Cataplexy, a sudden loss of muscle tone ranging from slight weakness
fragmented by frequent interruptions (Marcus, Loughlin, 1996). Hospital interns and residents routinely lose sleep during on-call periods, which may
The return to day work and morning shifts starting
Drowsy driving is a serious problem that leads to thousands of automobile
in recent times" in situations like sitting and reading, watching TV, and sitting in
Director
Wilkins and colleagues (1997) confirmed that crashes attributed to driver fatigue have
time in bed does not mean that adequate sleep has been obtained. (1994) were
fall-asleep crashes. The information gathered with these instruments has not been as widely applied to
The panel speculated that drinking
Naitoh (1992)
fall-asleep crashes. The panel would like to thank the following people for their assistance in reviewing and
Pack (1995) and Maycock (1996) both conclude that a
Consumer Automotive Safety Information Division
Sleep fragmentation. people, and males in particular, were the most likely to be involved in fall-asleep
The time from onset of
Question Drivers ages 45 through 65 have fewer nighttime
amenable to change. passenger, talking on a cellular phone or CB radio, chewing gum or ice, or snacking. One in four respondents who reported sleeping difficulties in a
Most current estimates of fatigue-related crashes are between 2 and 4% of total crashes. SAS or narcolepsy perform less well on driving simulation and vigilance or attention tests
strips on the highway in the future could repeatedly remind people of the message. The crash will likely be serious B.) and why they are a valuable addition to highways in rural areas. crashes; their value with other types of sleepiness or inattention crashes or other types
The current tools for the assessment of sleepiness are based on questionnaires and
midafternoon (Studies of police crash reports: Pack et al., 1995; Knipling, Wang, 1994;
Critical aspects
experiences. asleep in a standardized sleep-promoting situation during four or five 20-minute nap
disallow late-night driving among younger drivers can mandate this risk-avoiding behavior
continuity across a wide spectrum of prior sleep length and fragmentation. Laboratory tools for measuring sleepiness include the Multiple Sleep Latency Test
Pack and colleagues (1995) found that most sleepiness-related crashes occur at
Division of Pulmonary and Critical Care Medicine
(Dinges, 1995). disorder of the sleep-wake mechanism that also causes excessive daytime sleepiness. also appear to be a relatively low-cost solution with a positive benefit-to-cost ratio
However, because SAS is more common than narcolepsy, the absolute number of crashes is
The Expert Panel on Driver Fatigue and Sleepiness especially acknowledges
The sleep-wake cycle is governed by both homeostatic and circadian factors. designed to provide direction to an NCSDR/NHTSA educational campaign to combat drowsy
The midnight to 8 a.m. shift
there have been about 56,000 crashes annually in which driver drowsiness/fatigue was cited
A single vehicle leaves the roadway. In the
Sleep and wakefulness also are
suggest that they tell teenagers to call for a ride at any hour without recriminations if
radio, has not been demonstrated. fatigue-related accidents was one of its most wanted transportation safety improvements for 2016. strategies that enable some workers to adapt successfully to this situation are not well
group is high school age and more likely to live at home with parents; members of the
The panel concluded that the data on fatigue and inattention provide less support for
generally recommended in an educational campaign as a drowsy-driving countermeasure
younger than 30 accounted for almost two-thirds of drowsy-driving crashes, despite
critical to safe driving (Dinges, Kribbs, 1991). evaluate driver sleepiness. pain (Carskadon, 1993b). There is insufficient evidence at present
sleepiness range from "just about asleep" (left end) to "as wide awake as I
identified a number of chronic predisposing factors and acute situational factors that
experience sleep loss and sleep disruption that reduce alertness (kerstedt, 1995b; Samel
The number of off-road deviations by the driver was 4 times
Although evidence is limited or inferential, chronic predisposing factors
Homeostasis relates to the neurobiological need to sleep; the longer the period of
acute risk factors and frequently being on the roads during nighttime hours (greater
driver becomes sleepy, the key behavioral step is to stop driving-for example, letting a
This Context, Raise Public Awareness About Drowsy-Driving Risks and How To Reduce Them, Educate Shift Workers About the Risks of Drowsy Driving and How To Reduce Them, Other Organizations Can Provide Drowsy Driving Education. and wakefulness, restriction of sleep, and/or interruption or fragmentation of sleep. currently exist for measuring sleepiness in the immediacy of crash situations. and quantity of sleep. At best they can help sleepy drivers stay awake and alert
messages to affect attitudes, so that young men and their parents believe the risk is
Ph.D.
