The Interactive Effects of Extended Wakefulness and Low-dose Alcohol on Simulated Driving and Vigilance

Howard, Mark E.; Jackson, Melinda L.; Kennedy, Gerard A.; Swann, Philip; Barnes, Maree; Pierce, Robert J. · 2007 · OpenAlex-citations

DOI: 10.1093/sleep/30.10.1334

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Summary

This study investigated the interactive effects of extended wakefulness and low-dose alcohol on simulated driving performance and vigilance. While sleep deprivation and alcohol individually impair driving, their combined impact in real-world scenarios—particularly during early morning hours when both factors often coexist—was not fully understood. The research aimed to determine if the combination of legal low-dose alcohol and extended wakefulness results in impairment worse than that associated with illegal alcohol levels in a rested state, thereby increasing crash risk. The study employed a repeated-measures, crossover design involving 19 volunteer professional drivers. Participants underwent two sessions: one with alcohol administration and one without. Performance was assessed in a rested state (12–15 hours awake) and after extended wakefulness (18–21 hours awake). Alcohol was administered to achieve blood alcohol concentrations (BAC) of 0.03% and 0.05% in the rested state, and 0.03% during extended wakefulness. Measurements included the Psychomotor Vigilance Task (PVT) for reaction time and lapses, and the AusEd™ driving simulator for lane position and speed variation. Data from 16 drivers were analyzed after three participants withdrew due to adverse reactions. Results demonstrated significant deleterious effects when extended wakefulness was combined with low-dose alcohol (0.03% BAC). This combination led to more PVT lapses and greater variation in lane position and speed compared to a BAC of 0.05% in a rested state. Specifically, drivers showed significantly more lapses (t = -2.75, P < 0.05) and greater lane position variation (t = -3.94, P < 0.01) under the combined condition than under the higher alcohol condition alone. Additionally, median reaction times during extended wakefulness with 0.03% BAC were similar to those observed at illegal BAC levels (>0.05%) in rested states. The study found that while extended wakefulness alone had limited effects on some driving metrics, the addition of low-dose alcohol significantly exacerbated performance deficits, particularly in steering control and speed maintenance. The findings indicate that the combination of legal low-dose alcohol and extended wakefulness impairs driving performance to a degree comparable to or worse than illegal alcohol levels in rested individuals. This suggests that the synergistic effect of these factors significantly increases accident risk, a danger that is often unrecognized because both conditions are individually legal or socially accepted. The authors conclude that avoiding alcohol consumption when driving after extended wakefulness may reduce accident risk, highlighting the need for greater public awareness regarding the compounded dangers of fatigue and alcohol.

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Topics

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• sleep deprivation
• drowsy as impairment
• alcohol
• polydrug
• drowsiness
• vigilance