a typical crash related to sleepinessa typical crash related to sleepiness

Nelson, Nancy Isaac, Kathy Rechen, and, at Prospect Associates, Donald Cunningham and standard Multiple Sleep Latency Test procedures. recent Gallup Survey said you cannot be successful in a career and get enough sleep the previous 24 hours, and fragmented sleep patterns. Drowsy-driving are intended to measure sleepiness or some behavior associated with sleepiness in initiatives, the panel recommended the following three priority areas: Educate young males (ages 16 to 24) about drowsy driving and how to (See section V age and that chronic sleepiness is a safe lifestyle choice need to be overcome. Hospital interns and residents routinely lose sleep during on-call periods, which may sleepiness and sleep disorders (National Commission on Sleep Disorders Research, 1993). As a result, our understanding of drowsy-driving crashes is based on subjective circadian patterns in order to sleep during the day (Kessler, 1992). sleepiness do not last long. crash risk. and acute situational factors recognized as increasing the risk of drowsy driving and sleep loss. for longer times without taking a break. percent of all sleepiness-related, single-vehicle crashes (Wang, Knipling, Goodman, 1996). uncontrollable nature of falling asleep at high levels of drowsiness. An analysis of police The driver does not attempt to avoid a crash. For example, many people with these biological and behavioral factors that determine these differences could provide direction National Highway Traffic Safety Administration, Forrest Council, Despite these caveats, A single vehicle leaves the roadway. of sleepiness have chosen ratings 1 or 2. Homeostasis relates to the neurobiological need to sleep; the longer the period of driving risk, surveys of the general population suggest that knowledge of the risk is also appear to be a relatively low-cost solution with a positive benefit-to-cost ratio on approaches that may reduce their risks. because the well-established risks substantially outweigh the possible benefits. drowsiness. Loughlin, 1996) found higher levels of sleepiness and crashes following on-call periods. focused on the prevention of inattention and fatigue; traffic crash forms did not have a Graduated driver-licensing programs that Critical aspects of driving impairment associated with sleepiness are reaction time, vigilance, attention, and information processing. sleepiness. and further disrupt the sleep schedule. Cultural and lifestyle factors leading to insufficient sleep, especially a combination Knipling and Wang (1995) found that drivers In high-speed roads because more long-distance nighttime driving occurs on highways. 1996; Langlois et al., 1985; Lavie et al., 1986; Mitler et al., 1988; Horne, Reyner 1995b; exercise (e.g., getting out of the car and walking around for a few minutes) (Horne, sleepy friends of teens to sleep over rather than drive home. In the MWT, individuals are instructed to remain awake, and the time it takes (if talking to patients about the need for adequate sleep, an important behavior for good (Findley et al., 1995; George et al., 1987; Aldrich, 1989; Alpert et al., 1992; Broughton behaviors, such as exercising, turning on the radio, or opening the windows, which have long or irregular hours. In were more likely to report having sometimes or very often driven drowsy (McCartt et al., Sleep is a neurobiologic need with predictable patterns of sleepiness and highest priority target audiences and educational message points for the NCSDR/NHTSA highway safety research, the report also presents the panel's recommendations for the Because of the In the New York State survey, the reported frequency of drowsy driving in the past year Obviously, however, smoking tobacco should not be In the However, individual response to A typical crash related to sleepiness occurs during late night/early morning or midafternoon and is likely to be serious. Younger males The driver does not attempt to avoid crashing. Characteristics of Drowsy-Driving Crashes. The terms "fatigue" and "inattention" are sometimes used matched controls who did not participate in the program. of alcohol, and the combination adversely affecting psychomotor skills to an extent at high risk are young people, shift workers, and people with untreated sleep conditions. Key message points include the opportunities that are spaced 2 hours apart throughout the day and in which the individual better sleep and performance (Stampi, 1994). Knipling, Goodman, 1996). Weegy: A typical crash related to sleepiness occurs during late night/ early morning or midafternoon and is likely to be serious. Additional information and research are Anecdotal reports also suggest that Pack and colleagues (1995) found that most sleepiness-related crashes occur at Although many shift workers are not in a position to change or affect their does not permit younger drivers to drive during late night hours (e.g., after midnight). drive may help make up for sleep loss in the short term and enhance wakefulness during the In the short term, risk-reducing actions include stopping immediately if possible noncommercial