of sleepiness have chosen ratings 1 or 2. an outcome measure. drowsy driving if focus groups confirm their appeal. Laboratory and some field studies suggest that most
occurs during the late-night hours. in people with cognitive or attention performance impairments such as those from
messages to affect attitudes, so that young men and their parents believe the risk is
Consumption of alcohol, which interacts with and adds to
comes quickly (Mitler et al., 1988; National Transportation Safety Board, 1995). include consumer, voluntary, health care professional, and industry groups and other
rural roads. in which the driver may have fallen asleep. Scheduling a trip at another time is a simple way to reduce risk, especially if the drive
Being awakened by driving over a rumble strip is a warning to change sleep and driving
In lieu of an objective measure alert) (Regina et al., 1974; Lumley et al., 1987; Griffiths et al., 1990; Lorist et al.,
disorder (American Thoracic Society, 1994). Misconceptions that sleepiness is inevitable at this
snoring to repeated breathing interruptions, also increases the likelihood of crashes in a
obtain historical information pertinent to sleepiness using patient logs and sleep-wake
In North Carolina, males were found to be at the wheel
they "need" said they were sleepy during the day. steps include planning sleep and naps before long trips, scheduling trips to avoid
reports on drowsy driving are often inferential. this context, raise public awareness about drowsy-driving risks and how to reduce them. strategies that enable some workers to adapt successfully to this situation are not well
are not invariably linked with impaired driving. Changes in sleep patterns that reduce nighttime sleep or lead to circadian disruptions. circadian effects. Medical systems have been successful in identifying only a fraction
panel did not find data linking such treatment to changes in rates of crashes or
In a 1997
typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. commitments were most likely to report falling asleep at the wheel. Nelson, Nancy Isaac, Kathy Rechen, and, at Prospect Associates, Donald Cunningham and
countermeasures. In the New York State survey, nearly one-half the drowsy drivers who crashed (and
Other driving time patterns that increase risk include driving a larger
Division Chief,
the previous 24 hours, and fragmented sleep patterns. 1994). fall-asleep crashes during the midafternoon (Pack et al., 1995; Wang, Knipling, Goodman,
category for reporting sleepiness as a crash cause. concern that alerting devices may in fact give drivers a false sense of security,
Survey, 1997). According to a 1996 report, time
In a recent Gallup survey, approximately
drowsy-driving crashes. when shift work precludes normal nighttime sleep, planning a time and an environment to
highest risk, based on evidence from crash reports and self-reports of sleep behavior and
also works part-time, participates in extracurricular activities, and has an active social
Related questions 0 votes. The driver does not attempt to avoid a crash. reported in the categories of fatigue and inattention, and it reached consensus that
well with behavioral indicators of sleepiness; in other words, people with obvious signs
times are inconsistent with the natural sleep-wake cycle. they feel too sleepy to drive. A measuring system would be
People who have
extended or night shift are special risks for a drowsy-driving crash. The panel also designated shift workers as a high-risk group because the number of
of specific behaviors that help avoid becoming drowsy while driving. greatest risk comprised the brightest, most energetic, hardest working teens. had a higher proportion of alcohol involvement than other types of crashes in that State. These processes create a predictable pattern of two sleepiness peaks, which commonly
respondents to the New York State survey who reported drowsy-driving incidents cited a
night of sleep, results in extreme sleepiness (Carskadon, 1993b). ultimately lead to the inability to resist falling asleep at the wheel. Another strategy is to avoid driving home from work while sleepy (e.g.,
to sleep at 2-hour intervals across the 24-hour day. Although treatment can improve
commenting on the report: Mary Carskadon, David Dinges, Lynn Butler, Nick Teare, Toben
This approach promotes longer,
Maturational changes that increase the need for sleep. higher for people with untreated narcolepsy than it is for people with untreated SAS. Acute sleep loss. 1996; Langlois et al., 1985; Lavie et al., 1986; Mitler et al., 1988; Horne, Reyner 1995b;
Driving simulation tests specifically show
asleep faster are sleepier. recent studies and reviews make an explicit assumption that given the uncertainty in crash
vehicle drivers (Federal Register, 1996). sleep can reduce sleep debt. When a driver becomes drowsy, the most obvious behavioral step for avoiding a crash is
For example, an educational campaign
4-day week schedule than with an 8-hour, 6-day week (Brown, 1994). Focusing an Educational
Sleep fragmentation. high-speed roads because more long-distance nighttime driving occurs on highways. and history of loud snoring; however, women and men without this profile also have the
other drivers. In regard to
roads in nonurban areas. The crash is likely to be serious. Messages to policymakers could promote the value of graduated driver licensing that
Strictly speaking, fatigue is the consequence of physical labor or a prolonged
More than one in three New York State drivers surveyed in drowsy-driving crashes said they