approaches that are effective for reaching high-risk audiences will need to be developed
controlled-access, rural roads reduce drive-off-the-road crashes by 30 to 50 percent. typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. acute as well as chronic sleep loss. Successful strategies from drinking and driving campaigns might also be adapted to
Homeostatic factors govern circadian factors to regulate the
regularly produces feelings of sleepiness during the afternoon and evening, even among
F. rom high-profile politicians and celebrities to the general population, people often
In regard to
A few
More than one in three New York State drivers surveyed in drowsy-driving crashes said they
No definitive criteria are available for establishing how
methodological detail, outcome measures, and other variables, all of which precluded a
Director National Center on Sleep Disorders Research
approximately every 24 hours. and crashes, the panel believes that shift workers' increased risks for sleepiness are
sleepiness do not last long. The average fatality in an alcohol-related traffic crash costs $1.1 million. self-reports of the quality of sleep. The crash occurs on a high-speed road. differences have been found (Harma, 1993). instead of driving while sleepy. caffeine equivalent to two cups of coffee may help improve alertness for a short period. Workers on these shifts
at the wheel may be a major factor that motivates undiagnosed patients to seek medical
scene or retrospectively) that gather information on driver behavior preceding the crash
socializing, preparing for a trip or vacation, and "pulling all nighters" are
hours of sleep per 24 hours as compared with day workers. begin. factors sometimes are involuntary, such as a medication effect that interrupts sleep. A recent synthesis of reports on the effectiveness of rumble strips shows
Laboratory studies using a driver simulator or other fundamental tests that relate the
Studies of crash data that identify the characteristics of crashes in which the driver
Those who suffer chronic sleep
occur about 12 hours after the midsleep period (during the afternoon for most people who
Sleep apnea syndrome is somewhat more common among males than among females, and
Subjective and objective tools are available to approximate or detect
According to the National Commission on Sleep Disorders Research, a typical crash has the following characteristics: It is likely to be serious. effects (Kerr et al., 1991). The "all nighter" represents an acute risk because extreme tiredness
comes quickly (Mitler et al., 1988; National Transportation Safety Board, 1995). attitudes, and behaviors will need to be examined. experience and is defined as a disinclination to continue the task at hand. Score 1 User: There were more than__________ people injured in alcohol-related crashes in Florida. Although people with untreated sleep apnea syndrome may not be aware of the brief
Complementary educational messages to parents might
commenting on the report: Mary Carskadon, David Dinges, Lynn Butler, Nick Teare, Toben
environment (a room that is cool, quiet, and dark) and sleeping at regularly scheduled
As discussed in section II, the loss of
strict comparison. The scale correlates with standard
representing only about one-fourth of licensed drivers. that go off when indications of sleepiness occur. Information could be provided to the public and policymakers about the
or other measurable test is currently available to quantify levels of sleepiness at the
for about 15 minutes upon awakening from naps longer than 20 minutes (Dinges, 1992). shift workers in both the natural environment and the laboratory have shown that day sleep
younger drivers (25 years of age and younger) and drivers between the ages of 26 and 45. As noted earlier, the circadian pacemaker
Weegy: There were more than 12,000 people injured in alcohol-related crashes in Florida. risks for drowsy driving and effective countermeasures. sleepiness, drowsiness, sleep physiology, and sleep disorders, as well as on the
North Carolina, more of these crashes resulted in injury compared with other,
in which the driver may have fallen asleep. Training, occupation, education, motivation, skill level, and intelligence exert no
at high risk are young people, shift workers, and people with untreated sleep conditions. to fatigue and inattention, and given the lack of objective tests or uniform reporting
Other self-report instruments
1 in 10 saying the difficulties are frequent (National Sleep Foundation, 1995). steps include planning sleep and naps before long trips, scheduling trips to avoid
The driver does not attempt to avoid crashing. little is known about the knowledge and attitudes of this group regarding sleepiness and
sense; however, few rigorous studies support all sleep hygiene claims. commitments were most likely to report falling asleep at the wheel. The panel noted that the wake-up effects from remedial approaches to existing
5 hours per night for 1 week needed two full nights of sleep to recover vigilance,
External factors, some beyond the individual's control, include work hours, job and
the stresses of shift work varies (Harma, 1993), and the background factors or coping
No current data link other sleep disorders with
However, focus groups of youth in New York State revealed that drowsy-driving
young men will recognize themselves in the picture of a chronically sleepy student who
is not okay to drive when you are sleepy. Performance Slows With Sleep
However, rumble strips are not a solution for sleepy drivers, who must view any wake-up
uncomfortable seat or position and shivering or sweating) may also keep sleepy drivers
diaries (Douglas et al., 1990) and the Sleep Disorders Questionnaire (Douglas et al.,
these disorders and found a positive effect (Cassel et al., 1996; Haraldsson et al.,
As in the SSS,
reduce lifestyle- related risks. Sleep restriction or loss. Administration (NHTSA) and the National Center on Sleep Disorders Research (NCSDR) of the
alcohol" crashes involved a higher percentage of young males than did crashes in
Short-term work demands, child care,
(acute sleepiness) or routinely (chronic sleepiness). which the driver was asleep with no evidence of alcohol. and 1 in 20 scored at the "severe" sleepiness level (National Sleep Foundation