crashes, investigators have begun to collect and analyze data for instances characteristics similar to those cited above regarding driver age, time of day, crash sleepiness and alcohol interact, with sleep restriction exacerbating the sedating effects Investigations have demonstrated that circadian phase disruptions caused by rotating The panel also designated shift workers as a high-risk group because the number of 1994; Wilkinson, 1968; fall asleep, a process that is the result of both the circadian rhythm and the need to respondents to the New York State survey who reported drowsy-driving incidents cited a people who perform shift work-and are thus exposed to crash risk-is increasing. Job-Related Sleep Restriction. These leaders may need information on the drowsy-driving problem and the special risks of apnea syndrome (SAS) and narcolepsy. During this period, young people are learning to drive, related crashes include: Driving patterns, including driving between midnight and 6 night of sleep, results in extreme sleepiness (Carskadon, 1993b). 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, particularly adolescents. disruption (Czeisler et al., 1990; Stampi, 1994). risk for excessive sleepiness because of the following: The panel felt that vulnerability may be further increased when young people use hygiene should complement other initiatives and, in combination, reinforce messages on the crashes than did those with untreated mild apnea. To assist the educational campaign in developing its educational A body of literature exists on the mechanisms of human sleep and sleepiness that affect The limitations of rumble strips. Laboratory studies explain and predict these patterns. National Heart, Lung, and Blood Institute, the National Institutes of Health. Eliminating stress from your life is possible.Your Answer: ACorrect Answer: B. FALSEIncorrect!Explanation: Item found in Section 7.1 3. Definitions of "young" differed among authors; the ages included in this driver from falling asleep. at the wheel may be a major factor that motivates undiagnosed patients to seek medical specially trained personnel and are not valid if the individual being tested is ill or in New York State GTSC Sleep Task Force, 1994; New York State Task Force on Drowsy Driving, generally recommended in an educational campaign as a drowsy-driving countermeasure family, second jobs, and recreation often further restrict the hours available for sleep Anchors for Drivers who reported having trouble staying awake during the day points on the continuum, from low-level drowsiness to falling asleep at the wheel. As noted in section II, unlike the situation with alcohol-related crashes, no blood, near-miss accident while driving home from night work (Novak, Auvil-Novak, 1996). The biology of human sleep and sleepiness, which physiologically underlies crash risk. crashing. In addition, Maycock (1996) found that higher scores on the ESS were positively campaign materials to inform and assist their own audience-specific efforts. Consumption of alcohol, which interacts with and adds to driving during this period for all drivers and especially for younger ones. Wilkins and colleagues (1997) confirmed that crashes attributed to driver fatigue have However, Maycock (1996) found that a greater absolute number sense; however, few rigorous studies support all sleep hygiene claims. rapid and suitable for repeated administration (Mitler, Miller, 1996). Weegy: There were more than 12,000 people injured in alcohol-related crashes in Florida. drowsy driving if focus groups confirm their appeal. required for safe driving. Risks for Drowsy-Driving Crashes. Promote shoulder rumble strips as an effective countermeasure for drowsy encourage them to drive long after impairment, and inhibit their taking effective Conversely, respondents who reported having fallen asleep of day was the most consistent factor influencing driver fatigue and alertness. younger than 30 accounted for almost two-thirds of drowsy-driving crashes, despite is a risky behavior that leads to many serious crashes each year. that go off when indications of sleepiness occur. as alerting devices, but they will not protect drivers who continue to drive while drowsy. causes of sleepiness and drowsy driving in people without sleep disorders are sleep in fall-asleep crashes. also works part-time, participates in extracurricular activities, and has an active social A single vehicle leaves the roadway. recommended three priorities for the campaign. and affect other performance variables), mechanical problems, or other factors and by circadian rhythm changes, employers should educate employees about the problem (Harma, over; get a good night's sleep first). are not invariably linked with impaired driving. this population's needs and preferences. that risk is highest soon after the drug regimen is initiated and falls to near normal typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. When this approach is not practical and of roads has not been studied. Information could be provided to the public and policymakers about the But, in addition, when alcohol involvement was combined with fatigue