Fatal Crash Focuses National Attention on Drowsy Driving

AAA: One in six fatal traf­fic acci­dents result from drowsy dri­ving

By Mike Sheldrick

The recent injury to come­di­an Tra­cy Mor­gan and the death of Jim­my Mack, a fel­low pas­sen­ger, after a col­li­sion on the NJ Turn­pike has focused nation­al atten­tion on the prob­lem of drowsy dri­ving. About time.

The inci­dent on June 9 involved Kevin Rop­er, a Wal­mart dri­ver, who NJ state police said, had gone with­out sleep for 24 hours before he hit the star’s lim­ou­sine. Wal­mart said in a state­ment that the truck’s dri­ver was in com­pli­ance with fed­er­al hours-of ser­vice require­ments. “Fed­er­al law requires dri­vers to work no more than 14 hours for any shift and 11 hours of dri­ving.” NJ police charged the Wal­mart dri­ver with vehic­u­lar homi­cide under a law that pro­hibits dri­ving after 24 hours with­out sleep.

Sad­ly, as the New York Times point­ed out in an edi­to­r­i­al, the Sen­ate Appro­pri­a­tion Com­mit­tee had sev­er­al days ear­li­er vot­ed to roll­back a Depart­ment of Trans­porta­tion reg­u­la­tion that requires truck dri­vers to take at least 34 hours off after work­ing 60 hours in sev­en con­sec­u­tive days or 70 hours in eight days. In the after­math of the inci­dent, the move — spear­head­ed by Susan Collins, Repub­li­can of Maine — has giv­en some momen­tum to oppo­nents of the roll­back, but the out­come still hangs in the bal­ance.

Weak reg­u­la­tions

Many think the cur­rent reg­u­la­tions, even if fol­lowed, are too weak. They per­mit, as Wal­mart points out, 11 hours of dri­ving with only a 35 minute break and a 14 hour work day.There seems to be lit­tle chance that this will be changed in an elec­tion year and a inter­state truck­ing indus­try like­ly to pro­vide funds only to those leg­is­la­tors sup­port­ing its posi­tion, which appar­ent­ly is to relax the require­ments.

The reg­u­la­tions per­tain­ing to over-the-road truck­ing and the need to loosen or tight­en them notwith­stand­ing, drowsy dri­ving is a very seri­ous prob­lem that has received far too lit­tle atten­tion. To be sure, falling asleep at the wheel is the extreme, but there is a broad spec­trum, from “brain fog” to actu­al­ly falling asleep. It is impaired dri­ving, along with dis­tract­ed dri­ving.

Pro­hibit­ing dri­ving while drowsy will be much tougher than ban­ning phone use for voice, tex­ting, or inter­net brows­ing while dri­ving. Drowsy dri­vers num­ber in the mil­lions, report­ed a 2011 Nation­al Sleep Foun­da­tion poll, 60 per­cent of adults said they had dri­ven at least once while drowsy, and 37 per­cent admit­ted to have fall­en asleep at the wheel in the pre­vi­ous year. That’s just what they admit­ted to. It’s well known that peo­ple often lie in answer­ing such ques­tions because they are too embar­rassed to admit the truth. So, we prob­a­bly can guess that the real num­bers are high­er. In any event, AAA reports that one in six fatal traf­fic acci­dents result from drowsy dri­ving.

Sleep depri­va­tion

Some of the most inci­sive com­men­tary since the inci­dent comes from researchers at Rut­gers. “When you are sleep-deprived for more than 24 hours, you need stronger sen­so­ry stim­u­la­tion to main­tain alert­ness,” explains Xue Ming, a sleep med­i­cine doc­tor at Rut­gers New Jer­sey Med­ical School in Newark. “Sen­so­ry input such as light, noise and touch keeps peo­ple alert, but when there’s lit­tle stim­u­la­tion, the brain will drift into a full sleep state or a micro sleep, which can last from a frac­tion of a sec­ond up to 30 sec­onds. In this state, the per­son feels like he is awake – he might even still have his eyes open – but he is actu­al­ly asleep.”

That means that cam­era-based reti­nal sen­sors are not a ful­ly effec­tive means of mea­sur­ing drowsi­ness, or even the best way. Some NIH researchers sug­gest sup­ple­ment­ing, or using exclu­sive­ly, mea­sures such as steer­ing wheel move­ment, and lane keep­ing; behav­iors like odd head move­ments, high­er-than-nor­mal eye­lid clo­sures; and phys­i­o­log­i­cal mea­sures like an EEG or heart rate. These last mea­sures, they say, may be the best way to mea­sure drowsi­ness, but are the most intru­sive of all, and thus like­ly to be reject­ed by many if not all dri­vers.

Dri­vers are most vul­ner­a­ble to drowsi­ness from 2 a.m. to 4 a.m. and 1 p.m. to 3 p.m. he says. That’s when their cir­ca­di­an rhythm – which reg­u­lates peri­ods of sleepi­ness and wake­ful­ness – dips. The cir­ca­di­an rhythm also prompts peo­ple to feel drowsy in dimin­ish­ing day­light. “If a per­son had a big meal at lunch or did not sleep well the night before, this decline is more promi­nent,” says Ming, who stress­es that shift work­ers are par­tic­u­lar­ly vul­ner­a­ble when they leave work in the ear­ly morn­ing hours.

Ming sug­gests a few tips to help enhance dri­ving alert­ness for lim­it­ed peri­ods: a 20-minute nap, two cups of cof­fee or sim­i­lar caf­feinat­ed bev­er­age, bright­en­ing the dash­board or pur­chas­ing a visor light box that sim­u­lates morn­ing light for the pas­sen­ger side, since light boosts alert­ness.

“But, if you are feel­ing real­ly tired,” Ming says, “the best thing to do is park your car and call a cab.” Though we need sev­en to nine hours of unin­ter­rupt­ed sleep to feel ful­ly alert, Ming says, most Amer­i­cans get six or few­er. In fact, about 70 mil­lion Amer­i­cans suf­fer from a chron­ic sleep dis­or­der. The Cen­ters for Dis­ease Con­trol and Pre­ven­tion esti­mate that 8.6 mil­lion Amer­i­cans take pre­scrip­tion sleep­ing pills, which might affect alert­ness and coor­di­na­tion.

Sleep dri­ving

“Sleep dri­ving” grabbed head­lines when Patrick Kennedy and Ker­ry Kennedy report­ed­ly had Ambi­en in their sys­tems in sep­a­rate crash­es in 2006 and 2012.

“It’s dif­fi­cult to tell how a sleep­ing pill will affect an indi­vid­ual and how they dri­ve the next day,” says Beat­rix Roemheld-Hamm, asso­ciate pro­fes­sor, Depart­ment of Fam­i­ly Med­i­cine and Com­mu­ni­ty Health at Rut­gers Robert Wood John­son Med­ical School in New Brunswick. “For exam­ple, women typ­i­cal­ly are small­er than men, so the drug might affect them dif­fer­ent­ly.” She notes that the FDA has warned peo­ple tak­ing the longer-act­ing Ambi­en CR not to dri­ve at all the fol­low­ing day.

Fleet pol­i­cy

Elim­i­nat­ing drowsy dri­ving will be impos­si­ble. What fleet man­ag­er would dare tell an employ­ee not to watch Jim­my Fal­lon the night before a long dri­ve the next day? Still, this is a prob­lem that needs to be addressed by every fleet. If you have a pol­i­cy that you think can min­i­mize dri­ving while drowsy, please share it with us.

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