https://web.ics.purdue.edu/~duffy/IE486_Spr07/IE486_p14_Accid%20Anal%20Prv.pdf

Monotony of road environment and driver fatigue: a simulator study.

ContextSomnolence is a recognized adverse effect of dopamine agonists. Two
new dopamine agonists, pramipexole and ropinirole, have been reported to cause
sudden-onset sleep spells in patients with Parkinson disease (PD) while they
were driving. The frequency of these spells and whether driving should be
restricted has yet to be established.ObjectiveTo determine the frequency of and predictors for sudden-onset sleep
and, particularly, episodes of falling asleep while driving among patients
with PD.Design, Setting, and ParticipantsProspective survey conducted between January and April 2000 in 18 clinics
directed by members of the Canadian Movement Disorders Group; 638 consecutive
highly functional PD patients without dementia were enrolled, of whom 420
were currently drivers.Main Outcome MeasuresExcessive daytime sleepiness and sudden-onset sleep as assessed by the
Epworth Sleepiness Scale and the Inappropriate Sleep Composite Score. The
latter score, designed for this study, addressed falling asleep in unusual
circumstances. The 2 scales were combined in 3 separate formats: dozing off,
sudden unexpected sleep, and sudden blank spells.ResultsExcessive daytime sleepiness was present overall in 327 (51%) of the
638 patients and in 213 (51%) of the 420 drivers. Patients taking a variety
of different dopamine agonists had no differences in Epworth sleepiness scores,
in the composite score, or in the risk of falling asleep while driving. Sixteen
patients (3.8%) had experienced at least 1 episode of sudden onset of sleep
while driving (after the diagnosis of PD); in 3 (0.7%), it occurred without
warning. The 2 risk factors associated with falling asleep at the wheel were
the Epworth Sleepiness Scale score (odds ratio [OR], 1.14; 95% confidence
interval [CI], 1.06-1.24) and the Inappropriate Sleep Composite Score (OR,
2.54; 95% CI, 1.76-3.66). A standard Epworth Sleepiness Scale score of 7 or
higher predicted 75% of episodes of sleep behind the wheel at a specificity
of 50% (exclusion of the question related to driving provided 70% sensitivity
and 52% specificity), whereas a score of 1 on the Inappropriate Sleep Composite
Score generated a sensitivity of 52% and specificity of 82%.ConclusionsExcessive daytime sleepiness is common even in patients with PD who
are independent and do not have dementia. Sudden-onset sleep without warning
is infrequent. The Epworth score has adequate sensitivity for predicting prior
episodes of falling asleep while driving and its specificity can be increased
by use of the Inappropriate Sleep Composite Score. It is unknown if routinely
performing these assessments could be more effective in predicting future
risk for these rare sleep attacks. Patients should be warned not to drive
if they doze in unusual circumstances.

https://jamanetwork.com/journals/jama/articlepdf/194590/JOC10367.pdf

Excessive daytime sleepiness and sudden-onset sleep in Parkinson disease: a survey by the Canadian Movement Disorders Group.

We present a review of the studies that have been published about addiction to cell phones. We analyse the concept of cell phone addiction as well as its prevalence, study methodologies, psychological features and associated psychiatric comorbidities. Research in this field has generally evolved from a global view of the cell phone as a device to its analysis via applications and contents. The diversity of criteria and methodological approaches that have been used is notable, as is a certain lack of conceptual delimitation that has resulted in a broad spread of prevalent data. There is a consensus about the existence of cell phone addiction, but the delimitation and criteria used by various researchers vary. Cell phone addiction shows a distinct user profile that differentiates it from Internet addiction. Without evidence pointing to the influence of cultural level and socioeconomic status, the pattern of abuse is greatest among young people, primarily females. Intercultural and geographical differences have not been sufficiently studied. The problematic use of cell phones has been associated with personality variables such as extraversion, neuroticism, self-esteem, impulsivity, self-identity and self-image. Similarly, sleep disturbance, anxiety, stress, and, to a lesser extent, depression, which are also associated with Internet abuse, have been associated with problematic cell phone use. In addition, the present review reveals the coexistence relationship between problematic cell phone use and substance use such as tobacco and alcohol.

/pdf/cell-phone-addiction-a-review-3idlst8zf5.pdf

Cell-Phone Addiction: A Review

Objective:To review structural interventions in public health, identify distinct approaches to structural interventions, and assess their implications for HIV-prevention interventions.Method:The MEDLINE, HealthStar, PsychInfo and Sociofile databases were searched on specific health issues, types of

Structural interventions in public health.

Standardized diagnostic criteria determined by the International Restless Legs Syndrome Study Group were used to investigate the current prevalence of restless legs syndrome (RLS). Possible associations between RLS and neuropsychiatric and somatic complaints were also investigated. A random sample of 4,000 men living in central Sweden were sent a questionnaire that included questions about sleep habits, symptoms of sleepiness, and somatic and neuropsychiatric complaints. Four symptom questions accepted as minimal diagnostic criteria for RLS were also included. Odds (OR) ratios and 95% confidence interval (CI) for different variables were calculated by means of multivariate logistic regression; 5.8% of the men suffered from RLS. The prevalence of RLS increased with age. Sleep-related complaints were more frequent among the RLS sufferers. Complaints of headache at awakening and daytime headache were reported three to five times more frequently among RLS sufferers and there was a tendency toward reported social isolation related to RLS. Subjects with RLS more frequently reported depressed mood (OR, 2.6; 95% CI, 1.8–3.8), and complained more often of reduced libido (OR, 2.2; 95% CI, 1.4–3.3). RLS sufferers more frequently reported hypertension (OR, 1.5; 95% CI, 0.9–2.4) and heart problems (OR, 2.5; 95% CI, 1.4–4.3). Results show that restless legs syndrome is common among men. It is hypothesized that RLS may be associated with several somatic and neuropsychiatric symptoms. © 2001 Movement Disorder Society.

Prevalence of restless legs syndrome among men aged 18 to 64 years: An association with somatic disease and neuropsychiatric symptoms

Road accidents caused by drivers falling asleep

Hazard perception and driving experience among novice drivers.

An investigation of behavioural adaptation to airbags and antilock brakes among taxi drivers

Effects of route guidance Variable Message Signs (VMS) on speed and route choice were investigated in a field study on two sites on motorways. Two VMS were used in the study, which displayed information about a closed road section downstream on the motorways and recommendations for alternative routes. Route choice, speed and braking behaviour were compared between vehicles approaching the VMS while they displayed messages and while they were left blank without message. There was high compliance with the messages on the VMS. About every fifth vehicle changed route choice according to the recommendation, and almost none drove as far as the closed road section. Speed measurements of 3342 vehicles showed large speed reductions, and video observations showed that large proportions of vehicles braked while approaching the VMS. The speed reductions and braking manoeuvres can partly be attributed to attention overload or distraction due to the information on the VMS. However, a proportion of the speed reductions was due to chain reactions where one vehicle braked and forced the following vehicles to brake or change lanes in order to avoid collisions. Safety problems may result directly from distraction, or indirectly from the reactions of the drivers to the distraction.

Fridulv Sagberg

Papers

Road accidents caused by drivers falling asleep

Hazard perception and driving experience among novice drivers.

An investigation of behavioural adaptation to airbags and antilock brakes among taxi drivers

Effects of route guidance variable message signs (VMS) on driver behaviour

Driver health and crash involvement: A case-control study