Study shows high rate of truckers with undiagnosed sleep apnea

Truck drivers are not the best judges at diagnosing their own sleep apnea, a new study reports. Research showed that self-diagnosis and symptom reports fell far short of determining sleep apnea when compared to home testing. Only 4 percent of 517 commercial vehicle drivers in Australia reported an earlier diagnosis of sleep apnea. The study found another 41 percent when drivers were tested with home monitors.

Obstructive sleep apnea (OSA) has been associated with a higher risk of motor vehicle crashes. In December, the Federal Motor Carrier Safety Administration (FMCSA) announced new rules for the maximum hours of work per shift and mandatory rest periods for truck drivers. The FMCSA reduced by 12 hours the maximum number of hours a truck driver. Truck drivers also were mandated a break of at least 30 minutes after every eight hours worked.

The truckers in the Australian study worked an average of 65 hours a week. When surveyed, 40 percent of the drivers said they had trouble staying awake while driving in the last month. Of the commercial operators diagnosed with sleep apnea, less than half used continuous positive airway pressure (CPAP) therapy. CPAP is the first-line treatment for sleep apnea.

The study appears in the April edition of the journal SLEEP. Visit the Your Sleep website to find out if you are at risk for sleep apnea. Get help for sleep apnea at an AASM-accredited sleep center.

Image Courtesy KOMUnews

Early School Start Times Endanger Teen Drivers, Study Finds

Teens as a group are notoriously bad drivers, with the highest annual accident and traffic violation rate of any age group in the United States. Parents have good reason to fear for the worst every time their child gets behind the wheel: auto accidents are the leading cause of death for America’s teens.

A recent study in the Journal of Clinical Sleep Medicine is directing some of the blame on schools for creating dangerous driving conditions for teens. The study found that accident rates are 41 percent higher when high school classes begin before 7:30 a.m.

The study compared teen accident rates at two demographically similar neighboring communities in southeast Virginia: Chesapeake and Virginia Beach.

Accident data from 2008 provided by the Virginia Department of Motor Vehicles showed that there were 65.8 auto crashes for every 1,000 teen drivers in Virginia Beach compared to 46.6 for Chesapeake.

The only significant difference, according to the authors, was school start times. Classes started at 7:20 a.m. in Virginia Beach. Students in Chesapeake were able to sleep in an extra hour and twenty minutes because of the 8:40 a.m. start time.

The American Academy of Sleep Medicine reports that the average teen needs more than nine hours of sleep per night. Falling asleep early can be difficult for teens because of natural night-owl tendencies and distractions such as smart phones and video games. As a result, teens often fail to get enough sleep and may drive to school with severe sleep deprivation.

Pushing forward start times for high school students will help them get more sleep, and as a result, make the roads safer. School districts across the United States have taken notice and have moved the opening high school bell to 8 a.m. or later.

Learn more about the sleep habits of teenagers.

Image by Carlos Lei

Why Accidents Increase After Daylight Savings Switch

Was traffic noticeably slower on your morning commute these past couple of days? If so, blame daylight saving time. The “spring forward” is believed to cause a temporary spike in traffic incidents. A 1998 Canadian study found that auto accidents may increase as much as 17 percent immediately following the time change.

Media outlets tend to report a few theories on why accidents swell after the spring time change. Each seems reasonable at first glance:

• Drivers acclimated to commuting after the sun is already out may find themselves blinded by the sunrise or driving in the dark.


• More drowsy drivers are on the road after difficulty falling asleep at the regular time due to the spring forward.


• Some people recklessly rushed to work after forgetting to reset their alarm clocks and accidently oversleeping.

The authors of the Canadian study argue drowsy driving – rather than the other two factors – is why the frequency of accidents escalates after the time change. The study found the only significant increase in accidents occurred during the afternoon commute. That finding appears to rule out an early sunrise or forgetfulness as the reason for an increase in accidents.

Last week, the Sleep Education Blog shared some tips to better brace for the time change but not everyone spends days preparing for the hour of lost sleep. The blog also reported that well-intentioned evening types may still struggle because falling asleep even slightly earlier than normal may be difficult. It may take weeks, but most of the people who fall under either category will eventually adjust and become safer drivers once again.

The “fall back” in November appears to have the opposite effect of the “spring forward”: a sudden temporary decrease in accidents, according to the study. However, that may be quickly negated by Seasonal Affective Disorder (SAD), which tends flare up with the fall time change. SAD may lead to increased daytime sleepiness, which potentially, could mean more drowsy drivers on the roadways during the winter months.

