Prolonged Eyelid Closure Episodes during Sleep Deprivation in Professional Drivers

Abstract

Study Objectives: Real life ocular measures of drowsiness use average blink duration, amplitude and velocity of eyelid movements to reflect drowsiness in drivers. However, averaged data may conceal the variability in duration of eyelid closure episodes, and more prolonged episodes that indicate higher levels of drowsiness. The current study aimed to describe the frequency and duration of prolonged eyelid closure episodes during acute sleep deprivation. Methods: Twenty male professional drivers (mean age ± standard deviation = 41.9 ± 8.3 years) were recruited from the Transport Workers Union newsletter and newspaper advertisements in Melbourne, Australia. Each participant underwent 24 hours of sleep deprivation and completed a simulated driving task (AusEd), the Psychomotor Vigilance Task, and the Karolinska Sleepiness Scale. Eyelid closure episodes during the driving task were recorded and analyzed manually from digital video recordings. Results: Eyelid closure episodes increased in frequency and duration with a median of zero s/h of eyelid closure after 3 h increasing to 34 s/h after 23 h awake. Eyelid closure episodes were short and infrequent from 3 to 14 h of wakefulness. After 17 h of sleep deprivation, longer and more frequent eyelid closure episodes began to occur. Episodes lasting from 7 seconds up to 18 seconds developed after 20 h of wakefulness. Length of eyelid closure episodes was moderately to highly correlated with the standard deviation of lateral lane position, braking reaction time, crashes, impaired vigilance, and subjective sleepiness. Conclusions:The frequency and duration of episodes of prolonged eyelid closure increases during acute sleep deprivation, with very prolonged episodes after 17 hours awake. Automated devices that assess drowsiness using averaged measures of eyelid closure episodes need to be able to detect prolonged eyelid closure episodes that occur during more severe sleep deprivation. Keywords: drowsiness, sleepiness, eyelid closure episodes, professional drivers, averaged data, automated devices Citation: Alvaro PK, Jackson ML, Berlowitz DJ, Swann P, Howard ME. Prolonged eyelid closure episodes during sleep deprivation in professional drivers. I NTRO DUCTI O NSleep deprivation and resultant drowsiness are common causes of impaired performance and motor vehicle accidents (MVA) in both the general population and professional drivers.1,2 A lack of real-time drowsiness measures has hampered efforts to develop and assess interventions for sleep deprivation. Objective measures of real-time drowsiness that accurately identify sleepy individuals before and during driving events can potentially prevent MVAs by alerting the driver to significant drowsiness levels and in turn suggest the use of countermeasures, such as a nap or caffeine. They would also provide an opportunity to evaluate the impact of different driving schedules, identifying high risk schedules that result in drowsy driving and assisting with the design of safer work schedules.Slow, prolonged eyelid closure is associa...

One Neglected Yawning Function like Slow Wave Sleep: The Hypothetic Neurovascular Regulation from Mouth to Eye Driven by Expiration

“…For evidence, on the one hand, it is common knowledge that the sleep need close the eyelids. It has been demonstrated that the closure or tiredness of eyelids manifest the extent of drowsiness and sleepiness [45] [46]. On the other hand, the expiration in SWS can really regulate the vascular circulation in eyes.…”

Classification of three forms of regulations on emotional/autonomic nervous system by slow wave sleep

“…In the induction or initiation of SWS, this decrease in ratio of inspiratory/expiratory pressure of air against the sensory posterior palate and maxillary sinuses can be relayed in head up to the vascular circulation in eye (Cai, 2018a), necessary for eye closure in SWS. For evidence, on the one hand, it has been demonstrated that the closure or tiredness of eyelids manifests the extent of drowsiness and sleepiness (Alvaro, Jackson, Berlowitz, Swann & Howard, 2016;Filtness et al, 2014). On the other hand, the inspiration/expiration in SWS can really regulate the vascular circulation in eyes, as it has been demonstrated that many vascular diseases of eyes are associated with the obstructive sleep apnea, such as the glaucoma, retinal vein occlusion, nonarteritic anterior ischemic opt ic neuropathy, cent ral serou s chorioretinopathy, floppy eyelid syndrome and so on (Huon, Liu, Camacho & Guilleminault, 2016;Skorin & Knutson, 2016).…”

Eye-Blink Parameters Detect On-Road Track-Driving Impairment Following Severe Sleep Deprivation

“…In laboratory-based experiments, drowsiness has been observed as slower eye and eyelid movements, 45 especially longer blink durations [46][47][48][49] and episodes of prolonged eyelid closure that can last for more than 10 seconds. 47,50 Drowsiness has reduced the amplitude and velocity of eyelid closure and reopening, 15,46,47 resulting in increased proportion of time with eyes closed. 15,47,51 The slower eyelid movements and longer eyelid closure times are attributed to more relaxed face and eyelid muscles after sleep loss due to reduced inputs to the motor projections to the face and eyelids.…”

“…15 In addition, pupillary activity 54,55 and saccadic velocity (ballistic eye movements) have been impaired by extended awake time (sleep deprivation) 55 that could further affect undesirable driving outcomes such as crash frequency. 54,55 Although eye-blink parameters have been clearly described in the laboratory setting, 15,[45][46][47][48][49][50][51][52][53] few studies have evaluated oculomotor changes during naturalistic drives or identified those ocular parameters that best identify drowsiness-related driving impairments. Lee et al 17 evaluated driving performance and ocular parameters in shift workers during daytime track driving following a night shift compared to a well-rested night.…”