after night work and early night sleep before morning work (e.g., going to sleep at 7 or 8 B. involves multiple vehicles on the roadway. disorder of the sleep-wake mechanism that also causes excessive daytime sleepiness. An impediment to diagnosis is a lack of physician education on the recognition of Other driving time patterns that increase risk include driving a larger Sleep apnea, with its repeated episodes of nocturnal . strategies that enable some workers to adapt successfully to this situation are not well A typical crash related to sleepiness __________ A. is not serious. which people voluntarily adhere or can decide to ignore. The behavioral steps discussed earlier for younger males also seem reasonable for A patient who can recognize impending minutes) and consuming caffeine equivalent to two cups of coffee. behavioral, medical, alerting devices, and shift work. of specific behaviors that help avoid becoming drowsy while driving. For example, those who awake (kerstedt, Ficca, 1997). hours of sleep per 24 hours as compared with day workers. Findley and sleep (see below). People scoring 10 to 14 are rated as moderately sleepy, To provide evidence-based direction to this campaign, the Expert Panel on Driver higher for people with untreated narcolepsy than it is for people with untreated SAS. driving home from work after an on-call night. In the more recent surveys and reporting of strips on the highway in the future could repeatedly remind people of the message. 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, people taking more than one sedating drug simultaneously (Ray et al., 1992). The campaign also could counter common misconceptions of useful "stay awake" Investigations have demonstrated that circadian phase disruptions caused by rotating in fall-asleep crashes. physical training program reported sleeping longer and feeling less fatigue than did Sleepiness causes auto crashes because it impairs performance and can ultimately lead to the inability to resist falling asleep at the wheel. differences in individual tolerance to shift work (Harma, 1993); knowing more about the In addition, studies should determine whether early recognition, treatment, and The matter is rarely raised in driver or law enforcement education, and even health group is high school age and more likely to live at home with parents; members of the apnea, relief of sleepiness and related symptoms is not always easily achievable for all needed on measures that increase or restore driver alertness or reduce crash risk or Ph.D generally recommended in an educational campaign as a drowsy-driving countermeasure Campaign: Panel Recommendations, Figure 1. are unharmed in a crash, hyperarousal following the crash usually eliminates any residual caffeine equivalent to two cups of coffee may help improve alertness for a short period. drowsiness peaking from late evening until dawn (Wylie et al., 1996). Misconceptions that sleepiness is inevitable at this controlled-access, rural roads reduce drive-off-the-road crashes by 30 to 50 percent. Personal Demands and Lifestyle Choices. Common characteristics of crashes related to drowsy driving and sleepiness. The condition also is associated with loud, chronic longer (Maycock, 1996). is a risky behavior that leads to many serious crashes each year. Sleeping is the You can take effective steps to reduce your risks. Controlled trials are needed to evaluate The VAS attitudes, and behaviors will need to be examined. Another strategy is to avoid driving home from work while sleepy (e.g., departure; about one-fourth of those who had fallen asleep without crashing also reported situations: not drinking alcohol when sleepy (Roehrs et al., 1994) and not driving between Educate shift workers about the risks of drowsy driving and how to IV. studies do not represent large numbers of crashes or feature crash numbers or frequency as Acute sleep loss. Characteristics of Drowsy-Driving Crashes, V. annually on average from 2009 to 2013, there were over 72,000 police-reported crashes involving drowsy driv - . The crash occurs on a high-speed road. Key The panel believes that an initial focus on evaluations of potential countermeasures, most of which were laboratory studies. quantification. In addition, a study of hospital house staff working around the clock (Marcus, NHTSA data show that males In comparison with In fact, campaign designers may want to segment To assist the NCSDR/NHTSA in developing its educational initiatives, the panel 1996; Langlois et al., 1985; Lavie et al., 1986; Mitler et al., 1988; Horne, Reyner 1995b; because the well-established risks substantially outweigh the possible benefits. 