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Asleep At The Wheel: Drowsy Driving As A Public Health Crisis

The National Highway Transportation Safety Administration says there were more than 72,000 documented accidents involving drowsy drivers between 2009 and 2013. But that’s just from official police reports, so experts say it’s a gross under-estimate. (Jesse Costa/WBUR)

The National Highway Transportation Safety Administration says there were more than 72,000 documented accidents involving drowsy drivers between 2009 and 2013. But that’s just from official police reports, so experts say it’s a gross under-estimate. (Jesse Costa/WBUR)

It’s midafternoon and I’m fighting to keep my eyes open. It’s a matter of life and death. That’s because I’m northbound on I-93, going 65 miles an hour — with many cars passing me.

Once or twice on the monotonous two-hour drive, a jolt of adrenaline surges through my bloodstream as I suddenly realize I’ve actually drifted off for a micromoment. Thankfully I get home without killing myself or anybody else.

If you say you haven’t had the same experience behind the wheel, I don’t believe you.

The National Highway Transportation Safety Administration (NHTSA) says there were more than 72,000 documented accidents involving drowsy drivers between 2009 and 2013. But that’s just from official police reports, so experts say it’s a gross under-estimate.

After all, there’s no sleep-a-lyzer test for drowsiness like the blood alcohol-level test for drunk drivers. And it’s harder for a cop to spot a drowsy driver than one distracted by a smart phone.

“Twenty to twenty-five percent of all crashes could be fatigue-related — drowsy drivers,” says Dr. Mark Rosekind, the NHTSA administrator. “We could be looking at over a million crashes and potentially up to 8,000 lives lost.”

Rosekind made those remarks during a webcast this week sponsored by the Harvard T. H. Chan School of Public Health and The Huffington Post. The discussion included HuffPost editor-in-chief Arianna Huffington, Harvard sleep expert Charles Czeisler, and Jay Winsten, associate dean for health communication at the Harvard Chan School.

The forum is part of a national campaign against drowsy driving that’s just getting underway.

The idea is to treat drowsy driving as the public health issue that many believe it is and to bring to the campaign the same strategies that stigmatized drunk driving. Winsten master-minded that effort 28 years ago when he coined the term “designated driver” and nagged movie and TV producers to insinuate it into their scripts.

I moderated the online discussion. Here are some highlights:

The Brain Split

Czeisler, who’s the head of the division of sleep and circadian disorders at Brigham and Women’s Hospital, says the sleep-deprived brain can split itself in two. One part goes through the motions of a “highly over-learned task” such as driving. Meanwhile, cognitive centers involuntarily transition from wakefulness to sleep.

“So it’s particularly concerning that 56 million Americans a month admit that they drive when they haven’t gotten enough sleep and they’re exhausted,” Czeisler says. “Eight million of them lose the struggle to stay awake and actually admit to falling asleep at the wheel every month.”

My powerful mid-afternoon drowsiness was typical. “It used to be thought that [drowsiness-related crashes] only happened at night, but that’s because people weren’t looking,” Czeisler says. “Most sleep-deficient driving incidents happen during the daytime because there are so many more drivers on the road.”

And there’s a physiological factor. Mid-afternoon is before the brain’s internal clock “has given us a second wind to help us stay awake in the evening,” he says.

Who Falls Asleep Most?

Three groups are particularly vulnerable to falling asleep at the wheel, Czeisler says: young people, night-shift workers, and the millions of people who suffer from sleep apnea.

“Young people think that because they’re young, they’re fit, they can do anything,” the Harvard sleep researcher says. “But actually, young people are the most vulnerable. More than half of fatigue-related accidents are in people under 25 years of age.” Continue reading

Related:

After A Death, Crackdown On Drowsy Teen Drivers Led To Fewer Crashes, Study Finds

(KaritoGlam/Flickr)

(KaritoGlam/Flickr)

By Marina Renton
CommonHealth Intern

It was to be Maj. Robert Raneri’s last day of work before his wedding the following week. On June 26, 2002, Raneri, a member of Army Reserves, left his home in Nashua, New Hampshire for the Devens Reserve Forces Training Area in Ayer, Massachusetts. But he never arrived.