Do you find yourself nodding off at the wheel on a regular basis? You may have a sleep disorder that prevents you from getting regular restful sleep. Schedule an appointment with a clinical sleep specialist and find out if you have sleep apnea or seek treatment for insomnia.

Photo by Slinkydragon

CDC: More than 1 in 3 Americans are Sleep-Deprived

The Centers for Disease Control and Prevention (CDC) has shed light on some unsettling trends involving our sleep. More than 35 percent of Americans get less than seven hours of sleep per night – and 1 in 20 has fallen asleep at the wheel in the past month.

Drowsy driving is one of the most overlooked dangers on our roadways. It’s estimated that as many as 1,550 deaths and 40,000 personal-injury accidents are caused by drowsy drivers.

The CDC surveyed about 74,000 adults in 12 states about various topics related to sleep. The survey was a new module included in the CDC’s 2009 Behavioral Risk Factor Surveillance System (BRFSS).

Results show nearly half of the people surveyed snore and 38 percent unintentionally nodded off during the day at least once in the past month.

The AASM reports that adults need a minimum of seven hours of sleep per night. Even an hour less of sleep per night can lead to long-term health problems such as diabetes, heart disease and diabetes. It also can sap your energy, ruin your productivity and put you in a foul mood.

There’s a reason why Americans are constantly among the most sleep deprived in the world. Aside from the many worries that keep us awake at night, our society seems to reward those who stay up working or socializing rather than sleeping. Sleep deprivation isn’t a badge of honor; it’s a threat to your health.

AAA Study Finds 2 out of 5 Americans Drive Drowsy

New traffic safety statistics provide a wake-up call for America about the public safety threat that is drowsy driving.

About 1 in 6 fatal accidents involves a drowsy driver, the AAA Foundation for Traffic Safety reports. And there’s a 41 percent chance you’re part of the problem, study results show.

Approximately 2 out of every 5 drivers admit to drifting to sleep behind the wheel at some point in their lives. About 10 percent nodded off while driving within the past year. Alarmingly, half of the survey respondents the incident said it happened on a busy highway.

Drowsy driving is the cause of an estimated 4,400 deadly crashes per year, accounting for 17 percent of all fatal accidents on U.S. roadways. You may think most drowsy driving accidents happen in the pitch black and bleary-eyed overnight hours, but findings show the afternoon rush is actually slightly more risky.

Teens and young adults are most likely to cause drowsy driving accidents. The risk is 78 percent higher compared to middle-aged adults, and may be the symptom of a larger problem.

The American Academy of Sleep Medicine reports teens need more sleep than adults, yet rarely achieve it on school nights. More than a quarter of teens are badly sleep deprived while only about 15 percent of teens sleep 8.5 hours on a given school night. In many cases accumulated sleep debt can be as great as five to 15 hours per week, the equivalent of total sleep deprivation.

In severe cases the effects of sleep deprivation are comparable to alcohol intoxication. Teens’ inexperience at the wheel worsens an already dangerous scenario.

Men cause more drowsy driving-related accidents compared to women. The study doesn’t provide a reason, but men are more likely to have obstructive sleep apnea, a breathing disorder that can wreck your sleep and make it difficult to stay awake and alert in the daytime.

Accidents most often occur within the first hour of driving. Most people don’t realize they may struggle to stay awake towards the beginning of a trip, the study found.

The AASM reports the following are signs you may be too drowsy to drive:

1. Yawning repeatedly
2. Inability to keep your eyes open.
3. You catch yourself “nodding off” and have trouble keeping your head up.
4. Trouble remembering driving the last few miles.
5. You end up too close to cars in front of you.
6. Missing road signs or driving past your turn.
7. Drifting into the other lane of traffic.
8. Drifting onto the “rumble strip” or onto the shoulder of the road.

If you find yourself doing any of the things listed above, pull over and take a nap. Drink a cup of coffee and wait a half hour for the caffeine to enter your bloodstream for the boost in alertness you need to finish the trip.

Always get a full night’s sleep before driving. If you can’t sleep, arrange for a ride from a friend.
Make the right choices before and after you get behind the wheel and avoid being one of the 41 percent of Americans who drive drowsy.

