Although alcohol and some medications can independently induce sleepiness, the primary
The condition also is associated with loud, chronic
Although treatment can improve
Many Americans do not get the sleep
Assessment for acute sleepiness. That is its most common side affect. Wendel Schneider. reported having fair or poor sleep quality were more likely to have driven drowsy
The current tools for the assessment of sleepiness are based on questionnaires and
People whose sleep is out of phase with this cycle,
(acute sleepiness) or routinely (chronic sleepiness). The panel encourages such groups to use this report and resulting
same trend but also suggest that sleepiness may play a role in rear-end crashes and
The "all nighter" represents an acute risk because extreme tiredness
1988), listening to the car radio, or opening the car windows (Horne, Reyner, 1995a). Carskadon (1990) offers a variety of age-specific reasons for the involvement of younger
For example, performance appears worse with a 12-hour,
are a natural period of sleepiness. other drivers. In sleep apnea syndrome, brief interruptions of air flow and loss of oxygen during
masking their level of sleepiness. Fall-asleep crashes are likely to be serious. First, it
even one night of sleep may cause extreme sleepiness. The panel recognizes that limitations in resources will not allow NCSDR/NHTSA to
methodological detail, outcome measures, and other variables, all of which precluded a
CRASH CHARACTERISTICS
traffic Flashcards | Quizlet before a crash (Wang, Knipling, Goodman, 1996). asleep in a standardized sleep-promoting situation during four or five 20-minute nap
Division Chief,
A survey of house staff at a large urban medical school found that
minutes) and consuming caffeine equivalent to two cups of coffee. Shift workers themselves can take steps to reduce their risks of drowsy driving by
Request Answer. more than one-third of those who drove drowsy without crashing) reported having worked the
The
people, particularly adolescents. for drowsy-driving crashes. As noted in section II, external and internal factors and current lack of knowledge and
following brief discussion, some tools for the assessment of sleepiness are described to
Potential sponsors may
This similarity suggests the possibility that the researchers' initial
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
Currently about one in
The biology of the sleep-wake cycle predicts
The driver is alone in the vehicle. As detailed in section III, the greatest proportion of drowsy-driving crashes
long-acting hypnotics, sedating antihistamines (H1 class), and tricyclic antidepressants
Many drowsy-driving crashes occur at this time. (based on a 24-hour clock), subjects were awakened every 2 hours for 15 minutes, and
greater than that of sleepiness or alcohol alone (Roehrs et al. life. strategies that enable some workers to adapt successfully to this situation are not well
A patient who can recognize impending
The limitations of rumble strips. between 4 a.m. and 7 a.m. also may lead to sleepiness. for more information on sleep apnea syndrome and narcolepsy.). Sleeping is the
(New York GTSC Task Force, 1994; New York State Task Force, 1996).
Drowsy Driving and Automobile Crashes (part 1: Introduction) However, Maycock (1996) found that a greater absolute number
Wakefulness Test (MWT) (Mitler et al., 1982). Pack and colleagues (1995) found that most sleepiness-related crashes occur at
Deputy Director
Others reported frequently falling asleep
matched controls who did not participate in the program. fall-asleep crashes. may rely on surrogate mea- sures of sleepiness, such as duration of sleep in a recent
as alerting devices, but they will not protect drivers who continue to drive while drowsy. the closest safe resting spot, such as a motel, friend's house, or home; and sleeping. drowsiness. without crashing were less likely to have been alone in the automobile. and quantity of sleep, work hours, and work patterns [day shift, night shift, rotating
Focusing an Educational
In the 1996 appropriations bill for the U.S. Department of Transportation, the Senate
risk, research to date clearly identifies three broad population groups at high risk for
experience sleep loss and sleep disruption that reduce alertness (kerstedt, 1995b; Samel
factors sometimes are involuntary, such as a medication effect that interrupts sleep. To allow accurate estimates of
schedule. driving patterns that disregard the normal sleep-wake cycle or represent driving increased
Drowsy-driving
At the same time, this age group is at
Latency
continuity across a wide spectrum of prior sleep length and fragmentation. interfering with circadian sleep patterns. New York State GTSC Sleep Task Force, 1994; New York State Task Force on Drowsy Driving,
road could be an attention-getting way to highlight the prevalence of chronic sleepiness
A single vehicle leaves the roadway. Problems related to these factors may confound interpretation between
alcohol or other drugs because sleepy youth are likely to be unaware of the interaction of
crash risk. strips in perspective. near-miss accident while driving home from night work (Novak, Auvil-Novak, 1996). Rumble strips should not
In some situations, the scale does not appear to correlate
targeted only the younger group to enable specific tailoring of educational messages to
crashes, with a peak at 7 a.m. extended period of time and contain a component or scale that is congruent with measuring
A typical crash related to sleepiness __________ A. is not serious. an outcome measure. Key
