a typical crash related to sleepinessmobile homes for rent in ellsworth maine
see sleep as a luxury. management approaches is likely to be most effective. Micro-sleeps, or involuntary intrusions of sleep
shift workers in both the natural environment and the laboratory have shown that day sleep
driving limit produced a greater number of deviations from the road after 4 hours of sleep
These processes create a predictable pattern of two sleepiness peaks, which commonly
age and that chronic sleepiness is a safe lifestyle choice need to be overcome. intermediate risk, based on subjective reports of their having higher levels of sleepiness
sleepiness-related crashes, particularly using prescribed benzodiazepine anxiolytics,
In the more recent surveys and reporting of
For example,
such as night workers, air crews, and travelers who cross several time zones, can
Sleepiness causes auto crashes because it impairs performance and can ultimately lead to the inability to resist falling asleep at the wheel. The
to stop driving and sleep for an extended period. The problem occurs during late-night hours. Sleep Loss ; Driving Patterns ; The Use of Sedating Medications ; Untreated Sleep Disorders: Sleep Apnea Syndrome and Narcolepsy Sleep-restrictive work patterns. care. ; If you have a sleep disorder or have symptoms of a sleep disorder such as snoring or feeling sleepy during the day, talk to your doctor about treatment options. that go off when indications of sleepiness occur. A few
. risk, research to date clearly identifies three broad population groups at high risk for
Those who suffer chronic sleep
Certainly, sleepiness can contribute
before bedtime) (Richardson et al., 1982; see figure 1). The panel recognizes that limitations in resources will not allow NCSDR/NHTSA to
CRASH CHARACTERISTICS experimenting and taking risks, and testing limits. Narcolepsy is a
behaviors for safety. driver becomes sleepy, the key behavioral step is to stop driving-for example, letting a
About 95 percent
strategies that enable some workers to adapt successfully to this situation are not well
B. involves multiple vehicles on the roadway. effectiveness of rumble strips has been demonstrated only in drive-off-the-highway
give drivers a false sense of security about driving while sleepy. Studies based on driver self-reports: Maycock, 1996; McCartt et al., 1996). Studies of crash data that identify the characteristics of crashes in which the driver
Many drowsy-driving crashes occur at this time. patients (Broughton et al., 1981; Haraldsson et al., 1995). Rumble strips
of alcohol, and the combination adversely affecting psychomotor skills to an extent
Testing during the daytime followed
effective alerting device may prevent one crash, a driver who falls asleep once is likely
For
Figure 1. NHTSA found that drivers had consumed some alcohol in nearly 20
An inherent deficiency in all types of alerting devices is that many people continue to
Key
Employers, unions, and shift work employees need to be informed about
masking their level of sleepiness. the closest safe resting spot, such as a motel, friend's house, or home; and sleeping. colleagues (1989) found that patients with severe untreated sleep apnea had more frequent
What to do when awakened by driving over a rumble strip. This focus
Sleep apnea syndrome is somewhat more common among males than among females, and
Ph.D.
An active lifestyle that restricts sleep is a special risk. Score 1 Some safety experts have expressed
Although an
The panel of experts reviewed the literature on fatigue-related crashes and produced a 36-page report covering the biology of human sleep and . sleep loss. driving; in this context, raise public and policymaker awareness about drowsy-driving
drift (Dinges, 1995). For example, those who
Sleepiness causes auto crashes because it impairs performance and can
The driver is alone in . without crashing were less likely to have been alone in the automobile. sleepiness. representing only about one-fourth of licensed drivers. Juggling work and
survey of lifetime incidents, 82 percent of drowsy-driving crashes involved a single
In a recent Gallup survey, approximately
Definitions of "young" differed among authors; the ages included in this
Institute for Traffic Safety Management and Research
interfering with circadian sleep patterns. make a short-term difference in driving alertness: taking a short nap (about 15 to 20
1 . Undiagnosed sleep-disordered breathing, ranging from habitual
Drowsy driving is a serious problem that leads to thousands of automobile
The ESS has been used in research on driver sleepiness and in correlations of
Taking a break for a short nap (about 15 to 20
disallow late-night driving among younger drivers can mandate this risk-avoiding behavior
1996; Langlois et al., 1985; Lavie et al., 1986; Mitler et al., 1988; Horne, Reyner 1995b;
The strength of the inferences is
In the New York State survey, nearly one-half the drowsy drivers who crashed (and
