To assist the NCSDR/NHTSA in developing its educational initiatives, the panel
getting a ride from a family member, taking a cab, napping before heading home). Virtually all studies that analyzed data by gender and age group found that young
apnea syndrome (SAS) and narcolepsy, and the increased drowsiness and performance
Division of Pulmonary and Critical Care Medicine
that go off when indications of sleepiness occur. These statistics also do not deal with crashes caused by driver
is common, and 7 to 9 hours is needed to optimize performance (Carskadon, Roth, 1991). or more sleepless nights (e.g., do not drive home from college the day your exams are
before bedtime) (Richardson et al., 1982; see figure 1). association of these topics with driving risk and crash prevention. Assessment for chronic sleepiness. each day; driving in the midafternoon hours (especially for older persons); and driving
studies do not represent large numbers of crashes or feature crash numbers or frequency as
Although evidence is limited or inferential, chronic predisposing factors
It is possible that the effects of low levels of blood alcohol may have an interaction
in fall-asleep crashes. have the greatest negative effects on alertness (Rosenthal et al., 1993a; Gillberg, 1995). and driving is no exception (kerstedt, 1995a, 1995b; Dinges, 1995; Horne, 1988;
common causes of acute sleep loss. associated with crashes. et al., 1987; Dinges, 1992, 1995). disruption (Czeisler et al., 1990; Stampi, 1994). employees would complement and reinforce other drowsy-driving messages directed to the
People scoring 10 to 14 are rated as moderately sleepy,
sense; however, few rigorous studies support all sleep hygiene claims. However, unlike the situation with alcohol-related crashes, no blood, breath,
which the driver was asleep with no evidence of alcohol. The primary internal cause is illness, including untreated sleep disorders. Among New York State
Despite the tendency of society
As noted earlier, the circadian pacemaker
An inherent deficiency in all types of alerting devices is that many people continue to
of these types of crashes. Acute sleep loss. No current data link other sleep disorders with
crash. shift workers in both the natural environment and the laboratory have shown that day sleep
disorder (American Thoracic Society, 1994). crash risk. commercial drivers show a similar pattern (see figure 3). to fatigue and inattention, and given the lack of objective tests or uniform reporting
The crash is likely to be serious. In addition, the number of studies is relatively small, and some of the
impairment that could assist investigating officers in attributing a crash to sleepiness. wakefulness, the more pressure builds for sleep and the more difficult it is to resist
The recommended action is not to start a long drive after one
(based on a 24-hour clock), subjects were awakened every 2 hours for 15 minutes, and
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
The morbidity
factors in predicting crashes related to sleepiness (which this report called
It is widely recognized that these statistics underreport the extent
assumptions influenced the determination of crash characteristics. As noted in section II, external and internal factors and current lack of knowledge and
between 4 a.m. and 7 a.m. also may lead to sleepiness. 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 No measures
Others reported frequently falling asleep
is convenient and rapidly administered over repeated measurements. Add an answer. The panel noted that the sleep-wake cycle is intrinsic and inevitable, not a pattern to
are 5 times more likely than females to be involved in drowsy-driving crashes (Wang,
loss are cumulative (Carskadon, Dement, 1981). on approaches that may reduce their risks. circadian rhythm changes, employers should educate employees about the problem (Harma,
Huntley, Centybear, 1974; Peeke et al., 1980). Conversely, respondents who reported having fallen asleep
rural roads. There is insufficient evidence at present
shift]) could enhance understanding of the problems. complexity of the issues involved (Rosekind et al., 1995), a combination of alertness
Shift workers whose sleep is disrupted by working at night or working
behaviors, such as exercising, turning on the radio, or opening the windows, which have
The panel of experts reviewed the literature on fatigue-related crashes and produced a 36-page report covering the biology of human sleep and . disorders report no auto crashes (Findley et al., 1988; Aldrich, 1989). In lieu of an objective measure night. sleep loss. only those crashes known not to be caused by alcohol (because alcohol can cause sleepiness
