Sleep-deprived driving

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Sleep-deprived driving (commonly known as tired driving, drowsy driving, or fatigued driving) is the operation of a motor vehicle while being cognitively impaired by a lack of sleep. Sleep deprivation is a major cause of motor vehicle accidents, and it can impair the human brain as much as inebriation can. [1] [2] According to a 1998 survey, 23% of adults have fallen asleep while driving. [3] According to the United States Department of Transportation, male drivers admit to have fallen asleep while driving twice as much as female drivers. [4]


In the United States, 250,000 drivers fall asleep at the wheel every day, according to the Division of Sleep Medicine at Harvard Medical School and in a national poll by the National Sleep Foundation, 54% of adult drivers said they had driven while drowsy during the past year with 28% saying they had actually fallen asleep while driving. According to the National Highway Traffic Safety Administration, drowsy driving is a factor in more than 100,000 crashes, resulting in 6,550 deaths and 80,000 injuries annually in the USA. [5]

When a person does not get an adequate amount of sleep, their ability to function is affected. As listed below, their coordination is impaired, have longer reaction time, impairs judgment, and memory is impaired.

The effects of sleep deprivation on driving performance

Sleep deprivation has been proven to affect driving ability mainly in four areas: [6]

  1. It impairs coordination.
  2. It causes longer reaction times.
  3. It impairs judgment.
  4. It impairs memory and ability to retain information.

Sufficient sleep before driving improves memory. Researchers recorded activity in the hippocampus during learning, and recorded from the same locations during sleep. The results were patterns that occurred during sleep resembled those that occurred during learning, except they were more rapid during sleep. Also, the amount of hippocampal activity during sleep correlated highly with a subsequent improvement in performance. [7] Signs that tell a driver of a need to stop and rest:

  1. Difficulty focusing, frequent blinking, or heavy eyelids
  2. Daydreaming; wandering/disconnected thoughts
  3. Trouble remembering last few miles driven or missing exits and street signs
  4. Yawning repeatedly/rubbing eyes
  5. Trouble keeping head up
  6. Drifting from lane to lane, tailgating, or hitting a shoulder or rumble strip
  7. Feeling restless and irritable [8]

The effects of sleep deprivation compared to the effects of alcohol while driving

Numerous studies have found that sleep deprivation can affect driving as much as (and sometimes more than) alcohol. British researchers have found that driving after 17 to 18 hours of being awake is as harmful as driving with a blood alcohol level of .05%, the legal limit in many European countries. [6] The MythBusters TV show dedicated a special episode "Tipsy vs. Tired" to exploring these findings and has confirmed that sleep deprivation can be more dangerous than driving with a BAC over the legal limit.


Unique warning sign on Interstate 15 in Utah UtahSignByPhilKonstantin.jpg
Unique warning sign on Interstate 15 in Utah

A 2017 meta-analysis found that driving while sleepy was associated with being approximately two-and-a-half times as likely to have a motor vehicle collision, with significant heterogeneity between the risk estimates in individual studies. [9] The National Highway Traffic Safety Administration (NHTSA) has estimated that between the years 2011 and 2015, driver drowsiness was involved in approximately 1.4% of all car crashes reported to police in the United States, including 2.0% of crashes that resulted in injuries and 2.4% of crashes that resulted in a death. [10] However, this estimate is based on police reports based on investigations conducted after the crash, and is thought by experts to greatly underestimate the true contribution of sleep-deprived driving to collisions. [11] Between October 2010 and December 2013, researchers at the AAA Foundation conducted a study in which they continuously monitored 3513 drivers from six locations across the United States, using in-vehicle cameras and other equipment to objectively assess driver sleepiness using the PERCLOS measure, which is the percentage of time that the driver's eyes are closed over a defined time period. [11] Of 701 crashes the researchers studied, drowsiness was a factor in 8.8%-9.5%, including 10.6%–10.8% of crashes that led to significant property damage, deployment of the airbag, or injury. No fatal crashes occurred over the course of the study, however, so the researchers were unable to reliably estimate drowsy driving's contributions to fatalities. [11]