NTSB: Tired Trucker Caused Crash that Killed 10

The National Transportation Safety Board promises to turn up the pressure on the trucking industry, following a year-long investigation that ruled driver fatigue as the cause of a devastating semi crash on an Oklahoma highway. 10 people died, and five more were injured when Donald L. Creed, then 76, rammed through a line of cars stopped in traffic 90 miles northeast of Tulsa. Creed was apparently unaware and never tried to brake or swerve to avoid the stopped cars.

Investigators believe Creed only slept five hours before starting his shift at 3 a.m. He had been driving for 10 hours when he caused the accident. The Associated Press reports Creed had recently returned from vacation and was still readjusting to shift work.

Creed also had mild sleep apnea, and it’s not clear if he was receiving treatment.
The NTSB recommends federal regulators take action in response to the accident report. Measures would include require fatigue risk management program that would make sure drivers sleep before beginning their shift. The program would include sleep apnea screenings for drivers.

The Federal Motor Carrier Safety Administration is working on a similar model program that is expected to finish development in about two years. It would not be required under current regulations.

Other measures include requiring “black box” recorders for accident investigations and collision warning systems. The systems, currently available for $1,000 to $2,000, give visual and audio alerts when their truck is within 350 feet of colliding with another vehicle. The NTSB recommended the use of collision warning systems in 2001, but the devices were never required.

NTSB Chairman Deborah A.P. Hersman said in the Tuesday hearing, "The time to act on all three of these safety fundamentals is now so that this kind of horrific tragedy will not occur again."

Accident investigators claim the systems could save an estimated 96 lives each year by preventing as many as 4,700 accidents.

The U. S. National Highway Traffic Safety Administration (NHTSA) reports that drowsy driving is related to more than 1,500 deaths per year.

Auto accident rate higher for excessively sleepy Michigan motorists

An analysis of driver data collected by the Michigan State Police further demonstrates the risks associated with drowsy driving. The study published in the June issue of SLEEP is the first to look at the driving records of randomly selected test subjects.

The findings suggest extreme sleepiness multiplies the likelihood of being in an accident causing serious injury. Overall crash rates were about 12 percent higher for tired drivers.

Researchers at Michigan State University and the Henry Ford Hospital Sleep Disorders and Research Center randomly called residents in metro Detroit, a region with demographics similar to the United States as a whole.

Each subject answered a series of questions about sleep and health habits, including use of medications, alcohol and illegal drugs.

About a third of the residents went in for laboratory tests, including an overnight sleep study and a Multiple Sleep Latency Test (MSLT).

Researchers worked with the Michigan State Police to collect crash data from from a 10 year span of the study subjects’ driving.

The drivers were divided up into three groups according to their MSLT scores. Those who were excessively sleepy had an accident rate of 59.4 percent. Only 47.3 percent of alert subjects were in an accident during that period.

Learn more about drowsy driving on SleepEducation.com.

Teens & Drowsy Driving

A new study of teen drivers found that sleepiness at the wheel and poor sleep quality increased their risk of crashing a vehicle. The results were published today in the Journal of Clinical Sleep Medicine.

The Italian study involved 339 high school students. Each of them had a driver’s license. Their average age was 18.4 years. Fifty-eight percent of participants were male.

They were surveyed about lifestyle habits, sleep habits, sleep disorder symptoms and daytime sleepiness. Driving habits and sleepiness at the wheel also were evaluated. Questions assessed the frequency and timing of car use and accidents.

Results show that teen drivers who reported having bad sleep or being sleepy while driving were twice as likely to have had a crash. Eighty of the 339 students had already crashed at least once. Fifteen percent of them considered sleepiness to have been the main cause of the crash. Fifty-six percent of students who had at least one previous crash reported driving while sleepy.

Lead author Dr. Fabio Cirignotta said the most effective way to combat drowsy driving is to pull over to a safe place and take a nap.

“Opening the window, listening to the radio, or drinking a coffee, are known to be short-lasting and, essentially, useless,” Cirignotta told the AASM.

The study also found that students suffered from chronic sleep deprivation. They reported that they needed an average of 9.2 hours of nightly sleep. But only six percent of students slept nine hours or more on weeknights. Instead they reported sleeping for an average of only 7.3 hours on weeknights. Fifty-eight percent of students tried to catch up by sleeping nine hours or more on weekends.

Sleep problems also were commonly reported by the students. Forty-five percent woke up at least once during the night with trouble falling asleep again. Forty percent had trouble waking up in the morning and 19 percent reported bad sleep.

The dual problems of chronic sleep loss and poor sleep quality had a negative effect on the students’ alertness. Sixty-four percent complained of excessive daytime sleepiness.

