title: Sleepy driver near-misses may predict accident risks.
abstract: OBJECTIVE
  To quantify the prevalence of self-reported near-miss sleepy driving accidents and their association with self-reported actual driving accidents.
  
  
  METHODS
  A prospective cross-sectional internet-linked survey on driving behaviors.
  
  
  METHODS
  Dateline NBC News website.
  
  
  RESULTS
  Results are given on 35,217 (88% of sample) individuals with a mean age of 37.2 +/- 13 years, 54.8% women, and 87% white. The risk of at least one accident increased monotonically from 23.2% if there were no near-miss sleepy accidents to 44.5% if there were > or = 4 near-miss sleepy accidents (P < 0.0001). After covariate adjustments, subjects who reported at least one near-miss sleepy accident were 1.13 (95% CI, 1.10 to 1.16) times as likely to have reported at least one actual accident as subjects reporting no near-miss sleepy accidents (P < 0.0001). The odds of reporting at least one actual accident in those reporting > or = 4 near-miss sleepy accidents as compared to those reporting no near-miss sleepy accidents was 1.87 (95% CI, 1.64 to 2.14). Furthermore, after adjustments, the summary Epworth Sleepiness Scale (ESS) score had an independent association with having a near-miss or actual accident. An increase of 1 unit of ESS was associated with a covariate adjusted 4.4% increase of having at least one accident (P < 0.0001).
  
  
  CONCLUSIONS
  A statistically significant dose-response was seen between the numbers of self-reported sleepy near-miss accidents and an actual accident. These findings suggest that sleepy near-misses may be dangerous precursors to an actual accident.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery and Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, Stanford, CA, 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: Christian
authors.initials: C
authors.lastname: Guilleminault
authors.forename: Rayleigh Ping-ying
authors.initials: RP
authors.lastname: Chiang
authors.forename: Edward M
authors.initials: EM
authors.lastname: Weaver
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000453:epidemiology; D011446:Prospective Studies; D012306:Risk; D012891:Sleep Apnea Syndromes / Q000453:epidemiology; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D014481:United States