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Original Investigation |

Sleep-Deprived Young Drivers and the Risk for Crash:  The DRIVE Prospective Cohort Study

Alexandra L. C. Martiniuk, MSc, PhD1,8; Teresa Senserrick, PhD5; Serigne Lo, PhD1,4; Ann Williamson, PhD5; Wei Du, PhD6; Ronald R. Grunstein, MD, PhD2; Mark Woodward, PhD1; Nick Glozier, MBBS, PhD3; Mark Stevenson, PhD, MPH7; Robyn Norton, PhD1; Rebecca Q. Ivers, MPH, PhD1
[+] Author Affiliations
1The George Institute for Global Health, University of Sydney, Sydney, Australia
2Woolcock Institute, University of Sydney, Sydney, Australia
3Brain and Mind Research Institute, University of Sydney, Sydney, Australia
4Sydney Medical School, University of Sydney, Sydney, Australia
5Transport and Road Safety, University of New South Wales, Sydney, Australia
6Neuroscience Research Australia, Sydney, Australia
7Monash University Accident Research Center, Melbourne, Australia
8University of Toronto, Toronto, Ontario, Canada
JAMA Pediatr. 2013;167(7):647-655. doi:10.1001/jamapediatrics.2013.1429.
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Importance  Short sleep duration is common in adolescents and young adults, and short sleep duration is a risk factor for motor vehicle crash.

Objective  To assess the association between hours of sleep and the risk for motor vehicle crash, including the time of day of crash and types of crash (single, multiple vehicle, run off road, and intersection).

Design  Prospective cohort study.

Setting  New South Wales, Australia.

Participants  Questionnaire responses were obtained from 20 822 newly licensed drivers aged 17 to 24 years. Participants held a first-stage provisional license between June 2003 and December 2004 prospectively linked to licensing and police-reported crash data, with an average of 2 years of follow-up. Analyses were conducted on a subsample of 19 327 participants for which there was full information.

Exposure  Sleeping 6 or fewer hours per night.

Main Outcomes and Measures  The main outcome variable was police-reported crash. Multivariable Poisson regression models were used to investigate the role of sleep duration on the risk for crash.

Results  On average, those who reported sleeping 6 or fewer hours per night had an increased risk for crash compared with those who reported sleeping more than 6 hours (relative risk [RR], 1.21; 95% CI, 1.04-1.41). Less weekend sleep was significantly associated with an increased risk for run-off-road crashes (RR, 1.55; 95% CI, 1.21-2.00). Crashes for individuals who had less sleep per night (on average and on weekends) were significantly more likely to occur between 8 pm and 6 am (RR, 1.86; 95% CI, 1.11-3.13, for midnight to 5:59 am and RR, 1.66; 95% CI, 1.15-2.39, for 8:00 pm to 11:59 pm).

Conclusions and Relevance  Less sleep per night significantly increased the risk for crash for young drivers. Less sleep on weekend nights increased the risk for run-off-road crashes and crashes occurring in the late-night hours. This provides rationale for governments and health care providers to address sleep-related crashes among young drivers.

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Figures

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Figure 1.
Relative Risk for Crash by Average Sleep Hours per Day (>6 Hours vs ≤ 6 Hours)

*Adjusted analyses of all crashes by sleep hours controlled for time in the study, prior crashes, age group, sex, average weekly driving hours, remoteness of residence, drinking behavior (Alcohol Use Disorders Identification Test score), risky driving behaviors, self-harm, drug use, sensation seeking, and psychological distress. Adjusted analyses of crash types by sleep hours controlled for time in the study, prior crashes, age group, sex, average weekly driving hours, remoteness of residence, and driving behavior owing to smaller sample sizes.

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Figure 2.
Relative Risk for Crash by Average Sleep Hours per Weekday (>6 Hours vs ≤ 6 Hours)

*Adjusted analyses of all crashes by sleep hours controlled for time in the study, prior crashes, age group, sex, average weekly driving hours, remoteness of residence, drinking behavior (Alcohol Use Disorders Identification Test score), risky driving behaviors, self-harm, drug use, sensation seeking, and psychological distress. Adjusted analyses of crash types by sleep hours controlled for time in the study, prior crashes, age group, sex, average weekly driving hours, remoteness of residence, and driving behavior owing to smaller sample sizes.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.
Relative Risk for Crash by Average Sleep Hours per Weekend (>6 Hours vs ≤ 6 Hours)

*Adjusted analyses of all crashes by sleep hours controlled for time in the study, prior crashes, age group, sex, average weekly driving hours, remoteness of residence, drinking behavior (Alcohol Use Disorders Identification Test score), risky driving behaviors, self-harm, drug use, sensation seeking, and psychological distress. Adjusted analyses of crash types by sleep hours controlled for time in the study, prior crashes, age group, sex, average weekly driving hours, remoteness of residence, and driving behavior owing to smaller sample sizes.

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