in which the driver may have fallen asleep. a better understanding of young men's perceptions of fall-asleep crash risk and the kinds
Helpful behaviors
To provide evidence-based direction to this campaign, the Expert Panel on Driver
Latency
The driver could see the point of run-off or the object hit prior to the crash. situations: not drinking alcohol when sleepy (Roehrs et al., 1994) and not driving between
Another effective approach is to allow and
between 4 a.m. and 7 a.m. also may lead to sleepiness. Untreated sleep apnea syndrome and narcolepsy increase the risk of automobile crashes
To allow accurate estimates of
illustrate the different subjective and objective measures of chronic and situational
include consumer, voluntary, health care professional, and industry groups and other
attitudes about sleep cause many Americans to get inadequate sleep either occasionally
However, other sponsors can make an
Although an
sleep-deprived drivers who consumed caffeine reduced lane deviations, potential crashes,
studies and between groups of different ages or cultures. Workers on these shifts
increase the risk of drowsy driving and drowsy-driving crashes. to judge its application and efficacy in regard to noncommercial driving. socializing, preparing for a trip or vacation, and "pulling all nighters" are
requirements, which hinder quantification. practical for crash assessment; however, the use of a modified "nap test" has
to fatigue and inattention, and given the lack of objective tests or uniform reporting
need information on the risks of drowsy driving and crashes to put the need for rumble
are not invariably linked with impaired driving. which people voluntarily adhere or can decide to ignore. addition, sleepiness is identifiable, predictable, and preventable. The condition also is associated with loud, chronic
drowsiness. serious and young men are vulnerable. Division of Pulmonary and Critical Care Medicine
In addition, Maycock (1996) found that higher scores on the ESS were positively
extended period of time and contain a component or scale that is congruent with measuring
methodological detail, outcome measures, and other variables, all of which precluded a
Sleep can be irresistible; recognition is emerging that
For example, "asleep with
alcohol before driving in the afternoon or at night might pose special risks given the
family, second jobs, and recreation often further restrict the hours available for sleep
behaviors for safety. many of which are appropriate for all public audiences: Sleepiness is a serious risk for young male drivers. campaign. even one night of sleep may cause extreme sleepiness. laboratory and in-vehicle studies include: Often, people use physical activity and dietary stimulants to cope with sleep loss,
Short-term work demands, child care,
public was deemed "significantly" sleepy on the Epworth Sleepiness Scale (ESS),
Promote shoulder rumble strips as an effective countermeasure for drowsy
effective measures they can take to reduce sleepiness resulting from shift work schedules. in fall-asleep crashes. this context, raise public awareness about drowsy-driving risks and how to reduce them. The three groups
higher for those with untreated SAS (Aldrich, 1989). Ph.D.
The subgroup at
In addition, a higher reported frequency of
one-half of U.S. adults reported experiencing sleeping difficulties sometimes, with about
midnight through 6 a.m. driving, and avoiding alcohol and sedating medicines while sleepy
a fairly clear picture emerges from studies conducted to date of the typical crash related
driving simulator performance (Findley et al., 1989), individual performance varies. circadian rhythm changes, employers should educate employees about the problem (Harma,
timing of sleepiness and wakefulness. Taking a break for a short nap (about 15 to 20
roads in nonurban areas. The driver does not attempt to avoid a crash. without crashing were less likely to have been alone in the automobile. throughout a 24-hour period. factors sometimes are involuntary, such as a medication effect that interrupts sleep. B. involves multiple vehicles on the roadway. Ph.D.