The study also found that male students and smokers were three times more likely to crash a vehicle. The authors suggested that some students may use tobacco to counteract sleepiness.

Last year a study suggested that school start times may be linked to drowsy driving. Crash rates for teen drivers dropped by 16.5 percent in a Kansas county that changed the high school start time from 7:30 a.m. to 8:30 a.m. In the rest of the state teen crash rates increased 7.8 percent during the same time period.

Read more about sleep and teens and drowsy driving.

Image by Rich Evenhouse

Drowsy Driving: OSA, Sleep Loss & Alcohol

Sleep loss and alcohol both have negative effects on driving performance. Are people with obstructive sleep apnea more vulnerable to these effects?

A new study from Australia involved 38 people with untreated OSA. They were compared with 20 healthy controls.

Participants were tested three times in a driving simulator. They drove after a normal night of sleep and after only four hours of sleep.

They also drove after consuming enough vodka to raise their blood alcohol concentration level to 0.05 grams per deciliter; this means they had 50 milligrams of alcohol in every 100 milliliters of blood. For most drivers in Australia a BAC level of 0.05 or higher is considered “drink driving.”

The simulators tracked steering, speed control and other measures of driving performance. These measures have been linked to car crashes, noted a study summary for patients.

Results show that driving ability was much more impaired in people with OSA; 24 people with sleep apnea crashed during simulated driving. In contrast, only one person in the control group crashed.

After only four hours of sleep, people with OSA were four times more likely to crash than after a night of normal sleep; they were two times more likely to crash after alcohol consumption.

People with OSA also had more trouble steering the simulator; after sleep loss and alcohol consumption their steering ability was about 40 percent worse than controls.

But steering wasn’t their only problem. People with sleep apnea also had trouble keeping their eyes open. Prolonged eye closures of more than two seconds and brief “microsleeps” were significant crash predictors in people with OSA.

The AASM reports that daytime sleepiness is a common symptom of sleep apnea. Breathing pauses related to sleep apnea cause brief arousals from sleep. These arousals can occur hundreds of times during one night of sleep.

A study in the March issue of the journal Sleep found that a simulated driving test is a suitable tool to measure daytime alertness in people with OSA. A previous study in the journal Sleep described a number of driving impairments in people with sleep apnea; it found that the poor performance appeared to be related to lapses in attention.

Earlier this year the Sleep Education Blog reported that the alerting effect of roadside “rumble strips” may last for only a few minutes. In July the blog reported that some car makers are using high-tech systems to help prevent drowsy-driving accidents.

Learn more about drowsy driving on SleepEducation.com.

Image by Stefan Van der Straeten

Drowsy Driving: Mercedes, SAAB Develop Prevention Systems

Car makers Mercedes-Benz and SAAB are both using high-tech systems to help prevent drowsy-driving accidents.

Mercedes introduced its Attention Assist system as a standard feature of the 2010 E-Class. Sensors measure more than 70 parameters to monitor your alertness.

They keep track of your speed and acceleration. The sensors record your use of turn indicators and pedals. They even take into account external factors such as wind.

But the system focuses on your steering behavior. It detects minor steering errors that often occur in the early stages of drowsiness.

Attention Assist then warns you when you are at risk of falling asleep behind the wheel. A chime sounds, and a message appears on the instrument display. It shows a coffee cup with the words, “Attention Assist: Time for a break?”

You can see the system in action in this interactive, online test drive of the new E-Class.

SAAB is taking a different approach. Its Driver Attention Warning System uses an infrared camera to keep an eye on your eyes.

Software analyzes the image and measures your rate of eye blinking. Warnings occur when it detects drowsy eye-lid closures.

First a chime sounds, and a warning appears on the instrument panel. Then verbal warning messages are played through the car’s sound system.

The camera also monitors movement of the head and eyes. If you look away from the road for too long, your seat cushion will vibrate.

“It is a fact that many drivers do not stop and get out of the car if they are feeling drowsy,” SAAB representative Arne Nabo said in a prepared statement. “So we are now trying to help drivers to help themselves.”

SAAB also is developing a TV ad called “Sleep Attack.” It shows a drowsy-driving accident from the driver’s point of view. See an online storyboard of the ad.

The ad’s message is simple and direct: “Sleep before you drive.”

Learn more about drowsy driving on SleepEducation.com.

Drowsy Racing: NASCAR’s Jeff Gordon Learns About Sleep Loss & Parenthood

Even a top NASCAR driver can suffer from drowsy driving. Especially when he’s a new parent.