five men (20.2 percent) and almost one in six women (15 percent) work other than a daytime
The panel would like to thank the following people for their assistance in reviewing and
naps and the need for secure rest areas. Studies of commercial vehicle drivers present similar findings. The midnight to 8 a.m. shift
younger than 30 accounted for almost two-thirds of drowsy-driving crashes, despite
Nicotine can improve short-term performance significantly
factors sometimes are involuntary, such as a medication effect that interrupts sleep. Weegy: There were more than 12,000 people injured in alcohol-related crashes in Florida. evaluate driver sleepiness. The messages might be the following: sleepiness is not inevitable for teens, and it
Drivers ages 45 through 65 have fewer nighttime
electrophysiological measures of sleep, and there is interest in vehicle-based monitors. Driving simulation tests specifically show
individuals' sleepiness by their tendency to fall asleep "in your usual way of life
typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. 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 5 hours per night for 1 week needed two full nights of sleep to recover vigilance,
circadian patterns in order to sleep during the day (Kessler, 1992). category fell between 16 and 29. occur about 12 hours after the midsleep period (during the afternoon for most people who
wakefulness, the more pressure builds for sleep and the more difficult it is to resist
is not okay to drive when you are sleepy. methodological detail, outcome measures, and other variables, all of which precluded a
uncomfortable seat or position and shivering or sweating) may also keep sleepy drivers
Messages to the general public can explain the following: What rumble strips are and why they are increasingly being used. 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. fall-asleep crashes during the midafternoon (Pack et al., 1995; Wang, Knipling, Goodman,
fragmentation cause inadequate sleep and can negatively affect functioning (Dinges, 1995). crash. In another alcohol strategy variation, parents might allow
Score 1 User: There were more than__________ people injured in alcohol-related crashes in Florida. alarm. passenger drive or stopping to sleep before continuing a trip. The crash is likely to be serious. impairment that could assist investigating officers in attributing a crash to sleepiness. One result can be a progressive withdrawal of attention to the tasks
The driver does not attempt to avoid a crash. Elderly subjects (n = 10) were 60 to 83 years of
this population's needs and preferences. crash site. had a higher proportion of alcohol involvement than other types of crashes in that State. dose-response manner (Stradling et al., 1991; Philip et al., 1996; Hanning, Welch, 1996;
Working the night shift,
Score 1 percent of all sleepiness-related, single-vehicle crashes (Wang, Knipling, Goodman, 1996). Special Assistant to Executive Deputy Commissioner
with untreated sleep apnea syndrome (SAS) and narcolepsy. Several studies show that timed exposure to bright light has been successful in helping
Effective countermeasures used to prevent drowsy driving and related crashes. As detailed in section III, the greatest proportion of drowsy-driving crashes
ultimately lead to the inability to resist falling asleep at the wheel. This latest study also found that fatigue contributed to crashes at much higher rates than was previously believed and is a contributing factor in 12% of all crashes and in 10% of all near-crashes. driving during this period for all drivers and especially for younger ones. IV. strict comparison. Researchers also have found
wakefulness. Ph.D.
include consumer, voluntary, health care professional, and industry groups and other
long enough to find a motel, call for a ride, or stop driving and sleep. fall-asleep crashes. is long. hypnotics, tricyclic antidepressants, and some antihistamines. people who perform shift work-and are thus exposed to crash risk-is increasing. initiatives, the panel recommended the following three priority areas: Educate young males (ages 16 to 24) about drowsy driving and how to
health as well as drowsy-driving prevention. higher for those with untreated SAS (Aldrich, 1989). environment (a room that is cool, quiet, and dark) and sleeping at regularly scheduled
before a crash (Wang, Knipling, Goodman, 1996). 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. Chronic sleepiness. sleepiness to driving performance in people with medical disorders. because the well-established risks substantially outweigh the possible benefits. people who are not sleep deprived (Dinges, 1995). Carskadon (1990) offers a variety of age-specific reasons for the involvement of younger
Others reported frequently falling asleep
The panel conducted
Critical aspects of driving impairment associated with sleepiness are reaction time, vigilance, attention, and information processing. age; young subjects (n = 8) were 19 to 23 years of age (Carskadon and Dement, 1987). educational opportunities to convey key drowsy-driving messages. Director
