], and in young male adult drivers [19,20].…”

Section: Discussionsupporting

confidence: 87%

One night’s CPAP withdrawal in otherwise compliant OSA patients: marked driving impairment but good awareness of increased sleepiness

2011

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Results: Withdrawal of CPAP markedly increased sleep disturbance, and led to significantly more incidents, a shorter 'safe' driving duration, increased alpha and theta EEG power and greater subjective sleepiness. However, increased EEG beta activity indicated more compensatory effort was being applied. Importantly, under both conditions there was a highly significant correlation between subjective and EEG measures of sleepiness, to the extent that participants were well aware of the effects of nil CPAP Conclusions: Patients should be aware that compliance with treatment every night is crucial for safe driving.

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Section: Discussionsupporting

confidence: 87%

One night’s CPAP withdrawal in otherwise compliant OSA patients: marked driving impairment but good awareness of increased sleepiness

2011

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“…We found that postnight-shift drivers were much sleepier, and noticed increasing difficulty keeping their eyes open and maintaining lane position, particularly when driving for more than 15-30 min, which has been related to slowing on EEG (increased θ power), lane drifting and severe driving impairment during simulated driving, and increased crash risk (2,(31)(32)(33). Our findings on the controlled driving track were comparable to a study of nurses driving home after night shift, which showed that the maximum total blink duration was increased after the night shift and was associated with a greater incidence of subjective sleep-related events, such as "resting your eyes," or "falling asleep at the stop light" (21).…”

Section: Discussionmentioning

confidence: 95%

High risk of near-crash driving events following night-shift work

Lee

Howard

Horrey

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

175

119

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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 postnightshift 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. drowsy driving | sleep | EEG | infrared oculography | fatigue

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“…While subjective assessments of sleepiness have been found to be accurate in the laboratory, their relationship to objective sleepiness measures has not been shown reliably in applied settings. 43,44 Hence, selfratings of sleepiness have limited value in the workplace compared to objective sleepiness measures, which do not rely upon the accuracy of an individual's introspection. In-vehicle sleepiness-detection systems provide the driver with immediate notification of their current alertness state and risk of performance impairment and attentional failure in the future, potentially preventing sleepiness-related motor vehicle crashes.…”

Section: Discussionmentioning

confidence: 99%

Ocular Measures of Sleepiness Are Increased in Night Shift Workers Undergoing a Simulated Night Shift Near the Peak Time of the 6-Sulfatoxymelatonin Rhythm

Ftouni

Nicholas

Kennaway

et al. 2015

Journal of Clinical Sleep Medicine

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Study Objectives:The study examined the relationship between the circadian rhythm of 6-sulphatoxymelatonin (aMT6s) and ocular measures of sleepiness and neurobehavioral performance in shift workers undergoing a simulated night shift. Methods: Twenty-two shift workers (mean age 33.4, SD 11.8 years) were tested at approximately the beginning (20:00) and the end (05:55) of a simulated night shift in the laboratory. At the time point corresponding to the end of the simulated shift, 14 participants were classifi ed as being within range of 6-sulphatoxymelatonin (aMT6s) acrophasedefi ned as 3 hours before or after aMT6s peak-and 8 were classifi ed as outside aMT6s acrophase range. Participants completed the Karolinska Sleepiness Scale (KSS) and the auditory psychomotor vigilance task (aPVT). Waking electroencephalography (EEG) was recorded and infrared refl ectance oculography was used to collect ocular measures of sleepiness: positive and negative amplitude/velocity ratio (PosAVR, NegAVR), mean blink total duration (BTD), the percentage of eye closure (%TEC), and a composite score of sleepiness levels (Johns Drowsiness Scale; JDS).Results: Participants who were tested within aMT6s acrophase range displayed higher levels of sleepiness on ocular measures (%TEC, BTD, PosAVR, JDS), objective sleepiness (EEG delta power frequency band), subjective ratings of sleepiness, and neurobehavioral performance, compared to those who were outside aMT6s acrophase range. Conclusions:The study demonstrated that objective ocular measures of sleepiness are sensitive to circadian rhythm misalignment in shift workers. Keywords: oculometrics, circadian misalignment, shift work, performance, sleepiness Citation: Ftouni S, Sletten TL, Nicholas CL, Kennaway DJ, Lockley SW, Rajaratnam SM. Ocular measures of sleepiness are increased in night shift workers undergoing a simulated night shift near the peak time of the 6-sulfatoxymelatonin rhythm. J Clin Sleep Med 2015;11(10):1131 -1141 .pii: jc-00268-14 http://dx.doi.org/10.5664/jcsm.5086 S hift work has become a ubiquitous part of labor practices due to the increasing pressure for 24-hour provision of goods and services. This drive for round-the-clock productivity, however, has resulted in negative consequences to health, safety, and performance.1 Such consequences have been welldocumented in a number of occupational sectors in which peak functioning during the night shift is critical, for example, commercial transport, mining, emergency services, and health care. The impairment to alertness that occurs during night shift work is mainly attributed to misalignment of the imposed sleep-wake cycle from the internally generated circadian (~24-hour) rhythm of sleepiness, 3 often against a background of chronic sleep defi ciency and prolonged periods of wakefulness. Alertness and neurobehavioral performance peak when the circadian pacemaker promotes wakefulness during the daytime, and decline markedly during the night, particularly between 03:00 and 06:00, 4 as the circadian pacemaker strongly promotes...

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Awareness of sleepiness when driving

Cited by 181 publications

References 13 publications

One night’s CPAP withdrawal in otherwise compliant OSA patients: marked driving impairment but good awareness of increased sleepiness

One night’s CPAP withdrawal in otherwise compliant OSA patients: marked driving impairment but good awareness of increased sleepiness

High risk of near-crash driving events following night-shift work

Ocular Measures of Sleepiness Are Increased in Night Shift Workers Undergoing a Simulated Night Shift Near the Peak Time of the 6-Sulfatoxymelatonin Rhythm

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