Earlier school start time can mean more car crashes

Start changing your child's sleep schedule back to school time. - JR

Teens with an earlier school start time get into more car crashes which can indicate these teens are sleep deprived due to the earlier school start time.

A new study suggests that teen drivers who start class earlier in the morning are involved in significantly more motor vehicle accidents than peers with a later high school start time. The results underscore the importance of the "Awake at the Wheel" campaign of the National Healthy Sleep Awareness Project.

Results show that the weekday crash rate for teen drivers during the 2009 to 2010 school year was about 29 percent higher in Chesterfield County, Va., where high school classes began at 7:20 a.m., than in adjacent Henrico County, Va., where classes started at 8:45 a.m. Similar results were found for the 2010 to 2011 school year, when the weekday crash rate for 16-17 year old teens in Chesterfield County was about 27 percent higher than for those in Henrico County. In contrast, there was no difference in adult crash rates in the two counties for either year. A secondary analysis evaluating the causes and types of crashes found that Chesterfield County adolescents had a significantly higher rate of run-off-road crashes, which is a common feature of drowsy driving accidents.

"There are more and more data suggesting that insufficient sleep is common in our teens and that early high school start times are a contributor to teens' reduced sleep," said principal investigator and lead author Dr. Robert Vorona, associate professor in the Division of Sleep Medicine at Eastern Virginia Medical School in Norfolk, Va. "Insufficient sleep appears to have deleterious consequences such as decrements in mood and increased risk taking, impaired academics and increased crash rates."

The results corroborate the findings of a previous study by Vorona's team that evaluated teen crash rates from 2007 to 2008. Results of the current study are published in the November issue of the Journal of Clinical Sleep Medicine.

"When high school classes begin early in the morning, we ask teens to shine when their biological clock tells them to sleep," said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler, a national spokesperson for the Healthy Sleep Project. "Many do not get adequate sleep as a result. Smarter school start times, that are more consistent with sleep needs, will improve students' safety, overall health, mood and academic performance."

Recently the Healthy Sleep Project launched the "Awake at the Wheel" campaign to increase public awareness of the risks of drowsy driving. More details are available athttp://www.projecthealthysleep.org.

The study involved an analysis of data provided by the Virginia Department of Motor Vehicles. During both school years there were more than 520 motor vehicle accidents involving teen drivers in Chesterfield County and more than 320 teen crashes in Henrico County.

The American Academy of Sleep Medicine recommends that adolescents get a little more than nine hours of nightly sleep for optimal health and daytime alertness during the critical transition from childhood to adulthood. The AASM advises parents and local school boards to work together to implement high school start times that allow teens to get the healthy sleep they need to meet their full potential.

A new report from the AAA Foundation for Traffic Safety estimates that drowsy driving may cause 328,000 motor vehicle accidents and 6,400 fatal crashes on U.S. roads each year. Previous data analysis by AAA also shows that the prevalence of drowsy driving crashes is highest among drivers between the ages of 16 and 24 years.

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Insomnia raises risk of fatal injury

Having insomnia can raise a person's risk of death by motor vehicle and other fatal injuries.

New research suggests that insomnia is a major contributor to deaths caused by motor vehicle crashes and other unintentional fatal injuries. The results underscore the importance of the "Sleep Well, Be Well" campaign of the National Healthy Sleep Awareness Project.

Results show that the risk of unintentional fatal injury increased in a dose-dependent manner with the number of insomnia symptoms present. People with all three symptoms of insomnia were 2.8 times more likely to die from a fatal injury than those with no insomnia symptoms, even after adjusting for potential confounders such as alcohol consumption and daily use of sleep medication.

Among the three insomnia symptoms, difficulty falling asleep appeared to have the strongest and most robust association with fatal injuries. People who almost always had difficulty falling asleep were more than two times more likely to die from a motor vehicle injury (hazard ratio = 2.40) and more than 1.5 times more likely to die from any fatal injury (HR = 1.66) than people who never had trouble initiating sleep. Further analysis found that self-reported difficulty falling asleep contributed to 34 percent of motor vehicle deaths and eight percent of all unintentional fatal injuries, which could have been prevented in the absence of insomnia.