Raneri was killed by a 19-year-old drowsy driver who admitted to having stayed up through the night playing video games. Shortly after Raneri’s death, his fiancée, Maj. Amy Huther, learned she was pregnant with his child.

In accordance with Massachusetts law at the time, the teen driver faced misdemeanor charges, leading to five years probation, a 10-year license suspension and 140 hours of mandated community service, The Boston Globe reported in 2004.

Drowsy Driving

But the tragedy brought attention to the problem of drowsy driving and, in 2007, led to new rules that govern the way young drivers grow into their adult licenses: the graduated driver-licensing program.

Those rules (amendments to already existing law) included stiffer nighttime driving penalties, driver’s education on drowsy driving and tougher penalties for negligent or reckless driving. And it seems the strict new rules have worked, dramatically decreasing the number of drowsy driving accidents involving teenagers, according to a new study out this month in the journal Health Affairs.

Indeed, the results are striking: Among junior operators (ages 16-17), the overall rate of car accidents fell by 18.6 percent, the rate of night crashes decreased by almost 29 percent, and there was an almost 40 percent decrease in car crashes resulting in a fatal or incapacitating injury, researchers report. The study focused on data from one year before and five years after the implementation of the new amendments.

Legal Crackdown

This is the first study of its kind to look at the effects of individual components of a driver licensing law, such as more exacting penalties, the authors state.

Dr. Charles Czeisler, chief of the Division of Sleep and Circadian Disorders at Brigham and Women’s Hospital in Boston and co-author of the study, said in an interview that researchers are “confident that these features of the law were critical in the decline in the teen fatal and incapacitating injuries as well as the overall crash rate that we observed.”

Like young drivers everywhere, Massachusetts teens don’t have the same privileges as adult drivers. They aren’t allowed to drive at certain times of night; they can’t have friends in the car right away; and they have to drive with a parent or other adult in the car when they’re first starting out. Continue reading

It’s The Driver, Stupid: So Don’t Blame The Cell Phone

(Marilyn M./flickr)

Bad news for those comforted by laws that restrict cell phone use while driving: it’s not the technology causing the problems, it’s the aggressive, bad drivers, a new report from MIT suggests.

The Boston Globe reports:

People who chat behind the wheel often drive more aggressively even after they hang up, according to a study from the Massachusetts Institute of Technology,

“The people who are more willing to frequently engage in cellphone use are higher-risk drivers, independent of the phone,” Continue reading

Just Thinking About Cell Phone Calls While Driving Can Lead To Crashes, Study Finds

(Mike "Dakinewavamon" Kline/flickr)

Making calls while you’re driving is bad — we know this. But new research suggests that even thinking about cell phone calls when you’re driving can lead to accidents.

This distressing new research that underscores how profoundly distracting cell phone use (even anticipated use) can be was presented this week as part of the Pediatric Academic Societies annual meeting held in Boston. Here’s the news release:

New research…shows that even anticipating calls or messages may distract drivers, increasing the risk of a crash.

Jennifer M. Whitehill, PhD, postdoctoral fellow at Harborview Injury Prevention and Research Center at the University of Washington, and her colleagues sought to determine whether compulsive cell phone use is associated with motor vehicle crashes. They enlisted undergraduate students to complete the Cell Phone Overuse Scale (CPOS), a 24-item instrument that assesses four aspects of problematic cell phone use: 1) frequent anticipation of calls/messages, 2) interference with normal activities (e.g., impacting friends/family), 3) a strong emotional reaction to the cell phone and 4) recognizing problem use.
Continue reading

Test Your Skill: How Distracted Are You When Texting?

A while back, The New York Times published a nifty little interactive game to determine how hopelessly distracted we can be when we’re texting while driving. (I failed miserably, with a much slower reaction and double the number of missed gates while I was texting.)

So, in commemoration of Massachusetts’ new statewide ban on text-driving — a law that police say they will enforce vigorously — here’s the online game for you to check out. Hopefully it will help you take the texting ban to heart.