Florida Today reports that sleep loss may help explain Jeff Gordon’s disappointing 2008 season. It seems that the four-time NASCAR Cup Series champion is still adjusting to fatherhood. His wife Ingrid gave birth to their daughter Ella Sofia on June 20, 2007.

“It's that I'm not sleeping,” Gordon recently told reporters. “I'm showing up to the race track trying to hold my eyes open because I'm sleep deprived because she was up crying at 3 in the morning. I'm trying to be a good husband, not necessarily just a good father, and play my role."

The 37-year-old Gordon already ranks as one of the best NASCAR drivers in history. He is sixth on NASCAR’s all-time win list with 81 victories; “The King” Richard Petty is untouchable at the top with 200 wins. In the “modern era” of NASCAR racing, Gordon ranks second behind Darrel Waltrip’s 84 victories.

Yet in 2008 Gordon was winless for the first time since 1993. On Sunday he started in third at the Daytona 500, race one of 36 in the 2009 Sprint Cup Series. He finished in 13th place.

Gordon’s problems are magnified because of his place in the public spotlight. But his sleep struggles are common for new parents.

According to AASM spokesperson Dr. Daniel Glaze, parents are at risk for losing hundreds of hours of sleep during their child’s first year of life. This sleep loss can have a severe effect on how you function during the day, even if you’re not a NASCAR driver.

“Sleep loss can affect job performance, impair cognitive performance, increase errors and slow reaction times,” said Glaze.

For Gordon, the race goes on. He’ll try to get some quality sleep before this Sunday’s Auto Club 500 in Fontana, Calif.

Are you a parent who can relate to Gordon’s struggles? Did you find any good ways to get some sleep after your baby arrived?

The AASM offers these tips to help new parents get a good night’s sleep.

Image courtesy of DuPont

Update 2/25/09: Gordon finished second in the Auto Club 500 behind Daytona 500 winner Matt Kenseth, crossing the finish line just 1.463 seconds after the winner.

To Sleep or To Wake: A Drowsy Driving Dilemma

Today Boston Globe writer Geoff Edgers shares some interesting insights from his recent episode of drowsy driving.

It wasn’t quite a near-death experience. But it was enough to destroy his tire. And put a scare into the friend who was riding with him.

It also caused him to question his priorities. Where exactly is sleep supposed to fit in his busy schedule? It seems like the need for sleep is a frustrating nuisance that prevents him from getting more done.

One of Edgers’ main complaints is that he feels like he doesn’t have time to sleep. In a competitive workplace he can’t get by on talent alone. He has to put in more time than the next person.

On top of that there are other obligations that demand his time. Family. Hobbies. Other projects.

Is it worth it to cut back on something he values just so he can get more sleep? Is it true that getting more sleep will actually enable him to get more done?

Two sleep specialists provide their perspective on Edgers’ dilemma. Their consensus: Sleep is the solution, not the problem.

Not only is Edgers playing Russian roulette with his life by drowsy driving. But he’s also less efficient during the day because he’s sleep deprived.

He needs to practice self-control to get the seven to eight hours of sleep that he needs. A full night of sleep? In the end, Edgers wonders what that would feel like.

Can you relate to Edgers? How do you balance all of the demands on your time with your need for sleep? Is it simply a matter of self-control? When you have to make a choice, does sleep come out on the losing end?

Drowsy Driving & Rumble Strips

You’re sleepy, but you’re intent on making it to your destination on time. So you keep driving.

You fight to keep your eyes open. Suddenly you’re startled by a loud noise as your car begins to shake.

Your eyes pop open as you realize that your car was drifting off the road. You just encountered a rumble strip.

The first shoulder rumble strips appeared on New Jersey's Garden State Parkway in 1955. They are used to prevent run-off-road crashes.

The Federal Highway Administration reports that this type of crash causes one-third of all traffic fatalities. The main cause? Drivers are too sleepy.

But are rumble strips an effective solution for drowsy driving? A recent study examined how rumble strips affect sleepy drivers.

Thirty-five shift workers operated a driving simulator in the morning after a full night shift. Measures of sleepiness such as eye closure duration increased as they drove.

After hitting a rumble strip their alertness increased in most parameters. But the alerting effect was very brief. Signs of sleepiness returned after five minutes.

So a rumble strip may briefly wake you up. But it won’t keep you from drowsy driving.