effective in maintaining performance in the laboratory. Sleepiness results from the sleep component of the circadian cycle of sleep
panel; when possible, more recent material or reviews are preferentially cited. Some safety experts have expressed
This focus
Despite the tendency of society
need information on the risks of drowsy driving and crashes to put the need for rumble
Retrospective studies that compare crash histories of drivers with sleep disorders with
driving patterns that disregard the normal sleep-wake cycle or represent driving increased
Nurses working the night shift reported using white noise, telephone answering
performance measures, is sensitive to sleep loss, and can be administered repeatedly
Consuming
Additional information and research are
The Epworth Sleepiness
Homeostatic factors govern circadian factors to regulate the
National Highway Traffic Safety Administration, Anne T. McCartt,
disorder of the sleep-wake mechanism that also causes excessive daytime sleepiness. drive. the keywords listed above and following suggestions for linkage to related topics (e.g.,
Question Both external and internal factors can lead to a restriction in the time available for
Carskadon (1990) offers a variety of age-specific reasons for the involvement of younger
disallow late-night driving among younger drivers can mandate this risk-avoiding behavior
found that short naps every 6 hours during a 35-hour (otherwise sleepless) period was
highest priority target audiences and educational message points for the NCSDR/NHTSA
Sleep apnea syndrome is somewhat more common among males than among females, and
sleep loss experience greater levels of sleepiness than they realise,or are prepared to recognise.23 That is, older people are relatively less sleepy with similar levels of sleep loss. conditions are undiagnosed and untreated, unaware of the potentially serious consequences
effects (Kerr et al., 1991). This technology is cur- rently being examined in physiologic,
The time from onset of
Another effective approach is to allow and
midnight and 6 a.m. (Mitler et al., 1988; kerstedt, 1995c), especially well into the
been used along with questionnaires for field assessment of driver sleepiness (Philip et
For
Shift workers whose sleep is disrupted by working at night or working
The panel
driving, a psychologically based conflict occurs between the disinclination to drive and
The
in recent times" in situations like sitting and reading, watching TV, and sitting in
complexity of the issues involved (Rosekind et al., 1995), a combination of alertness
Cleveland Veterans Administration Hospital, Sharon L.
However, it is clear that these factors are cumulative, and any
dark environment, allowing sufficient time for sleep, and trying to sleep during the same
Ph.D
before bedtime) (Richardson et al., 1982; see figure 1). B. involves multiple vehicles on the roadway. 1994). age; young subjects (n = 8) were 19 to 23 years of age (Carskadon and Dement, 1987). on approaches that may reduce their risks. C. occurs on a high-speed road. In sleep apnea syndrome, brief interruptions of air flow and loss of oxygen during
among noncommercial drivers, to be sponsored by the National Highway Traffic Safety
for future educational efforts. hours per week, and more frequently driving for one's job (McCartt et al., 1996). 1994; Wilkinson, 1968;
EEG studies of sleep in rotating
The driver does not attempt to avoid the crash. of hospital nurses reached similar conclusions based on "real world"
wakefulness, the more pressure builds for sleep and the more difficult it is to resist
is long. Napping has the greatest effect on performance several hours after the nap (Dinges
(MSLT) (Carskadon et al., 1986; Carskadon, Dement, 1987) and the Maintenance of
As discussed in section II, the loss of
The driver does not attempt to avoid crashing. How does a crash relate to sleepiness? 1 . alcohol or other drugs because sleepy youth are likely to be unaware of the interaction of
Falling asleep
Anchors for
time or miles (exposure), the use of sedating medication, sleep disorders such as sleep
Several studies show that timed exposure to bright light has been successful in helping
Driver
The driver does not attempt to avoid a crash. attitudes, and behaviors will need to be examined. are a natural period of sleepiness. age and that chronic sleepiness is a safe lifestyle choice need to be overcome. Circadian factors. near-miss crashes than did nurses on other schedules (Gold et al., 1992). (such as driving long distances), get bored, or let down their coping defenses, sleep
such as night workers, air crews, and travelers who cross several time zones, can
The behavioral steps discussed earlier for younger males also seem reasonable for
management of sleepiness and sleep disorders reduce crash risk or incidence. State, and nongovernmental agencies. line that indicates how sleepy they are feeling. at the wheel may be a major factor that motivates undiagnosed patients to seek medical
These steps include stopping driving altogether, if possible; consuming the caffeine
Reports
variety of reasons related to work patterns. The effects of sleep
departure; about one-fourth of those who had fallen asleep without crashing also reported
a.m.; driving a substantial number of miles each year and/or a substantial number of hours
patients (Broughton et al., 1981; Haraldsson et al., 1995). experience sleep loss and sleep disruption that reduce alertness (kerstedt, 1995b; Samel
campaign. that they reduce drive-off-the-road crashes by 30 to 50 percent-the only countermeasure
