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Daytime Sleepiness in Children Linked to Pedestrian Safety Risk

BIRMINGHAM (March 7,  2014) - Even children who look both ways before crossing a street run the risk of being  struck by amotor vehicle when sleepy, according to a recent study conducted at Children’s of Alabama.

The study utilized a virtual reality pedestrian environment and found that children with untreated excessive daytime sleepiness were twice as likely to be struck or nearly hit by a vehicle.  Although sleepy children looked appropriately at oncoming traffic, they exhibited impaired decision making when attempting to cross the street.

The study - co-authored by Dr. Kristin Avis, associate director of the Sleep Disorders Center at Children's and an associate professor of pediatrics at UAB; Karen Gamble, an assistant professor of psychiatry at UAB and David Schwebel, a professor of psychology at UAB, appears in the February issue of SLEEP.

 “In our study, sleepy children were much more likely to become a victim of a pedestrian accident involving a motor vehicle,” Avis said. “Basically, they were going through the motions of looking left to right, but not processing the world around them or making safe decisions on when to cross a street.”

The study introduced a virtual reality pedestrian environment to 66 children between the ages of 6 to 18 - half of whom were being treated for narcolepsy or Excessive Daytime Sleepiness (EDS). The other half was comprised of healthy children. The results concluded that children with EDS were riskier pedestrians than the healthy children and twice as likely to be struck by a virtual vehicle in the environment as the healthy children of the same age, race and gender.

Pediatric pedestrian accidents have increased significantly at Children’s of Alabama within the last five years. In 2013, Children’s treated 41 trauma patients in relation to a pedestrian accident, up from 30 in 2009. In just the first two months of 2014, Children’s has recorded six traumas involving pedestrians and motor vehicles.  Annually, 5,300 American pedestrians are killed and 85,000 others are injured, according to the National Center for Injury Prevention and Control (NCIPC).  In middle childhood, 60 percent of pedestrian injuries and deaths occur when the child is crossing the road at or between intersections, typically within a half-mile of the child’s home.

SLEEP is a monthly peer-reviewed scientific and medical journal featuring a wide spectrum of sleep-related research. The journal is the official publication of the Associated Professional Sleep Societies, LLC (APSS), a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.

The primary audiences are clinicians and research professionals specializing in sleep-related disorders.

Children’s of Alabama has provided specialized medical care for ill and injured children since 1911, offering inpatient and outpatient services throughout central Alabama. Last year, families made more than 659,000 outpatient and nearly 14,000 inpatient visits to Children’s from every county in Alabama and from 45 other states and four foreign countries. With more than 2 million square feet, Children’s is the third largest pediatric medical facility in the U.S. and has been ranked among the top children’s hospital programs in the country for the past four years by US News & World Report. More information is available at