title: Driver sleepiness and risk of serious injury to car occupants: population based case control study.
abstract: OBJECTIVE
  To estimate the contribution of driver sleepiness to the causes of car crash injuries.
  
  
  METHODS
  Population based case control study.
  
  
  METHODS
  Auckland region of New Zealand, April 1998 to July 1999.
  
  
  METHODS
  571 car drivers involved in crashes where at least one occupant was admitted to hospital or killed ("injury crash"); 588 car drivers recruited while driving on public roads (controls), representative of all time spent driving in the study region during the study period.
  
  
  METHODS
  Relative risk for injury crash associated with driver characteristics related to sleep, and the population attributable risk for driver sleepiness.
  
  
  RESULTS
  There was a strong association between measures of acute sleepiness and the risk of an injury crash. After adjustment for major confounders significantly increased risk was associated with drivers who identified themselves as sleepy (Stanford sleepiness score 4-7 v 1-3; odds ratio 8.2, 95% confidence interval 3.4 to 19.7); with drivers who reported five hours or less of sleep in the previous 24 hours compared with more than five hours (2.7, 1.4 to 5.4); and with driving between 2 am and 5 am compared with other times of day (5.6, 1.4 to 22.7). No increase in risk was associated with measures of chronic sleepiness. The population attributable risk for driving with one or more of the acute sleepiness risk factors was 19% (15% to 25%).
  
  
  CONCLUSIONS
  Acute sleepiness in car drivers significantly increases the risk of a crash in which a car occupant is injured or killed. Reductions in road traffic injuries may be achieved if fewer people drive when they are sleepy or have been deprived of sleep or drive between 2 am and 5 am.
authors: Division of Community Health, University of Auckland, Private Bag 92019, Auckland, New Zealand. j.connor@auckland.ac.nz
authors: Jennie
authors: J
authors: Connor
authors: Robyn
authors: R
authors: Norton
authors: Shanthi
authors: S
authors: Ameratunga
authors: Elizabeth
authors: E
authors: Robinson
authors: Ian
authors: I
authors: Civil
authors: Roger
authors: R
authors: Dunn
authors: John
authors: J
authors: Bailey
authors: Rod
authors: R
authors: Jackson
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving; D016022:Case-Control Studies; D005221:Fatigue / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D012307:Risk Factors; D012892:Sleep Deprivation / Q000150:complications* / Q000453:epidemiology; D014947:Wounds and Injuries / Q000209:etiology*