"Our results suggest that a large proportion of unintentional fatal injuries and fatal motor vehicle injuries could have been prevented in the absence of insomnia," said lead author Lars Laugsand, MD, PhD, postdoctoral fellow in the department of public health at the Norwegian University of Science in Technology in Trondheim, Norway. "Increasing public health awareness about insomnia and identifying and treating people with insomnia may be important in preventing unintentional fatal injuries."

The study results are published in the November issue of the journal Sleep.

"Healthy sleep is essential for physical health, mental well-being, and personal and public safety," said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler, a national spokesperson for the Healthy Sleep Project. "Sleep is a necessity, not a luxury, and the promotion of healthy sleep should be a fundamental public health priority."

Earlier this year the Healthy Sleep Project launched the "Sleep Well, Be Well" campaign to increase awareness of the importance of sleep as one of the three pillars of a healthy lifestyle. More details are available at http://www.projecthealthysleep.org.

The study involved that analysis of population-based survey data from 54,399 men and women between 20 and 89 years of age. Cause of death was identified using a national registry. During the 13-year follow-up period there were 277 unintentional fatal injuries, including 169 deaths from falls and 57 deaths from motor vehicle crashes.

According to the Centers for Disease Control and Prevention, there are more than 126,000 unintentional injury deaths in the U.S. each year, making it the fifth leading cause of death. There are more than 33,000 motor vehicle traffic fatalities and more than 27,000 unintentional fall deaths annually, as well as 29.3 million emergency department visits related to unintentional injuries.

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Causes of childhood concussion in rural versus urban areas

A study of causes of childhood concussions in rural versus urban areas shows that children living in rural areas get concussions from motorized vehicles and children living in urban areas get concussions from sports.

Researchers at Western University (London, Canada) have found youth living in rural areas are more likely to sustain concussions from injuries involving motorized vehicles such as all-terrain vehicles and dirt bikes, whereas youth living in urban areas suffer concussions mostly as a result of sports. Hockey accounts for 40 per cent of those injuries. The study which reveals where and how children are receiving concussions is published in the Journal of Trauma and Acute Care Surgery.

Dr. Doug Fraser, a scientist with the Children's Health Research Institute at Lawson Health Research Institute and Tanya Charyk Stewart, the Injury Epidemiologist for the Trauma Program at Children's Hospital, London Health Sciences Centre (LHSC) and their team tracked all the youth under the age of 18 who presented to the LHSC emergency departments with a concussion over a six year period. There were 2,112 paediatric concussions, with a steady increase in number treated each year.

"It was important for us to learn about who is getting injured, where they're getting injured, and why they're getting injured. Once you answer those questions, then you can implement targeted injury prevention programs," says Dr. Fraser, an associate professor in the Departments of Paediatrics, Physiology & Pharmacology and Clinical Neurological Sciences at Western's Schulich School of Medicine & Dentistry.

Concussions are a particular concern for children and adolescents because their brains are still developing and they are more susceptible to effects of a head injury. The goal following this research is to create injury prevention programs that target and educate those at high risk of sustaining a concussion.

Concussions can often be predictable. Along with properly following the rules of the sport and wearing the protective equipment, Charyk Stewart suggests, "In sports, if you have been hit, then just get off the field immediately and stop play. If you are experiencing any symptoms, be seen by a doctor."

Dr. Fraser explained what to look for in a child who has experienced a head injury, "Watch the person carefully. In young children look for symptoms like, irritability or an inability to console the child. If the care giver has any concerns at all; if a person has any symptoms whatsoever in conjunction with an injury, they should immediately go and be seen by a doctor. Better safe than sorry, so be seen."

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