What should you do if you feel drowsy when you’re behind the wheel? Let another passenger take over the driving duties.

Or pull off the road at a rest stop. Have a drink that contains caffeine and then take a brief nap. Put your alertness – and your safety – first.

Drowsy Plow Driving

The snowstorms hitting the Midwest and Northeast are a nightmare for commuters. Driving would be nearly impossible without the armies of snowplows and salt trucks that come out to rid the streets of snow.

But for the plow drivers who work all night, clearing the streets isn’t their only challenge. The Nashua Telegraph in New Hampshire points out that they also have to fight to stay awake.

Working through the night. Icy streets. Poor visibility. It’s almost a perfect storm for drowsy driving. Especially for those who are clearing long stretches of empty highways.

What’s the extent of the problem? Clearing streets can involve thousands of people in the states and cities with the most snow.

Illinois has more than 3,000 employees working to keep state routes clear. The effort involves more than 482,000 labor hours. The city of Chicago deploys a fleet of 274 trucks to clear city streets.

Chicago gets an average of about 39 inches of snow per year. But that’s nothing compared to the 116 inches of snow that falls on Syracuse annually.

Of course it isn’t just snow plow drivers who are in danger of drowsy driving. Any shift worker is at risk. This includes truck drivers, pilots and police officers.

A shift-work schedule can cause severe sleep problems. The AASM offers these Sleep Tips for Shift Workers as a helpful resource.

Should Teens Start School Later?

The Washington Post reports that Fairfax County in Virginia is the latest school district to join the debate over school start times. A proposal would change the start time of most high schools in the county from 7:20 a.m. to 8:30 a.m.

The goal is to help sleep-deprived teens get more sleep. Research shows that teen sleep loss is related in part to a biological change that occurs during the teen years.

A shift in the body clock’s timing makes it hard for teens to fall asleep before 11 p.m. As a result teens fail to get enough sleep when they have to get up early for school.

But will teens really get more sleep if school starts later in the morning? Or will they just stay up even later at night?

A new study in the Journal of Clinical Sleep Medicine examined this question. It focused on a Kansas county that changed the high school start time from 7:30 a.m. to 8:30 a.m. Results show that the change had a positive effect.

A higher percentage of students got eight or nine hours of sleep per night. There was a decrease in “catch-up sleep” on weekends. Daytime sleepiness also decreased.

The study also suggests that school start times may be linked to drowsy driving. Crash rates for teen drivers in the county dropped by 16.5 percent in the two years after the change. In the rest of the state teen crash rates increased 7.8 percent.

Changing school start times can be a complex decision. It requires altering bus schedules. It has an impact on after-school sports, activities and jobs. It also affects after-school care for younger children.

But the change may be worth the effort. A study looked at how the change affected more than 12,000 high school students in the Minneapolis Public School District. It found that student attendance and enrollment improved. Students also got an average of five more hours of sleep per week.

So what do you think? Should teens get a later start in the morning?

Should Drowsy Driving be a Crime?

Is drowsy driving a crime? That is the question that Maryland prosecutors recently faced.

In August a 19-year-old driver fell asleep behind the wheel. She swerved into oncoming traffic on the Chesapeake Bridge and hit a tractor trailer. The crash turned fatal when the truck plunged into the bay, taking the truck driver’s life.

In December prosecutors decided that they would not press criminal charges against the young woman. Instead she would only be cited for motor vehicle violations. Sleep scientist Dr. Charles Czeisler responded with an editorial in the Washington Post on Jan. 4.

Czeisler argues that drowsy driving should be a criminal offense. He writes that drowsy driving is as deadly as drunk driving. Czeisler urges Maryland to develop drowsy-driving legislation.

Together the AASM and the Sleep Research Society crafted model drowsy-driving legislation. It gives states direction on the issue. The model legislation includes exceptions for drivers who have a sleep disorder.

By all accounts drowsy driving is common. A 2002 Gallup survey found that 37 percent of people reported falling asleep or nodding off at least once while driving. Ten percent of drowsy drivers had driven drowsy in the past month.

It is also common for drowsy driving to be deadly. The U. S. National Highway Traffic Safety Administration (NHTSA) reports that drowsy driving is related to more than 1,500 deaths per year.

Yet drowsy driving often goes unreported. Unless the driver admits falling asleep, drowsy driving can be difficult to detect. Czeisler estimates that drowsy-driving crashes take the lives of about 8,000 people in the U.S. each year.

So what do you think? Should it be a crime to drive drowsy?