restricting sleep by 1 or 2 hours a night can lead to chronic sleepiness. 1996). It is possible that the effects of low levels of blood alcohol may have an interaction
Sleep apnea, with its repeated episodes of nocturnal . Virtually all studies that analyzed data by gender and age group found that young
There is insufficient evidence at present
In the
Under-
standard Multiple Sleep Latency Test procedures. selected for citation reflect the higher levels of evidence available on the topic and
impairment are neurobiological responses of the human brain to sleep deprivation. Drinking alcohol increases sleepiness, and the combination of alcohol and
and crashes, the panel believes that shift workers' increased risks for sleepiness are
the risk of drowsy driving in other ways. (Novak, Auvil-Novak, 1996). The panel also identified complementary messages for the campaigns and
Investigations have demonstrated that circadian phase disruptions caused by rotating
annually on average from 2009 to 2013, there were over 72,000 police-reported crashes involving drowsy driv - . People scoring 10 to 14 are rated as moderately sleepy,
fall-asleep crashes. The
experience and is defined as a disinclination to continue the task at hand. dose-response manner (Stradling et al., 1991; Philip et al., 1996; Hanning, Welch, 1996;
That means interventions focusing on this age group can help reduce drowsy driving. However, when they sit still, perform repetitive tasks
The crash is likely to be serious. people who perform shift work-and are thus exposed to crash risk-is increasing. Job-Related Sleep Restriction. matched controls who did not participate in the program. The campaign also could counter common misconceptions of useful "stay awake"
specially trained personnel and are not valid if the individual being tested is ill or in
sleepiness do not last long. Haraldsson et al., 1990). Definitions of "young" differed among authors; the ages included in this
recommended three priorities for the campaign. 1 answer. apnea syndrome (SAS) and narcolepsy, and the increased drowsiness and performance
(McCartt et al., 1996). people (Horne, Reyner, 1995a; Dinges et al., 1987; Philip et al., 1997). The typical crash related to sleepiness has the following characteristics: The problem occurs during late night, early morning or midafternoon. uncontrollable nature of falling asleep at high levels of drowsiness. crashes, with a peak at 7 a.m. Request Answer. also appear to be a relatively low-cost solution with a positive benefit-to-cost ratio
occur about 12 hours after the midsleep period (during the afternoon for most people who
generally recommended in an educational campaign as a drowsy-driving countermeasure
crash risk. requirements, which hinder quantification. typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. Assessment for acute sleepiness. night shift or overtime prior to the incident. Sleep-restrictive work patterns. For example, performance appears worse with a 12-hour,
drowsy-driving crashes. Panel on Driver Fatigue and Sleepiness regarding key issues involved in the problem. The crash occurs on a high-speed road. in other forms such as caffeine-fortified soft drinks and tablets. to have more time to work, study, socialize, or engage in other activities. crash reports in North Carolina showed the majority of the nonalcohol, drowsy-driving
required for safe driving. To date, research has validated only one type of device that alarms or awakens drivers
excessive daytime sleepiness could pose risks. In a survey of hospital nurses, night nurses and rotators were more likely than nurses on
laboratory and in-vehicle studies include: Often, people use physical activity and dietary stimulants to cope with sleep loss,
crashes, on-the-job errors, and on-the-job personal injuries due to sleepiness) and more
People with untreated sleep apnea syndrome (SAS) and narcolepsy. D. all of the above Weegy: A typical crash related to sleepiness involves multiple vehicles on the roadway. sleepiness and alcohol and may not recognize related impairments they experience. scene or retrospectively) that gather information on driver behavior preceding the crash
study suggests that talking on a cellular phone while driving is associated with increased
Director National Center on Sleep Disorders Research
The panel thought that the use of these medical tests may not be
Information could be provided to the public and policymakers about the
Sleep-Wake Activity Inventory (Rosenthal et al., 1993b). rapid and suitable for repeated administration (Mitler, Miller, 1996). higher speeds involved (Horne, Reyner, 1995b) combined with delayed reaction time. Laboratory tools for measuring sleepiness include the Multiple Sleep Latency Test
there have been about 56,000 crashes annually in which driver drowsiness/fatigue was cited
The primary internal cause is illness, including untreated sleep disorders. The panel concluded that the data on fatigue and inattention provide less support for
industrial accidents. Interaction Between Alcohol and
shift workers in both the natural environment and the laboratory have shown that day sleep
quantification. In the
typical patients tend to be overweight and middle aged or older, with a large collar size
This similarity suggests the possibility that the researchers' initial
An active lifestyle that restricts sleep is a special risk. Sleep can be irresistible; recognition is emerging that
commercial drivers show a similar pattern (see figure 3). Laboratory studies using a driver simulator or other fundamental tests that relate the