acute. It is important to learn more about
drowsy driving if focus groups confirm their appeal. (such as driving long distances), get bored, or let down their coping defenses, sleep
In another alcohol strategy variation, parents might allow
Elderly subjects (n = 10) were 60 to 83 years of
1994; Wilkinson, 1968;
was associated with the quantity and quality of sleep obtained. Educate shift workers about the risks of drowsy-driving and how to reduce them. This technology is cur- rently being examined in physiologic,
suggest that they tell teenagers to call for a ride at any hour without recriminations if
sleepiness is an underrecognized feature of noncommercial automobile crashes. subjective sleep measures in this scale show strong covariation and relation to sleep
people who are not sleep deprived (Dinges, 1995). Undiagnosed sleep-disordered breathing, ranging from habitual
The VAS is scored by measuring the
Director National Center on Sleep Disorders Research
before driving again. evidence of a corrective maneuver, such as skid marks or brake lights, is usually absent
1 in 10 saying the difficulties are frequent (National Sleep Foundation, 1995). and information processing. equivalent of two cups of coffee; taking a 20-minute nap, and after the nap, driving to
road could be an attention-getting way to highlight the prevalence of chronic sleepiness
drowsy-driving crashes. Campaign: Panel Recommendations, Figure 1. Population surveys that relate driver factors to fall-asleep or drowsy-driving crashes
hours, the scheduling of work and rest periods to conform to circadian rhythms promotes
practical for crash assessment; however, the use of a modified "nap test" has
Drowsy-driving
Critical aspects of driving impairment associated with sleepiness are reaction time, vigilance, attention, and information processing. Many also were unlikely to use a rest area when they were driving alone at
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 . (Novak, Auvil-Novak, 1996). The panel encourages such groups to use this report and resulting
Nicotine can improve short-term performance significantly
and history of loud snoring; however, women and men without this profile also have the
As noted earlier, the circadian pacemaker
Nurses on rotating schedules reported more "accidents" (including auto
Several approaches have been effective in reducing sleepiness caused by working
1 answer. In addition, limited evidence suggests that physical discomfort (such as sitting in an
show that sleepy drivers are less likely than alert drivers to take corrective action
Horne, Reyner, 1995a). sleep can reduce sleep debt. greater absolute or relative number of fall-asleep crashes and/or (2) increased
snoring. snoring to repeated breathing interruptions, also increases the likelihood of crashes in a
D. all of the above A typical crash related to sleepiness involves multiple vehicles on the roadway. Investigations have demonstrated that circadian phase disruptions caused by rotating
Score 1 Other rating tools that measure an individual's experience with sleepiness over an
significantly improves alertness in sleepy people (but only marginally in those already
young men will recognize themselves in the picture of a chronically sleepy student who
Across the 24-Hour Day, Figure 2. A more informed medical community could help reduce drowsy driving by
Some, but not all,
evaluations of potential countermeasures, most of which were laboratory studies. As a result, our understanding of drowsy-driving crashes is based on subjective
Obviously, however, smoking tobacco should not be
line that indicates how sleepy they are feeling. working extended shifts (day plus evening plus night), and working many hours a week
Wilkins and colleagues (1997) confirmed that crashes attributed to driver fatigue have
educational opportunities to convey key drowsy-driving messages. The Expert Panel on Driver Fatigue and Sleepiness especially acknowledges
five men (20.2 percent) and almost one in six women (15 percent) work other than a daytime
crashes, with a peak at 7 a.m. Common characteristics of crashes related to drowsy driving and sleepiness. Related questions 0 votes. That is its most common side affect. Inattention can result from fatigue, but the crash literature
Assessment for acute sleepiness. Young people (ages 16 to 29), especially males. fundamental work situation, they and their families may benefit from information on their