obtain sufficient restorative sleep. Napping has the greatest effect on performance several hours after the nap (Dinges
Deputy Director
crashes, with a peak at 7 a.m. The driver does not attempt to avoid a crash. As a result, our understanding of drowsy-driving crashes is based on subjective
These data from Roehrs et al. of roads has not been studied. Some of the crash-related factors have been studied more than others. These rumble strips placed on high-speed,
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 points on the continuum, from low-level drowsiness to falling asleep at the wheel. Laboratory studies explain and predict these patterns. line that indicates how sleepy they are feeling. to sleep at 2-hour intervals across the 24-hour day. that risk is highest soon after the drug regimen is initiated and falls to near normal
in developing successful educational approaches. performance and increase crashes. evidence of a corrective maneuver, such as skid marks or brake lights, is usually absent
Campaign: Panel Recommendations, Figure 1. behaviors, such as exercising, turning on the radio, or opening the windows, which have
Changes in sleep patterns that reduce nighttime sleep or lead to circadian disruptions. naps and the need for secure rest areas. shift work and drowsy driving issues. effects. The crash occurs on a high-speed road. same trend but also suggest that sleepiness may play a role in rear-end crashes and
Definitions of "young" differed among authors; the ages included in this
more than one-third of those who drove drowsy without crashing) reported having worked the
following brief discussion, some tools for the assessment of sleepiness are described to
currently used, can emphasize what rumble strips are, their relative cost-effectiveness,
In addition, a study of hospital house staff working around the clock (Marcus,
Personal Demands and Lifestyle Choices. reducing risk in this population. Findley and
between 4 a.m. and 7 a.m. also may lead to sleepiness. A typical crash related to sleepiness __________ A.) negative effects this choice can have on health and functioning (Mitler et al., 1988). uninterrupted sleep, which may help reduce sleepiness on the job and behind the wheel. sleep can reduce sleep debt. common causes of acute sleep loss. National Commission on Sleep Disorders Research, 1993). The crash is likely to be serious. Circadian factors. Fatigue and Sleepiness reviewed the research conducted to date on drowsy-driving crashes. The panel also believes it may be worthwhile to educate
Study guides. causes of sleepiness and drowsy driving in people without sleep disorders are sleep
This approach promotes longer,
Institute for Traffic Safety Management and Research
to complete collapse, is another major symptom of narcolepsy that increases the risk of
Maturational changes that increase the need for sleep. Focus group research is needed to develop
In another alcohol strategy variation, parents might allow
For example, "asleep with
latency of return to sleep was measured. However, the
risks and how to reduce them. Medical systems have been successful in identifying only a fraction
The panel conducted a wide-ranging search for information on sleep, circadian rhythms,
In the
Employers, unions, and shift workers are potential target audiences for education on
example, people with chronic sleep loss who drive in the early morning hours are likely to
standard Multiple Sleep Latency Test procedures. educational opportunities to convey key drowsy-driving messages. These conditions are unrecognized and untreated in a substantial number of people
driving, a psychologically based conflict occurs between the disinclination to drive and
defining risk factors and high-risk groups than the data on sleepiness or drowsiness. normal. matched controls who did not participate in the program. Although alcohol and some medications can independently induce sleepiness, the primary
Research has shown that effective steps are available for both employers and employees
throughout the day. NHTSA data
looking for evidence of a sleepiness effect in categories of inattention or fatigue. The driver is alone in . overtime, or rotating shifts is a risk for drowsy driving that may be both chronic and
physical training program reported sleeping longer and feeling less fatigue than did
The strips are not a technological quick fix for sleepy drivers. A single vehicle leaves the roadway. see sleep as a luxury. increased when different types of studies reach similar conclusions. 1994). to have more time to work, study, socialize, or engage in other activities. the need to drive. Population surveys that relate driver factors to fall-asleep or drowsy-driving crashes
irregular hours and nighttime hours. In the New York State survey, the reported frequency of drowsy driving in the past year
Drivers who reported having trouble staying awake during the day
1996). although caffeine content of coffee varies widely (Fox, 1993). The risk of a crash related to sleepiness increases during nighttime hours among both
(McCartt et al., 1996). In addition, periods of work longer than 8 hours have been shown to impair task
Score 1 User: There were more than__________ people injured in alcohol-related crashes in Florida. However, unlike the situation with alcohol-related crashes, no blood, breath,
disturbances, poor sleep quality often leads to daytime sleepiness. the risk of drowsy driving in other ways. at risk for drowsy driving and drowsy-driving crashes. fall-asleep crashes during the midafternoon (Pack et al., 1995; Wang, Knipling, Goodman,
However, it is clear that these factors are cumulative, and any
The recommended action is not to start a long drive after one
can make a short-term difference: Napping. intermediate risk, based on subjective reports of their having higher levels of sleepiness
Job-Related Sleep Restriction. NHTSA found that drivers had consumed some alcohol in nearly 20
following: Shift work may increase the risk of drowsy-driving crashes. A more informed medical community could help reduce drowsy driving by
(based on a 24-hour clock), subjects were awakened every 2 hours for 15 minutes, and
; Before you drive, avoid taking medicines that make you sleepy. For
1994). Problems related to these factors may confound interpretation between
make a short-term difference in driving alertness: taking a short nap (about 15 to 20