driven over a rumble strip in the past could personalize the risk, and even seeing the
mechanical defect, speeding, excess alcohol, bad . colleagues (1989) found that patients with severe untreated sleep apnea had more frequent
Panel on Driver Fatigue and Sleepiness regarding key issues involved in the problem. references provided do not, however, reflect all resources available or reviewed by the
drift (Dinges, 1995). follows one sleepless night. impaired to drive safely. More information is needed on chronic and acute risks
inattention, which is believed to be a larger problem.". Although alcohol and some medications can independently induce sleepiness, the primary
The behavioral steps discussed earlier for younger males also seem reasonable for
The crash occurs on a high-speed road. strips on the highway in the future could repeatedly remind people of the message. The biology of the sleep-wake cycle predicts
In a recent Gallup survey, approximately
this effect, even with modest reductions in sleep, low alcohol doses, and low blood
see sleep as a luxury. Population surveys that relate driver factors to fall-asleep or drowsy-driving crashes
However, with increasing age, the daily peak of SRVAs seems to shift to later in the day, and among those drivers aged 50-69 it is in the early afternoon.21 Nicotine can improve short-term performance significantly
Director
preteen boys, their parents, and their schools to influence attitudes before problems
increases crash risk. subjective sleep measures in this scale show strong covariation and relation to sleep
risks and how to reduce them. to fatigue and inattention, and given the lack of objective tests or uniform reporting
they feel too sleepy to drive. When this approach is not practical and
In the
All factors may interact, and
Special Assistant to Executive Deputy Commissioner
The driver is alone in . To allow accurate estimates of
care professionals may not recognize a history of sleepiness as a risk factor for
group is high school age and more likely to live at home with parents; members of the
effective measures they can take to reduce sleepiness resulting from shift work schedules. In the longer term, planning ahead can help people avoid driving while drowsy. of specific behaviors that help avoid becoming drowsy while driving. typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. intermediate risk, based on subjective reports of their having higher levels of sleepiness
To prevent drowsy driving and its consequences, Americans need information
In addition, studies should determine whether early recognition, treatment, and
The key to safety is what the driver does after hearing the
hypnotics, tricyclic antidepressants, and some antihistamines. Regularly losing 1 to 2 hours of sleep a
Characteristics of Drowsy-Driving Crashes. For example, those who
crash. 1993). purpose and meaning of shoulder rumble strips, which alarm or awaken sleepy drivers whose
age groups were overrepresented in fall-asleep crashes (New York State Task Force, 1996). effects. The panel also identified complementary messages for the campaigns and
Sleepiness can result in crashes any time of the day or night, but three factors are most commonly associated with drowsy-driving crashes. dose-response manner (Stradling et al., 1991; Philip et al., 1996; Hanning, Welch, 1996;
A patient who can recognize impending
without crashing were less likely to have been alone in the automobile. Sleep is a neurobiologic need with predictable patterns of sleepiness and
Nighttime and
The crash occurs on a high-speed road C.) The driver will be alone in the vehicle D.) All the above Get the Correct ANSWER All the above last 24 hours or more. A typical crash related to sleepiness has the following characteristics. messages could be lost or ignored if paired with "don't drink and drive"
; If you have a sleep disorder or have symptoms of a sleep disorder such as snoring or feeling sleepy during the day, talk to your doctor about treatment options. the keywords listed above and following suggestions for linkage to related topics (e.g.,
roads in nonurban areas. of interventions that would be effective with this group. Sleep apnea, with its repeated episodes of nocturnal . Wiki User. drowsiness peaking from late evening until dawn (Wylie et al., 1996). The panel would like to thank the following people for their assistance in reviewing and
a method for objectively assessing sleepiness at the crash site also would enable better
As
Across the 24-Hour Day, Figure 2. departure; about one-fourth of those who had fallen asleep without crashing also reported
It appears
State of New York, David Willis
categorically too sleepy to drive a motor vehicle (Mitler, Miller, 1996). and sleepiness for about an hour after consumption (Horne, Reyner, 1995a). is important to give regular priority to getting good sleep by creating a quiet, cool,
sleep-deprived. circadian effects. message that rumble strips are designed to arouse sleepy drivers before they drive off the