A 2002 fact sheet from the Nebraska Rural Health and Safety Coalition once posted on the Centers for Disease Control website once claimed that collisions related to sleep deprivation are most likely to happen in the early to mid afternoon, and in the very early morning hours. [12] However, several other groups including the AAA Foundation naturalistic studies have found that crashes that occurred in darkness were more than three times as likely to involve driver drowsiness as those that occurred during the day. [11]

The reason that collisions involving drowsy driving are more or less likely to happen at different times of the day may have to do with circadian rhythms (the biological time clock). The biological master clock in the hypothalamus is the suprachiasmatic nucleus or SCN. It provides the main control of the circadian rhythms for sleep, body temperature and other functions. The reason night time driving is so risky is because sleep becomes an irresistible urge especially from about midnight until 6 a.m. A sleepy period is also "programmed" for the afternoon which makes that a risky time. [ citation needed ]

Sleep-deprived driving in commercial transportation and in the military

Sleep-deprived driving is a major problem in commercial transportation and in the military. 20% of commercial pilots and 18% of train operators have admitted to making a serious error due to fatigue. [13] Commercial truck drivers are especially susceptible to drowsy driving. A recent study of 80 long-haul truck drivers in the United States and Canada found that drivers averaged less than 5 hours of sleep per day. The National Transportation Safety Board reported that drowsy driving was likely the cause of more than half of crashes leading to a truck driver's death. For each truck driver fatality, another three to four people are killed. [14] In the fall of 2013 a new law was passed in the USA requiring the Federal Motor Carrier Safety Administration to propose guidelines related to screening for sleep apnea among commercial drivers. [15] The US military estimates that approximately 9% of crashes resulting in death or serious injury during Operation Desert Storm and Operation Desert Shield were caused by sleep-deprived driving. [3]

Sleep deprivation was blamed a major cause of the Selby rail crash in which 10 people died and 82 were injured. [16]

Physician reporting

Six US states require physicians to report patients who drive while impaired, including those who may be chronically sleep-deprived. [17] Another twenty-five US states permit physicians to violate doctor-patient confidentiality to report sleep-deprived drivers or those with sleeping disorders likely to impair driving, if they so choose. [17] The American Medical Association endorsed physician reporting in 1999, but deferred to the states on whether such notification should be mandatory or permissive. [17] An authority on professional confidentiality, Jacob Appel of New York University, has written that physician reporting is a double-edged sword, because it may deter some patients from seeking care. According to Appel, "Reporting may remove some dangerous drivers from the roads, but if in doing so it actually creates other dangerous drivers, by scaring them away from treatment, then society has sacrificed confidentiality for no tangible return in lives saved." [17]

Government response to sleep-deprived driving

Governments had attempted to reduce sleep-deprived driving through education messages and by ingraining roads with dents, known as rumble strips in the US, which cause a noise when drivers wander out of their lane. In 2018, the Government of Western Australia [ when? ] introduced a "Driver Reviver" program where drivers can receive free coffee to help them stay awake. [18]

See also

Related Research Articles

Driving Operation of a vehicle

Driving is the controlled operation and movement of a vehicle, including cars, motorcycles, trucks, buses, and bicycles. Permission to drive on public highways is granted based on a set of conditions being met and drivers are required to follow the established road and traffic laws in the location they are driving. The word driving, has etymology dating back to the 15th century and has developed as what driving has encompassed has changed from working animals in the 15th to automobiles in 1888. Driving skills have also developed since the 15th century with physical, mental and safety skills being required to drive. This evolution of the skills required to drive have been accompanied by the introduction of driving laws which relate to not only the driver but the driveability of a car.

Drunk driving is the act of operating a motor vehicle with the operator's ability to do so impaired as a result of alcohol consumption, or with a blood alcohol level in excess of the legal limit. For drivers 21 years or older, driving with a blood alcohol concentration (BAC) of 0.08% or higher is illegal. For drivers under 21 years old, the legal limit is lower, with state limits ranging from 0.00 to 0.02. Lower BAC limits apply when operating boats, airplanes, or commercial vehicles. Among other names, the criminal offense of drunk driving may be called driving under the influence (DUI), driving while intoxicated or impaired (DWI), operating [a] vehicle under the influence of alcohol (OVI), or operating while impaired (OWI).

