title: Sleepy driving: accidents and injury.
abstract: OBJECTIVE
  The study goals were to evaluate the associated risks of driving and to assess predictors of accidents and injury due to sleepiness.
  
  
  METHODS
  A cross-sectional Internet-linked survey was designed to elicit data on driving habits, sleepiness, accidents, and injuries during the preceding 3 years. Statistical analysis included logistic models with covariate-adjusted P values of <0.01 (odds ratios and 95% confidence intervals or limits). Independent accident predictors were sought.
  
  
  RESULTS
  Responses from 10,870 drivers were evaluated. The mean +/- SD age was 36.9 +/- 13 years; 61% were women and 85% were white. The Epworth Sleepiness Scale overall baseline score was 7.4 +/- 4.2 (for drivers with no accidents) and ranged to 12.7 +/- 7.2 (for drivers with > or = 4 accidents) (P = < 0.0001). Twenty-three percent of all respondents experienced > or = 1 accident. Among respondents who reported > or = 4 accidents, a strong association existed for the most recent accident to include injury (P < 0.0001). Sleep disorders were reported by 22.5% of all respondents, with a significantly higher prevalence (35%, P = 0.002) for drivers who had been involved in > or = 3 accidents.
  
  
  CONCLUSIONS
  Factors of sleepiness were strongly associated with a greater risk of automobile accidents. Predictors were identified that may contribute to accidents and injury when associated with sleepiness and driving.
authors.affiliation: Department of Psychiatry and Behavioral Science, Stanford University Medical School, and the Stanford Sleep Disorders and Research Center, Stanford, California, USA. npowell@ix.netcom.com
authors.forename: Nelson B
authors.initials: NB
authors.lastname: Powell
authors.forename: Kenneth B
authors.initials: KB
authors.lastname: Schechtman
authors.forename: Robert W
authors.initials: RW
authors.lastname: Riley
authors.forename: Kasey
authors.initials: K
authors.lastname: Li
authors.forename: Christian
authors.initials: C
authors.lastname: Guilleminault
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D001334:Automobile Driving / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D012306:Risk; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires