over-representation in crash statistics and because many of their lifestyle risks are
The reasons young males have more crashes than do young females
Regularly losing 1 to 2 hours of sleep a
followup survey, three of four Americans who reported getting as much or more sleep than
circadian sleepiness peak is expected. 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
is instructed to try to fall asleep. Wiki User. et al., 1987; Dinges, 1992, 1995). driving. The panel also believes it may be worthwhile to educate
Knipling, Goodman, 1996). Rotating shifts (working four or more day or evening shifts and four night
Potential sponsors may
line that indicates how sleepy they are feeling. The scale correlates with standard
The time from onset of
Young people (ages 16 to 29), especially males. care. crashes; their value with other types of sleepiness or inattention crashes or other types
sense; however, few rigorous studies support all sleep hygiene claims. (Novak, Auvil-Novak, 1996). number of miles each year and a greater number of hours each day (McCartt et al., 1996)
ethanol concentrations. panel; when possible, more recent material or reviews are preferentially cited. al., 1997). management of sleepiness and sleep disorders reduce crash risk or incidence. irregular hours and nighttime hours. impairment that could assist investigating officers in attributing a crash to sleepiness. and affect other performance variables), mechanical problems, or other factors and by
ever) in 20 minutes to fall asleep by brain wave criteria is the measure of sleepiness. A study
Figure 4. manner by which law enforce- ment officers can assess and report crashes resulting from
other types of crashes, drowsy-driving crashes more often take place on highways and major
Countermeasures include following effective strategies for scheduling shift changes and,
Studies were performed in the morning
Because of the
commitments were most likely to report falling asleep at the wheel. Although evidence is limited or inferential, chronic predisposing factors
increases crash risk. young men will recognize themselves in the picture of a chronically sleepy student who
likely to have such a crash than were drivers ages 30 years or older. Under-
asleep faster are sleepier. crash site. differences have been found (Harma, 1993). highest priority target audiences and educational message points for the NCSDR/NHTSA
overtime, or rotating shifts is a risk for drowsy driving that may be both chronic and
Driving between midnight and 6 a.m. is a high-risk situation. to judge its application and efficacy in regard to noncommercial driving. 2017-03-07 19:52:48. 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. Office of Research and Traffic Records
sleepiness (Kerr et al., 1991). This
No measures
fundamental work situation, they and their families may benefit from information on their
have the greatest negative effects on alertness (Rosenthal et al., 1993a; Gillberg, 1995). The driver could see the point of run-off or the object hit prior to the crash. after several months (Ceutel, 1995). which people rate their current level of alertness (e.g., 1= "feelingwide
public. drift (Dinges, 1995). People who have
approximately every 24 hours. An impediment to diagnosis is a lack of physician education on the recognition of
Department of Medical-Surgical Nursing Center for Narcolepsy Research
Key message points include the
Although many shift workers are not in a position to change or affect their
messages to affect attitudes, so that young men and their parents believe the risk is
sleepiness and sleep disorders (National Commission on Sleep Disorders Research, 1993). The effects of sleep
strategies that enable some workers to adapt successfully to this situation are not well
Although current understanding largely comes from inferential evidence, a typical crash related to sleepiness has the following characteristics: Only
The VAS
drowsy driving. Such measures are often promoted as "sleep hygiene" and make intuitive
shift]) could enhance understanding of the problems. State of New York, David Willis
Driving patterns, including both time of day and amount of time driven, can increase
higher speeds, attributing this finding to the effect of sleep loss on reaction time. than after 8 hours of sleep (Roehrs et al., 1994) (see figure 4). does not permit younger drivers to drive during late night hours (e.g., after midnight). collected in a laboratory using a driving simulator. At best they can help sleepy drivers stay awake and alert
for drowsy-driving crashes. important contribution by disseminating messages to high-risk audiences, intermediaries,
percent of all sleepiness-related, single-vehicle crashes (Wang, Knipling, Goodman, 1996). Sleep can be irresistible; recognition is emerging that
These rumble strips placed on high-speed,
of driving while drowsy, or unaware of the seriousness of the difficulty they may
The presumption under-lying this test is that people who fall
Examples include brain wave monitors, eye-closure
1994; Wilkinson, 1968;
Although people with untreated sleep apnea syndrome may not be aware of the brief
typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. sleepy a driver is or a threshold at which driver sleepiness affects safety. In addition, the
interfering with circadian sleep patterns. prevention of fall-asleep crashes. be at greater risk than are early morning drivers who slept well the night before and
combination of chronic and acute factors substantially increases crash risk. true Exceeding the speed limit or driving too fast for conditions is not a contributing factor in the vast majority of fatal motor vehicle crashes. Messages to the general public can explain the following: What rumble strips are and why they are increasingly being used. sleepiness. V on shift workers.). These leaders may need information on the drowsy-driving problem and the special risks of
Relevant impairments identified in
Weegy: There were more than 12,000 people injured in alcohol-related crashes in Florida. inattention (Treat et al., 1979). loss are cumulative (Carskadon, Dement, 1981). had a higher proportion of alcohol involvement than other types of crashes in that State. times. In the New York State survey, nearly one-half the drowsy drivers who crashed (and
Fall-asleep crashes are likely to be serious. You can take effective steps to reduce your risks. the risk of drowsy driving in other ways. Laboratory studies explain and predict these patterns. at high risk are young people, shift workers, and people with untreated sleep conditions. awake" to 7= "sleep onset soon"). recent studies and reviews make an explicit assumption that given the uncertainty in crash
campaign materials to inform and assist their own audience-specific efforts. roads in nonurban areas. before driving again. obtain historical information pertinent to sleepiness using patient logs and sleep-wake
Anecdotal reports also suggest that
symptoms to diagnosis of narcolepsy averages 10 years (American Thoracic Society, 1994;
Sleepiness causes auto crashes because it impairs performance and can
At the same time, this age group is at
was associated with the quantity and quality of sleep obtained. shifts or more within a month) caused the most severe sleep disruptions of any work
However, other sponsors can make an
Despite these caveats,
Haraldsson et al., 1990). Narcolepsy is a
(New York GTSC Task Force, 1994; New York State Task Force, 1996). other shifts to report nodding off at work and at the wheel and having had a driving
All factors may interact, and
Educate shift workers about the risks of drowsy driving and how to
People with untreated sleep apnea syndrome (SAS) and narcolepsy. Annual averages of roughly 40,000 nonfatal injuries and 1,550 fatalities result
to fall asleep again unless he or she stops driving. It also thanks Cathy Lonergan for logistical support. Studies of commercial vehicle drivers present similar findings. Eliminating stress from your life is possible.Your Answer: ACorrect Answer: B. FALSEIncorrect!Explanation: Item found in Section 7.1 3. Promote shoulder rumble strips as an effective countermeasure for drowsy driving; in
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. Employers, unions, and shift work employees need to be informed about
This approach promotes longer,
occur about 12 hours after the midsleep period (during the afternoon for most people who
The typical crash related to sleepiness has the following characteristics: The problem occurs during late night, early morning or midafternoon. Laboratory and some field studies suggest that most
As in the SSS,
talking to patients about the need for adequate sleep, an important behavior for good
people taking more than one sedating drug simultaneously (Ray et al., 1992). In the New York State survey, the reported frequency of drowsy driving in the past year
People scoring 10 to 14 are rated as moderately sleepy,
Be notified when an answer is posted. night can create a "sleep debt" and lead to chronic sleepiness over time. Personal Demands and Lifestyle Choices. The Sleep-Wake Cycle ; Sleepiness Impairs Performance ; The Causes of Sleepiness/Drowsy Driving ; Evaluating Sleepiness ; III. National Highway Traffic Safety Administration, Anne T. McCartt,
risk, research to date clearly identifies three broad population groups at high risk for
are intended to measure sleepiness or some behavior associated with sleepiness in
The resulting report outlines the following: In addition to summarizing what is known-and what remains unknown-from sleep and
Sleep restriction or loss. panel found no studies evaluating other driver-reported steps such as talking to another
The information gathered with these instruments has not been as widely applied to
subject to parental authority. 1995). environment (a room that is cool, quiet, and dark) and sleeping at regularly scheduled
Another strategy is to avoid driving home from work while sleepy (e.g.,
; Before you drive, avoid taking medicines that make you sleepy. Policymakers also may
acute. apnea syndrome (SAS) and narcolepsy. people, and males in particular, were the most likely to be involved in fall-asleep
The behavioral steps discussed earlier for younger males also seem reasonable for
approaches that are effective for reaching high-risk audiences will need to be developed
Other rating tools that measure an individual's experience with sleepiness over an
times are inconsistent with the natural sleep-wake cycle. people who are not sleep deprived (Dinges, 1995). greater than that of sleepiness or alcohol alone (Roehrs et al. Special Assistant to Executive Deputy Commissioner
Successful strategies from drinking and driving campaigns might also be adapted to
1994). The key to safety is what the driver does after hearing the
and point out the risks and possible consequences of drowsy driving. begin. typical crash related to sleepiness has the following characteristics: The problem occurs during late night/ early morning or midafternoon. the true prevalence of drowsy-driving crashes, it will be important to develop a standard
can make a short-term difference: Napping. because the well-established risks substantially outweigh the possible benefits. instead of driving while sleepy. drowsiness. sleep-deprived drivers who consumed caffeine reduced lane deviations, potential crashes,
drowsy-driving crashes. A single vehicle leaves the roadway. Retrospective studies that compare crash histories of drivers with sleep disorders with
An ideal measure of sleepiness would be a physiologically based screening tool that is
Employers, unions, and shift workers are potential target audiences for education on
extended or night shift are special risks for a drowsy-driving crash. sleep at night) and before the next consolidated sleep period (most commonly at night,
the stresses of shift work varies (Harma, 1993), and the background factors or coping
Although its conclusions were based on a limited body of knowledge, the panel
the keywords listed above and following suggestions for linkage to related topics (e.g.,
Young males, ages 16 to 24, received highest priority because of their clear
without crashing were less likely to have been alone in the automobile. people (Horne, Reyner, 1995a; Dinges et al., 1987; Philip et al., 1997). when shift work precludes normal nighttime sleep, planning a time and an environment to
Although this evidence does not demonstrate a conclusive association between shift work
inattention, which is believed to be a larger problem.". Nelson, Nancy Isaac, Kathy Rechen, and, at Prospect Associates, Donald Cunningham and
show that sleepy drivers are less likely than alert drivers to take corrective action
Sleepiness, Kingman P.
However, when they sit still, perform repetitive tasks
The report presents the results of a literature review and opinions of the Expert
and driving a longer time without taking a break or, more often, driving for 3 hours or
reported in the categories of fatigue and inattention, and it reached consensus that
evaluations of potential countermeasures, most of which were laboratory studies. and mortality associated with drowsy-driving crashes are high, perhaps because of the
such as night workers, air crews, and travelers who cross several time zones, can
Sleep apnea, with its repeated episodes of nocturnal . You can take effective steps if you become sleepy while driving. and crashes, the panel believes that shift workers' increased risks for sleepiness are
well with behavioral indicators of sleepiness; in other words, people with obvious signs
sleepy friends of teens to sleep over rather than drive home. Focusing an Educational
Ph.D.
Research has shown that effective steps are available for both employers and employees
When this approach is not practical and
During this period, young people are learning to drive,
with circadian rhythms that produces sleepiness in the afternoon and evening (Roehrs et
Drivers ages older than 65 are more likely to have
after night work and early night sleep before morning work (e.g., going to sleep at 7 or 8
getting a ride from a family member, taking a cab, napping before heading home). of roads has not been studied. of night nurses working 12-hour shifts reported having had an automobile accident or
1988), listening to the car radio, or opening the car windows (Horne, Reyner, 1995a). Panel members noted the possibility that more crashes occur on
sleepiness while driving, and in many studies a majority of shift workers admit having
crashes were single-vehicle roadway departures (Pack et al., 1995). can be" (right end). Critical aspects of driving impairment associated with sleepiness are reaction time, vigilance, attention, and information processing. Horne and Reyner (1995a) suggest that a combination of having more of the chronic and
The detection and management of illnesses
from these crashes. 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,
messages could be lost or ignored if paired with "don't drink and drive"
University of Illinois, Jesse Blatt,
complements Federal Highway Administration efforts to address the problem among commercial
within the 25-to-34 age group (McCartt et al., 1996), and both the 18-to-24 and 25-to-39
higher proportion of the most serious crashes are sleepiness related. The MSLT mea- sures the tendency to fall
focused on the prevention of inattention and fatigue; traffic crash forms did not have a
The strips are useful
They are not a
Males. acute risk factors and frequently being on the roads during nighttime hours (greater
masking their level of sleepiness. Graduated driver-licensing programs that
1 answer. Fatigue and Sleepiness reviewed the research conducted to date on drowsy-driving crashes. the previous 24 hours, and fragmented sleep patterns. drowsiness was markedly greater during night driving than during daytime driving, with
Director
Circadian factors. identified a number of chronic predisposing factors and acute situational factors that
The subgroup at
Consumption of alcohol, which interacts with and adds to
are 5 times more likely than females to be involved in drowsy-driving crashes (Wang,
amenable to change. One in three of the adult
people who perform shift work-and are thus exposed to crash risk-is increasing. Juggling work and
The biology of human sleep and sleepiness, which physiologically underlies crash risk. further, creating different messages for the 16-to-18 and 19-to-24 age groups. midafternoon peaks are consistent with human circadian sleepiness patterns. This similarity suggests the possibility that the researchers' initial
dose-response manner (Stradling et al., 1991; Philip et al., 1996; Hanning, Welch, 1996;
effects (Kerr et al., 1991). conditions are undiagnosed and untreated, unaware of the potentially serious consequences
An active lifestyle that restricts sleep is a special risk. Countermeasures for drowsy driving aim either to prevent it or to ameliorate it after
Although effective treatments are available for both narcolepsy and obstructive sleep
assumptions influenced the determination of crash characteristics. self-reports of the quality of sleep. Although the absolute number of crashes is low, crash risk is increased among people
targeted only the younger group to enable specific tailoring of educational messages to
In sleep apnea syndrome, brief interruptions of air flow and loss of oxygen during
several questions are asked to determine values for subjective sleepiness. Many also were unlikely to use a rest area when they were driving alone at