Sleeping is the
The biology of the sleep-wake cycle predicts
that they reduce drive-off-the-road crashes by 30 to 50 percent-the only countermeasure
which people voluntarily adhere or can decide to ignore. Driving
longer (Maycock, 1996). factors in predicting crashes related to sleepiness (which this report called
(1994) were
panel did not find data linking such treatment to changes in rates of crashes or
Other rating tools that measure an individual's experience with sleepiness over an
this effect, even with modest reductions in sleep, low alcohol doses, and low blood
1996). subject to parental authority. studies do not represent large numbers of crashes or feature crash numbers or frequency as
effects. interchangeably with sleepiness; however, these terms have individual meanings (Brown,
or sleep deprived. influenced by the light/dark cycle, which in humans most often means wakefulness during
same trend but also suggest that sleepiness may play a role in rear-end crashes and
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,
increased when different types of studies reach similar conclusions. however, the panel suggests that campaign designers consider the following message points,
even one night of sleep may cause extreme sleepiness. 1 answer. greater than that of sleepiness or alcohol alone (Roehrs et al. period when sleep is usual (Brown, 1994). Although effective treatments are available for both narcolepsy and obstructive sleep
Sleep can be irresistible; recognition is emerging that
begin. instead of driving while sleepy. nonalcohol-related crashes-fatalities occurred in 1.4 percent and 0.5 percent,
and wakefulness, restriction of sleep, and/or interruption or fragmentation of sleep. individuals who exhibit a sleep latency of less than 15 minutes on the MWT are
family responsibilities, and school bus or school opening times. 4-day week schedule than with an 8-hour, 6-day week (Brown, 1994). A body of literature exists on the mechanisms of human sleep and sleepiness that affect
shift, including evening, night, rotating, split, and irregular shifts (Kessler, 1992). Inattention can result from fatigue, but the crash literature
assumptions influenced the determination of crash characteristics. management of sleepiness and sleep disorders reduce crash risk or incidence. Self-reports from drivers involved in crashes (with data collected either at the crash
Although the relative risk for fall-asleep crashes has not been established,
suggest that they tell teenagers to call for a ride at any hour without recriminations if
Currently about one in
be used to assess situational sleepiness or to measure sleepiness in response to an acute
To provide evidence-based direction to this campaign, the Expert Panel on Driver
studies and between groups of different ages or cultures. Pack (1995) and Maycock (1996) both conclude that a
when shift work precludes normal nighttime sleep, planning a time and an environment to
category for reporting sleepiness as a crash cause. NHTSA data
commenting on the report: Mary Carskadon, David Dinges, Lynn Butler, Nick Teare, Toben
Many also were unlikely to use a rest area when they were driving alone at
Joy Mara of Joy R. Mara Communications for her assistance in the writing of this report. 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. The biology of human sleep and sleepiness, which physiologically underlies crash risk. Add an answer. Laboratory and some field studies suggest that most
performance (Dinges et al., 1987; Hamilton et al., 1972; Williams et al., 1959). (See section V
driven over a rumble strip in the past could personalize the risk, and even seeing the
association of these topics with driving risk and crash prevention. hours each day. preteen boys, their parents, and their schools to influence attitudes before problems
In jobs with extended
sleep loss, aggravating their risk of drowsy driving. approaches that are effective for reaching high-risk audiences will need to be developed
example, the National Transportation Safety Board (1995) concluded that the critical
restriction and sleep fragmentation. Cultural and lifestyle factors leading to insufficient sleep, especially a combination
Figure 4. An ideal measure of sleepiness would be a physiologically based screening tool that is
Although the absolute number of crashes is low, crash risk is increased among people
However, nappers are often groggy
In
references provided do not, however, reflect all resources available or reviewed by the
Section II lists some of the technological in-vehicle monitors designed to detect and
Economic pressures and the global economy place increased demands on many people to work
employees would complement and reinforce other drowsy-driving messages directed to the
the keywords listed above and following suggestions for linkage to related topics (e.g.,
slept involuntarily on the night shift. Only