occur in built-up areas. strategy" that can get drowsy drivers safely to their destination. Sleep-restrictive work patterns. reported having fair or poor sleep quality were more likely to have driven drowsy
That means interventions focusing on this age group can help reduce drowsy driving. or relevant work, sleep, and other lifestyle habits. sleepiness range from "just about asleep" (left end) to "as wide awake as I
other types of crashes, drowsy-driving crashes more often take place on highways and major
standing the concept of sleep debt could be useful, as could recognizing the
The midnight to 8 a.m. shift
is long. one-half of U.S. adults reported experiencing sleeping difficulties sometimes, with about
Survey, 1997). C. occurs on a high-speed road. The panel reviewed the knowledge base in four categories of countermeasures:
Nighttime and
Subjective and objective tools are available to approximate or detect
Currently, many people with these
At the same time, this age group is at
Although alcohol and some medications can independently induce sleepiness, the primary
complements Federal Highway Administration efforts to address the problem among commercial
for drowsy-driving crashes. risks and how to reduce them. Weegy: A typical crash related to sleepiness occurs during late night/ early morning or midafternoon and is likely to be serious. shifts or more within a month) caused the most severe sleep disruptions of any work
The panel conducted a wide-ranging search for information on sleep, circadian rhythms,
Currently about one in
need information on the risks of drowsy driving and crashes to put the need for rumble
were more likely to report having sometimes or very often driven drowsy (McCartt et al.,
time or miles (exposure), the use of sedating medication, sleep disorders such as sleep
commercial and noncommercial driving. family responsibilities, and school bus or school opening times. Caffeine, even in low doses,
literature searches of online databases in traffic safety, medicine, and physiology using
head-on crashes (Knipling, Wang, 1994). minutes) has been shown to improve subsequent performance, even among sleep-deprived
hours of sleep per 24 hours as compared with day workers. In addition, limited evidence suggests that physical discomfort (such as sitting in an
commenting on the report: Mary Carskadon, David Dinges, Lynn Butler, Nick Teare, Toben
these disorders and found a positive effect (Cassel et al., 1996; Haraldsson et al.,
or A typical crash related to sleepiness occurs on a high-speed road. Then the driver should get off the road (e.g., at a
No definitive criteria are available for establishing how
Regularly losing 1 to 2 hours of sleep a
The
Research has shown that effective steps are available for both employers and employees
Findley and
Misconceptions that sleepiness is inevitable at this
awake" to 7= "sleep onset soon"). drowsiness peaking from late evening until dawn (Wylie et al., 1996). performance of persons with sleep disorders compared with a control group. sleep disrupt and fragment sleep. The biology of the sleep-wake cycle predicts
1996; Langlois et al., 1985; Lavie et al., 1986; Mitler et al., 1988; Horne, Reyner 1995b;
B. involves multiple vehicles on the roadway. Score 1 User: There were more than__________ people injured in alcohol-related crashes in Florida. deliveries, round-the-clock computer operations, overnight cleaning crews, 24-hour
The panel also identified complementary messages for the campaigns and
sleepiness and alcohol and may not recognize related impairments they experience. The VAS
Drivers who reported having trouble staying awake during the day
reduce lifestyle- related risks. respondents averaged 3 hours of sleep during 33-hour on-call shifts, much of which was
Furthermore, a crash is likely to be an altering circumstance. of night nurses working 12-hour shifts reported having had an automobile accident or
Figure 1. Related questions 0 votes. Sleep-Wake Activity Inventory (Rosenthal et al., 1993b). In
In the more recent surveys and reporting of
The proportion of crashes is
hours, the scheduling of work and rest periods to conform to circadian rhythms promotes
Develop good sleeping habits, such as sticking to a sleep schedule. risks for drowsy driving and effective countermeasures. Although there was no formal ranking of the
In some situations, the scale does not appear to correlate
1994; Wilkinson, 1968;
Consuming
conditions are undiagnosed and untreated, unaware of the potentially serious consequences
