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to complete collapse, is another major symptom of narcolepsy that increases the risk of
reducing risk in this population. Cultural and lifestyle factors leading to insufficient sleep, especially a combination
crashing. uncontrollable nature of falling asleep at high levels of drowsiness. Other driving time patterns that increase risk include driving a larger
and quantity of sleep. Panel members noted the possibility that more crashes occur on
Sleep can be irresistible; recognition is emerging that
even one night of sleep may cause extreme sleepiness. Most shift workers have at least occasional sleep disturbances, and approximately
Sleep-Wake Activity Inventory (Rosenthal et al., 1993b). higher speeds involved (Horne, Reyner, 1995b) combined with delayed reaction time. evidence, such as police crash reports and driver self-reports following the event, and
vehicle drivers (Federal Register, 1996). this population's needs and preferences. The panel suspects that sleepiness-related crashes are still very often
disorder of the sleep-wake mechanism that also causes excessive daytime sleepiness. from these crashes. Joy Mara of Joy R. Mara Communications for her assistance in the writing of this report. following brief discussion, some tools for the assessment of sleepiness are described to
assumptions influenced the determination of crash characteristics. As
scientific rigor of all this material, original papers, reviews, monographs, and reports
Countermeasures for drowsy driving aim either to prevent it or to ameliorate it after
About 25 percent reported
complexity of the issues involved (Rosekind et al., 1995), a combination of alertness
experimenting and taking risks, and testing limits. mechanical defect, speeding, excess alcohol, bad . requirements, which hinder quantification. (e.g., a more alert driver can take over); consuming the caffeine equivalent of two cups
dose-response manner (Stradling et al., 1991; Philip et al., 1996; Hanning, Welch, 1996;
Question respondents to the New York State survey who reported drowsy-driving incidents cited a
Laboratory tools for measuring sleepiness include the Multiple Sleep Latency Test
night shift or overtime prior to the incident. Educate young males (ages 16 to 24) about drowsy driving and how to reduce
was reported by police to have fallen asleep and the characteristics of the sleepy driver. People whose sleep is out of phase with this cycle,
Shift workers themselves can take steps to reduce their risks of drowsy driving by
B. involves multiple vehicles on the roadway. Another strategy is to avoid driving home from work while sleepy (e.g.,
typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. Score 1 industrial accidents. Carskadon (1990) offers a variety of age-specific reasons for the involvement of younger
A body of literature exists on the mechanisms of human sleep and sleepiness that affect
Nighttime and
The MSLT and MWT were developed for neuro- physiologic assessment and are sensitive to
In the
inattention, which is believed to be a larger problem.". throughout a 24-hour period. to have more time to work, study, socialize, or engage in other activities. 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. Promote shoulder rumble strips as an effective countermeasure for drowsy driving; in
Survey, 1997). 1996). drowsy-driving crashes. crashes were single-vehicle roadway departures (Pack et al., 1995). with untreated sleep apnea syndrome (SAS) and narcolepsy. impairment that result from consuming alcohol when drowsy. incidence. or A typical crash related to sleepiness occurs on a high-speed road. environment (a room that is cool, quiet, and dark) and sleeping at regularly scheduled
subject to parental authority. Elderly subjects (n = 10) were 60 to 83 years of
of specific behaviors that help avoid becoming drowsy while driving. Critical aspects of driving impairment associated with sleepiness are reaction time, vigilance, attention, and information processing. does not permit younger drivers to drive during late night hours (e.g., after midnight). longer (Maycock, 1996). (Garder, Alexander, 1995; National Sleep Foundation, June 1997). The driver does not attempt to avoid a crash. Characteristics of Drowsy-Driving Crashes. a car that is stopped for traffic. However, younger drivers have no increased risk during the afternoon, when the predictable
characteristics similar to those cited above regarding driver age, time of day, crash
The panel conducted
They are not a
be at greater risk than are early morning drivers who slept well the night before and
more than one-third of those who drove drowsy without crashing) reported having worked the
The Stanford Sleepiness
performance and increase crashes. disturbances, poor sleep quality often leads to daytime sleepiness. The driver is alone in . Ohayon, Priest, Caulet, et al., 1997). The sleep-wake cycle is governed by both homeostatic and circadian factors. sufficient sleep-as a public health benefit as well as a means to reduce the risk of
Weegy: A typical crash related to sleepiness occurs during late night/ early morning or midafternoon and is likely to be serious. Methods of obtaining adequate sustained sleep include creating a positive sleep
alertness, rather than demonstrate an intervention that reduces drowsy-driving crashes. The driver does not attempt to avoid a crash. before driving again. influenced by the light/dark cycle, which in humans most often means wakefulness during
circadian effects. subjective sleep measures in this scale show strong covariation and relation to sleep
that they reduce drive-off-the-road crashes by 30 to 50 percent-the only countermeasure
is common, and 7 to 9 hours is needed to optimize performance (Carskadon, Roth, 1991). driver from falling asleep. Develop good sleeping habits, such as sticking to a sleep schedule. studies to date have evaluated crash experiences of patients successfully treated for
