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Forgotten hazard of the road - Drowsy drivers

By Senator Richard T. Moore

March 23, 2005 - If you knew a road danger in this country that kills and injures hundreds of thousands of people a year can be remedied by something as simple as getting more sleep, would you do it? Many of us don't. We operate our cars, trucks, buses, and even heavy equipment, when we can't keep our eyes open.

The incidence of driving drowsy is growing as quickly as this nation's poor sleep habits. Our desire to live a 24/7 lifestyle, ignoring our biological programming to be asleep at night and awake and alert during the day, is taking a toll. Yet drowsy driving is the forgotten stepchild of the many problems we think of when we think of safety on the roadways.

Our regular worries - road conditions, weather and traffic - and concerns about the chance that we'll be on the road with a driver who is drunk or impaired by alcohol or drugs, take precedence. Who thinks about the drowsy driver?

We should. 32 million of us, according to a National Sleep Foundation poll, have fallen asleep at the wheel; 51% of adult drivers report that they have driven drowsy in the past year. The risk we pose to ourselves and others is every bit as deadly as that of a drunk driver. We do it daily. We know we're tired, that we're struggling to stay awake, yet we decide it's more important to get to our destination than to get some extra sleep. We decide that we can probably make it, driving drowsy, to wherever we have to go.

But, in reality, we can't. The National Highway Traffic Safety Administration conservatively estimates that 100,000 police-reported crashes, 71,000 injuries and over 1,550 deaths are the direct result of driver fatigue each year, and cost an estimated $12.5 billion in monetary losses. We see headlines nearly every day, in which a driver falls asleep at the wheel, veers off the road or into traffic, and kills or injures him or herself or others. We know that these incidents happen often. But even they are underreported; there is little or no police training in identifying drowsiness as a crash factor. And there is no uniformity in how states report sleepiness on their crash report forms.

According to a report by the National Center on Sleep Disorders Research, crashes that result from drowsiness typically have several characteristics in common. Generally they take place late at night, in the early morning, or in mid-afternoon. Because the drowsy motorist does not attempt to avoid the crash, these crashes are likely to be serious in nature. Frequently they consist of a single vehicle leaving the roadway. Often they occur on high-speed roads. And the driver most commonly is alone in the vehicle at the time of the crash.

Factors that create risk include sleep deprivation, driving between midnight and 6 a.m., driving a substantial number of miles each year and/or a substantial number of hours each day, driving in mid-afternoon, especially for older drivers, and driving long periods without rest. Other contributing factors include the use of sedating medications, anti-depressants, and some antihistamines, as well as unrecognized sleep disorders, particularly sleep apnea syndrome (SAS) and narcolepsy. Alcohol, when combined with any of these risk factors, compounds the danger.

Young male drivers age 16 to 29, shift workers, and people with untreated sleep apnea syndrome or narcolepsy are considered at greatest risk of drowsy driving. Commercial truck drivers also are considered high risk due to excessively long work hours.

The federal government advocates a number of remedies to minimize crashes that involve drowsiness, but doesn't pursue any of them vigorously. Among proposed remedies are the creation of educational campaigns to alert motorists who are most at risk, installation of rumble strips along high-speed roads, and more restrictive and closely monitored hours of service for commercial truck drivers who may push themselves or be pushed by their employers. 

Because drowsy driving crashes are not well known to the public and basic steps to prevent them are not taken by our government, most such crashes are written off as accidents. Generally there is little or no punishment for the driver even when the crash involves obvious negligence, such as driving many hours without rest. There is also little or no compensation for innocent victims. 

The tragedy of driving drowsy is that there is a simple solution that most of us are willing to ignore. We can take just a little longer before getting up in the morning, or take a nap before getting behind the wheel. We can easily refrain from driving when we are exhausted, and reduce the number of crashes that result from sleepiness. We can, but we don't. And we need to. Many of us don't get as much sleep as we need. We believe we can operate effectively without it. Unfortunately, that is not the case, particularly when we get behind the wheel.

Massachusetts needs to require driver education and police training about the problems of sleep deprivation and driving. We need to add drowsy driving to accident reports when it is the cause or among the causes of accidents, especially of fatalities. Finally, we need to raise the bar on civil and criminal penalties when some of us act negligently or recklessly by drowsy driving and commit vehicular homicide. 

How many deaths, at the hands of how many sleepy drivers, will it take for us to wake up to the reality that sleepiness when driving can and does kill?

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