The effect of daylight versus darkness on driver sleepiness: a driving simulator study.

Driver sleepiness studies are often carried out with alert drivers during daytime and sleep-deprived drivers during night-time. This design results in a mixture of different factors (e.g. circadian effects, homeostatic effects, light conditions) that may confound the results. The aim of this study was to investigate the effect of light conditions on driver sleepiness. Thirty young male drivers (23.6 ± 1.7 years old) participated in a driving simulator experiment where they drove on a rural road. A 2 × 2 design was used with the conditions daylight versus darkness, and daytime (full sleep) versus night-time (sleep deprived). The results show that light condition had an independent effect on the sleepiness variables. The subjective sleepiness measured by Karolinska Sleepiness Scale was higher, lateral position more left-oriented, speed lower, electroencephalogram alpha and theta higher, and blink durations were longer during darkness. The number of line crossings did not change significantly with light condition. The day/night condition had profound effects on most sleepiness indicators while controlling for light condition. The number of line crossings was higher during night driving, Karolinska Sleepiness Scale was higher, blink durations were longer and speed was lower. There were no significant interactions, indicating that light conditions have an additive effect on sleepiness. In conclusion, Karolinska Sleepiness Scale and blink durations increase primarily with sleep deprivation, but also as an effect of darkness. Line crossings are mainly driven by the need for sleep and the reduced alertness at the circadian nadir. Lane position is, however, more determined by light conditions than by sleepiness.

Sleep-related eye symptoms and their potential for identifying driver sleepiness.

The majority of individuals appear to have insight into their own sleepiness, but there is some evidence that this does not hold true for all, for example treated patients with obstructive sleep apnoea. Identification of sleep-related symptoms may help drivers determine their sleepiness, eye symptoms in particular show promise. Sixteen participants completed four motorway drives on two separate occasions. Drives were completed during daytime and night-time in both a driving simulator and on the real road. Ten eye symptoms were rated at the end of each drive, and compared with driving performance and subjective and objective sleep metrics recorded during driving. 'Eye strain', 'difficulty focusing', 'heavy eyelids' and 'difficulty keeping the eyes open' were identified as the four key sleep-related eye symptoms. Drives resulting in these eye symptoms were more likely to have high subjective sleepiness and more line crossings than drives where similar eye discomfort was not reported. Furthermore, drivers having unintentional line crossings were likely to have 'heavy eyelids' and 'difficulty keeping the eyes open'. Results suggest that drivers struggling to identify sleepiness could be assisted with the advice 'stop driving if you feel sleepy and/or have heavy eyelids or difficulty keeping your eyes open'.

Having to stop driving at night because of dangerous sleepiness--awareness, physiology and behaviour.

A large number of accidents are due to the driver falling asleep at the wheel, but details of this link have not been studied on a real road. The purpose of the present study was to describe the development of sleepiness indicators, leading to the drive being terminated prematurely by the onboard expert driving instructor because of imminent danger. Eighteen individuals participated during a day drive and a night drive on a motorway (both 90 min). Eight drivers terminated (N) prematurely (after 43 min) because of sleep-related imminent danger [according to the driving instructor or their own judgement (two cases)]. The results showed very high sleepiness ratings (8.5 units on the Karolinska Sleepiness Scale) immediately before termination (<7 at a similar time interval for those 10 who completed the drive). Group N also showed significantly higher levels of sleep intrusions on the electroencephalography/electro-oculography (EEG/EOG) than those who completed the drive (group C). The sleep intrusions were increased in group N during the first 40 min of the night drive. During the day drive, sleep intrusions were increased significantly in group N. The night drive showed significant increases of all sleepiness indicators compared to the day drive, but also reduced speed and driving to the left in the lane. It was concluded that 44% of drivers during late-night driving became dangerously sleepy, and that this group showed higher perceived sleepiness and more sleep intrusions in the EEG/EOG.

In-car countermeasures open window and music revisited on the real road: popular but hardly effective against driver sleepiness.

This study investigated the effects of two very commonly used countermeasures against driver sleepiness, opening the window and listening to music, on subjective and physiological sleepiness measures during real road driving. In total, 24 individuals participated in the study. Sixteen participants received intermittent 10-min intervals of: (i) open window (2 cm opened); and (ii) listening to music, during both day and night driving on an open motorway. Both subjective sleepiness and physiological sleepiness (blink duration) was estimated to be significantly reduced when subjects listened to music, but the effect was only minor compared with the pronounced effects of night driving and driving duration. Open window had no attenuating effect on either sleepiness measure. No significant long-term effects beyond the actual countermeasure application intervals occurred, as shown by comparison to the control group (n = 8). Thus, despite their popularity, opening the window and listening to music cannot be recommended as sole countermeasures against driver sleepiness.

