I’ve previously mentioned that driving when sleep deprived is like driving drunk, but are sleep-deprived mothers at higher risk of road crashes?
Let’s look at what a recent Australian study (1) found when they looked at driving behaviour in mothers with infants who didn’t sleep well. This study (first published on the 30th October 2023) tested whether mothers with poor-sleeping infants were more at risk for vehicle crashes than mothers of well-sleeping infants, and women with no children.
While it is known that infant sleep problems are associated with numerous adverse child and parent outcomes, this is one of the first studies that investigated how sleep-deprived mothers cope (or not) on the road. In this article we’ll look at what they considered “sleep deprived” (my terminology, not theirs), and how it was measured.
Why is this important?
It is estimated that 15 – 30% of babies experience “considerable and persistent difficulties initiating and maintaining sleep, prolonged nighttime wakefulness, or dependence on external regulation for sleep onset.” (2) If you’re a parent of one of these children, you know how the sleep deprivation can affect you. But do you know how it affects your baby?
Research shows that left untreated, sleep problems can cause physical health issues for the baby, along with cognitive, motor, emotional, behavioural and social functioning issues (3).
Babies need way more sleep than adults. And it needs to be quality sleep.
However, the sleep problems aren’t limited to the baby. Poor sleep also affects parents or caregivers. If your baby isn’t sleeping well, chances are no one in the household is getting the sleep the need.
Past studies have shown that poor sleep causes parental depression, anxiety, stress, poor physical health, and reduced quality of life (4). Yet not much research has focused on “infant insomnia on parents’ ability to safely perform “next-day” applied tasks, such as driving a motor vehicle.” Until now.
It’s not a new concept
Driving while sleep deprived is not a new concept. We know it poses a serious road safety risk. However, most research examines the effects of drowsy driving on certain at-risk populations: individuals with sleep disorders like obstructive sleep apnea, narcolepsy (5); or night-shift-workers. (6)
But what about Mothers who have infants who don’t sleep well?
What do we mean by “infants who don’t sleep well”? The term this study used is “infants with insomnia”. I’ve just broken it down into layman’s terms for ease of reading.
Wondering if you’re in the potential risk group?
Mothers were included in the “sleep-deprived” group if their infant was aged 6 to 23 months, took more than 30-minutes to fall asleep, woke after less than 30 minutes of sleep, or had more than 2 wakes per night on average. These sleep issues were not otherwise explained by any infant, developmental, environmental or medical, condition.
Plus, the sleep issues needed to be self-perceived as causing distress or impairment to the mother.
Can you relate to these Mums? Maybe you have an infant like this?
Infant Insomnia is real!
Of interest, these “sleep deprived mothers” were included as their babies met the international classification of sleep disorders-third edition (ICSD-3) for infant insomnia.
Yes, the criteria above (longer time to fall asleep, short sleep time and more than 2 wakes per night) is considered an infant sleep disorder by the American Academy of Sleep Medicine. I’ll just leave you there to ponder that a moment…
Would your baby be considered an “infant with insomnia”?
More methodology
If you were interested, the non-clinical control group included mothers of infants aged 6–23 months who reportedly slept well and did not meet the criteria described above. Whereas the childless control group included women who did not have any children.
All women in the study were aged between 21 and 40 years old, held a valid driver’s licence, and were NOT employed as night shift workers.
Women from these three groups completed a 25-minute simulated driving test and self-reported on their driving behaviour. They did this using a Driving Behaviour Questionnaire, and reported on sleep, sleepiness and insomnia symptoms using 7-day sleep diaries and questionnaires.
Of note, this is the first study where women actually “drove”, albeit in a simulator.
What did the results show?
More swerving
Study results showed that the mothers of infants with insomnia demonstrated greater lane deviation (i.e. swerving within a lane) than the other two groups. The researchers report that this increased tendency to swerve or drift can elevate the chances of collisions with other vehicles or roadside objects.
Moreover, the magnitude of deviation observed in the sleep-deprived group was similar to that documented in drivers with a blood alcohol level of 0.08% and 0.11% compared with sober drivers. (8) The researchers state that “not only did mothers of infants with insomnia perform significantly worse than controls in terms of lateral vehicular control, but they also performed at a level that exceeds legal [drunk driving] limits in most western countries.”
Higher speeds
The sleep deprived mothers also had a higher maximum speed than the childless women. Moreover, the longer they stayed on the road, the higher their tendency to speed.
The average maximal speed in the clinical group was approximately 110 km hr. The sleep-deprived mums exceeded the designated scenario speed limit by 10%. As the researchers note, “Speeding is considered a serious driving-related risk behaviour, as it increases both the probability of being involved in a car crash and crash severity (9).”
But if you then add the speeding with the tendency to experience lane weaving, there is even more potential risk for mothers of infants with insomnia when it comes to road safety.
Surely the mums didn’t realise?
Would you drive with your child if you knew your driving was compromised? Apparently yes (at least for these mums).
The mothers of babies who didn’t sleep well had significantly poorer self-rated driving behaviour compared with the two control groups. They knew their driving was poor.
