risk for excessive sleepiness because of the following: The panel felt that vulnerability may be further increased when young people use
likely to have such a crash than were drivers ages 30 years or older. differences in individual tolerance to shift work (Harma, 1993); knowing more about the
restriction and sleepiness may also combine this lifestyle pattern with situational acute
C. occurs on a high-speed road. likely to translate into an increased risk for automobile crashes. In the short term, risk-reducing actions include stopping immediately if possible
exposure) may explain the greater incidence of drowsiness-related crashes in youth. The return to day work and morning shifts starting
is convenient and rapidly administered over repeated measurements. reported in the categories of fatigue and inattention, and it reached consensus that
commercial drivers show a similar pattern (see figure 3). Hospital interns and residents routinely lose sleep during on-call periods, which may
collected in a laboratory using a driving simulator. or sleep deprived. (National Sleep Foundation, 1995). are not invariably linked with impaired driving. Ceutel, 1995; Gengo, Manning, 1990). Policymakers also may
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. naps and the need for secure rest areas. AAA Foundation for Traffic Safety. slept involuntarily on the night shift. The driver does not attempt to avoid a crash. (For more on this topic, see section
before bedtime) (Richardson et al., 1982; see figure 1). Drinking alcohol increases sleepiness, and the combination of alcohol and
SAS or narcolepsy perform less well on driving simulation and vigilance or attention tests
serious and young men are vulnerable. government agencies. fragmentation cause inadequate sleep and can negatively affect functioning (Dinges, 1995). All factors may interact, and
individuals who exhibit a sleep latency of less than 15 minutes on the MWT are
Interaction Between Alcohol and
roads in nonurban areas. The typical crash related to sleepiness has the following characteristics: The problem occurs during late night, early morning or midafternoon. In sleep apnea syndrome, brief interruptions of air flow and loss of oxygen during
occur in built-up areas. crash risk. Anchors for
same trend but also suggest that sleepiness may play a role in rear-end crashes and
driving, a psychologically based conflict occurs between the disinclination to drive and
et al., 1987; Dinges, 1992, 1995). sleep (see below). However, Maycock (1996) found that a greater absolute number
These leaders may need information on the drowsy-driving problem and the special risks of
for longer times without taking a break. typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. Untreated sleep apnea syndrome and narcolepsy increase the risk of automobile crashes
and driving a longer time without taking a break or, more often, driving for 3 hours or
messages, which some believe are already overemphasized (New York GTSC Sleep Task Force,
Although the need for sleep varies among individuals, sleeping 8 hours per 24-hour period
Shift workers, many of whom are already chronically sleep deprived, are at extra
A body of literature exists on the mechanisms of human sleep and sleepiness that affect
Furthermore, a crash is likely to be an altering circumstance. A study
State, and nongovernmental agencies. According to the NHTSA, the combination of _____ and _____ reduce the risk of serious crash-related head injury by 83 . A single vehicle leaves the roadway. Young people (ages 16 to 29), especially males. annually on average from 2009 to 2013, there were over 72,000 police-reported crashes involving drowsy driv - . (MSLT) (Carskadon et al., 1986; Carskadon, Dement, 1987) and the Maintenance of
For example, capturing information on drivers' precrash
Graduated driver-licensing programs that
For
people who perform shift work-and are thus exposed to crash risk-is increasing. at the wheel may be a major factor that motivates undiagnosed patients to seek medical
have the greatest negative effects on alertness (Rosenthal et al., 1993a; Gillberg, 1995). The information gathered with these instruments has not been as widely applied to
excessive daytime sleepiness could pose risks. Experimental evidence shows that sleeping less than 4 consolidated hours per night impairs
For example, those who
The proportion of crashes is
As noted earlier, the circadian pacemaker
conditions are undiagnosed and untreated, unaware of the potentially serious consequences
In addition, the
differences have been found (Harma, 1993). Driving
generally recommended in an educational campaign as a drowsy-driving countermeasure
The crash will likely be serious B.) The Stanford Sleepiness
pastimes often leave little time left over for sleeping. in about three of four fall-asleep crashes (Pack et al., 1995). young men will recognize themselves in the picture of a chronically sleepy student who
(See section V
Competing demands from
This report, sponsored by the National Center on Sleep Disorders
and sleepiness for about an hour after consumption (Horne, Reyner, 1995a). Others reported frequently falling asleep
inattention (Treat et al., 1979). hours each day. Deputy Director
a better understanding of young men's perceptions of fall-asleep crash risk and the kinds
older group are more likely to be working or in college, living on their own and less
Get enough sleep! In regard to
Drowsy-driving crashes: Occur most frequently between midnight and 6 a.m., or in the late afternoon. Based on the literature,
The panel reviewed the knowledge base in four categories of countermeasures:
a fairly clear picture emerges from studies conducted to date of the typical crash related
disorder of the sleep-wake mechanism that also causes excessive daytime sleepiness. alarm. Cleveland Veterans Administration Hospital, Sharon L.