that they reduce drive-off-the-road crashes by 30 to 50 percent-the only countermeasure
hours per week, and more frequently driving for one's job (McCartt et al., 1996). literature searches of online databases in traffic safety, medicine, and physiology using
When this approach is not practical and
The principal types of primary data the panel used fall into the following categories: The literature reviewed had variations in design, method, rigor, populations included,
Director National Center on Sleep Disorders Research
for longer times without taking a break. although caffeine content of coffee varies widely (Fox, 1993). snoring. The number of off-road deviations by the driver was 4 times
fall-asleep crashes. related crashes include: Driving patterns, including driving between midnight and 6
A single vehicle leaves the roadway. snoring to repeated breathing interruptions, also increases the likelihood of crashes in a
Shift workers, many of whom are already chronically sleep deprived, are at extra
Loughlin, 1996) found higher levels of sleepiness and crashes following on-call periods. younger than 30 accounted for almost two-thirds of drowsy-driving crashes, despite
on approaches that may reduce their risks. also identifies preoccupation, distractions inside the vehicle, and other behaviors as
and quantity of sleep, work hours, and work patterns [day shift, night shift, rotating
the true prevalence of drowsy-driving crashes, it will be important to develop a standard
one-third complain of fatigue (kerstedt, 1995a, 1995b, 1995c). Regularly losing 1 to 2 hours of sleep a
effects on performance of sleepiness, sleep loss, and the combined effects of sleep loss
and driving is no exception (kerstedt, 1995a, 1995b; Dinges, 1995; Horne, 1988;
Sleepiness causes auto crashes because it impairs performance and can
Competing demands from
Furthermore, a crash is likely to be an altering circumstance. mishap on the way home from work (Gold et al., 1992). and gatekeepers, such as industries where shift work is prevalent. sometimes or very often than were those who said their sleep was good or excellent
Drowsy-driving crashes: Occur most frequently between midnight and 6 a.m., or in the late afternoon. Both external and internal factors can lead to a restriction in the time available for
Effective countermeasures used to prevent drowsy driving and related crashes. Most current estimates of fatigue-related crashes are between 2 and 4% of total crashes. University of Illinois, Jesse Blatt,
over-representation in crash statistics and because many of their lifestyle risks are
and tested; ultimately, the impact of such approaches on drowsy-driving knowledge,
or sleep deprived. Individuals who fall asleep in 5 minutes or less are
sleep loss, aggravating their risk of drowsy driving. They found only a few scientific
A
midnight and 6 a.m. (Mitler et al., 1988; kerstedt, 1995c), especially well into the
Currently, many people with these
However, unlike the situation with alcohol-related crashes, no blood, breath, or other measurable test is currently available to quantify levels of sleepiness at the crash site. Findley and
age and that chronic sleepiness is a safe lifestyle choice need to be overcome. An inherent deficiency in all types of alerting devices is that many people continue to
of roads has not been studied. Cultural and lifestyle factors leading to insufficient sleep, especially a combination
criteria that some researchers have used to define a crash as having been caused by
The Stanford Sleepiness
risks and how to reduce them. Sharpley, 1996; Martikainen, 1992). complements Federal Highway Administration efforts to address the problem among commercial
A single vehicle leaves the roadway. Latency To Sleep at 2-Hour Intervals
To date, research has validated only one type of device that alarms or awakens drivers
About 25 percent reported
Problems related to these factors may confound interpretation between
in people with cognitive or attention performance impairments such as those from
appear to have more sleep-related difficulties than do younger workers, but no gender
Undiagnosed sleep-disordered breathing, ranging from habitual
"fatigue") were duration of the most recent sleep period, the amount of sleep in
al., 1997). ; Before you drive, avoid taking medicines that make you sleepy. combination of chronic and acute factors substantially increases crash risk. Additional information and research are
annually on average from 2009 to 2013, there were over 72,000 police-reported crashes involving drowsy driv - . the risk of drowsy driving in other ways. About 95 percent
and more of the chronic or acute factors that underlie risk for everyone. highest priority target audiences and educational message points for the NCSDR/NHTSA
Based on the literature,
Although its conclusions were based on a limited body of knowledge, the panel
long or irregular hours. Other rating tools that measure an individual's experience with sleepiness over an
At least one motor vehicle crash during the year prior to follow-up evaluation was reported by 6.9% of the 3201 participants. can make a short-term difference: Napping. continuity across a wide spectrum of prior sleep length and fragmentation. The driving literature before 1985 made little mention of sleepiness and instead
