, et al
Sleep-deprived young drivers and the risk for crash: the DRIVE Prospective Cohort Study
JAMA Pediatr.
; doi:

Investigators from Australia and Canada explored the effect of sleep duration on the risk of motor vehicle crash (MVC). Between June 2003 and December 2004, all newly licensed drivers in New South Wales (NSW), Australia who were 17 to 24 years old were invited to complete an online baseline questionnaire regarding their weekday and weekend sleep hours, demographics, driving exposure, driver training, drug and alcohol use, and risky driving behavior. Their survey responses were subsequently linked to a database maintained by the NSW Roads and Traffic Authority that contained information about police-reported MVCs. Average follow-up time for each participant was 2 years.

The primary study outcome was police-reported crashes. Secondary outcomes were crash time of day and crash types (single vehicle, multiple vehicle, or “run off road”). The primary study exposure was sleep duration as reported by participants on the baseline questionnaire in response to the question, “During the past month, about how long have you slept each night (weekday hours) and (weekend hours)?” Sleep duration was dichotomized into ≤6 hours and >6 hours per night. The investigators determined the association between sleep duration and MVCs while controlling for potential confounders including age group (17, 18–19, 20–24 years), gender, average weekly driving hours, remoteness of residence, drinking behavior, and risky driving behavior (eg, speeding and prior crashes).

Of 131,000 eligible new drivers, 20,822 (16%) participated in the study; data on 19,327 with full information were included in the analysis. Overall, those who reported sleeping on average ≤6 hours per night were at increased risk for having had a police-reported crash (adjusted relative risk [RR] 1.21; 95% CI, 1.04–1.41) and a multiple vehicle crash (RR 1.30; 95% CI, 1.11–1.53) compared to those who reported sleeping >6 hours per night. Sleeping ≤6 hours per weekend night was associated with increased risk for “run off road” crashes (RR 1.55; 95% CI, 1.21–2.00). Sleep of ≤6 hours per night was also significantly associated with increased risk of a crash occurring from midnight to 5:59 am and 8:00 pm to 11:59 pm.

The authors conclude that younger drivers who sleep ≤6 hours per night have an increased risk for MVCs.

Dr Dubik has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

As the editorial accompanying this study points out, driving is one of the riskiest activities that adolescents and young adults undertake. Twenty percent of all MVCs and approximately 8,000 deaths per year in the United States are attributable to drowsy driving. Relatively inexperienced, younger drivers would be expected to be more vulnerable to the effects of drowsiness, a finding confirmed by the investigators of this study. The results of this study are also...

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