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Title: Feeling sleepy? Stop Driving - Awareness of Fall Asleep Crashes.
Austin Authors: Anderson, Clare;Cai, Anna W T;Lee, Michael L;Horrey, William J;Liang, Yulan;O'Brien, Conor S;Czeisler, Charles A;Howard, Mark E 
Affiliation: Turner Institute of Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800 Australia.
Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115 USA
Division of Sleep and Circadian Disorders, Department of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115 USA.
AAA Foundation for Traffic Safety, Washington, D.C. 20005 USA.
Center for Behavioral Sciences, Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748 USA.
Center for Innovation in Digital Healthcare, Mass General Hospital, Boston MA USA.
Institute for Breathing and Sleep
Issue Date: 8-Nov-2023
Date: 2023
Publication information: Sleep 2023-11-08; 46(11)
Abstract: To examine whether drivers are aware of sleepiness and associated symptoms, and how subjective reports predict driving impairment and physiological drowsiness. Sixteen shift workers (19-65y; 9 women) drove an instrumented vehicle for 2-hours on a closed-loop track after a night of sleep and a night of work. Subjective sleepiness/symptoms were rated every 15-minutes. Severe and moderate driving impairment was defined by emergency brake manoeuvres and lane deviations, respectively. Physiological drowsiness was defined by eye closures (Johns Drowsiness Scores, JDS) and EEG-based microsleep events. All subjective ratings increased post night-shift (p<0.001). No severe drive events occurred without noticeable symptoms beforehand. All subjective sleepiness ratings, and specific symptoms, predicted a severe driving event occurring in the next 15-minutes (OR: 1.76-2.4, AUC>0.81, p<0.009), except 'head dropping down'. KSS, ocular symptoms, difficulty keeping to center of the road, and nodding off to sleep, were associated with a lane deviation in the next 15-minutes (OR: 1.17-1.24, p<0.029), although accuracy was only 'fair' (AUC 0.59-0.65). All sleepiness ratings predicted severe ocular-based drowsiness (OR: 1.30-2.81, p<0.001), with very good-to-excellent accuracy (AUC>0.8), while moderate ocular-based drowsiness was predicted with fair-to-good accuracy (AUC>0.62). KSS, likelihood of falling asleep, ocular symptoms and 'nodding off' predicted microsleep events, with fair-to-good accuracy (AUC 0.65-0.73). Drivers are aware of sleepiness, and many self-reported sleepiness symptoms predicted subsequent driving impairment/physiological drowsiness. Drivers should self-assess a wide range of sleepiness symptoms and stop driving when these occur to reduce the escalating risk of road crashes due to drowsiness.
DOI: 10.1093/sleep/zsad136
ORCID: 0000-0002-5086-4865
Journal: Sleep
PubMed URL: 37158173
ISSN: 1550-9109
Type: Journal Article
Subjects: Driving
Eye Closure
Lane Departure
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