Effects of acute or cumulative 8-hour sleep loss on simulated driving in a naturalistic, monotonous night-time setting: a randomized, controlled, crossover trial

Lakämper, Stefan; Scholz, Michael; Kraemer, Thomas; Landolt, Hans-Peter; Keller, Kristina · 2026 · Crossref

DOI: 10.64898/2026.01.08.26343648

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Summary

This study investigates the differential effects of acute versus cumulative sleep loss on simulated driving performance, addressing a gap in understanding how equivalent amounts of sleep deprivation impact vehicle control. While sleep loss is a major contributor to traffic accidents, previous research has often examined acute and cumulative sleep loss in isolation, making direct comparisons difficult. The authors aimed to determine whether an 8-hour sleep deficit incurred acutely (one night of total deprivation) or cumulatively (four nights of 2-hour restriction) produces comparable impairments in driving-relevant performance domains under naturalistic conditions. The researchers conducted a randomized, controlled, crossover trial with 17 healthy male participants. Each participant underwent three conditions: normal sleep, cumulative sleep restriction, and acute total sleep deprivation, all resulting in an equivalent 8-hour total sleep loss. Following each sleep condition, participants completed a 22-minute simulated nighttime-to-early-morning driving protocol using a high-fidelity simulator. The task included monotonous car-following scenarios with a concurrent tone-based vigilance task, followed by open driving in foggy conditions. Performance was assessed using metrics for lateral control (standard deviation of lateral position, inappropriate line crossings), longitudinal control (distance to lead vehicle), speed variability, steering stability, and vigilance (reaction time and sensitivity). Data were analyzed using linear mixed-effects models to evaluate condition effects and time-on-task dynamics. The results revealed distinct impairment patterns between the two sleep-loss modes. Acute total sleep deprivation caused pronounced and rapid deterioration in vehicle control, particularly in lateral stability. Metrics such as the standard deviation of lateral position and steering wheel reversals showed significant worsening under acute deprivation compared to both normal sleep and cumulative restriction, with effect sizes comparable to high blood alcohol concentrations. In contrast, cumulative sleep restriction resulted in smaller, less consistent changes in driving performance, with no statistically significant difference from normal sleep in overall integrated driving scores. While subjective sleepiness increased significantly in both sleep-loss conditions, with acute deprivation eliciting higher ratings, vigilance task performance and speed variability remained relatively preserved across all conditions. Time-on-task analysis indicated that lateral control degradation accelerated significantly during the drive only under acute sleep deprivation. These findings demonstrate that acute and cumulative sleep loss have fundamentally different consequences for driving safety, despite producing similar total sleep deficits and subjective feelings of sleepiness. Acute sleep deprivation uniquely and rapidly disrupts operational vehicle control, posing a disproportionate risk to safety. The study challenges assumptions that rely solely on subjective sleepiness or total sleep debt to assess fitness to drive. It highlights the necessity of distinguishing between sleep-loss patterns in traffic medicine and safety regulations, suggesting that acute deprivation requires more stringent risk mitigation than cumulative restriction.

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Summary generated by qwen3.6-27b-nvidia on 2026-08-10; verification: verified_with_issues.

Topics

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• sleep deprivation
• time on task
• drowsiness
• vigilance
• circadian factors
• drowsiness detection algorithms

Information type

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• Empirical Findings: physiological data, behavioral performance data
• Theoretical Contribution: computational model