Drowsiness,
drunkenness pose comparable threats behind the wheel
BY RUTHANN RICHTER
Drowsy truckers are as
much a menace on the road as those who drink, yet society
has paid little attention to the problem of driver
fatigue, sleep researcher Dr. William Dement asserted in
an editorial in the Sept. 11 New England Journal of
Medicine.
The editorial accompanied
a study by scientists at the Scripps Research Institute,
who found that commercial long-haul drivers in the United
States and Canada get too little sleep to stay alert on
the road.
The Scripps researchers
videotaped the drivers and monitored their brain waves 24
hours a day to measure their sleep and drowsiness levels.
They found that the drivers slept, on average, 4.78 hours
during the workday at least two hours less than the
ideal of 7.1 hours. Drivers were most likely to show
signs of drowsiness in the late-night or early-morning
hours, the researchers found.
The study corroborates
earlier studies that have found driver fatigue to be the
leading cause of accidents involving large trucks, noted
Dement, the Lowell W. and Josephine A. Berry Professor of
Psychiatry and Behavioral Sciences and director of
Stanford's Sleep Research Center. It also follows on the
heels of a study indicating that drivers who remain awake
for as much as 17 hours suffer the same impaired
performance on the road as those who have drunk the
equivalent of two glasses of spirits, he said.
"In many circles,
being sleep-deprived is described with pride as a badge
of honor indicating hard work on an important job,"
Dement wrote. "Furthermore, 26 percent of Americans
believe you cannot be successful in a career and get
enough sleep. Drunk driving, on the other hand, is now
uniformly condemned."
In his own studies, Dement
has found that commercial truck drivers are three times
more likely to suffer from sleep apnea than the general
population. Sleep apnea is characterized by momentary
lapses in breathing that briefly awaken a person,
sometimes hundreds of times a night. Dement was the first
to identify sleep apnea as a major illness in the United
States. He was also among the first to discover rapid eye
movement (REM) sleep and has done groundbreaking studies
on narcolepsy.
As chair of the National
Commission on Sleep Disorders Research, Dement has
campaigned to heighten awareness about the perils of
fatigue in America, where the rates of sleep deprivation
and sleep disorders are alarmingly high, he contends.
"In my view,
pervasive drowsy driving is an established fact in the
United States," Dement wrote in his editorial.
"Numerous polls have found that up to 56 percent of
the general public drives while drowsy."
Despite the sometimes
fatal consequences of drowsy driving, which costs the
nation an estimated $12.4 billion a year, regulatory
agencies and the public at large have made little effort
to address the problem, he said. He noted, for instance,
that the truck drivers in the latest study had the
opportunity to obtain a full night's sleep but didn't
bother to do so. And when traffic accidents do occur on
the nation's roads, he said, fatigue is rarely considered
as a contributing cause, despite the existence of
National Transportation Safety Board guidelines for
objectively measuring fatigue-related factors.
"With driver fatigue
recently judged to be the No. 1 problem in commercial
transportation, we must begin to look at the impairment
caused by sleep deprivation in the same light as that
which is caused by alcohol consumption," Dement
said. "This breakthrough study should be a wake-up
call to the public as well as government officials who
regulate the rules of the road."
Dement said he believes
the general lack of concern about drowsy driving is
rooted in the lack of education on the issue at all
levels, including medical school. He argues for
marshaling greater resources for scientific study of the
subject, including studies on the effects of
countermeasures such as caffeine and napping.
"It is high time to
mobilize society's scientific resources to gauge fully
the extent and consequences of drowsy driving," he
concluded in his editorial. SR
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