SLEEPINESS, DRIVING, AND MOTOR-VEHICLE CRASHES

Objective.-To assess the contribution of driver sleepiness to highway crashes and review recent recommendations to change federal hours-of-s ervice regulations for commercial motor vehicle drivers. Data Sources. -Information was derived from a search of the MEDLINE, Transportation Research information Service (TRIS), and Bibliographic Electronic Data bases of Sleep (BEDS) databases from 1975 through 1997 and from manual review of the reference lists in relevant journal articles, governmen t publications, conference proceedings, and textbooks. Data Synthesis. -Driver sleepiness is a causative factor in 1% to 3% of all US motor v ehicle crashes. Surveys of the prevalence of sleepy behavior in driver s suggest that sleepiness may be a more common cause of highway crashe s than is reflected in these estimates. About 96% of sleep-related cra shes involve passenger vehicle drivers and 3% involve drivers of large trucks. Risk factors include youth, shift work, alcohol and other dru g use, over-the-counter and prescription medications, and sleep disord ers. Conclusions.-Increased awareness of the relationship between slee piness and motor vehicle crashes will promote the health and safely of drivers and highway users. Physicians can contribute by encouraging g ood sleep habits, recognizing and treating sleep-related problems, and counseling patients about the risks of driving while sleepy. To prote ct public health and safety, the American Medical Association recommen ds continued research on devices and technologies to detect the signs of sleepiness and prevent the deterioration of driver alertness and pe rformance. Educational programs about the risks of falling asleep whil e driving are needed for physicians, the public, and commercial truck drivers.