Effects of the road environment on the development of driver sleepiness in young male drivers.

Latent driver sleepiness may in some cases be masked by for example social interaction, stress and physical activity. This short-term modulation of sleepiness may also result from environmental factors, such as when driving in stimulating environments. The aim of this study is to compare two road environments and investigate how they affect driver sleepiness. Thirty young male drivers participated in a driving simulator experiment where they drove two scenarios: a rural environment with winding roads and low traffic density, and a suburban road with higher traffic density and a more built-up roadside environment. The driving task was essentially the same in both scenarios, i.e. to stay on the road, without much interaction with other road users. A 2 × 2 design, with the conditions rural versus suburban, and daytime (full sleep) versus night-time (sleep deprived), was used. The results show that there were only minor effects of the road environment on subjective and physiological indicators of sleepiness. In contrast, there was an increase in subjective sleepiness, longer blink durations and increased EEG alpha content, both due to time on task and to night-time driving. The two road environments differed both in terms of the demand on driver action and of visual load, and the results indicate that action demand is the more important of the two factors. The notion that driver fatigue should be countered in a more stimulating visual environment such as in the city is thus more likely due to increased task demand rather than to a richer visual scenery. This should be investigated in further studies.

Are professional drivers less sleepy than non-professional drivers?

Objective It is generally believed that professional drivers can manage quite severe fatigue before routine driving performance is affected. In addition, there are results indicating that professional drivers can adapt to prolonged night shifts and may be able to learn to drive without decreased performance under high levels of sleepiness. However, very little research has been conducted to compare professionals and non-professionals when controlling for time driven and time of day. Method The aim of this study was to use a driving simulator to investigate whether professional drivers are more resistant to sleep deprivation than non-professional drivers. Differences in the development of sleepiness (self-reported, physiological and behavioral) during driving was investigated in 11 young professional and 15 non-professional drivers. Results Professional drivers self-reported significantly lower sleepiness while driving a simulator than non-professional drivers. In contradiction, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness. They also drove faster. The reason for the discrepancy in the relation between the different sleepiness indicators for the two groups could be due to more experience to sleepiness among the professional drivers or possibly to the faster speed, which might unconsciously have been used by the professionals to try to counteract sleepiness. Conclusion Professional drivers self-reported significantly lower sleepiness while driving a simulator than non-professional drivers. However, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness, and they drove faster.

An on-road study of sleepiness in split shifts among city bus drivers.

Bus drivers often work irregular hours or split shifts and their work involves high levels of stress. These factors can lead to severe sleepiness and dangerous driving. This study examined how split shift working affects sleepiness and performance during afternoon driving. An experiment was conducted on a real road with a specially equipped regular bus driven by professional bus drivers. The study had a within-subject design and involved 18 professional bus drivers (9 males and 9 females) who drove on two afternoons; one on a day in which they had driven early in the morning (split shift situation) and one on a day when they had been off duty until the test (afternoon shift situation). The hypothesis tested was that split shifts contribute to sleepiness during afternoon, which can increase the safety risks. The overall results supported this hypothesis. In total, five of the 18 drivers reached levels of severe sleepiness (Karolinska Sleepiness Scale ≥8) with an average increase in KSS of 1.94 when driving in the afternoon after working a morning shift compared with being off duty in the morning. This increase corresponded to differences observed between shift workers starting and ending a night shift. The Psychomotor Vigilance Task showed significantly increased response time with split shift working (afternoon: 0.337s; split shift 0.347s), as did the EEG-based Karolinska Drowsiness Score mean/max. Blink duration also increased, although the difference was not significant. One driver fell asleep during the drive. In addition, 12 of the 18 bus drivers reported that in their daily work they have to fight to stay awake while driving at least 2-4 times per month. While there were strong individual differences, the study clearly showed that shift-working bus drivers struggle to stay awake and thus countermeasures are needed in order to guarantee safe driving with split shift schedules.

Factors associated with self-reported driver sleepiness and incidents in city bus drivers.

Driver fatigue has received increased attention during recent years and is now considered to be a major contributor to approximately 15-30% of all crashes. However, little is known about fatigue in city bus drivers. It is hypothesized that city bus drivers suffer from sleepiness, which is due to a combination of working conditions, lack of health and reduced sleep quantity and quality. The overall aim with the current study is to investigate if severe driver sleepiness, as indicated by subjective reports of having to fight sleep while driving, is a problem for city based bus drivers in Sweden and if so, to identify the determinants related to working conditions, health and sleep which contribute towards this. The results indicate that driver sleepiness is a problem for city bus drivers, with 19% having to fight to stay awake while driving the bus 2-3 times each week or more and nearly half experiencing this at least 2-4 times per month. In conclusion, severe sleepiness, as indicated by having to fight sleep during driving, was common among the city bus drivers. Severe sleepiness correlated with fatigue related safety risks, such as near crashes.