C. occurs on a high-speed road. noted earlier, more research is needed on this topic. substitute for good sleep habits and should not be viewed as a "driving
The "all nighter" represents an acute risk because extreme tiredness
Horne and Reyner (1995a) suggest that a combination of having more of the chronic and
in about three of four fall-asleep crashes (Pack et al., 1995). Helpful behaviors
Most adults need at least 7 hours of sleep a day, and teens need at least 8 hours. 1994). One in three of the adult
The key to safety is what the driver does after hearing the
Consuming
For example, "asleep with
performance and increase crashes. greater absolute or relative number of fall-asleep crashes and/or (2) increased
In addition, studies should determine whether early recognition, treatment, and
driving performance. Many Americans are unaware of the
Department of Medical-Surgical Nursing Center for Narcolepsy Research
The panel concluded that preventing drowsiness with adequate sleep
The current tools for the assessment of sleepiness are based on questionnaires and
that they had been involved in a motor vehicle crash, 40 percent of which occurred while
or near sleep, can overcome the best intentions to remain awake. Individuals who fall asleep in 5 minutes or less are
Rumble strips should not
Key message points include the
in developing successful educational approaches. apnea syndrome (SAS) and narcolepsy. driving risks. disorder of the sleep-wake mechanism that also causes excessive daytime sleepiness. However, this is not just a reporting problem;
literature upon which the major concepts or opinions of the panel report are based. loss of one night's sleep can lead to extreme short-term sleepiness, while habitually
Population Groups at Highest Risk, VII. National Highway Traffic Safety Administration, Anne T. McCartt,
is a risky behavior that leads to many serious crashes each year. who are drowsy or asleep-shoulder rumble strips placed on high-speed, controlled-access,
A single vehicle leaves the roadway. As noted earlier, the circadian pacemaker
A single vehicle leaves the roadway. obtain historical information pertinent to sleepiness using patient logs and sleep-wake
Sleep fragmentation. No definitive criteria are available for establishing how
In the longer term, planning ahead can help people avoid driving while drowsy. Driving between midnight and 6 a.m. is a high-risk situation. literature searches of online databases in traffic safety, medicine, and physiology using
older group are more likely to be working or in college, living on their own and less
categorically too sleepy to drive a motor vehicle (Mitler, Miller, 1996). Other self-report instruments
Expert answered| Mr.BreadMan |Points 167| Log in for more information. The panel encourages such groups to use this report and resulting
National Highway Traffic Safety Administration, Forrest Council,
important contribution by disseminating messages to high-risk audiences, intermediaries,
Medical systems have been successful in identifying only a fraction
today to give sleep less priority than other activities, sleepiness and performance
Cleveland Veterans Administration Hospital, Sharon L.
increases crash risk. concern that alerting devices may in fact give drivers a false sense of security,
care professionals may not recognize a history of sleepiness as a risk factor for
high-speed roads because more long-distance nighttime driving occurs on highways. The proportion of crashes is
facilitate napping for night shift workers (Dinges, 1992; Naitoh, 1992). Sleep disruption and
they need because their schedules do not allow adequate time for it. The effects of sleep
Caffeine, even in low doses,
The strips are useful
Externally,
Ohayon, Priest, Caulet, et al., 1997). higher speeds involved (Horne, Reyner, 1995b) combined with delayed reaction time. For example, an educational campaign
prevention of fall-asleep crashes. The
Scheduling a trip at another time is a simple way to reduce risk, especially if the drive
For example, capturing information on drivers' precrash
It also thanks Cathy Lonergan for logistical support. to sleep at 2-hour intervals across the 24-hour day. They are not a
The crash occurs on a high-speed road. drowsiness peaking from late evening until dawn (Wylie et al., 1996). Rumble strips act as an alarm clock, alerting drivers to the fact that they are too
How does a crash relate to sleepiness? The panel also identified complementary messages for the campaigns and
before driving is both easier and much more successful than any remedial measure reviewed. Senior Research Psychologist
behaviors (e.g., duration of prior wakefulness, recent sleep-wake patterns, the quality
may rely on surrogate mea- sures of sleepiness, such as duration of sleep in a recent
been used along with questionnaires for field assessment of driver sleepiness (Philip et
physical training program reported sleeping longer and feeling less fatigue than did
Ph.D.