Fatigue Range of afflictions, usually associated with physical and/or mental weakness

Fatigue is a feeling of tiredness. It may be sudden or gradual in onset. It is a normal phenomenon if it follows prolonged physical or mental activity, and resolves completely with rest. However, it may be a symptom of a medical condition if it is prolonged, severe, progressive, or occurs without provocation.

Automotive safety Study and practice to minimize the occurrence and consequences of motor vehicle accidents

Automotive safety is the study and practice of design, construction, equipment and regulation to minimize the occurrence and consequences of traffic collisions involving motor vehicles. Road traffic safety more broadly includes roadway design.

Driving under the influence Driving a motor vehicle while under the influence of an impairing substance

Driving under the influence (DUI) is the offense of driving, operating, or being in control of a vehicle while impaired by alcohol or other drugs, to a level that renders the driver incapable of operating a motor vehicle safely.

Rumble strip Road safety feature

Rumble strips are a road safety feature to alert inattentive drivers of potential danger, by causing a tactile vibration and audible rumbling transmitted through the wheels into the vehicle interior. A rumble strip is applied along the direction of travel following an edgeline or centerline, to alert drivers when they drift from their lane. Rumble strips may also be installed in a series across the direction of travel, to warn drivers of a stop or slowdown ahead, or of an approaching danger spot.

A microsleep (MS) is a sudden temporary episode of sleep or drowsiness which may last for a fraction of a second or up to 30 seconds where an individual fails to respond to some arbitrary sensory input and becomes unconscious. MSs occur when an individual loses and regains awareness after a brief lapse in consciousness, often without warning, or when there are sudden shifts between states of wakefulness and sleep. In behavioural terms, MSs may manifest as droopy eyes, slow eyelid-closure, and head nodding. In electrical terms, microsleeps are often classified as a shift in electroencephalography (EEG) during which 4–7 Hz activity replaces the waking 8–13 Hz background rhythm.

Sleep inertia is a physiological state of impaired cognitive and sensory-motor performance that is present immediately after awakening. It persists during the transition of sleep to wakefulness, where an individual will experience feelings of drowsiness, disorientation and a decline in motor dexterity. Impairment from sleep inertia may take several hours to dissipate. In the majority of cases, morning sleep inertia is experienced for 15 to 30 minutes after waking.

Mobile phones and driving safety

Mobile phone use while driving is common but it is widely considered dangerous due to its potential for causing distracted driving and crashes. Due to the number of crashes that are related to conducting calls on a phone and texting while driving, some jurisdictions have made the use of calling on a phone while driving illegal. Many jurisdictions have enacted laws to ban handheld mobile phone use. Nevertheless, many jurisdictions allow use of a hands-free device. Driving while using a hands-free device is not safer than using a handheld phone to conduct calls, as concluded by case-crossover studies, epidemiological, simulation, and meta-analysis. In some cases restrictions are directed only at minors, those who are newly qualified license holders, or to drivers in school zones. In addition to voice calling, activities such as texting while driving, web browsing, playing video games, or phone use in general can also increase the risk of a crash.

Transportation safety in the United States Overview of transportation safety

Transportation safety in the United States encompasses safety of transportation in the United States, including automobile crashes, airplane crashes, rail crashes, and other mass transit incidents, although the most fatalities are generated by road incidents yearly killing from 32,479 to nearly 38,680 (+19%) in the last decade. The number of deaths per passenger-mile on commercial airlines in the United States between 2000 and 2010 was about 0.2 deaths per 10 billion passenger-miles. For driving, the rate was 150 per 10 billion vehicle-miles for 2000 : 750 times higher per mile than for flying in a commercial airplane.

Wrong-way driving Driving a motor vehicle against the direction of traffic

Wrong-way driving (WWD), also known as counterflow driving, is the act of driving a motor vehicle against the direction of traffic. It can occur on either one- or two-way roads, as well as in parking lots and parking garages, and may be due to driver inattention or impairment, or because of insufficient or confusing road markings or signage, or a driver from a right-hand traffic country being unaccustomed to driving in a left-hand traffic country, and vice versa. People intentionally drive in the wrong direction because they missed an exit, for thrill-seeking, or as a shortcut.