The current tools for the assessment of sleepiness are based on questionnaires and
alcohol" crashes involved a higher percentage of young males than did crashes in
For
Two other proven interventions avoid known problem
Department of Motor Vehicles State of New York, James Kiley,
sleepiness and sleep disorders (National Commission on Sleep Disorders Research, 1993). One in three of the adult
restriction and sleep fragmentation. 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. Taking a break for a short nap (about 15 to 20
Latency
A single vehicle leaves the roadway. with untreated sleep apnea syndrome (SAS) and narcolepsy. is common, and 7 to 9 hours is needed to optimize performance (Carskadon, Roth, 1991). in recent times" in situations like sitting and reading, watching TV, and sitting in
literature searches of online databases in traffic safety, medicine, and physiology using
survey of lifetime incidents, 82 percent of drowsy-driving crashes involved a single
Drowsy Driving - NHTSA | National Highway Traffic Safety Administration Changes in sleep patterns that reduce nighttime sleep or lead to circadian disruptions. association of these topics with driving risk and crash prevention. Although these conditions place people at higher risk for drowsy-driving crashes, they
percent of all sleepiness-related, single-vehicle crashes (Wang, Knipling, Goodman, 1996). Although people with untreated sleep apnea syndrome may not be aware of the brief
Studies were performed in the morning
The panel also designated shift workers as a high-risk group because the number of
hygiene should complement other initiatives and, in combination, reinforce messages on the
Two remedial actions can
CRASH CHARACTERISTICS driver at the scene of a crash. These steps include stopping driving altogether, if possible; consuming the caffeine
of driving impairment associated with sleepiness are reaction time, vigilance, attention,
Some of these devices contain alarms or other alerting devices
The panel concluded that the data on fatigue and inattention provide less support for
The driver could see the point of run-off or the object hit prior to the crash. To assist the educational campaign in developing its educational
loss of one night's sleep can lead to extreme short-term sleepiness, while habitually
Fatigued Driving - National Safety Council In a driving simulation study, alcohol levels below the legal
In Pack and
fall asleep, a process that is the result of both the circadian rhythm and the need to
higher speeds involved (Horne, Reyner, 1995b) combined with delayed reaction time. A typical crash related to sleepiness __________ A. is not serious. as a need for sleep that is present at a particular point in time. External factors, some beyond the individual's control, include work hours, job and
example, the National Transportation Safety Board (1995) concluded that the critical
In sleep apnea syndrome, brief interruptions of air flow and loss of oxygen during
In the New York State survey, nearly one-half the drowsy drivers who crashed (and
was reported by police to have fallen asleep and the characteristics of the sleepy driver. is not okay to drive when you are sleepy. does not permit younger drivers to drive during late night hours (e.g., after midnight). Acute sleepiness is defined
of alcohol, and the combination adversely affecting psychomotor skills to an extent
Laboratory studies using a driver simulator or other fundamental tests that relate the
The panel
whereas in New York State the greatest number of drowsy drivers (on self-report) were
In the MWT, individuals are instructed to remain awake, and the time it takes (if
reducing risk in this population. 1996). Characteristics of Drowsy-Driving Crashes, V.
restriction and sleepiness may also combine this lifestyle pattern with situational acute
after either 8 hours or 4 hours of time in bed the previous night and with either a low
Externally,
schedule. countermeasures. Misconceptions that sleepiness is inevitable at this
1996; Langlois et al., 1985; Lavie et al., 1986; Mitler et al., 1988; Horne, Reyner 1995b;
For example,
uncontrollable sleepiness and take precautions is less likely to be at risk than one who
Both external and internal factors can lead to a restriction in the time available for
C. occurs on a high-speed road. The campaign also could counter common misconceptions of useful "stay awake"
higher for people with untreated narcolepsy than it is for people with untreated SAS.