exercise (e.g., getting out of the car and walking around for a few minutes) (Horne,
disruption (Czeisler et al., 1990; Stampi, 1994). This
Although males up to age 45 have increased crash risks, the panel
These included working more than one job,
sleep-deprived drivers who consumed caffeine reduced lane deviations, potential crashes,
Office of Research and Traffic Records
Obviously, however, smoking tobacco should not be
Focusing an Educational
Sleepiness causes auto crashes because it impairs performance and can ultimately lead to the inability to resist falling asleep at the wheel. strips on the highway in the future could repeatedly remind people of the message. in other forms such as caffeine-fortified soft drinks and tablets. evidence, such as police crash reports and driver self-reports following the event, and
Practical issues with this strategy include the inability of some people to take short
The risk of a crash related to sleepiness increases during nighttime hours among both
is instructed to try to fall asleep. Interaction between alcohol and sleepiness. Potential sponsors may
considered pathologically sleepy; taking 10 minutes or more to fall asleep is considered
The Sleep-Wake Cycle ; Sleepiness Impairs Performance ; The Causes of Sleepiness/Drowsy Driving ; Evaluating Sleepiness ; III. Examples include brain wave monitors, eye-closure
Although evidence is limited or inferential, chronic predisposing factors
When this approach is not practical and
drowsy-driving crashes. However, because SAS is more common than narcolepsy, the absolute number of crashes is
Administration (NHTSA) and the National Center on Sleep Disorders Research (NCSDR) of the
The younger
Young people (ages 16 to 29), especially males. drive may help make up for sleep loss in the short term and enhance wakefulness during the
al., 1994; Horne, Baumber, 1991; Horne, Gibbons, 1991). Information could be provided to the public and policymakers about the
Homeostasis relates to the neurobiological need to sleep; the longer the period of
Short duration of sleep appears to
can be" (right end). The Karolinska Sleep Diary (kerstedt et al., 1994) contains questions relating to
are not clear because both young men and young women are likely to be chronically
One
Drowsy driving affects everyone, including adolescents and teens, who are not getting enough sleep (according to the CDC, it is recommended that teens get 8-10 hours of sleep each night). The number of off-road deviations by the driver was 4 times
talking to patients about the need for adequate sleep, an important behavior for good
Wakefulness Test (MWT) (Mitler et al., 1982). driving risk, surveys of the general population suggest that knowledge of the risk is
the need to drive. from these crashes. strips in perspective. one-half of U.S. adults reported experiencing sleeping difficulties sometimes, with about
Anecdotal reports also suggest that
In a survey of hospital nurses, night nurses and rotators were more likely than nurses on
before driving again. occupant (McCartt et al., 1996). for longer times without taking a break. and more of the chronic or acute factors that underlie risk for everyone. studies to date have evaluated crash experiences of patients successfully treated for
night. Under-
The driver does not attempt to avoid a crash. to have more time to work, study, socialize, or engage in other activities. recommended three priorities for the campaign. Laboratory tools for measuring sleepiness include the Multiple Sleep Latency Test
sleep disrupt and fragment sleep. You can take effective steps if you become sleepy while driving. In all these attempts to measure subjective sleepiness, a person's response is
typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. sleepiness (Kerr et al., 1991). amenable to change. Although treatment can improve
In Pack and
D. all of the above A typical crash related to sleepiness involves multiple vehicles on the roadway. This technology is cur- rently being examined in physiologic,
which the driver was asleep with no evidence of alcohol. than do people without these disorders (Findley, 1995; American Thoracic Society, 1994;
Shift workers whose sleep is disrupted by working at night or working
1995). "fatigue") were duration of the most recent sleep period, the amount of sleep in
standing the concept of sleep debt could be useful, as could recognizing the
need information on the risks of drowsy driving and crashes to put the need for rumble
In addition, patients with untreated
Internal or personal
effective in maintaining performance in the laboratory. In fact, campaign designers may want to segment
experiences. Deputy Director
and acute situational factors recognized as increasing the risk of drowsy driving and
commercial and noncommercial driving. The MSLT mea- sures the tendency to fall
Nelson, Nancy Isaac, Kathy Rechen, and, at Prospect Associates, Donald Cunningham and
whereas in New York State the greatest number of drowsy drivers (on self-report) were
Scale (ESS) (Johns, 1991) is an eight-item, self-report measure that quantifies
People also asked. true Graduated driver-licensing programs that
in fall-asleep crashes. Conversely, respondents who reported having fallen asleep
impairment are neurobiological responses of the human brain to sleep deprivation. Yes it is a depressant, it will cause sleepiness. hours of sleep per 24 hours as compared with day workers. Although its conclusions were based on a limited body of knowledge, the panel
higher speeds, attributing this finding to the effect of sleep loss on reaction time. alcohol" crashes involved a higher percentage of young males than did crashes in
Performance Slows With Sleep
in recent times" in situations like sitting and reading, watching TV, and sitting in
performance, and normal mood (Dinges et al., 1997). 555 Waverly Avenue, Brooklyn,
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