The Scope & Nature of Drowsy Driving Wake Up Michigan! Symposium September 20, 2007

1. The Scope & Nature of Drowsy DrivingWake Up Michigan! SymposiumSeptember 20, 2007 Darrel Drobnich Chief Program Officer – Policy, Education & Research National Sleep Foundation 1522 K Street, NW, Suite 500 Washington, DC 20005 www.sleepfoundation.org

2. The National Sleep Foundation (NSF) is an independent nonprofit organization dedicated to improving public health and safety by achieving public understanding of sleep and sleep disorders, and by supporting sleep-related education, research and advocacy. National Sleep Foundation

3. Our Mantra Good sleep promotes health, safety, productivity and well-being

4. The Triad of Well-Being

5. Chronically Sleep Deprived... • The average American sleeps less than 7 hours • 37% of adults say they are so tired during the day it interferes with daily activities • 74% of adults experience at least one symptom of a sleep disorder a few nights a week or more • 35% of adults nap at least once during the week NSF 2002 Sleep in America Poll

6. Why We Aren’t Sleeping... • Volitional sleep deprivation (work, lifestyle) • Poor sleep habits • Circadian factors (shift work) • Environmental disruptions • Untreated sleep problems/disorders • We don’t take sleep seriously!!!

7. Americans Don’t Understand Sleep • 83% of Americans failed NSF’s “Sleep IQ Test” (regardless of age, socioeconomic status, and education level). • 50 million Americans suffer from over 80 different sleep disorders, yet most go undiagnosed and/or untreated–only 4% of Americans are seeing a healthcare provider for their sleep problem. NSF 1999 “Sleep in America” Survey

8. Institute of Medicine Report An Unmet Public Health Problem “The cumulative effects of sleep loss and sleep disorders represent an under-recognized public health problem and have been associated with a wide range of health consequences including an increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke.Almost 20 percent of all serious car crash injuries in the general population are associated with driver sleepiness. Hundreds of billions of dollars a year are spent on direct medical costs related to sleep disorders such as doctor visits, hospital services, prescriptions, and over-the-counter medications.”

9. Impairment is Impairment is Impairment! The Effects of Fatigue Mirror That of Drugs and Alcohol

10. Fatigue vs. Alcohol • 15 hours sustained wakefulness produces performance impairment = .05% BAC • 24 hours = .10% BAC (Dawson & Reid, 1997; Williamson & Feyer, 2000). • People with mild to moderate untreated sleep apnea performed worse than those with a 0.06% BAC (Powell, 1999) • On 4 hours sleep, 1 beer can have the impact of a six-pack (Roehrs et al., 1994)

11. How Big is the Problem of Drowsy Driving?

12. Drowsy DrivingNational Statistics • National Highway Traffic Safety Administration estimates • 100,000 police-report crashes annually • 1,550 fatalities (4%) • 71,000 injuries • $12.5 billion in monetary losses • 1 million – 1/6 of all crashes are linked to inattention (Knipling, 1996)

13. International Studies • England—About 20%; 30% on some roads • Australia—Between 15-20% of all crashes; 30% of single-vehicle crashes • New Zealand—13% of fatal crashes & 6% of injury crashes • Germany—35% of fatal motorway crashes • France—About 10%

14. Drowsy Driving Experiences Percent Reporting Their Experiences While Driving During the Past Year (% Yes) Driven a vehicle while feeling drowsy Dozed off while at the wheel of a vehicle (at any time) Had an accident because they dozed off or were too tired 2003* Parents who drive 2004* Adults 55-84

15. NHTSA National Survey of Distracted and Drowsy Driving Attitudes and Behaviors 

16. Fatigued and Drowsy DrivingAttitudes, Concern and Practices ofOntario Drivers • Traffic Injury Research Foundation • Telephone survey of randomized sample of 750 drivers in Ontario area in 2007.

17. Fatigued and Drowsy DrivingAttitudes, Concern and Practices ofOntario Drivers • Nearly 60% (5 million) admit that they have driven while fatigued or drowsy at least sometime; • 14.5% (1,280,000) say they actually fell asleep or nodded off while driving at least once in the past year; • Among those 1,280,000 drivers who fell asleep or nodded off while driving about 105,000 of them did so on numerous occasions (more than five times) • The total number involved in at least one crash in the past year due to fatigued or drowsy driving may be as high as 167,000.

18. Average Rating of Perceived Effectiveness of a Variety of Tactics

19. Tactics used to “overcome” fatigue or drowsiness while driving in the last 12 months

20. What are the Characteristics of Drowsy Driving Crashes?

21. Characteristics of Drowsy Driving Crashes • Most happen between midnight – 6:00 am & in the midafternoon (circadian dip) • The driver is alone and more likely to be male • A single vehicle drifts off the road and hits a stationary object • Most are rear-end or head-on collisions • Many involve serious injuries and/or fatalities • There is no evidence of braking or evasive maneuvers – NO SKID MARKS!! (Pack, 1995, Knipling & Wang 1995)

22. Why Do People Have Drowsy Driving Crashes? AAA FTS Study Occupational Factors: • People with more than one job are 2x more likely to have a fall-asleep crash • Working the night shift increases the risk by 6x • Working more 60 hrs per week increased the risk by 40%

23. Why Do People Have Drowsy Driving Crashes? AAA FTS Study Amount of Sleep: • One fourth of drivers in sleep-related crashes and 1/3 of drivers fatigue-related crashes got less than 6 hrs of sleep. • 7 to 8 hrs = 1.2x higher risk • 6 to 7 hrs = 1.8x higher risk • 5 to 6 hrs = 3.3x higher risk

24. Why Do People Have Drowsy Driving Crashes? AAA FTS Study Sleep Quality and Sleep Disorders: • Drivers in DD crashes were more likely to report sleep problems. • Drivers with “fair” sleep = 1.7x increased risk • Drivers with “poor” sleep = 3.5x increased risk • Drivers in crashes were 2x more likely to mention that they got inadequate sleep • Few drivers reported having a diagnosed sleep disorder – problem with public education???

25. Are You At Risk?

26. Special At-Risk Groups Include: • Young people • Shift workers • Commercial drivers • People with undiagnosed or untreated sleep disorders • Business travelers • The elderly

27. 2006 Sleep in America Poll • 51% of adolescents who drive report that they have driven drowsy in the past year • 16% of 11th graders and 20% of 12th graders drive drowsy once a week or more.

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31. Who is Driving Your Children? • June 22, 2005: A school bus carrying 14 children collided head-on with a semi trailer in West Jordan, Utah, sending 13 kids and one adult to hospitals with minor injuries. • “The 22-year-old driver told police he may have dozed off.” Source: The Salt Lake Tribune

32. For More Information www.sleepfoundation.org www.drowsydriving.org www.sleepforkids.org

33. Summary • America is chronically sleep deprived • Drowsy driving affects everyone, especially certain at risk groups • There are common characteristics that increase your risk for drowsy driving • Drowsy driving is likely to increase as Americans work more hours, experience commute times, and face an expanding 24/7 culture