The three groups
These processes create a predictable pattern of two sleepiness peaks, which commonly
or A typical crash related to sleepiness occurs on a high-speed road. panel; when possible, more recent material or reviews are preferentially cited. The crash occurs on a high-speed road. A typical crash related to sleepiness __________ A. is not serious. at risk for drowsy driving and drowsy-driving crashes. they feel too sleepy to drive. Acute sleep loss, even the loss of one
As a result, our understanding of drowsy-driving crashes is based on subjective
group is high school age and more likely to live at home with parents; members of the
found that short naps every 6 hours during a 35-hour (otherwise sleepless) period was
Misconceptions that sleepiness is inevitable at this
Practical issues with this strategy include the inability of some people to take short
Only
evaluations of potential countermeasures, most of which were laboratory studies. Score 1 sleep-deprived. inattention, which is believed to be a larger problem.". The driver does not attempt to avoid a crash. colleagues' study (1995), 20 was the peak age of occurrence of drowsy-driving crashes,
roads in nonurban areas. breath, or other objective test for sleepiness currently exists that is administered to a
motel or rest stop) as soon as possible and sleep. factors in predicting crashes related to sleepiness (which this report called
sleep at night) and before the next consolidated sleep period (most commonly at night,
industrial accidents. is convenient and rapidly administered over repeated measurements. Institute for Traffic Safety Management and Research
The panel would like to thank the following people for their assistance in reviewing and
Similar to sleep restriction, sleep fragmentation can have internal and external causes. follows one sleepless night. symptoms to diagnosis of narcolepsy averages 10 years (American Thoracic Society, 1994;
The ESS is not designed to
sleepiness include the Pittsburgh Sleep Quality Index (Buysse et al., 1989) and the
The MSLT and MWT were developed for neuro- physiologic assessment and are sensitive to
alcohol before driving in the afternoon or at night might pose special risks given the
Most adults need at least 7 hours of sleep a day, and teens need at least 8 hours. it occurs. drive. The matter is rarely raised in driver or law enforcement education, and even health
people who are not sleep deprived (Dinges, 1995). preteen boys, their parents, and their schools to influence attitudes before problems
example, people with chronic sleep loss who drive in the early morning hours are likely to
An analysis of police
For example, an educational campaign
Furthermore, a crash is likely to be an altering circumstance. Figure 1. Ceutel, 1995; Gengo, Manning, 1990). reducing risk in this population. The panel believes that focusing a campaign on shoulder rumble strips offers multiple
that exist tend to address the biological feasibility of reducing drowsiness or improving
The strength of the inferences is
of driving impairment associated with sleepiness are reaction time, vigilance, attention,
One
Reports
performance and increase crashes. Laboratory studies using a driver simulator or other fundamental tests that relate the
and history of loud snoring; however, women and men without this profile also have the
President
EEG studies of sleep in rotating
There is insufficient evidence at present
Sleepiness causes auto crashes because it impairs performance and can ultimately lead to the inability to resist falling asleep at the wheel. Nighttime and
The panel also identified complementary messages for the campaigns and
sleepiness to driving performance in people with medical disorders. message that rumble strips are designed to arouse sleepy drivers before they drive off the
behaviors, such as exercising, turning on the radio, or opening the windows, which have
apnea syndrome (SAS) and narcolepsy. A single vehicle leaves the roadway. specially trained personnel and are not valid if the individual being tested is ill or in
Shift work also can disturb sleep by
All factors may interact, and
been used along with questionnaires for field assessment of driver sleepiness (Philip et
In lieu of an objective measure driving; in this context, raise public and policymaker awareness about drowsy-driving
addition, sleepiness is identifiable, predictable, and preventable. No current data link other sleep disorders with
fragmented by frequent interruptions (Marcus, Loughlin, 1996). The midnight to 8 a.m. shift
literature upon which the major concepts or opinions of the panel report are based. Driving simulation tests specifically show
PDF Drowsy Driving and Automobile Crashes: Report and Recommendations Countermeasures include following effective strategies for scheduling shift changes and,
is long. The scale correlates with standard
Recreational drug use also may exacerbate sleepiness
the panel found in any category that has a demonstrated effect on crashes. example, the National Transportation Safety Board (1995) concluded that the critical
or other measurable test is currently available to quantify levels of sleepiness at the
a method for objectively assessing sleepiness at the crash site also would enable better
slept involuntarily on the night shift. electrophysiological measures of sleep, and there is interest in vehicle-based monitors. encourage them to drive long after impairment, and inhibit their taking effective
commercial and noncommercial driving.
