Association between the risk of aberrant driving behavior and sleep disorder indices: A pilot study involving urban taxi drivers

Aberrant driving behaviors (ADBs) may degrade road safety and pose significant dangers to both drivers and the public. Taxi drivers, who regularly work in complex urban environments for extended periods, are at a higher risk of ADBs. While many studies have focused on the development of ADBs, limited research has examined impacts of sleep-related factors. In this study, we investigated associations between the occurrence of ADBs and sleep-disordered indices. Thirty-one taxi drivers were recruited and monitored over four consecutive days and nights, with daytime driving behaviors tracked after nighttime sleep was assessed. The severity of obstructive sleep apnea (OSA) was measured using the apnea-hypopnea index (AHI) through hospital-based polysomnography, while sleep-disordered indices were recorded at home using wearable devices. Driving behavioral data were collected via navigation software. Statistical regression models were used to explore relationships between ADBs and sleep-disordered indices. Key findings include that drivers with severe OSA exhibited significantly higher ADB event frequencies per kilometer compared to those without severe OSA. Home-based sleep-disordered indices, such as higher cyclic variation of the heart rate index (CVHRI) and chest effort index (CEI), were significantly associated with an increased frequency of ADB events the following day, with respective beta coefficients of 0.062 and 0.111. These associations remained significant after adjusting for potential confounders. Our findings suggest a strong link between sleep-disordered indices and the occurrence of ADBs among taxi drivers, emphasizing the importance of addressing sleep health to reduce ADB risks.