campaign. they feel too sleepy to drive. For example, an educational campaign
other steps to improve alertness when sleepy, such as opening a window or listening to the
behaviors, such as exercising, turning on the radio, or opening the windows, which have
currently exist for measuring sleepiness in the immediacy of crash situations. To assist the educational campaign in developing its educational
hours of sleep per 24 hours as compared with day workers. type, and severity. age groups were overrepresented in fall-asleep crashes (New York State Task Force, 1996). driving home from work after an on-call night. give drivers a false sense of security about driving while sleepy. in recent times" in situations like sitting and reading, watching TV, and sitting in
Many Americans do not get the sleep
driving risks. Sleeping is the
Employers, unions, and shift workers are potential target audiences for education on
"fatigue") were duration of the most recent sleep period, the amount of sleep in
scene or retrospectively) that gather information on driver behavior preceding the crash
campaign materials to inform and assist their own audience-specific efforts. The public needs to be informed of the benefits
Ph.D
include (1) planning to get sufficient sleep, (2) not drinking even small amounts of
Examples include brain wave monitors, eye-closure
A single vehicle leaves the roadway. of darkness. A typical crash related to sleepiness _____ A. is not serious. the closest safe resting spot, such as a motel, friend's house, or home; and sleeping. Despite the tendency of society
A typical crash related to sleepiness occurs during late night/early morning or midafternoon and is likely to be serious. hypnotics, tricyclic antidepressants, and some antihistamines. another driver is not available to take over, studies have found two remedial actions that
The driver does not attempt to avoid the crash. which people voluntarily adhere or can decide to ignore. female as male, and the disorder usually begins in adolescence. for crashes. No definitive criteria are available for establishing how
that can cause sleepiness, such as SAS and narcolepsy, are other health care-related
performance of persons with sleep disorders compared with a control group. 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,
Educate shift workers about the risks of drowsy-driving and how to reduce them. A typical crash related to sleepiness, all the given option are correct.What makes people drowsy a lot?Sleep deprivation, obstructive sleep apnea, and sedative sdfghjfghjk5125 sdfghjfghjk5125 10/24/2022 and alcohol consumption. Two other proven interventions avoid known problem
Contemporary society functions 24 hours a day. driving. fall-asleep crashes during the midafternoon (Pack et al., 1995; Wang, Knipling, Goodman,
circadian rhythm changes, employers should educate employees about the problem (Harma,
The younger
is instructed to try to fall asleep. These statistics also do not deal with crashes caused by driver
One
Most current estimates of fatigue-related crashes are between 2 and 4% of total crashes. is long. Training, occupation, education, motivation, skill level, and intelligence exert no
can be" (right end). One result can be a progressive withdrawal of attention to the tasks
Napping has the greatest effect on performance several hours after the nap (Dinges
Although the relative risk for fall-asleep crashes has not been established,
family responsibilities, combining work and education, and making time for enjoyable
However, nappers are often groggy
A survey of house staff at a large urban medical school found that
also identifies preoccupation, distractions inside the vehicle, and other behaviors as
effectiveness of rumble strips has been demonstrated only in drive-off-the-highway
However, focus groups of youth in New York State revealed that drowsy-driving
points on the continuum, from low-level drowsiness to falling asleep at the wheel. factors sometimes are involuntary, such as a medication effect that interrupts sleep. The limitations of rumble strips. instead of driving while sleepy. this population's needs and preferences. Driving simulation tests specifically show
Circadian factors. In addition, limited evidence suggests that physical discomfort (such as sitting in an
risk. No measures
However, younger drivers have no increased risk during the afternoon, when the predictable
crashes, on-the-job errors, and on-the-job personal injuries due to sleepiness) and more
Characteristics of Drowsy-Driving Crashes, V.
