“Anyone who is human and gets behind the wheel [of a car] should worry about it.” NTSB Board Member Mark Rosekind speaking on drowsy driving.
“There will be sleep enough in the grave.” How many times have we heard someone say something similar, implying that he or she doesn’t need or have time for sleep? Ben Franklin made that statement over 200 years ago and it is still used today, sometimes as a badge of honor. In today’s culture, with many of us traveling in large and potentially deadly weapons on a road or highway, mixing the lack of sleep with driving is a deadly combination. However, there are practical steps each of us can take to avoid these dangers, with acknowledgement of the existence of drowsy driving being the first.
Dr. Mark Rosekind, Board Member of the National Transportation Safety Board (NTSB) and one of the world’s foremost human fatigue experts, examines the fallacy that we can put sleep off to a later time. As human beings, we are hardwired for sleep. We have to breath, we have to eat, we have to drink, and we have to sleep. It is a biological requirement for our survival. Starting with that premise, Dr. Rosekind discusses:
- How much sleep we need
- What happens when we don’t get a sufficient amount of sleep
- How fatigue plays a role in drowsy driving, and
- What we can do about driving and fatigue
Having a “Sleep Debt”
As we age the amount of sleep needed each night changes. What many people do not understand is that teens actually need 9¼ hours of sleep, not the typical 8 hours mentioned. What is especially concerning is that in high school teenagers get on average 6½ hours of sleep. They may think that they are 90 minutes short on sleep, but they are actually more than two hours below what is needed. Adults need 7-9 hours or an average of 8 hours. This is true as we age and become senior citizens, although in our later years our sleep patterns are broken up. We still need the 8 hour average, however, it is not as refreshing thus it is often harder to get a good night’s sleep. Many retirees enjoy a mid-day nap to help make up for the lost overnight sleep. This is why teens and senior citizens are considered higher risks for drowsy driving.
When we don’t get sufficient sleep, we start to build up a “sleep debt.” One night of poor sleep, and our abilities are affected. If we don’t get sufficient sleep a second night, the sleep debt increases. Go a third night, and it continues to accumulate. Go three nights with 2 hours lack of sleep each night, and the sleep debt is up to 6 hours. In a single night, losing 2 hours of sleep can result in a person acting as if they were at a .05 BrAC (Breath Alcohol Content). With a sleep debt, our attention, reaction time and decision making are all significantly effected by as much as 20-50%. A slower reaction time or making a poor decision means not reacting to the brake lights in front of us or seeing the traffic light turning red. Falling asleep while driving can have devastating consequences.
Drowsy Driving’s Impact is Underestimated
How dangerous is drowsy driving? There are estimates in the U.S. that annually we could be looking at a million or more crashes or near crashes – 20% of all crashes could be due to fatigue. All the experts agree that the number of crashes and fatalities due to fatigue is underestimated.
According to the Automobile Association of America (AAA) two out of every five drivers (41.0%) reported having fallen asleep or nodding off while driving, and that one in four reported that they had fallen asleep between the hours of noon and 5 p.m. Drowsy driving happens during the night and during the day.
Drowsy driving is a problem no matter where we live or travel. Last year in India, a bus crashed, killing 45 people. One media outlet reported that the driver admitting he dozed off while driving. Pick any country, and you can find reports of drowsy driving.
Possible Solutions to Drowsy Driving?
Many of us, when we notice we are sleepy while driving, try to “fix” it by turning up the radio or opening the window, or biting a lip. These “remedies” work for only about 10 minutes. Caffeine can provide a short-term jolt, but even that is limited in time and needs to be taken before feeling tired since it requires time for us to feel the effects. Bottom line: We are still sleep deprived and we are still dangerous as we drive down the road.
The only real solution to drowsy driving is sleep, whether it is finding a safe place to stop and get a short nap, such as at a Rest Area or a good night’s sleep before leaving.
3-Step Checklist Before Traveling
To be prepared for any drive, Dr. Rosekind provides a three-step checklist:
- Recognize that fatigue is a risk and ask:
- Do you have a sleep debt from the last night or a combination of nights?
- How long have you been awake at this point?
- What is the time of day when the driving is occurring?
- Do you have a sleep disorder?
- If fatigue is an issue, take a nap or get some caffeine.
- Be sensitive to the environment. Are you driving at night or on a monotonous road? Driving in these conditions can reveal your fatigue.
Individually, each of these steps can raise a red flag. Combined, they ensure we consider what condition we are in, and whether we are safe to travel. Reviewing this checklist can save lives. In the meantime, get a good night’s sleep.
