Medical risk factors amongst drivers in single-car accidents.

OBJECTIVES: To estimate medical risk factors amongst drivers in single-car accidents with special reference to sleepiness and alcohol abuse. DESIGN: An epidemiological survey by means of multiple-choice questionnaires that were mailed to drivers and a random control group. SETTING: Iceland. SUBJECTS: All drivers in single-car accidents (n = 471) during 1989-91 and a control group from the general population (n = 1000). MAIN OUTCOME MEASURE: Medical health profile and answers to questions concerning sleep disorders and alcohol abuse. RESULTS: Compared to the controls the drivers were younger and there were three times more males. The drivers abused alcohol more often. Chronic disorders such as epilepsy, diabetes mellitus, and cardiac disorders were not over-represented. Altogether, 15.4% claimed that sleepiness had caused their traffic accident, logistic regression analyses revealed that these 'sleepy' drivers more often had alcohol abuse and a history of 'almost falling a sleep whilst driving'. CONCLUSIONS: Compared to controls, drivers in single-car accidents are more likely to be young, male, have a history of sleepiness whilst driving, and also have a history suggestive of alcoholism. Chronic disorders like epilepsy and diabetes mellitus were not over-represented amongst the single-car accidents drivers. These results raise the question of how drivers with a high probability of causing an accident (sleepiness and alcoholism) can be identified in time and proper measures taken to prevent 'accidents waiting to happen'.

Sleep habits and sleep disturbances among the elderly--an epidemiological survey.

OBJECTIVES: To analyse simultaneously sleep habits and sleep disturbances in an elderly population and numerous factors possibly affecting sleep at the same time. DESIGN: A cross-sectional epidemiological survey by means of questionnaires. SETTING: The capital city of Iceland, Reykjavík and surrounding suburbs. PARTICIPANTS: A randomly selected, but stratified sample with 100 men and 100 women in each 5-year age group of the ages 65-84 years--800 individuals altogether. MAIN OUTCOME MEASURE: Sleep habits and sleep disturbances. RESULTS: The mean duration of sleep was 7.25 h (SD 74 min). Mean sleep onset time was 00.13 hours and was not related to age and gender but was delayed at weekends. Daytime napping was reported by 50% of the men and 31% of the women (P < 0.001). Difficulty maintaining sleep (DMS) was the most commonly reported insomnia complaint (men 37% and women 30%). Sleep charts revealed that men woke up an average of 1.2 times per night but women 0.8 times per night (P < 0.01). Difficulty initiating sleep was reported by 9.6% and early morning awakening (EMA) by 16.7%. Pain was a strong factor contributing to EMA. There was also an increase in EMA complaints among the elderly with obstructive pulmonary diseases and systemic hypertension. The prevelance of insomnia was only partly related to age and gender. Multiple regression analyses, however, showed different interrelationships between insomnia and other symptoms and findings for men versus women. CONCLUSION: DMS is the most commonly reported insomnia complaint among the elderly (men 37% and women 30%). The prevalence of insomnia did not increase with age in our study group.