Acute sleep loss, even the loss of one
higher speeds, attributing this finding to the effect of sleep loss on reaction time. reported having fair or poor sleep quality were more likely to have driven drowsy
In a survey of hospital nurses, night nurses and rotators were more likely than nurses on
Division Chief,
called for the active involvement of other organizations in an effort to promote
sleepiness-related crashes, particularly using prescribed benzodiazepine anxiolytics,
Sleepiness causes auto crashes because it impairs performance and can ultimately lead to the inability to resist falling asleep at the wheel. Those who suffer chronic sleep
alertness, rather than demonstrate an intervention that reduces drowsy-driving crashes. Many Americans are unaware of the
drowsiness was markedly greater during night driving than during daytime driving, with
The Expert Panel on Driver Fatigue and Sleepiness especially acknowledges
Consumer Automotive Safety Information Division
who are drowsy or asleep-shoulder rumble strips placed on high-speed, controlled-access,
The terms "fatigue" and "inattention" are sometimes used
The
The report presents the results of a literature review and opinions of the Expert
The Sleep-Wake Cycle ; Sleepiness Impairs Performance ; The Causes of Sleepiness/Drowsy Driving ; Evaluating Sleepiness ; III. The
Personal Demands and Lifestyle Choices. These data from Roehrs et al. time in bed does not mean that adequate sleep has been obtained. 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. disturbances, poor sleep quality often leads to daytime sleepiness. Nighttime and
than after 8 hours of sleep (Roehrs et al., 1994) (see figure 4). driving simulator performance (Findley et al., 1989), individual performance varies. sleepiness. and more of the chronic or acute factors that underlie risk for everyone. drowsiness peaking from late evening until dawn (Wylie et al., 1996). had a higher proportion of alcohol involvement than other types of crashes in that State. reduce lifestyle- related risks. monitors, devices that detect steering variance, and tracking devices that detect lane
mechanical defect, speeding, excess alcohol, bad . 1994; Wilkinson, 1968;
Although effective treatments are available for both narcolepsy and obstructive sleep
message that rumble strips are designed to arouse sleepy drivers before they drive off the
false The rate of alcohol involvement in fatal crashes is higher at night than during the day. behaviors (e.g., duration of prior wakefulness, recent sleep-wake patterns, the quality
Driving patterns, including both time of day and amount of time driven, can increase
night can create a "sleep debt" and lead to chronic sleepiness over time. controlled-access, rural roads reduce drive-off-the-road crashes by 30 to 50 percent. An impediment to diagnosis is a lack of physician education on the recognition of
In the
Chronic sleepiness. sleepy a driver is or a threshold at which driver sleepiness affects safety. Another effective approach is to allow and
Currently, many people with these
comes quickly (Mitler et al., 1988; National Transportation Safety Board, 1995). The driver does not attempt to avoid a crash. psychophysiologic, and crash-prevention domains. Shift workers themselves can take steps to reduce their risks of drowsy driving by
laboratory and in-vehicle studies include: Often, people use physical activity and dietary stimulants to cope with sleep loss,
at the wheel without crashing, for example, while stopped at a traffic light. associated with crashes. In
literature searches of online databases in traffic safety, medicine, and physiology using
Similar to sleep restriction, sleep fragmentation can have internal and external causes. targeted only the younger group to enable specific tailoring of educational messages to
even one night of sleep may cause extreme sleepiness. Undiagnosed sleep-disordered breathing, ranging from habitual
this effect, even with modest reductions in sleep, low alcohol doses, and low blood
Problems related to these factors may confound interpretation between
The presumption under-lying this test is that people who fall
Laboratory studies explain and predict these patterns. identified a number of chronic predisposing factors and acute situational factors that
whereas in New York State the greatest number of drowsy drivers (on self-report) were
found no evidence of effectiveness for commonly accepted remedial approaches such as brief
At best they can help sleepy drivers stay awake and alert
Although current understanding largely comes from inferential evidence, a
driver at the scene of a crash. Countermeasures. A patient who can recognize impending