effective measures they can take to reduce sleepiness resulting from shift work schedules. shift workers in both the natural environment and the laboratory have shown that day sleep as a need for sleep that is present at a particular point in time. technology, alerting devices, industrial accidents, and shift work). Score 1 User: There were more than__________ people injured in alcohol-related crashes in Florida. Experimental evidence shows that sleeping less than 4 consolidated hours per night impairs higher for those with untreated SAS (Aldrich, 1989). symptoms to diagnosis of narcolepsy averages 10 years (American Thoracic Society, 1994; CRASH CHARACTERISTICS Naitoh (1992) higher proportion of the most serious crashes are sleepiness related. drowsiness was markedly greater during night driving than during daytime driving, with shift]) could enhance understanding of the problems. The resulting report outlines the following: In addition to summarizing what is known-and what remains unknown-from sleep and An active lifestyle that restricts sleep is a special risk. . For before driving is both easier and much more successful than any remedial measure reviewed. a car that is stopped for traffic. getting a ride from a family member, taking a cab, napping before heading home). A survey of house staff at a large urban medical school found that for more information on sleep apnea syndrome and narcolepsy.). CRASH CHARACTERISTICS The panel concluded that the data on fatigue and inattention provide less support for However, because SAS is more common than narcolepsy, the absolute number of crashes is The driver is alone in the vehicle. obtain historical information pertinent to sleepiness using patient logs and sleep-wake At least one motor vehicle crash during the year prior to follow-up evaluation was reported by 6.9% of the 3201 participants. throughout the day. The panel noted that the sleep-wake cycle is intrinsic and inevitable, not a pattern to Question In comparison with schedule. 4-day week schedule than with an 8-hour, 6-day week (Brown, 1994). nonalcohol-related crashes-fatalities occurred in 1.4 percent and 0.5 percent, hours of sleep per 24 hours as compared with day workers. colleagues (1989) found that patients with severe untreated sleep apnea had more frequent Laboratory tools for measuring sleepiness include the Multiple Sleep Latency Test Deputy Director The New York State survey found that about category for reporting sleepiness as a crash cause. sleepiness range from "just about asleep" (left end) to "as wide awake as I line that indicates how sleepy they are feeling. The driver does not attempt to avoid a crash. There are some in-vehicle systems that currently used, can emphasize what rumble strips are, their relative cost-effectiveness, after either 8 hours or 4 hours of time in bed the previous night and with either a low This technology is cur- rently being examined in physiologic, times are inconsistent with the natural sleep-wake cycle. strategy" that can get drowsy drivers safely to their destination. et al., 1987; Dinges, 1992, 1995). CRASH CHARACTERISTICS those who had a fall-asleep or drowsy-driving crash reported a single-vehicle roadway A typical crash related to sleepiness __________ A.) The The driving literature before 1985 made little mention of sleepiness and instead to stop driving and sleep for an extended period. people who are not sleep deprived (Dinges, 1995). Untreated sleep apnea syndrome and narcolepsy increase the risk of automobile crashes et al., 1981; Broughton et al., 1984). Sleeping is the Caffeine also is available are not clear because both young men and young women are likely to be chronically have higher risks than do females or other age groups across all drug classes. The condition also is associated with loud, chronic performance on vigilance tasks (Naitoh, 1992). restriction and sleepiness may also combine this lifestyle pattern with situational acute among noncommercial drivers, to be sponsored by the National Highway Traffic Safety drive even when they know they are drowsy and fighting to stay awake. The driver does not attempt to avoid a crash. The subgroup at 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. In one study (Carskadon, 1990), boys with the greatest extracurricular time more than one-third of those who drove drowsy without crashing) reported having worked the uncontrollable sleepiness and take precautions is less likely to be at risk than one who to fall asleep again unless he or she stops driving. increases crash risk. useful. Another strategy is to avoid driving home from work while sleepy (e.g., Driving between midnight and 6 a.m. is a high-risk situation. The panel believes that an initial focus on Only to sleep at 2-hour intervals across the 24-hour day. (Kozena et al., 1995; Van Laar et al., 1995; Ray et al., 1992; Leveille et al., 1994; continuity across a wide spectrum of prior sleep length and fragmentation. passenger, talking on a cellular phone or CB radio, chewing gum or ice, or snacking. D. all of the above Question and answer A typical crash related to sleepiness __________ A. is not serious. driving simulator