behavioral, medical, alerting devices, and shift work. conduct all needed educational interventions. sleep loss. Subjective and objective tools are available to approximate or detect
Population surveys that relate driver factors to fall-asleep or drowsy-driving crashes
The MSLT mea- sures the tendency to fall
significantly improves alertness in sleepy people (but only marginally in those already
crash site. Studies based on driver self-reports: Maycock, 1996; McCartt et al., 1996). daylight and sleep during darkness. The younger
One in three of the adult
The terms "fatigue" and "inattention" are sometimes used
Section II lists some of the technological in-vehicle monitors designed to detect and
Although there was no formal ranking of the
No definitive criteria are available for establishing how
The report presents the results of a literature review and opinions of the Expert
experience in maintaining alertness (Arbus et al., 1991; Hansotia, 1997). intermediate risk, based on subjective reports of their having higher levels of sleepiness
other steps to improve alertness when sleepy, such as opening a window or listening to the
Critical aspects of driving impairment associated with sleepiness are reaction time, vigilance, attention, and information processing. North Carolina, more of these crashes resulted in injury compared with other,
ever) in 20 minutes to fall asleep by brain wave criteria is the measure of sleepiness. life. factors in predicting crashes related to sleepiness (which this report called
older group are more likely to be working or in college, living on their own and less
passenger, talking on a cellular phone or CB radio, chewing gum or ice, or snacking. study suggests that talking on a cellular phone while driving is associated with increased
designed to provide direction to an NCSDR/NHTSA educational campaign to combat drowsy
A
Critical aspects of driving impairment associated with sleepiness are reaction time, vigilance, attention, and information processing. Often, however, reasons for sleep restriction represent a lifestyle choice-sleeping less
night of sleep, results in extreme sleepiness (Carskadon, 1993b). of interventions that would be effective with this group. public. No blood, breath or other measurable test is currently available to quantify level of sleepiness at a motor vehicle crash site.Your Answer: ACorrect Answer: A. TRUECorrect!Explanation: Item found in Section 7.2 1. been used along with questionnaires for field assessment of driver sleepiness (Philip et
Request Answer. conditions are undiagnosed and untreated, unaware of the potentially serious consequences
It is widely recognized that these statistics under report the extent of these types of crashes. Investigations have demonstrated that circadian phase disruptions caused by rotating
Sleepiness causes auto crashes because it impairs performance and can ultimately lead to the inability to resist falling asleep at the wheel. Drowsy driving is a serious problem that leads to thousands of automobile
driven over a rumble strip in the past could personalize the risk, and even seeing the
Many Americans are unaware of the
The panel of experts reviewed the literature on fatigue-related crashes and produced a 36-page report covering the biology of human sleep and . fragmented by frequent interruptions (Marcus, Loughlin, 1996). nonalcohol-related crashes-fatalities occurred in 1.4 percent and 0.5 percent,
is not okay to drive when you are sleepy. NHTSA General Estimates System data reflect the
Being awakened by driving over a rumble strip is a warning to change sleep and driving
The driver is alone in . rural roads. following brief discussion, some tools for the assessment of sleepiness are described to
drift (Dinges, 1995). health as well as drowsy-driving prevention. drowsiness was markedly greater during night driving than during daytime driving, with
(McCartt et al., 1996). Driving while sleepy
The Epworth Sleepiness
A survey of house staff at a large urban medical school found that
Most adults need at least 7 hours of sleep a day, and teens need at least 8 hours. Assessment for acute sleepiness. In regard to
respectively (Pack et al., 1995). occur in built-up areas. The resulting report outlines the following: In addition to summarizing what is known-and what remains unknown-from sleep and
However, younger drivers have no increased risk during the afternoon, when the predictable
dose of ethanol or placebo. disruption (Czeisler et al., 1990; Stampi, 1994). Driving
These data from Roehrs et al. drivers surveyed about their lifetime experience with drowsy driving, almost one-half of
In lieu of an objective measure driving; in this context, raise public and policymaker awareness about drowsy-driving
Police crash reports are the traditional source of information on crash-related behaviors. sleepiness while driving, and in many studies a majority of shift workers admit having
Sleep is a neurobiologic need with predictable patterns of sleepiness and
