0743 Race, Ethnicity, and Risk Factors Associated With Falling Asleep While Driving

Abstract

Abstract Drowsy driving is a significant cause of traffic accidents and fatalities. While previous reports have shown an association between race and drowsy driving, the reasons for this disparity remain unclear. We hypothesized that differences in economic barriers to healthcare, alcohol consumption, risk-taking behaviors, or sleep characteristics would explain the disparity. We undertook cross-sectional analysis of 193,776 white, black, and Hispanic adults participating in the U.S. Behavioral Risk Factor Surveillance Study from 2009-2012 who answered a question about drowsy driving. Drowsy driving was defined as self-reporting falling asleep while driving within the past 30 days. All analyses were adjusted for age, sex, body mass index, coronary artery disease, diabetes, smoking, and mental health morbidity. Multivariable logistic modeling evaluated the impact of differences in healthcare access, alcohol consumption, risk-taking behaviors, and sleep quality on the race - drowsy driving relationship. Sleep quality was assessed by: frequency of daytime somnolence, frequency of insufficient sleep, sleep duration, and snoring. After adjusting for age, sex, and comorbidities, the odds ratio (OR) for drowsy driving was 2.07 (95% CI [1.69-2.53]) in blacks and 1.80 (95% CI [1.51-2.15]) in Hispanics, relative to whites. Accounting for sleep quality differences resulted in a modest reduction in the OR for drowsy driving in blacks (OR=1.55, 95% CI [1.27-1.89]) but not Hispanics (OR = 1.74, 95% CI [1.45-2.08]). Accounting for healthcare access, alcohol use, and risk-taking behaviors had little effect; in fully adjusted analysis, the OR for drowsy driving was not significantly changed at 1.57 (95% CI [1.28-1.91]) in blacks and 1.73 (95% CI [1.44-2.09]) in Hispanics, relative to whites. U.S. blacks and Hispanics have approximately twice the risk of drowsy driving compared to whites. Differences in sleep quality explained some of this disparity in blacks but not in Hispanics. After adjustment for all covariates, blacks and Hispanics had an over 50% greater risk of falling asleep while driving compared to whites. Further research to understand the root causes of these disparities is needed. This work was supported by NIH T32HL083825 and K24HL127307.