- Automobile Association of America (AAA) – Drowsy Driving
- Drowsy Driving.org
- National Sleep Foundation (NSF) – Drowsy Driving
- AAA Report on Drowsy Driving
- National Highway Traffic Safety Administration (NHTSA) Research on Drowsy Driving
- NSF White Paper on Drowsy Driving
- Bus Crashes in India Result of Drowsy Driving
- Highway to Safety Podcast Episode #1 – Impaired Driving
 .08 BrAC is the level when a person is presumed to be under the influence of alcohol in the United States and some countries. A majority of countries have .05 BrAC or lower as the illegal limit.
December 2-6, 2013 is Older Driver Safety Awareness Week
Jacob (Jake) Nelson is an epidemiologist and the Director of Traffic Safety Advocacy & Research for the Automobile Association of America (AAA). Because of his background, Jake sees traffic safety in a different light from traditional traffic safety professionals. In terms of Senior Driving, he analyzes the data and recognizes that when compared to other age groups, there is a greater percentage of seniors dying in fatal crashes. However, it is usually because of their inability to recover from injuries received in a crash, not because of their driving abilities. Thus, while senior drivers are typically safe drivers, their reaction time and judgment are affected by the aging process. So what is one to do? Just stop driving at a certain age? The short answer to that question according to Jake, and based on the research, is an emphatic No. Chronological age is not a good indication of safe—or unsafe—driving. However, as we grow older issues can arise. Understanding and addressing those issues is the critical consideration for any senior driver. Ultimately, that makes it safer for the senior driver and everyone else on the road.
Making Plans Beforehand
It is important for senior drivers and their family members to recognize that in time they could become a danger on the road. Hanging up the keys for good can be one of the hardest decisions for any senior. It can also be one of the hardest conversations for family members to have with a parent or grandparent. How can it be made easier? By planning ahead. In this episode Jake discusses how each family should have a conversation on what to do IF a senior driver becomes a danger to others on the road. The first step is to have the conversation before it is an issue, while the senior driver is still a safe driver. Planning ahead for what to do if the situations arises demonstrates that you care for the person, while allowing for a free flowing discussion on how to remedy a future potentially dangerous situation. The senior driver is an active participant in the decision-making process.
A Self-Evaluation Tool for Senior Drivers
AAA’s on-line tool, “Roadwise Review” is a useful tool to help senior drivers evaluate their driving skills.. It’s free, it can be done by anyone, and it takes only about 30-45 minutes to complete. In making its determination, the evaluation looks at eight important considerations, including:
- Visual Acuity
- Memory, and
- Mental Processing Speed.
After completing it, the person evaluated receives a confidential report. The report provides feedback on each area using three levels: Severe, Moderate or None. Where appropriate, suggestions on ways to improve driving abilities are also provided. Taking this evaluation annually can help show clear changes in ability.
Medication and Senior Drivers
As we age, we are likely to take medication for a variety of ailments. In a recent AAA Foundation for Traffic Safety survey of people 55 years and older, 18% of the people surveyed indicated that they had received a warning from a doctor or nurse about the medication they were using and how it could impact their driving abilities; only 28% even recognized it as a possibility. However, the fact that that some senior drivers are driving impaired from medication is a significant and growing concern. Jake discusses another useful tool AAA developed that can help educate you on how medications may affect your driving. Called “Roadwise RX,” it is a free online tool to list medications you take and then receive a report on how that drug or drugs may impair you. It also includes possible interactions between medications.
Know the Useful Car Features
Jake also points out that having the “right” car could make a difference in being a safe driver. While there is no “best” car for senior drivers because of the wide variety of individual physical challenges, there may be important features that should be considered when choosing a car. It is important to know of any personal limitations, and then look for features that help address these limitations. To learn about any features that may be helpful, check out Smart Features for Older Drivers. It is another useful free web-based tool to find out what features may be useful depending on your situation. The list developed can be printed and then taken with you when looking for a car.
An Overview of Senior Driving Issues
Before my conversation with Jake, I provide an overview of some Senior Driving issues, along with a few questions a senior driver or loved one might ask. With the number of older drivers growing, this will be an increasing challenge for families everywhere. This podcast provides great information for families and senior drivers on what is needed to continue driving long into retirement, allowing older drivers to have the freedom to go where they want, visit who they wish, and take on new adventures.
- Older Driver Safety Awareness Week
- Roadwise Review
- Roadwise RX
- Senior Driving AAA
- Smart Features for Older Drivers
- Driving Safety While Aging Gracefully – NHTSA Publication
- Traffic Safety Guy Blog: Senior Drivers and Medication—Are You Driving Impaired?
- Traffic Safety Guy Blog: Senior Drivers: To Drive or Not to Drive