Asleep at the wheel: who's at risk?

R Doug McEvoy
Med J Aust 2003; 178 (8): . || doi: 10.5694/j.1326-5377.2003.tb05249.x
Published online: 21 April 2003

Careful assessment of car accident risk in patients with sleep disorders should guide advice

Alcohol and excessive speed, often combined with inexperience and youthfulness, are the most widely recognised causes of motor vehicle accidents (MVAs). There is, however, increasing recognition that fall-asleep MVAs contribute significantly to road accident statistics.1-5 The typical fall-asleep accident involves a sole driver driving at night or in the early afternoon "siesta" period at relatively high speed.1 As with other causes of MVAs, fall-asleep accidents are more common in men under 30 years.1,3,5

  • Adelaide Institute for Sleep Health, Repatriation General Hospital, Daw Park, SA.


  • 1. Pack AI, Pack AM, Rodgman E, et al. Characteristics of crashes attributed to the driver having fallen asleep. Accid Anal Prev 1995; 27: 769-775.
  • 2. McCartt AT, Ribner SA, Pack AI, Hammer MC. The scope and nature of the drowsy driving problem in New York State. Accid Anal Prev 1996; 28: 511-517.
  • 3. Stutts JC, Wilkins JW, Vaughn BV. Why do people have drowsy driving crashes? Washington DC: AAA Foundation for Traffic Safety, 1999. Available at: (accessed Mar 2003).
  • 4. Masa JF, Rubio M, Findley LJ. Habitually sleepy drivers have a high frequency of automobile crashes associated with respiratory disorders during sleep. Am J Respir Crit Care Med 2000; 162: 1407-1412.
  • 5. Connor J, Norton R, Ameratunga S, et al. Driver sleepiness and risk of serious injury to car occupants: population based case control study. BMJ 2002; 324: 1125.
  • 6. Desai AV, Ellis E, Wheatley JR, Grunstein RR. Fatal distraction: a case series of fatal fall-asleep road accidents and their medicolegal outcomes. Med J Aust 2003; 178: 396-399. <MJA full text>
  • 7. Bearpark H, Elliott L, Grunstein R, et al. Snoring and sleep apnea. A population study in Australian men. Am J Respir Crit Care Med 1995; 151: 1459-1465.
  • 8. George CFP, Findley LJ, Hack MA, McEvoy RD. Across country viewpoints on sleepiness during driving. Am J Resp Crit Care Med 2002: 165; 746-749.
  • 9. George CF, Smiley A. Sleep apnea and automobile crashes. Sleep 1999; 22: 790-795.
  • 10. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991; 14: 540-545.
  • 11. Assessing fitness to drive: guidelines and standards for health professionals in Australia. Sydney: Austroads Inc, 2001.
  • 12. Medical examinations of commercial vehicle drivers. Melbourne: National Road Transport Commission and Federal Office of Road Safety, 1997.


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