The effect of low-frequency road noise on driver sleepiness and performance.

It is a well-known fact today that driver sleepiness is a contributory factor in crashes. Factors considered as sleepiness contributor are mostly related to time of the day, hours being awake and hours slept. Factors contributing to active and passive fatigue are mostly focusing on the level of cognitive load. Less is known what role external factors, e.g. type of road, sound/noise, vibrations etc., have on the ability to stay awake both under conditions of sleepiness and under active or passive fatigue. The aim of this moving base driving simulator study with 19 drivers participating in a random order day and night time, was to evaluate the effect of low-frequency road noise on driver sleepiness and performance, including both long-term and short-term effects. The results support to some extent the hypothesis that road-induced interior vehicle sound affects driving performance and driver sleepiness. Increased low-frequency noise helps to reduce speed during both day- and night time driving, but also contributes to increase the number of lane crossings during night time.

Real driving at night--predicting lane departures from physiological and subjective sleepiness.

Only limited information is available on how driving performance relates to physiological and subjective sleepiness on real roads. This relation was the focus of the present study. 33 volunteers drove for 90 min on a rural road during the afternoon and night in an instrumented car, while electroencephalography and electrooculography and lane departures were recorded continuously and subjective ratings of sleepiness were made every 5 min (Karolinska Sleepiness Scale - KSS). Data was analyzed using Bayesian multilevel modeling. Unintentional LDs increased during night driving, as did KSS and long blink durations(LBD). Lateral position moved to the left . LDs were predicted by self-reported sleepiness and LBDs across time and were significantly higher in individuals with high sleepiness. Removal of intentional LDs, enhanced the KSS/LD relation. It was concluded that LDs, KSS, and LBDs are strongly increased during night driving and that KSS predicts LDs.

Observer rated sleepiness and real road driving: an explorative study.

The aim of the present study was to explore if observer rated sleepiness (ORS) is a feasible method for quantification of driver sleepiness in field studies. Two measures of ORS were used: (1) one for behavioural signs based on facial expression, body gestures and body movements labelled B-ORS, and (2) one based on driving performance e.g. if swerving and other indicators of impaired driving occurs, labelled D-ORS. A limited number of observers sitting in the back of an experimental vehicle on a motorway about 2 hours repeatedly 3 times per day (before lunch, after lunch, at night) observed 24 participant's sleepiness level with help of the two observer scales. At the same time the participant reported subjective sleepiness (KSS), EOG was recorded (for calculation of blink duration) and several driving measure were taken and synchronized with the reporting. Based on mixed model Anova and correlation analysis the result showed that observer ratings of sleepiness based on drivers' impaired performance and behavioural signs are sensitive to extend the general pattern of time awake, circadian phase and time of driving. The detailed analysis of the subjective sleepiness and ORS showed weak correspondence on an individual level. Only 16% of the changes in KSS were predicted by the observer. The correlation between the observer ratings based on performance (D-ORS) and behavioural signs (B-ORS) are high (r = .588), and the B-ORS shows a moderately strong association (r = .360) with blink duration. Both ORS measures show an association (r>0.45) with KSS, whereas the association with driving performance is weak. The results show that the ORS-method detects the expected general variations in sleepy driving in field studies, however, sudden changes in driver sleepiness on a detailed level as 5 minutes is usually not detected; this holds true both when taking into account driving behaviour or driver behavioural signs.

Sleepy driving on the real road and in the simulator--A comparison.

Sleepiness has been identified as one of the most important factors contributing to road crashes. However, almost all work on the detailed changes in behavior and physiology leading up to sleep related crashes has been carried out in driving simulators. It is not clear, however, to what extent simulator results can be generalized to real driving. This study compared real driving with driving in a high fidelity, moving base, driving simulator with respect to driving performance, sleep related physiology (using electroencephalography and electrooculography) and subjective sleepiness during night and day driving for 10 participants. The real road was emulated in the simulator. The results show that the simulator was associated with higher levels of subjective and physiological sleepiness than real driving. However, both for real and simulated driving, the response to night driving appears to be rather similar for subjective sleepiness and sleep physiology. Lateral variability was more responsive to night driving in the simulator, while real driving at night involved a movement to the left in the lane and a reduction of speed, both of which effects were absent in the simulator. It was concluded that the relative validity of simulators is acceptable for many variables, but that in absolute terms simulators cause higher sleepiness levels than real driving. Thus, generalizations from simulators to real driving must be made with great caution.