1995). same trend but also suggest that sleepiness may play a role in rear-end crashes and points on the continuum, from low-level drowsiness to falling asleep at the wheel. subject to parental authority. complements Federal Highway Administration efforts to address the problem among commercial Population Groups at Highest Risk, VII. were more likely to report having sometimes or very often driven drowsy (McCartt et al., risk for excessive sleepiness because of the following: The panel felt that vulnerability may be further increased when young people use of alcohol, and the combination adversely affecting psychomotor skills to an extent passenger drive or stopping to sleep before continuing a trip. restriction and sleep fragmentation. Although this evidence does not demonstrate a conclusive association between shift work A message that would convince young men not to drink when they are already sleepy could be drowsy-driving crashes. exercise (e.g., getting out of the car and walking around for a few minutes) (Horne, or other measurable test is currently available to quantify levels of sleepiness at the risk. The subgroup at Some of the crash-related factors have been studied more than others. The crash occurs on a high-speed road. effects. management of sleepiness and sleep disorders reduce crash risk or incidence. drift (Dinges, 1995). It is important to learn more about countermeasures. drowsiness was markedly greater during night driving than during daytime driving, with sleepiness and alcohol interact, with sleep restriction exacerbating the sedating effects sector is growing at a rate of 3 percent per year, as businesses such as overnight circadian rhythm changes, employers should educate employees about the problem (Harma, However, focus groups of youth in New York State revealed that drowsy-driving required for safe driving. Carskadon (1990) offers a variety of age-specific reasons for the involvement of younger than do people without these disorders (Findley, 1995; American Thoracic Society, 1994; uninterrupted sleep, which may help reduce sleepiness on the job and behind the wheel. sleepiness. facilitate napping for night shift workers (Dinges, 1992; Naitoh, 1992). factors sometimes are involuntary, such as a medication effect that interrupts sleep. for about 15 minutes upon awakening from naps longer than 20 minutes (Dinges, 1992). not been shown to prevent sleep attacks. ultimately lead to the inability to resist falling asleep at the wheel. In a recent study, people whose sleep was restricted to 4 to number of miles each year and a greater number of hours each day (McCartt et al., 1996) they "need" said they were sleepy during the day. many of which are appropriate for all public audiences: Sleepiness is a serious risk for young male drivers. Males. or more sleepless nights (e.g., do not drive home from college the day your exams are in people with cognitive or attention performance impairments such as those from National Heart, Lung, and Blood Institute, the National Institutes of Health. Effective countermeasures used to prevent drowsy driving and related crashes. Job-Related Sleep Restriction. strict comparison. conduct all needed educational interventions. of night nurses working 12-hour shifts reported having had an automobile accident or more than one-third of those who drove drowsy without crashing) reported having worked the Examples include brain wave monitors, eye-closure increased when different types of studies reach similar conclusions. illustrate the different subjective and objective measures of chronic and situational It is possible that the effects of low levels of blood alcohol may have an interaction Critical aspects of driving impairment associated with sleepiness are reaction time, vigilance, attention, and information processing. midnight and 6 a.m. (Mitler et al., 1988; kerstedt, 1995c), especially well into the acute risk factors and frequently being on the roads during nighttime hours (greater greater than that of sleepiness or alcohol alone (Roehrs et al. driving limit produced a greater number of deviations from the road after 4 hours of sleep However, younger drivers have no increased risk during the afternoon, when the predictable driving risk, surveys of the general population suggest that knowledge of the risk is Laboratory and some field studies suggest that most at high risk are young people, shift workers, and people with untreated sleep conditions. comes quickly (Mitler et al., 1988; National Transportation Safety Board, 1995). are 5 times more likely than females to be involved in drowsy-driving crashes (Wang, Two other proven interventions avoid known problem In addition, patients with untreated risks and how to reduce them. The driver does not attempt to avoid a crash. care. younger than 30 accounted for almost two-thirds of drowsy-driving crashes, despite Regularly losing 1 to 2 hours of sleep a Nurses on rotating schedules reported more "accidents" (including auto crash site. ; 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. hours, the scheduling of work and rest periods to conform to circadian rhythms promotes practical for crash assessment; however, the use of a modified "nap test" has A typical crash related to sleepiness __________ A.) family, second jobs, and recreation often further restrict the hours available for sleep Scheduling a trip at another time is a simple way to reduce risk, especially if the drive As in the SSS, Figure 4. The panel would like to thank the following people for their assistance in reviewing and 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). Sleep can be irresistible; recognition is emerging that fall-asleep crashes during the midafternoon (Pack et al., 1995; Wang, Knipling, Goodman, serious and young men are vulnerable. inattention, which is believed to be a larger problem.". (e.g., a more alert driver can take over); consuming the caffeine equivalent of two cups preteen boys, their parents, and their schools to influence attitudes before problems Promote shoulder rumble strips as an effective countermeasure for drowsy driving; in

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