environment (a room that is cool, quiet, and dark) and sleeping at regularly scheduled
Latency
Researchers also have found
to judge its application and efficacy in regard to noncommercial driving. with untreated sleep apnea syndrome (SAS) and narcolepsy. A survey of house staff at a large urban medical school found that
Caffeine also is available
1 . North Carolina, more of these crashes resulted in injury compared with other,
minutes) and consuming caffeine equivalent to two cups of coffee. Population Groups at Highest Risk, VII. 1995). The VAS is scored by measuring the
Young males, ages 16 to 24, received highest priority because of their clear
The presumption under-lying this test is that people who fall
Nurses on rotating schedules reported more "accidents" (including auto
Promote shoulder rumble strips as an effective countermeasure for drowsy driving; in
Weegy: There were more than 12,000 people injured in alcohol-related crashes in Florida. Study guides. Externally,
typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. Driving patterns, including both time of day and amount of time driven, can increase
pastimes often leave little time left over for sleeping. sleepiness decreases performance and increases risk, even at low levels of alcohol use. obtain sufficient restorative sleep. crashing. 5 hours per night for 1 week needed two full nights of sleep to recover vigilance,
as alerting devices, but they will not protect drivers who continue to drive while drowsy. following brief discussion, some tools for the assessment of sleepiness are described to
The public needs to be informed of the benefits
It occurs during late night/ early morning or mid-afternoon. family, second jobs, and recreation often further restrict the hours available for sleep
there have been about 56,000 crashes annually in which driver drowsiness/fatigue was cited
drive even when they know they are drowsy and fighting to stay awake. during late night/early morning hours increases risk for all drivers because those hours
long enough to find a motel, call for a ride, or stop driving and sleep. National Highway Traffic Safety Administration, Forrest Council,
disorder (American Thoracic Society, 1994). fundamental work situation, they and their families may benefit from information on their
at the wheel may be a major factor that motivates undiagnosed patients to seek medical
Shift workers, many of whom are already chronically sleep deprived, are at extra
disturbances such as noise, children, activity and lights, a restless spouse, or
in people with cognitive or attention performance impairments such as those from
1994). The driver is alone in the vehicle. Graduated driver-licensing programs that
Characteristics of Drowsy-Driving Crashes, V.
example, people with chronic sleep loss who drive in the early morning hours are likely to
Hospital interns and residents routinely lose sleep during on-call periods, which may
Reports
The driver is alone in . have higher risks than do females or other age groups across all drug classes. it occurs. fragmented by frequent interruptions (Marcus, Loughlin, 1996). higher speeds involved (Horne, Reyner, 1995b) combined with delayed reaction time. Sleepiness causes auto crashes because it impairs performance and can ultimately lead to the inability to resist falling asleep at the wheel. of roads has not been studied. Carskadon (1990) offers a variety of age-specific reasons for the involvement of younger
of schoolwork demands and part-time jobs, extracurricular activities, and late-night
Risks for crashes attributed to drowsy driving. although caffeine content of coffee varies widely (Fox, 1993). Drowsy-driving crashes: Occur most frequently between midnight and 6 a.m., or in the late afternoon. shift, including evening, night, rotating, split, and irregular shifts (Kessler, 1992). working extended shifts (day plus evening plus night), and working many hours a week
Critical aspects of driving impairment associated with sleepiness are reaction time, vigilance, attention, and information processing. greater absolute or relative number of fall-asleep crashes and/or (2) increased
instead of driving while sleepy. Deputy Director
The crash occurs on a high-speed road. subject to parental authority. awake (kerstedt, Ficca, 1997). In response, Congress allocated funds for a public education campaign on drowsy driving
attitudes about sleep cause many Americans to get inadequate sleep either occasionally
Director National Center on Sleep Disorders Research
disallow late-night driving among younger drivers can mandate this risk-avoiding behavior
Drinking alcohol increases sleepiness, and the combination of alcohol and
Performance Slows With Sleep
The ESS is not designed to
crashes occur predominantly after midnight, with a smaller secondary peak in the
Narcolepsy is a
The information gathered with these instruments has not been as widely applied to
had a higher proportion of alcohol involvement than other types of crashes in that State. crash risk. of driving impairment associated with sleepiness are reaction time, vigilance, attention,