While this bodes well for education strategies targeting these mums in the future, the researchers say. It still results in a potential road safety risk for mothers of infants with insomnia currently.
Let’s be real, as Mums we often have to drive (even short distances like the 25-minute test in the study). But are we putting our children and ourselves at risk?
Is this information valid and reliable?
OK, to be honest, the sample population was small (n = 54 women), so further research is needed, as the researchers state. But the agreement between subjective and objective assessments of driving reinforces the validity of differences seen between the groups.
The researchers believe that it “is highly plausible that inadequate sleep underlies the poorer driving outcomes observed in mothers of infants with insomnia.” They note that their findings suggest that “parents, healthcare providers and policymakers should be aware of the potential consequences of infant sleep problems on road safety” and I totally agree!
If you have a child who is not sleeping well, please don’t drive! And maybe seek help.
But this only applies overseas, right?
This study was done in Australia, which is pretty close to home!
Some of the stories my parent clients tell me about driving with their child in the car, or just caring for a child in general, in a sleep-deprived state, are super scary! You may have also had a near crash, but not related it to sleep deprivation. Chances are if you have a child who doesn’t sleep well, that is exactly the reason for the near miss.
Please let this latest study be the incentive for you to make changes to your child’s sleep – for the better.
You can start with a FREE, no obligation call to see if I can help and learn more about what I do. Book your call HERE.
And in the meantime, make sure you’re following me on Facebook, Instagram and Tik Tok (coming soon) for more information and sleep tips.
Sleep well,
Kim
References:
(1) Khan et A; 2023 : https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.14083
(2) Honaker, S. M., & Meltzer, L. (2016). Sleep in pediatric primary care: A review of the literature. Sleep Medicine Reviews, 25, 31–39. https://doi.org/10.1016/j.smrv.2015.01.004
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Williamson, A. A., Mindell, J. A., Hiscock, H., & Quach, J. (2019). Child sleep behaviors and sleep problems from infancy to school-age. Sleep Medicine, 63, 5–8. https://doi.org/https://doi.org/10.1016/j.sleep.2019.05.003
(3) Sadeh, A., Tikotzky, L., & Kahn, M. (2014). Sleep in infancy and childhood: Implications for emotional and behavioral difficulties in adolescence and beyond. Current Opinion in Psychiatry, 27(6), 453–459. https://doi.org/10.1097/YCO.0000000000000109
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Spruyt, K. (2019). A review of developmental consequences of poor sleep in childhood. Sleep Medicine, 60, 3–12. https://doi.org/10.1016/j.sleep.2018.11.021
(4) Bayer, J. K., Hiscock, H., Hampton, A., & Wake, M. (2007). Sleep problems in young infants and maternal mental and physical health. Journal of Paediatrics and Child Health, 43(1–2), 66–73. https://doi.org/10.1111/j.1440-1754.2007.01005.x
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Liew, S. C., & Aung, T. (2021). Sleep deprivation and its association with diseases-a review. Sleep Medicine, 77, 192–204. https://doi.org/10.1016/j.sleep.2020.07.048
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Sadeh, A., Tikotzky, L., & Scher, A. (2010). Parenting and infant sleep. Sleep Medicine Reviews, 14(2), 89–96. https://doi.org/10.1016/j.smrv.2009.05.003
(5) McCall, C. A., & Watson, N. F. (2020). Therapeutic strategies for mitigating driving risk in patients with narcolepsy. Therapeutics and Clinical Risk Management, 16, 1099–1108. https://doi.org/10.2147/TCRM.S244714
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Rizzo, D., Lavigne, G., Creti, L., Baltzan, M., Rompré, P., Bailes, S., Fichten, C., & Libman, E. (2019). The role of fatigue and sleepiness in drivers with obstructive sleep apnea. Transportation Research Part F: Traffic Psychology and Behaviour, 62, 796–804. https://doi.org/10.1016/j.trf.2019.03.011
(6) Lee, M. L., Howard, M. E., Horrey, W. J., Liang, Y., Anderson, C., Shreeve, M. S., O’Brien, C. S., & Czeisler, C. A. (2016). High risk of near-crash driving events following night-shift work. Proceedings of the National Academy of Sciences, 113(1), 176–181. https://doi.org/10.1073/pnas.1510383112
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Smith, A., McDonald, A. D., & Sasangohar, F. (2020). Night-shift nurses and drowsy driving: A qualitative study. International Journal of Nursing Studies, 112, 103600. https://doi.org/10.1016/j.ijnurstu.2020.103600
(7) American Academy of Sleep Medicine. (2014). The international classification of sleep disorders:(ICSD-3). American Academy of Sleep Medicine. Google Scholar
Mets, M. A., Kuipers, E., de Senerpont Domis, L. M., Leenders, M., Olivier, B., & Verster, J. C. (2011). Effects of alcohol on highway driving in the STISIM driving simulator. Human Psychopharmacology: Clinical and Experimental, 26(6), 434–439. https://doi.org/10.1002/hup.1226