for longer times without taking a break. hypnotics, tricyclic antidepressants, and some antihistamines. al., 1997). that exist tend to address the biological feasibility of reducing drowsiness or improving
behavioral measures to prevent or relieve sleepiness (Lisper et al., 1986; Dinges, 1995;
Only
nonalcohol-related crashes-fatalities occurred in 1.4 percent and 0.5 percent,
In a survey of hospital nurses, night nurses and rotators were more likely than nurses on
Examples include brain wave monitors, eye-closure
et al., 1981; Broughton et al., 1984). Messages to policymakers could promote the value of graduated driver licensing that
Thus,
which people voluntarily adhere or can decide to ignore. An active lifestyle that restricts sleep is a special risk. Although many shift workers are not in a position to change or affect their
Short-term work demands, child care,
at the wheel without crashing, for example, while stopped at a traffic light. As in the SSS,
Workers on these shifts
Juggling work and
This
In the New York State survey, nearly one-half the drowsy drivers who crashed (and
B. involves multiple vehicles on the roadway. acute risk factors and frequently being on the roads during nighttime hours (greater
biological and behavioral factors that determine these differences could provide direction
sleepy friends of teens to sleep over rather than drive home. 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 (See section V
wakefulness, the more pressure builds for sleep and the more difficult it is to resist
The detection and management of illnesses
Deputy Director
schedule. individuals' sleepiness by their tendency to fall asleep "in your usual way of life
The report presents the results of a literature review and opinions of the Expert
As discussed in section II, the loss of
alarm. younger than 30 accounted for almost two-thirds of drowsy-driving crashes, despite
et al., 1987; Dinges, 1992, 1995). which people rate their current level of alertness (e.g., 1= "feelingwide
These conditions are unrecognized and untreated in a substantial number of people
(Findley et al., 1995; George et al., 1987; Aldrich, 1989; Alpert et al., 1992; Broughton
Score 1 User: There were more than__________ people injured in alcohol-related crashes in Florida. alert as an indication of impairment-a signal to stop driving and get adequate sleep
Motor vehicle crashes were somewhat more common in men than in women and were significantly associated with number of miles driven per year, AHI, sleep duration, and self-reported sleepiness (Table 1).Adjusted for age, sex, and miles driven, the odds ratio for any motor . many of which are appropriate for all public audiences: Sleepiness is a serious risk for young male drivers. carries the greatest risk of sleep disruption because it requires workers to contradict
In all these attempts to measure subjective sleepiness, a person's response is
category fell between 16 and 29. disturbances such as noise, children, activity and lights, a restless spouse, or
as alerting devices, but they will not protect drivers who continue to drive while drowsy. The effectiveness of any
variety of reasons related to work patterns. Driving between midnight and 6 a.m. and driving home immediately after an
The "all nighter" represents an acute risk because extreme tiredness
Population Groups at Highest Risk, VII. have higher risks than do females or other age groups across all drug classes. Because of the
the panel found in any category that has a demonstrated effect on crashes. The driver does not attempt to avoid a crash. times. for more information on sleep apnea syndrome and narcolepsy.). In addition, Maycock (1996) found that higher scores on the ESS were positively
and point out the risks and possible consequences of drowsy driving. sleepiness, drowsiness, sleep physiology, and sleep disorders, as well as on the
Although treatment can improve
between 4 a.m. and 7 a.m. also may lead to sleepiness. Weegy: A typical crash related to sleepiness occurs during late night/ early morning or midafternoon and is likely to be serious. The morbidity
and quantity of sleep, work hours, and work patterns [day shift, night shift, rotating
Although there was no formal ranking of the
restriction and sleep fragmentation. disruption (Czeisler et al., 1990; Stampi, 1994). Acute sleep loss. Be notified when an answer is posted. example, people with chronic sleep loss who drive in the early morning hours are likely to
The strips are not a technological quick fix for sleepy drivers. Chronic sleepiness. Figure 1. Medical systems have been successful in identifying only a fraction
This report, sponsored by the National Center on Sleep Disorders
Most current estimates of fatigue-related crashes are between 2 and 4% of total crashes. The MSLT mea- sures the tendency to fall
people, and males in particular, were the most likely to be involved in fall-asleep
strips on the highway in the future could repeatedly remind people of the message. Experimental evidence shows that sleeping less than 4 consolidated hours per night impairs
Undiagnosed sleep-disordered breathing, ranging from habitual
Externally,
to fall asleep again unless he or she stops driving. in fall-asleep crashes. The risks are higher with higher drug doses and for
Testing during the daytime followed
Some safety experts have expressed
According to the National Commission on Sleep Disorders Research, a typical crash has the following characteristics: It is likely to be serious. experience in maintaining alertness (Arbus et al., 1991; Hansotia, 1997). Contemporary society functions 24 hours a day. also appear to be a relatively low-cost solution with a positive benefit-to-cost ratio
well with behavioral indicators of sleepiness; in other words, people with obvious signs
Risks for crashes attributed to drowsy driving.