Effects of d-amphetamine on simulated driving performance before and after sleep deprivation.

RATIONALE: Stimulant drugs are commonly abused and also used to promote wakefulness, yet their effects on driving performance during sleep deprivation have not been thoroughly researched in experimental studies. OBJECTIVES: The aims were to assess the effects on fundamental driving parameters during simulated driving of two doses of d-amphetamine and further to assess the interaction between d-amphetamine and sleep deprivation. METHODS: A double-blind, placebo-controlled experiment including 18 healthy male volunteers was conducted. RESULTS: The participants felt more alert when taking a dose of d-amphetamine than when taking placebo, and the effect was stronger for the higher dose. However, the data did not show any evidence that taking d-amphetamine prevented the subjects from becoming successively sleepier during the night. A significant main effect of the dose was found for three out of the five primary indicators where the lower dose led to improved driving. These indicators were crossing-car reaction time, and coherence and delay from a car-following event. Regarding sleep deprivation, a main effect was found for four of the primary indicators and three of the secondary indicators. The results showed overall impaired driving with respect to standard deviation of lateral position and delay in reaction time when the sleep-deprived conditions were compared to the alert condition. We found no interactions between dose and sleep deprivation for any of the performance indicators. CONCLUSIONS: Our results suggest that administration of d-amphetamine does not compensate for impairment of driving due to fatigue. The positive effects of 10 mg were not further improved or even sustained when increasing the dose to 40 mg.

Measuring driver impairments: sleepiness, distraction, and workload.

Snow was falling heavily when Sarah was driving on a slippery road to her cousin's country cottage. It was dark outside, and the visibility was poor. She had planned to arrive before sunset, but the rental service had made a mistake, and it took hours before she got her rental car at the airport. It was past midnight now, and after a long day of traveling, Sarah was starting to get sleepy. Fortunately, there were only 15 km to go, but her eyelids were starting to feel heavy. To stay awake, she put her favorite CD on, turned up the volume, and started to sing along. This seemed to help a little-good-only 10 km to go. This was when Sarah's phone started ringing, and she awkwardly tried to find the mute button for the car stereo while answering the phone. As she looked up again, she barely caught a glimpse of the red brake lights of the car in front of her as she smashed into it.

The characteristics of sleepiness during real driving at night--a study of driving performance, physiology and subjective experience.

STUDY OBJECTIVES: Most studies of sleepy driving have been carried out in driving simulators. A few studies of real driving are available, but these have used only a few sleepiness indicators. The purpose of the present study was to characterize sleepiness in several indicators during real driving at night, compared with daytime driving. DESIGN: Participants drove 55 km (at 90 km/h) on a 9-m-wide rural highway in southern Sweden. Daytime driving started at 09:00 or 11:00 (2 groups) and night driving at 01:00 or 03:00 (balanced design). SETTING: Instrumented car on a real road in normal traffic. PARTICIPANTS: Eighteen participants drawn from the local driving license register. INTERVENTIONS: Daytime and nighttime drives. MEASUREMENT AND RESULTS: The vehicle was an instrumented car with video monitoring of the edge of the road and recording of the lateral position and speed. Electroencephalography and electrooculography were recorded, together with ratings of sleepiness every 5 minutes. Pronounced effects of night driving were seen for subjective sleepiness, electroencephalographic indicators of sleepiness, blink duration, and speed. Also, time on task showed significant effects for subjective sleepiness, blink duration, lane position, and speed. Sleepiness was highest toward the end of the nighttime drive. Night driving caused a leftward shift in lateral position and a reduction of speed. The latter two findings, as well as the overall pattern of sleepiness indicators, provide new insights into the effects of night driving. CONCLUSION: Night driving is associated with high levels of subjective, electrophysiologic, and behavioral sleepiness.

A laser Doppler system for intracerebral measurements during stereotactic neurosurgery.

A laser Doppler system for intracerebral measurements during stereotactic and functional neurosurgery is presented. The system comprises a laser Doppler perfusion monitor, an optical probe adapted for the Leksell Stereotactic System and a personal computer with software for acquisition, data analysis and presentation. The software makes it possible to present both the perfusion and the total backscattered light intensity (TLI) in real-time. During intracerebral measurements, the perfusion signal records the tissue's microcirculation whereas the TLI signal may be used to distinguish between grey and white matter. Evaluation of the system has been done during stereotactic neurosurgery in relation to implantation of deep brain stimulation electrodes. Measurements were made along trajectories towards targets in the deep brain structure as well as in pre-calculated target areas. The measurements show that the system has a potential to be used for intracerebral guidance but further evaluation of the technique is needed.