Hours of service U.S. commercial motor vehicle driver working and rest period restrictions

Hours of Service (HOS) regulations are issued by the Federal Motor Carrier Safety Administration (FMCSA) and govern the working hours of anyone operating a commercial motor vehicle (CMV) in the United States. These regulations apply to truck drivers, commercial and intercity bus drivers, and school bus drivers who operate CMVs. These rules limit the number of daily and weekly hours spent driving and working, and regulate the minimum amount of time drivers must spend resting between driving shifts. For intrastate commerce, the respective state's regulations apply.

Sleep deprivation, also known as sleep insufficiency or sleeplessness, is the condition of not having adequate duration and/or quality of sleep to support decent alertness, performance, and health. It can be either chronic or acute and may vary widely in severity.

The AAA Foundation for Traffic Safety is a non-profit, charitable organization based in Washington, DC, that is dedicated to saving lives through traffic safety research and education. Since its founding in 1947, the AAA Foundation has sponsored over 200 projects related to highway safety, covering topics such as distracted, impaired, and drowsy driving; road rage; graduated driver licensing; driver's education and training; and pedestrian safety. The AAA Foundation research agenda is centered on four priority areas: Driver behavior and performance, emerging technologies, roadway systems and drivers and vulnerable road users.

Traffic collision When a vehicle collides with another object

A traffic collision, also called a motor vehicle collision, car accident, or car crash, occurs when a vehicle collides with another vehicle, pedestrian, animal, road debris, or other stationary obstruction, such as a tree, pole or building. Traffic collisions often result in injury, disability, death, and property damage as well as financial costs to both society and the individuals involved. Road transport is the most dangerous situation people deal with on a daily basis, but casualty figures from such incidents attract less media attention than other, less frequent types of tragedy.

Effects of fatigue on safety

Fatigue is a major safety concern in many fields, but especially in transportation, because fatigue can result in disastrous accidents. Fatigue is considered an internal precondition for unsafe acts because it negatively affects the human operator's internal state. Research has generally focused on pilots, truck drivers, and shift workers.

Distracted driving is the act of driving while engaging in other activities which distract the driver's attention away from the road. Distractions are shown to compromise the safety of the driver, passengers, pedestrians, and people in other vehicles.

Fatigue detection software is intended to reduce fatigue related fatalities and incidents. Several companies are working on a technology for use in industries such as mining, road- and rail haulage and aviation. The technology may soon find wider applications in industries such as health care and education.

Work-related road safety in the United States

People who are driving as part of their work duties are an important road user category. First, workers themselves are at risk of road traffic injury. Contributing factors include fatigue and long work hours, delivery pressures, distractions from mobile phones and other devices, lack of training to operate the assigned vehicle, vehicle defects, use of prescription and non-prescription medications, medical conditions, and poor journey planning. Death, disability, or injury of a family wage earner due to road traffic injury, in addition to causing emotional pain and suffering, creates economic hardship for the injured worker and family members that may persist well beyond the event itself.

Two main questions arise in the law surrounding driving after having ingested cannabis: (1) whether cannabis actually impairs driving ability, and (2) whether the common practice of testing for THC is a reliable means to measure impairment. On the first question, studies are mixed. Several recent, extensive studies–including one conducted by the National Highway Traffic Safety Administration and one conducted by the American Automobile Association (AAA)–show that drivers with detectable THC in their blood are no more likely to cause car crashes than drivers with no amount of THC in their blood. Others show that cannabis can impair certain abilities important to safe driving –but no studies have been able to show that this increases the actual risk of crashing, or that drivers with THC in their blood cause a disproportionate number of crashes. On the second question, the studies that have been conducted so far have consistently found that THC blood levels and degree of impairment are not closely related. No known relationship between blood levels of THC and increased relative crash risk, or THC blood levels and level of driving impairment, has been shown by single-crash or classic-control studies. Thus, even though it is possible that cannabis impairs driving ability to some extent, there are currently no reliable means to test or measure whether a driver was actually impaired.


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