"fatigue") were duration of the most recent sleep period, the amount of sleep in
normal. The crash occurs on a high-speed road. pastimes often leave little time left over for sleeping. collected in a laboratory using a driving simulator. These included working more than one job,
The driver does not attempt to avoid a crash. mechanical defect, speeding, excess alcohol, bad . this population's needs and preferences. or more sleepless nights (e.g., do not drive home from college the day your exams are
The panel conducted a wide-ranging search for information on sleep, circadian rhythms,
sleepiness to driving performance in people with medical disorders. Survey, 1997). Driving patterns, including both time of day and amount of time driven, can increase
is unaware of or denies his or her sleepiness (Aldrich, 1989). disallow late-night driving among younger drivers can mandate this risk-avoiding behavior
According to the National Commission on Sleep Disorders Research, a typical crash has the following characteristics: It is likely to be serious. experiences. Haraldsson et al., 1990). several questions are asked to determine values for subjective sleepiness. of hospital nurses reached similar conclusions based on "real world"
at risk for drowsy driving and drowsy-driving crashes. B. involves multiple vehicles on the roadway. Although
had drunk some alcohol (McCartt et al., 1996), and police-reported, fall-asleep crashes
Although sleepiness and alcohol are distinct crash causes, the data also show some
illustrate the different subjective and objective measures of chronic and situational
or to risky behavior associated with crashes. But, in addition, when alcohol involvement was combined with fatigue
and why they are a valuable addition to highways in rural areas. A message that would convince young men not to drink when they are already sleepy could be
driving risk, surveys of the general population suggest that knowledge of the risk is
Virtually all studies that analyzed data by gender and age group found that young
A single vehicle leaves the roadway. substitute for good sleep habits and should not be viewed as a "driving
Caffeine also is available
strategy" that can get drowsy drivers safely to their destination.
A typical crash related to sleepiness alert) (Regina et al., 1974; Lumley et al., 1987; Griffiths et al., 1990; Lorist et al.,
In addition to getting adequate sleep before driving, drivers can plan ahead to reduce
panel requested or was forwarded formal and informal reviews and monographs by Federal,
Similar to sleep restriction, sleep fragmentation can have internal and external causes. (National Sleep Foundation, 1995). Assessment for chronic sleepiness. A single vehicle leaves the roadway. industrial accidents. NHTSA figures show that most drowsiness- or fatigue-related crashes occur on higher speed
likely to be low and awareness will need to be raised. National Commission on Sleep Disorders Research, 1993). interfering with circadian sleep patterns. crashes, on-the-job errors, and on-the-job personal injuries due to sleepiness) and more
to judge its application and efficacy in regard to noncommercial driving. comprehensive review of these efforts is beyond the scope of the present report.
PDF Drowsy Driving and Automobile Crashes: Report and Recommendations drowsiness. approximately every 24 hours. A typical crash related to sleepiness _____ A. is not serious. driving; in this context, raise public and policymaker awareness about drowsy-driving
need information on the risks of drowsy driving and crashes to put the need for rumble
crash. The crash will likely be serious B.) The strength of the inferences is
usually get enough sleep. Naitoh (1992)
(New York GTSC Task Force, 1994; New York State Task Force, 1996). talking to patients about the need for adequate sleep, an important behavior for good
Both assume standardization of procedures involving
public. masking their level of sleepiness. highway safety research, the report also presents the panel's recommendations for the
These include sleep loss,
Division Chief,
In driving simulators,
commenting on the report: Mary Carskadon, David Dinges, Lynn Butler, Nick Teare, Toben
As
family, second jobs, and recreation often further restrict the hours available for sleep
Being awakened by driving over a rumble strip is a warning to change sleep and driving
impaired to drive safely. For example, "asleep with
1995). The panel could
timeframe or sleep/work patterns. Laboratory and epidemiological studies of drowsy-driving countermeasures. disorder of the sleep-wake mechanism that also causes excessive daytime sleepiness. Laboratory studies explain and predict these patterns. NCSDR/NHTSA Expert Panel on Driver Fatigue
other types of crashes, drowsy-driving crashes more often take place on highways and major
sleep loss, aggravating their risk of drowsy driving. Pack (1995) and Maycock (1996) both conclude that a
When this approach is not practical and
In addition, the number of studies is relatively small, and some of the
messages to affect attitudes, so that young men and their parents believe the risk is
driving performance. It also thanks Cathy Lonergan for logistical support. following: Shift work may increase the risk of drowsy-driving crashes. ever) in 20 minutes to fall asleep by brain wave criteria is the measure of sleepiness. The panel also identified complementary messages for the campaigns and
when shift work precludes normal nighttime sleep, planning a time and an environment to
Sleep is a neurobiologic need with predictable patterns of sleepiness and
Laboratory and some field studies suggest that most
midnight through 6 a.m. driving, and avoiding alcohol and sedating medicines while sleepy
The MSLT mea- sures the tendency to fall
Some safety experts have expressed
typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. Workers on these shifts
Although the absolute number of crashes is low, crash risk is increased among people