Driving simulation tests specifically show
Other rating tools that measure an individual's experience with sleepiness over an
Hospital interns and residents routinely lose sleep during on-call periods, which may
The Karolinska Sleep Diary (kerstedt et al., 1994) contains questions relating to
Contemporary society functions 24 hours a day. Figure 4. Although current understanding largely comes from inferential evidence, a
and tested; ultimately, the impact of such approaches on drowsy-driving knowledge,
that they reduce drive-off-the-road crashes by 30 to 50 percent-the only countermeasure
midnight through 6 a.m. driving, and avoiding alcohol and sedating medicines while sleepy
and Sleepiness, II. The condition also is associated with loud, chronic
snoring to repeated breathing interruptions, also increases the likelihood of crashes in a
inconsistencies in the primary data and the literature can be expected. to complete collapse, is another major symptom of narcolepsy that increases the risk of
at high risk are young people, shift workers, and people with untreated sleep conditions. ; Before you drive, avoid taking medicines that make you sleepy. Investigations have demonstrated that circadian phase disruptions caused by rotating
Based on the literature,
dose-response manner (Stradling et al., 1991; Philip et al., 1996; Hanning, Welch, 1996;
give drivers a false sense of security about driving while sleepy. The driver is alone in . 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 It also will be important for
Countermeasures. generally recommended in an educational campaign as a drowsy-driving countermeasure
Elderly subjects (n = 10) were 60 to 83 years of
Many Americans are unaware of the
Maturational changes that increase the need for sleep. A recent synthesis of reports on the effectiveness of rumble strips shows
was reported by police to have fallen asleep and the characteristics of the sleepy driver. Department of Motor Vehicles State of New York, James Kiley,
impairment that result from consuming alcohol when drowsy. and point out the risks and possible consequences of drowsy driving. The Expert Panel on Driver Fatigue and Sleepiness especially acknowledges
effects on performance of sleepiness, sleep loss, and the combined effects of sleep loss
A body of literature exists on the mechanisms of human sleep and sleepiness that affect
typical crash related to sleepiness has the following characteristics: The problem occurs during late night/ early morning or midafternoon. Studies based on driver self-reports: Maycock, 1996; McCartt et al., 1996). NCSDR/NHTSA
If drivers
A message that would convince young men not to drink when they are already sleepy could be
extended or night shift are special risks for a drowsy-driving crash. impairment are neurobiological responses of the human brain to sleep deprivation. behavioral measures to prevent or relieve sleepiness (Lisper et al., 1986; Dinges, 1995;
at the wheel may be a major factor that motivates undiagnosed patients to seek medical
Panel Chairman Director, Center for Sleep Disorders Research
socializing, preparing for a trip or vacation, and "pulling all nighters" are
Study guides. a better understanding of young men's perceptions of fall-asleep crash risk and the kinds
subject to parental authority. (National Sleep Foundation Survey, 1997; American Thoracic Society, 1994). However, it is clear that these factors are cumulative, and any
Employers, unions, and shift workers are potential target audiences for education on
A more informed medical community could help reduce drowsy driving by
reports, all crashes in the fatigue and inattention categories should be attributed to
are not clear because both young men and young women are likely to be chronically
Retrospective studies that compare crash histories of drivers with sleep disorders with
Although these conditions place people at higher risk for drowsy-driving crashes, they
1994). sleep-deprived. considered pathologically sleepy; taking 10 minutes or more to fall asleep is considered
The presumption under-lying this test is that people who fall
near-miss crashes than did nurses on other schedules (Gold et al., 1992). Naitoh (1992)
drive. for longer times without taking a break. Director National Center on Sleep Disorders Research
For example, capturing information on drivers' precrash
It appears
fall-asleep crashes. Narcolepsy is a
Although the relative risk for fall-asleep crashes has not been established,
Driving while acutely tired, such as after a night shift, also increases the risk of
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