Sleep related vehicle accidents.

OBJECTIVES--To assess the incidence, time of day, and driver morbidity associated with vehicle accidents where the most likely cause was the driver falling asleep at the wheel. DESIGN--Two surveys were undertaken, in southwest England and the midlands, by using police databases or on the spot interviews. SUBJECTS--Drivers involved in 679 sleep related vehicle accidents. RESULTS--Of all vehicle accidents to which the police were summoned, sleep related vehicle accidents comprised 16% on major roads in southwest England, and over 20% on midland motorways. During the 24 hour period there were three major peaks: at around 0200, 0600, and 1600. About half these drivers were men under 30 years; few such accidents involved women. CONCLUSIONS--Sleep related vehicle accidents are largely dependent on the time of day and account for a considerable proportion of vehicle accidents, especially those on motorways and other monotonous roads. As there are no norms for the United Kingdom on road use by age and sex for time of day with which to compare these data, we cannot determine what the hourly exposure v risk factors are for these subgroups. The findings are in close agreement with those from other countries.     

Sleep and blood pressure.

Direct arterial pressure was recorded continuously over 24 hours in 18 totally unrestricted people (six normotensives, four untreated hypertensives, and eight treated hypertensives). There was an almost equal fall of about 20% in both systolic and diastolic blood pressure during sleep in the three groups when compared with their waking pressures. This fall in pressure was greater than that observed previously in patients sleeping in a laboratory or hospital. Furthermore, it suggests that hypertensive subjects do not have a higher centrally-induced vasoactive component and that hypotensive drugs do not alter the pattern of blood pressure behaviour induced by sleep.     

Sleep apnoea in acromegaly.

Day time somnolence or excessive snoring, or both, occurred in five out of 11 patients with acromegaly. All five had episodes of sleep apnoea, and three had the sleep apnoea syndrome. Growth hormone concentrations were higher (p less than 0.025) in these patients than in the six patients without these symptoms. One patient with daytime somnolence and one asymptomatic patient had flow loop evidence of upper airways obstruction. Two of the patients with the sleep apnoea syndrome had cardiomegaly. Sleep apnoea appears to be common and clinically important in acromegaly, and it may be central, obstructive, or mixed. Polygraphic nocturnal monitoring is indicated to assess these patients properly.     

Conservation helps to identify biologically relevant crystal contacts.

Some crystal contacts are biologically relevant, most are not. We assess the utility of combining measures of size and conservation to discriminate between biological and non-biological contacts. Conservation and size information is calculated for crystal contacts in 53 families of homodimers and 65 families of monomers. Biological contacts are shown to be usually conserved and typically the largest contact in the crystal. A range of neural networks accepting different combinations and encodings of this information is used to answer the following questions: (1) is a given crystal contact biological, and (2) given all crystal contacts in a homodimer, which is the biological one? Predictions for (1) are performed on both homodimer and monomer datasets. The best performing neural network combined size and conservation inputs. For the homodimers, it correctly classified 48 out of 53 biological contacts and 364 out of 366 non-biological contacts, giving a combined accuracy of 98.3 %. A more robust performance statistic, the phi-coefficient, which accounts for imbalances in the dataset, gave a value of 0.92. Taking all 535 non-biological contacts from the 65 monomers, this predictor made erroneous classifications only 4.3 % of the time. Predictions for (2) were performed on homodimers only. The best performing network achieved a prediction accuracy of 98.1 % using size information alone. We conclude that in answering question (1) size and conservation combined discriminate biological from non-biological contacts better than either measure alone. For answering question (2), we conclude that in our dataset size is so powerful a discriminant that conservation adds little predictive benefit.     

Sleep patterns afted graded exercise.

The effects of six graded and measured exercise activities on sleep patterns were investigated in two healthy young men. Electrophysiological recording were made continuously throughout the night to distinguish sleep states. This experiment was designed to test the hypothesis of a relation between physical activity and slow-wave sleep (SWS: stages 3 and 4 of non-REM sleep). A progressive increase in SWS over the whole-night sleep record was found with progressively increasing physical fatigue. A fall in rapid-eye-movement (REM) sleep and at higher exercise levels, of stage 2 sleep, was found. The results support the hypothesis that SWS is involved in the recovery process from fatigue.