effective measures they can take to reduce sleepiness resulting from shift work schedules. Sleep is a neurobiologic need with predictable patterns of sleepiness and
It is widely recognized that these statistics under report the extent of these types of crashes. strips in perspective. A message that would convince young men not to drink when they are already sleepy could be
public was deemed "significantly" sleepy on the Epworth Sleepiness Scale (ESS),
Sharpley, 1996; Martikainen, 1992). As a result, our understanding of drowsy-driving crashes is based on subjective
Question The crash is likely to be serious. Hospital interns and residents routinely lose sleep during on-call periods, which may
Carskadon (1990) offers a variety of age-specific reasons for the involvement of younger
The ESS has been used in research on driver sleepiness and in correlations of
crashes, on-the-job errors, and on-the-job personal injuries due to sleepiness) and more
true job-related duties (e.g., workers who are on call) can interrupt and reduce the quality
The driver is alone in the vehicle. drivers surveyed about their lifetime experience with drowsy driving, almost one-half of
likely to be low and awareness will need to be raised. Currently about one in
instead of sleep, and work hours and demands are a major cause of sleep loss. throughout a 24-hour period. in which the driver may have fallen asleep. crashes than did those with untreated mild apnea. Effective countermeasures used to prevent drowsy driving and related crashes. The condition also is associated with loud, chronic
A single vehicle leaves the roadway. In the MWT, individuals are instructed to remain awake, and the time it takes (if
near-miss accident while driving home from night work (Novak, Auvil-Novak, 1996). The panel believes that focusing a campaign on shoulder rumble strips offers multiple
A
vehicle drivers (Federal Register, 1996). of alcohol, and the combination adversely affecting psychomotor skills to an extent
New York State GTSC Sleep Task Force, 1994; New York State Task Force on Drowsy Driving,
during late night/early morning hours increases risk for all drivers because those hours
The average fatality in an alcohol-related traffic crash costs $1.1 million. One result can be a progressive withdrawal of attention to the tasks
the usefulness of these tools. crashing. performance measures, is sensitive to sleep loss, and can be administered repeatedly
There is insufficient evidence at present
family responsibilities, and school bus or school opening times. also identifies preoccupation, distractions inside the vehicle, and other behaviors as
risks for drowsy driving and effective countermeasures. 1996). Countermeasures. by police. not available. vehicles are going off the road. A
care professionals may not recognize a history of sleepiness as a risk factor for
crashes (Pack et al., 1995; Horne, Reyner, 1995b; Maycock, 1996; Knipling, Wang, 1994). related crashes include: Driving patterns, including driving between midnight and 6
The effectiveness of any
The driver is alone in . performance and increase crashes. alarm. Cataplexy, a sudden loss of muscle tone ranging from slight weakness
A typical crash related to sleepiness __________ A. is not serious. Institute for Traffic Safety Management and Research
The messages might be the following: sleepiness is not inevitable for teens, and it
Drowsy driving is a serious problem that leads to thousands of automobile
Medical systems have been successful in identifying only a fraction
sleep loss, aggravating their risk of drowsy driving. or to risky behavior associated with crashes. British study (Maycock, 1996), respondents said that working the night shift led to
Competing demands from
near-miss crashes than did nurses on other schedules (Gold et al., 1992). driving risk, surveys of the general population suggest that knowledge of the risk is
performance, and normal mood (Dinges et al., 1997). effective alerting device may prevent one crash, a driver who falls asleep once is likely
may rely on surrogate mea- sures of sleepiness, such as duration of sleep in a recent
About 25 percent reported
Sleep-restrictive work patterns. slept involuntarily on the night shift. A patient who can recognize impending
However, nappers are often groggy
These data from Roehrs et al. most effective way to reduce sleepiness. road could be an attention-getting way to highlight the prevalence of chronic sleepiness
Conversely, respondents who reported having fallen asleep
study suggests that talking on a cellular phone while driving is associated with increased
they need because their schedules do not allow adequate time for it.