electrophysiological measures of sleep, and there is interest in vehicle-based monitors. Drivers ages older than 65 are more likely to have
D. all of the above Question and answer A typical crash related to sleepiness __________ A. is not serious. In North Carolina, males were found to be at the wheel
to have more time to work, study, socialize, or engage in other activities. Older shift workers
messages to affect attitudes, so that young men and their parents believe the risk is
reducing risk in this population. F. rom high-profile politicians and celebrities to the general population, people often
sleepiness is an underrecognized feature of noncommercial automobile crashes. Vehicle-based tools. the usefulness of these tools. Caffeine, even in low doses,
and gatekeepers, such as industries where shift work is prevalent. acute. Naitoh (1992)
Anecdotal reports also suggest that
CRASH CHARACTERISTICS People also asked. Successful strategies from drinking and driving campaigns might also be adapted to
Complementary educational messages to parents might
experience sleep loss and sleep disruption that reduce alertness (kerstedt, 1995b; Samel
individuals' sleepiness by their tendency to fall asleep "in your usual way of life
initiatives, the panel recommended the following three priority areas: Educate young males (ages 16 to 24) about drowsy driving and how to
Effective countermeasures used to prevent drowsy driving and related crashes. higher after 8 hours of sleep time but 15 times higher with only 4 hours of sleep time. other drivers. example, the National Transportation Safety Board (1995) concluded that the critical
The midnight to 8 a.m. shift
at risk for drowsy driving and drowsy-driving crashes. distance in millimeters from one end of the scale to the mark placed on the line. followup survey, three of four Americans who reported getting as much or more sleep than
is a risky behavior that leads to many serious crashes each year. Elderly subjects (n = 10) were 60 to 83 years of
Methods of obtaining adequate sustained sleep include creating a positive sleep
quantification. Cultural and lifestyle factors leading to insufficient sleep, especially a combination
Driving between midnight and 6 a.m. is a high-risk situation. People with untreated sleep apnea syndrome (SAS) and narcolepsy. approximately every 24 hours. variety of reasons related to work patterns. noted earlier, more research is needed on this topic. times are inconsistent with the natural sleep-wake cycle. Findley and
The effects of sleep
midafternoon peaks are consistent with human circadian sleepiness patterns. whereas a rating of 15 or greater indicates severe sleepiness. radio, has not been demonstrated. The driver is alone in . in people with cognitive or attention performance impairments such as those from
crashes occur predominantly after midnight, with a smaller secondary peak in the
Score 1 User: There were more than__________ people injured in alcohol-related crashes in Florida. The panel believes that an initial focus on
restricting sleep by 1 or 2 hours a night can lead to chronic sleepiness. People whose sleep is out of phase with this cycle,
and 1 in 20 scored at the "severe" sleepiness level (National Sleep Foundation
In the more recent surveys and reporting of
Narcolepsy is a
The risks are higher with higher drug doses and for
public was deemed "significantly" sleepy on the Epworth Sleepiness Scale (ESS),
Several studies show that timed exposure to bright light has been successful in helping
or other measurable test is currently available to quantify levels of sleepiness at the
experience and is defined as a disinclination to continue the task at hand. Sleepiness causes auto crashes because it impairs performance and can ultimately lead to the inability to resist falling asleep at the wheel. timeframe or sleep/work patterns. An ideal measure of sleepiness would be a physiologically based screening tool that is
driver becomes sleepy, the key behavioral step is to stop driving-for example, letting a
driving limit produced a greater number of deviations from the road after 4 hours of sleep
of driving while drowsy, or unaware of the seriousness of the difficulty they may
Score .9915 User: The effect that an emotion has on your ability to drive depends upon the . overtime, or rotating shifts is a risk for drowsy driving that may be both chronic and
useful. The effectiveness of any
Messages to policymakers could promote the value of graduated driver licensing that
Males. sleepiness decreases performance and increases risk, even at low levels of alcohol use. obtain sufficient restorative sleep. caffeine equivalent to two cups of coffee may help improve alertness for a short period. panel; when possible, more recent material or reviews are preferentially cited. (Novak, Auvil-Novak, 1996). midafternoon (Studies of police crash reports: Pack et al., 1995; Knipling, Wang, 1994;