PDF drowsy driving body of night nurses working 12-hour shifts reported having had an automobile accident or
In addition, the number of studies is relatively small, and some of the
Night shift workers typically get 1.5 fewer
individuals' sleepiness by their tendency to fall asleep "in your usual way of life
dark environment, allowing sufficient time for sleep, and trying to sleep during the same
At best they can help sleepy drivers stay awake and alert
evidence of a corrective maneuver, such as skid marks or brake lights, is usually absent
or sleepiness, the patterns became more pronounced. risks and how to reduce them. management of sleepiness and sleep disorders reduce crash risk or incidence. Personal Demands and Lifestyle Choices. sense; however, few rigorous studies support all sleep hygiene claims. reports on drowsy driving are often inferential. overtime, or rotating shifts is a risk for drowsy driving that may be both chronic and
sleepiness and sleep disorders (National Commission on Sleep Disorders Research, 1993). purpose and meaning of shoulder rumble strips, which alarm or awaken sleepy drivers whose
Although males up to age 45 have increased crash risks, the panel
sleepiness do not last long. begin. Studies of
pastimes often leave little time left over for sleeping. concern that alerting devices may in fact give drivers a false sense of security,
Deprivation, Figure 4. For example, those who
of sleepiness have chosen ratings 1 or 2. Wilkins and colleagues (1997) confirmed that crashes attributed to driver fatigue have
higher for those with untreated SAS (Aldrich, 1989). (1994) were
Other self-report instruments
The characteristics of drowsy-driving crashes reported below resemble the inclusion
Policymakers also may
Under-
drivers surveyed about their lifetime experience with drowsy driving, almost one-half of
typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. Countermeasures for drowsy driving aim either to prevent it or to ameliorate it after
The Karolinska Sleep Diary (kerstedt et al., 1994) contains questions relating to
that they had been involved in a motor vehicle crash, 40 percent of which occurred while
markets, and continuous-operation factories prosper and expand. The crash is likely to be serious. normal. crashes each year. many of which are appropriate for all public audiences: Sleepiness is a serious risk for young male drivers. Additional information and research are
currently used, can emphasize what rumble strips are, their relative cost-effectiveness,
snoring to repeated breathing interruptions, also increases the likelihood of crashes in a
These statistics also do not deal with crashes caused by driver
attitudes, and behaviors will need to be examined. In addition, a study of hospital house staff working around the clock (Marcus,
Elderly subjects (n = 10) were 60 to 83 years of
Another effective approach is to allow and
shift work are associated with lapses of attention, increased reaction time, and decreased
Laboratory tools for measuring sleepiness include the Multiple Sleep Latency Test
In addition, Maycock (1996) found that higher scores on the ESS were positively
These included working more than one job,
To date, research has validated only one type of device that alarms or awakens drivers
Males. planning time and creating an environment for uninterrupted, restorative sleep (good sleep
in which the driver may have fallen asleep. uncontrollable nature of falling asleep at high levels of drowsiness. Although current understanding largely comes from inferential evidence, a
is not okay to drive when you are sleepy. The behavioral steps discussed earlier for younger males also seem reasonable for
crashes than did those with untreated mild apnea. In the New York State
of schoolwork demands and part-time jobs, extracurricular activities, and late-night
criteria that some researchers have used to define a crash as having been caused by
In the
occupant (McCartt et al., 1996). Some safety experts have expressed
midnight through 6 a.m. driving, and avoiding alcohol and sedating medicines while sleepy
following: Shift work may increase the risk of drowsy-driving crashes. not find evidence to determine whether chronic or acute situations pose the greater risk
The panel speculated that drinking
Population Groups at Highest Risk, VII. of the population with symptomatic sleep apnea (Strohl, Redline, 1996). crashes were single-vehicle roadway departures (Pack et al., 1995). complements Federal Highway Administration efforts to address the problem among commercial
and mortality associated with drowsy-driving crashes are high, perhaps because of the
The driver is alone in . The driver is alone in the vehicle. 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 the risk of drowsy driving in other ways. in developing successful educational approaches. For example,
usually get enough sleep. variety of reasons related to work patterns. Nurses working the night shift reported using white noise, telephone answering
External factors, some beyond the individual's control, include work hours, job and
alarm. although caffeine content of coffee varies widely (Fox, 1993). sleepiness-related crashes, particularly using prescribed benzodiazepine anxiolytics,
related crashes include: Driving patterns, including driving between midnight and 6
C. occurs on a high-speed road. sleep (see below). to have more time to work, study, socialize, or engage in other activities. Laboratory and some field studies suggest that most
A typical crash related to sleepiness - Weegy