title: Driver impairment at night and its relation to physiological sleepiness.
abstract: OBJECTIVE
  Studies of devices detecting sleepiness need reference points of physiological sleepiness. The present study sought to validate the Karolinska drowsiness score (KDS) as an indicator of physiological sleepiness against driving impairment and eye blink duration during a 45-minute drive in an advanced moving-base driving simulator.
  
  
  METHODS
  Data from 19 persons were used in the analysis. Electrooculography, electroencephalography, and electromyography were administered continuously. Physiological sleepiness was quantified by scoring the percentage (0-100%) of the scoring epoch with alpha and theta activity and slow eye movements (KDS). Lateral position and speed were used as measures of driving behavior. Lane departure was defined as two wheels touching the lane markers. Blink duration was used as a secondary indicator of sleepiness.
  
  
  RESULTS
  The results showed that, for young drivers, sleepiness increased with time in the task with higher levels. The variability of the lateral position and the mean and variability of the blink duration significantly changed when sleepiness increased to KDS > or =20%. Furthermore, there was an increase in the risk of lane departure for KDS > or =30%.
  
  
  CONCLUSIONS
  The results suggest that KDS scoring is a reasonable procedure for estimating physiological sleepiness under conditions of driving. The results also indicate that a younger age is associated with greater sensitivity to sleepiness at the wheel.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. anna.anund@vti.se
authors.forename: Anna
authors.initials: A
authors.lastname: Anund
authors.forename: Göran
authors.initials: G
authors.lastname: Kecklund
authors.forename: Björn
authors.initials: B
authors.lastname: Peters
authors.forename: Asa
authors.initials: A
authors.lastname: Forsman
authors.forename: Arne
authors.initials: A
authors.lastname: Lowden
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Akerstedt
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001334:Automobile Driving; D001767:Blinking / Q000502:physiology; D002940:Circadian Rhythm; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015203:Reproducibility of Results; D012894:Sleep Stages / Q000502:physiology*