Feeling sleepy? Stop Driving - Awareness of Fall Asleep Crashes.

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.