Wilkins and colleagues (1997) confirmed that crashes attributed to driver fatigue have
Pack (1995) and Maycock (1996) both conclude that a
circadian effects. IV. apnea syndrome (SAS) and narcolepsy, and the increased drowsiness and performance
Sleeping is the
Consuming caffeine. drive. All factors may interact, and
First, it
Maturational changes that increase the need for sleep. of day was the most consistent factor influencing driver fatigue and alertness. symptoms to diagnosis of narcolepsy averages 10 years (American Thoracic Society, 1994;
common causes of acute sleep loss. longer (Maycock, 1996). It is possible that the effects of low levels of blood alcohol may have an interaction
at-risk drivers who do not crash and about the impact of drowsiness on driving at all
pastimes often leave little time left over for sleeping. impairment that result from consuming alcohol when drowsy. Older shift workers
(National Sleep Foundation, 1995). The risks are higher with higher drug doses and for
hypnotics, tricyclic antidepressants, and some antihistamines. because the well-established risks substantially outweigh the possible benefits. younger drivers (25 years of age and younger) and drivers between the ages of 26 and 45. Training, occupation, education, motivation, skill level, and intelligence exert no
Horne and Reyner (1995a) suggest that a combination of having more of the chronic and
Inattention can result from fatigue, but the crash literature
for more information on sleep apnea syndrome and narcolepsy.). whereas in New York State the greatest number of drowsy drivers (on self-report) were
The panel also designated shift workers as a high-risk group because the number of
The
carries the greatest risk of sleep disruption because it requires workers to contradict
A typical crash related to sleepiness __________ A. is not serious. At best they can help sleepy drivers stay awake and alert
performance (Dinges et al., 1987; Hamilton et al., 1972; Williams et al., 1959). driver at the scene of a crash. or more sleepless nights (e.g., do not drive home from college the day your exams are
Virtually all studies that analyzed data by gender and age group found that young
Sleep fragmentation. These included working more than one job,
The typical crash related to sleepiness has the following characteristics: The problem occurs during late night, early morning or midafternoon. Practical issues with this strategy include the inability of some people to take short
The crash occurs on a high-speed road. Methods and Knowledge Base of This Report, Untreated Sleep Disorders: Sleep Apnea Syndrome and Narcolepsy, Consumption of Alcohol Interacts With Sleepiness To Increase Drowsiness and Impairment, Interactions Among Factors Increase Overall Risk, People With Untreated Sleep Apnea Syndrome and Narcolepsy, Medical Interventions To Treat Narcolepsy and Sleep Apnea Syndrome, Educate Young Males About Drowsy Driving and How To Reduce Lifestyle-Related Risks, Promote Shoulder Rumble Strips as an Effective Countermeasure for Drowsy Driving; in
or A typical crash related to sleepiness occurs on a high-speed road. talking to patients about the need for adequate sleep, an important behavior for good
job-related duties (e.g., workers who are on call) can interrupt and reduce the quality
Nurses on rotating schedules reported more "accidents" (including auto
dose-response manner (Stradling et al., 1991; Philip et al., 1996; Hanning, Welch, 1996;
increased when different types of studies reach similar conclusions. The effects of sleep
Promote shoulder rumble strips as an effective countermeasure for drowsy driving; in
However, when they sit still, perform repetitive tasks
In the 1996 appropriations bill for the U.S. Department of Transportation, the Senate
; 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. Many Americans do not get the sleep
targeted only the younger group to enable specific tailoring of educational messages to
These factors have cumulative effects; a combination of them substantially
Contemporary society functions 24 hours a day. was reported by police to have fallen asleep and the characteristics of the sleepy driver. C. occurs on a high-speed road. Motor vehicle crashes were somewhat more common in men than in women and were significantly associated with number of miles driven per year, AHI, sleep duration, and self-reported sleepiness (Table 1).Adjusted for age, sex, and miles driven, the odds ratio for any motor . Common characteristics of crashes related to drowsy driving and sleepiness. from these crashes. Night-, early morning-, and rotating-shift workers are often sleepy because their work
Rumble strips act as an alarm clock, alerting drivers to the fact that they are too
fundamental work situation, they and their families may benefit from information on their
hygiene should complement other initiatives and, in combination, reinforce messages on the
disturbances such as noise, children, activity and lights, a restless spouse, or
the need to drive. occur about 12 hours after the midsleep period (during the afternoon for most people who
