Short and long sleep duration and risk of drowsy driving and the role of subjective sleep insufficiency

Abstract

Experimental sleep restriction increases sleepiness and impairs driving performance. However, it is unclear whether short sleep duration in the general population is associated with drowsy driving. The goal of the present study was to evaluate whether individuals in the general population who obtained sleep of 6 hours or less are more likely to report drowsy driving, and evaluate the role of perceived sleep sufficiency. Data exploring whether subgroups of short sleepers (those who report the most or least unmet sleep need) show different risk profiles for drowsy driving are limited. From the 2009 Behavioral Risk Factor Surveillance System (N=31,522), we obtained the following self-reported data: 1) sleep duration (≤5, 6, 7, 8, 9, or ≥10h/night); 2) number of days/week of perceived insufficient sleep; 3) among drivers, yes/no response to: “During the past 30 days, have you ever nodded off or fallen asleep, even just for a brief moment, while driving?” 4) demographics, physical/mental health. Using 7h/night as reference, logistic regression analyses evaluated whether self-reported sleep duration was associated with drowsy driving. Overall, 3.6% reported drowsy driving. Self-identified short-sleepers reported drowsy driving more often, and long sleepers, less often. Among those who perceived sleep as always insufficient, drowsy driving was reported more often when sleep duration was ≤5h, 6h, or ≥10h. Among those who perceived sleep as always sufficient, drowsy driving was reported more often among ≤5h and 6h sleepers. Overall, drowsy driving was common, particularly in self-identified short-sleepers as a whole, as well as subgroups based on sleep insufficiency.

The Pittsburgh Sleep Quality Index in a multi-ethnic Asian population contains a three-factor structure

“…In Singapore, Yeo et al has reported that the prevalence of insomnia was 15.3 % in 1996 [5]. Sleep impairment is associated with an increased risk of hypertension, obesity, depression and cardiovascular diseases [6,7] and affects daily activities such as driving [8] and work [9].…”

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

“…Sleep is vital to human health, necessary for life, 1,2 and it serves critical roles in brain functions including neurobehavioral, cognitive and safety-related performance, [3][4][5][6][7][8][9][10][11][12][13] memory consolidation, 14,15 mood regulation, 16,17 nociception 18,19 and clearance of brain metabolites. 20,21 Sleep is also critically involved in systemic physiology, including metabolism, [22][23][24][25][26] appetite regulation, 27,28 immune and hormone function, [29][30][31][32][33] and cardiovascular systems.…”

Sleep Deprivation: Societal Impact and Long-Term Consequences

“…Surprisingly, when analyses were restricted to only those who report 0 nights/week of insufficient sleep, significant differences remained. Compared to those reporting 7-8 h of sleep, those who reported less than 5 or 6 h were more than 2.5 times as likely to report nodding off at the wheel [79]. Although other research suggests that short sleepers may not be at higher risk for driving accidents [78], the above findings suggest that some cognitive impairments may exist due to inability to maintain vigilance.…”

“…Several papers have shown that accidents are related to sleepiness caused by sleep apnea [69,72,73] and prolonged wakefulness [71,74,75]. Some evidence also suggests that short sleepers may exhibit more sleepiness than average [76,77], but currently there are very limited data to support the claim that short sleepers are more likely to experience auto accidents [78], though some evidence exists [79].…”