title: Sleepiness and Motor Vehicle Crashes in a Representative Sample of Portuguese Drivers: The Importance of Epidemiological Representative Surveys.
abstract: OBJECTIVE
  Sleepiness is considered to be a leading cause of crashes. Despite the huge amount of information collected in questionnaire studies, only some are based on representative samples of the population. Specifics of the populations studied hinder the generalization of these previous findings. For the Portuguese population, data from sleep-related car crashes/near misses and sleepiness while driving are missing. The objective of this study is to determine the prevalence of near-miss and nonfatal motor vehicle crashes related to sleepiness in a representative sample of Portuguese drivers.
  
  
  METHODS
  Structured phone interviews regarding sleepiness and sleep-related crashes and near misses, driving habits, demographic data, and sleep quality were conducted using the Pittsburgh Sleep Quality Index and sleep apnea risk using the Berlin questionnaire. A multivariate regression analysis was used to determine the associations with sleepy driving (feeling sleepy or falling asleep while driving) and sleep-related near misses and crashes.
  
  
  RESULTS
  Nine hundred subjects, representing the Portuguese population of drivers, were included; 3.1% acknowledged falling asleep while driving during the previous year and 0.67% recalled sleepiness-related crashes. Higher education, driving more than 15,000 km/year, driving more frequently between 12:00 a.m. and 6 a.m., fewer years of having a driver's license, less total sleep time per night, and higher scores on the Epworth Sleepiness Scale (ESS) were all independently associated with sleepy driving. Sleepiness-related crashes and near misses were associated only with falling asleep at the wheel in the previous year. Sleep-related crashes occurred more frequently in drivers who had also had sleep-related near misses.
  
  
  CONCLUSIONS
  Portugal has lower self-reported sleepiness at the wheel and sleep-related near misses than most other countries where epidemiological data are available. Different population characteristics and cultural, social, and road safety specificities may be involved in these discrepancies. Despite this, Portuguese drivers report sleep-related crashes in frequencies similar to those of drivers in other countries.
authors: a Centro de Medicina do Sono, Hospital Cuf Porto , Porto , Portugal.
authors: M
authors: M
authors: Gonçalves
authors: A R
authors: AR
authors: Peralta
authors: J
authors: J
authors: Monteiro Ferreira
authors: Christian
authors: C
authors: Guilleminault
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D001334:Automobile Driving / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011174:Portugal; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014851:Wakefulness
keywords: cars; driver; drowsiness; sleepiness