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Sleep Disturbances and Adverse Driving Events in a Predominantly Male Cohort of Active Older Drivers
Author(s) -
Vaz Fragoso Carlos A.,
Araujo Katy L.B.,
Van Ness Peter H.,
Marottoli Richard A.
Publication year - 2010
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2010.03083.x
Subject(s) - medicine , epworth sleepiness scale , cohort , insomnia , sleep apnea , excessive daytime sleepiness , adverse effect , poison control , apnea , obstructive sleep apnea , crash , cohort study , sleep disorder , physical therapy , pediatrics , emergency medicine , polysomnography , psychiatry , computer science , programming language
OBJECTIVES: To evaluate the association between sleep disturbances and adverse driving events in active older drivers. DESIGN: Longitudinal. SETTING: Clinic and community sites in greater New Haven, Connecticut. PARTICIPANTS: Four hundred thirty older persons (mean age 78.5, 84.9% male) who drove at least once a week. MEASUREMENTS: Baseline measures included self‐reported driving patterns and sleep questionnaires (Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and Sleep Apnea Clinical Score (SACS)). The primary outcome was an adverse driving event based on self‐report and driving records and categorized as a crash or traffic infraction (composite I) or as a crash, traffic infraction, near crash, or getting lost (composite II). RESULTS: Participants reported driving a median of 17.0 miles per day, with 96.7% (416/430) driving daily or every other day. Although 26.0% (112/430) had insomnia (ISI≥8), 19.3% (83/430) had daytime drowsiness (ESS≥10), and 19.9% (84/422) had high sleep apnea risk (SACS>15), the median scores for the ISI, ESS, and SACS were normal at 3.0, 6.0, and 8.0, respectively, and only 5.1% reported drowsy driving. Over a period of up to 2 years, 24.9% (104/418) and 51.4% (215/418) of participants had a composite I and II driving event, respectively. In unadjusted and adjusted multivariable models, insomnia, daytime drowsiness, and high sleep apnea risk were not associated with a composite I or II driving event. CONCLUSION: In a predominantly male cohort of active older drivers, sleep disturbances were mild and not associated with adverse driving events. Accordingly, and because older persons are known to self‐regulate driving practices, future studies should evaluate whether sleep disturbances are more important as a mechanism that underlies driving cessation rather than compromising driving safety.