Weegy: There were more than 12,000 people injured in alcohol-related crashes in Florida. The driver does not attempt to avoid a crash. The panel suspects that sleepiness-related crashes are still very often
No measures
a.m.; driving a substantial number of miles each year and/or a substantial number of hours
Joy Mara of Joy R. Mara Communications for her assistance in the writing of this report. The MSLT and MWT were developed for neuro- physiologic assessment and are sensitive to
messages to affect attitudes, so that young men and their parents believe the risk is
Sleep Loss ; Driving Patterns ; The Use of Sedating Medications ; Untreated Sleep Disorders: Sleep Apnea Syndrome and Narcolepsy uncomfortable seat or position and shivering or sweating) may also keep sleepy drivers
In the United Kingdom, fatigue related crashes have been identified using the following criteria: The vehicle has run off the road and/or collided with another vehicle or object. to stop driving and sleep for an extended period. with the exception of medical disorders, all factors may have either chronic or acute
There is insufficient evidence at present
The panel recognized that the risk-taking behaviors of younger men will be a challenge
In another alcohol strategy variation, parents might allow
experimenting and taking risks, and testing limits. loss of one night's sleep can lead to extreme short-term sleepiness, while habitually
shift, including evening, night, rotating, split, and irregular shifts (Kessler, 1992). panel found no studies evaluating other driver-reported steps such as talking to another
who are drowsy or asleep-shoulder rumble strips placed on high-speed, controlled-access,
inconsistencies in the primary data and the literature can be expected. During the night, from 2330 to 0800 hours
Internal or personal
The panel recognizes that limitations in resources will not allow NCSDR/NHTSA to
sector is growing at a rate of 3 percent per year, as businesses such as overnight
Personal Demands and Lifestyle Choices. circadian sleepiness peak is expected. distance in millimeters from one end of the scale to the mark placed on the line. performance on vigilance tasks (Naitoh, 1992). Self-reports from drivers involved in crashes (with data collected either at the crash
People with narcolepsy are as likely to be
In the MWT, individuals are instructed to remain awake, and the time it takes (if
Department of Medical-Surgical Nursing Center for Narcolepsy Research
typical patients tend to be overweight and middle aged or older, with a large collar size
people, and males in particular, were the most likely to be involved in fall-asleep
You can take effective steps if you become sleepy while driving. In addition, a study of hospital house staff working around the clock (Marcus,
New York State GTSC Sleep Task Force, 1994; New York State Task Force on Drowsy Driving,
they feel too sleepy to drive. Rumble strips
typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. among noncommercial drivers, to be sponsored by the National Highway Traffic Safety
Institutes of Health, and the National Highway Traffic Safety Administration (NHTSA), is
Recreational drug use also may exacerbate sleepiness
Driver
caffeine equivalent to two cups of coffee may help improve alertness for a short period. To prevent drowsy driving and its consequences, Americans need information
negative effects this choice can have on health and functioning (Mitler et al., 1988). Several studies show that timed exposure to bright light has been successful in helping
or other measurable test is currently available to quantify levels of sleepiness at the
as a need for sleep that is present at a particular point in time. patients (Broughton et al., 1981; Haraldsson et al., 1995). Drivers ages 45 through 65 have fewer nighttime
equivalent of two cups of coffee; taking a 20-minute nap, and after the nap, driving to
that exist tend to address the biological feasibility of reducing drowsiness or improving
midafternoon (Studies of police crash reports: Pack et al., 1995; Knipling, Wang, 1994;
standard Multiple Sleep Latency Test procedures. Conversely, respondents who reported having fallen asleep
driver from falling asleep. In driving simulators,
employees would complement and reinforce other drowsy-driving messages directed to the
Weegy: A typical crash related to sleepiness occurs during late night/ early morning or midafternoon and is likely to be serious. driving patterns that disregard the normal sleep-wake cycle or represent driving increased
are not clear because both young men and young women are likely to be chronically
Several approaches have been effective in reducing sleepiness caused by working
drowsy driving if focus groups confirm their appeal. times. commercial drivers show a similar pattern (see figure 3). The panel believes that focusing a campaign on shoulder rumble strips offers multiple
The driver is alone in . mechanical defect, speeding, excess alcohol, bad . also works part-time, participates in extracurricular activities, and has an active social
5 hours per night for 1 week needed two full nights of sleep to recover vigilance,
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