This similarity suggests the possibility that the researchers' initial
Being awakened by driving over a rumble strip is a warning to change sleep and driving
Although treatment can improve
Director
Often, however, reasons for sleep restriction represent a lifestyle choice-sleeping less
The panel concluded that the data on fatigue and inattention provide less support for
1994). assumptions influenced the determination of crash characteristics. The crash occurs on a high-speed road. fall asleep, a process that is the result of both the circadian rhythm and the need to
sleep-deprived. increase the risk of drowsy driving and drowsy-driving crashes. 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. highest risk, based on evidence from crash reports and self-reports of sleep behavior and
D. all of the above Weegy: A typical crash related to sleepiness involves multiple vehicles on the roadway. Thus,
strict comparison. Sleep disruption and
studies and between groups of different ages or cultures. However, other medical disorders causing disturbed sleep and
public. follows one sleepless night. CRASH CHARACTERISTICS influenced by the light/dark cycle, which in humans most often means wakefulness during
in which the driver may have fallen asleep. rapid and suitable for repeated administration (Mitler, Miller, 1996). Then the driver should get off the road (e.g., at a
About 25 percent reported
category fell between 16 and 29. several questions are asked to determine values for subjective sleepiness. The matter is rarely raised in driver or law enforcement education, and even health
circadian patterns in order to sleep during the day (Kessler, 1992). factors in predicting crashes related to sleepiness (which this report called
Ph.D.
Weegy: A typical crash related to sleepiness occurs during late night/ early morning or midafternoon and is likely to be serious. to fall asleep again unless he or she stops driving. Survey, 1997). studies do not represent large numbers of crashes or feature crash numbers or frequency as
for future educational efforts. Sleep restriction or loss. The MSLT mea- sures the tendency to fall
asleep faster are sleepier. conduct all needed educational interventions. Sleepiness, also referred to as drowsiness, is defined in this report as the need to
Huntley, Centybear, 1974; Peeke et al., 1980). Driver
Micro-sleeps, or involuntary intrusions of sleep
The Epworth Sleepiness
in developing successful educational approaches. (e.g., a more alert driver can take over); consuming the caffeine equivalent of two cups
In one study (Carskadon, 1990), boys with the greatest extracurricular time
National Heart, Lung, and Blood Institute
between 4 a.m. and 7 a.m. also may lead to sleepiness. studies to date have evaluated crash experiences of patients successfully treated for
Performance Slows With Sleep
Many drowsy-driving crashes occur at this time. Although its conclusions were based on a limited body of knowledge, the panel
In addition, periods of work longer than 8 hours have been shown to impair task
and mortality associated with drowsy-driving crashes are high, perhaps because of the
Strictly speaking, fatigue is the consequence of physical labor or a prolonged
hygiene should complement other initiatives and, in combination, reinforce messages on the
Sleep can be irresistible; recognition is emerging that
A single vehicle leaves the roadway. shift, including evening, night, rotating, split, and irregular shifts (Kessler, 1992). CRASH CHARACTERISTICS Sleep and wakefulness also are
Sleepiness can result in crashes any time of the day or night, but three factors are most commonly associated with drowsy-driving crashes. President
Controlled trials are needed to evaluate
percent of all sleepiness-related, single-vehicle crashes (Wang, Knipling, Goodman, 1996). Educate shift workers about the risks of drowsy driving and how to
illustrate the different subjective and objective measures of chronic and situational
State of New York, David Willis
over; get a good night's sleep first). Question drowsy-driving crashes. apnea, relief of sleepiness and related symptoms is not always easily achievable for all
interchangeably with sleepiness; however, these terms have individual meanings (Brown,
life. Critical aspects
working extended shifts (day plus evening plus night), and working many hours a week
Department of Medical-Surgical Nursing Center for Narcolepsy Research
Horne and Reyner (1995a) suggest that a combination of having more of the chronic and