The subgroup at
steps include planning sleep and naps before long trips, scheduling trips to avoid
According to the National Commission on Sleep Disorders Research, a typical crash has the following characteristics: It is likely to be serious. differences in individual tolerance to shift work (Harma, 1993); knowing more about the
In the
(based on a 24-hour clock), subjects were awakened every 2 hours for 15 minutes, and
Cataplexy, a sudden loss of muscle tone ranging from slight weakness
The driver does not attempt to avoid a crash. after night work and early night sleep before morning work (e.g., going to sleep at 7 or 8
One result can be a progressive withdrawal of attention to the tasks
after several months (Ceutel, 1995). Although the relative risk for fall-asleep crashes has not been established,
A single vehicle leaves the roadway. CRASH CHARACTERISTICS reported having fair or poor sleep quality were more likely to have driven drowsy
other shifts to report nodding off at work and at the wheel and having had a driving
likely to be low and awareness will need to be raised. Although the absolute number of crashes is low, crash risk is increased among people
throughout a 24-hour period. likely to have such a crash than were drivers ages 30 years or older. disorder of the sleep-wake mechanism that also causes excessive daytime sleepiness. However, because SAS is more common than narcolepsy, the absolute number of crashes is
extended or night shift are special risks for a drowsy-driving crash. approaches that are effective for reaching high-risk audiences will need to be developed
Young people. Some safety experts have expressed
The typical crash related to sleepiness has the following characteristics: The problem occurs during late night, early morning or midafternoon. The panel recognized that the risk-taking behaviors of younger men will be a challenge
which the driver was asleep with no evidence of alcohol. Subjective and objective tools are available to approximate or detect
One in four respondents who reported sleeping difficulties in a
Although
reduce lifestyle- related risks. However, it is clear that these factors are cumulative, and any
Other self-report instruments
in fall-asleep crashes. Yes it is a depressant, it will cause sleepiness. The time from onset of
State, and nongovernmental agencies. masking their level of sleepiness. For example,
But, in addition, when alcohol involvement was combined with fatigue
(Findley et al., 1995; George et al., 1987; Aldrich, 1989; Alpert et al., 1992; Broughton
In another alcohol strategy variation, parents might allow
Division Chief,
The risk of a crash related to sleepiness increases during nighttime hours among both
There are some in-vehicle systems that
however, the panel suggests that campaign designers consider the following message points,
(Kozena et al., 1995; Van Laar et al., 1995; Ray et al., 1992; Leveille et al., 1994;
or to risky behavior associated with crashes. employees would complement and reinforce other drowsy-driving messages directed to the
Laboratory studies explain and predict these patterns. A single vehicle leaves the roadway. However, unlike the situation with alcohol-related crashes, no blood, breath,
The panel conducted a wide-ranging search for information on sleep, circadian rhythms,
higher speeds, attributing this finding to the effect of sleep loss on reaction time. The sleep-wake cycle is governed by both homeostatic and circadian factors. interfering with circadian sleep patterns. Institutes of Health, and the National Highway Traffic Safety Administration (NHTSA), is
What to do when awakened by driving over a rumble strip. found that short naps every 6 hours during a 35-hour (otherwise sleepless) period was
ever) in 20 minutes to fall asleep by brain wave criteria is the measure of sleepiness. awake" to 7= "sleep onset soon"). female as male, and the disorder usually begins in adolescence. Then the driver should get off the road (e.g., at a
Score 1 Many drowsy-driving crashes occur at this time. or sleep deprived. uncontrollable sleepiness and take precautions is less likely to be at risk than one who
Director
The Epworth Sleepiness
Vehicle-based tools. The MSLT and MWT were developed for neuro- physiologic assessment and are sensitive to
disruption (Czeisler et al., 1990; Stampi, 1994). sleepiness do not last long. shift work and drowsy driving issues. (National Sleep Foundation, 1995). followup survey, three of four Americans who reported getting as much or more sleep than
Complementary educational messages to parents might
The driver does not attempt to avoid a crash. uncomfortable seat or position and shivering or sweating) may also keep sleepy drivers
make a short-term difference in driving alertness: taking a short nap (about 15 to 20
efforts to educate the public, especially youth, about the importance of sleep and sleep
fall-asleep crashes. little is known about the knowledge and attitudes of this group regarding sleepiness and