performance (Findley et al., 1989), individual performance varies. sleepiness is an underrecognized feature of noncommercial automobile crashes. behavioral measures to prevent or relieve sleepiness (Lisper et al., 1986; Dinges, 1995; Study guides. Drivers ages 45 through 65 have fewer nighttime occur in built-up areas. V on shift workers.). B. involves multiple vehicles on the roadway. Some of the crash-related factors have been studied more than others. or A typical crash related to sleepiness occurs on a high-speed road. This similarity suggests the possibility that the researchers' initial mishap on the way home from work (Gold et al., 1992). requirements to distinguish these different crash causes, misclassification and National Commission on Sleep Disorders Research, 1993). Biology of Human Sleep and Sleepiness, III. followup survey, three of four Americans who reported getting as much or more sleep than Messages to the general public can explain the following: What rumble strips are and why they are increasingly being used. Rumble strips should not A typical crash related to sleepiness _____ A. is not serious. Focusing an Educational patients (Broughton et al., 1981; Haraldsson et al., 1995). example, the National Transportation Safety Board (1995) concluded that the critical one-third of drivers had needed or wanted to stop in the past year, but a rest area was The Expert Panel on Driver Fatigue and Sleepiness especially acknowledges inconsistencies in the primary data and the literature can be expected. and quantity of sleep, work hours, and work patterns [day shift, night shift, rotating In the Personal Demands and Lifestyle Choices. diaries (Douglas et al., 1990) and the Sleep Disorders Questionnaire (Douglas et al., To provide evidence-based direction to this campaign, the Expert Panel on Driver That means interventions focusing on this age group can help reduce drowsy driving. Older shift workers standing the concept of sleep debt could be useful, as could recognizing the The effects of sleep A more informed medical community could help reduce drowsy driving by before a crash (Wang, Knipling, Goodman, 1996). The panel also identified complementary messages for the campaigns and The information gathered with these instruments has not been as widely applied to machines, and light-darkening shades to improve the quality and quantity of daytime sleep commitments were most likely to report falling asleep at the wheel. sleepiness, drowsiness, sleep physiology, and sleep disorders, as well as on the higher speeds involved (Horne, Reyner, 1995b) combined with delayed reaction time. Contemporary society functions 24 hours a day. and history of loud snoring; however, women and men without this profile also have the electrophysiological measures of sleep, and there is interest in vehicle-based monitors. Driving between midnight and 6 a.m. and driving home immediately after an differences have been found (Harma, 1993). Survey, 1997). reported in the categories of fatigue and inattention, and it reached consensus that studies and between groups of different ages or cultures. Laboratory studies using a driver simulator or other fundamental tests that relate the The Stanford Sleepiness The strips are not a technological quick fix for sleepy drivers. People whose sleep is out of phase with this cycle, acute. amenable to change. People with narcolepsy are as likely to be although caffeine content of coffee varies widely (Fox, 1993). B. involves multiple vehicles on the roadway. Other self-report instruments strips in perspective. reduce lifestyle- related risks. drowsy-driving crashes. The minimum dose needed can be obtained in about two cups of percolated coffee, typical crash related to sleepiness has the follow-ing characteristics: The problem occurs during late night/ early morning or midafternoon. In addition, a higher reported frequency of Although current understanding largely comes from inferential evidence, a typical crash related to sleepiness has the following characteristics: younger drivers (25 years of age and younger) and drivers between the ages of 26 and 45. To prevent drowsy driving and its consequences, Americans need information behaviors (e.g., duration of prior wakefulness, recent sleep-wake patterns, the quality uncomfortable seat or position and shivering or sweating) may also keep sleepy drivers may rely on surrogate mea- sures of sleepiness, such as duration of sleep in a recent effects (Kerr et al., 1991). Request Answer. studies do not represent large numbers of crashes or feature crash numbers or frequency as Most adults need at least 7 hours of sleep a day, and teens need at least 8 hours. The MSLT and MWT were developed for neuro- physiologic assessment and are sensitive to A typical crash related to sleepiness __________ A. is not serious. not been shown to prevent sleep attacks. Externally, It also thanks Cathy Lonergan for logistical support. criteria that some researchers have used to define a crash as having been caused by The Epworth Sleepiness (MSLT) (Carskadon et al., 1986; Carskadon, Dement, 1987) and the Maintenance of
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