Commercial Drivers Still at High Risk From "Drowsy Driving"

The issue of sleep-deprived or "drowsy" driving has made the news again following the tragic June 7 accident involving the comedian Tracy Morgan. Prosecutors say that the Walmart truck driver whose tractor-trailer slammed into a van, critically injuring Mr. Morgan and killing another passenger, had not slept in over 24 hours.
Drowsy driving is a leading cause of crashes and highway fatalities, according to federal officials: more than 30,000 people die on highways annually in the United States and crashes involving large trucks are responsible for one in seven of those deaths.
Federal rules introduced last year reduced the maximum workweek for truckers from 82 to 70 hours, after which drivers have a mandatory 34-hour resting period. This “restart” must include two periods between 1 a.m. and 5 a.m. to allow drivers to rest at least two nights a week: they cannot drive for more than 11 hours a day and must have a 30-minute break in their schedule.

But the trucking industry has been battling to get the new nighttime-break regulations repealed. On June 6, Senator Susan Collins, Republican of Maine, pushed an amendment through the Senate Appropriations Committee that would freeze the rules, pending further studies. Ms. Collins said the administration had failed to take into account that the new rules would put more trucks on the roads during peak traffic hours. Trucking officials and executives also said that drivers needed to be afforded maximum flexibility in their work and should not be told when to rest.

Safety investigators said that sleepy or drowsy driving is a far more common problem than most people realize, but how extensive the problem is remains a matter of debate, partly because it is difficult to obtain evidence that drivers fell asleep. In 1990, a National Transportation Safety Board study of 182 heavy-truck accidents in which the truck driver died concluded that fatigue played a role in 31 percent of the cases, more than alcohol or drugs.
But the American Trucking Associations said that a federal database of fatal crashes cited fatigue in less than 2 percent of police reports about accidents involving trucks; a more accurate estimate, they claim, is that driver fatigue plays a role in about 7 percent of truck crashes. “Until we have a blood test for determining fatigue, all estimates are likely going to under-report fatigue, because the dead don’t speak and the living often plead the Fifth, especially if they are facing criminal charges,” said Deborah A. P. Hersman, former chairwoman of the N.T.S.B. and now the president and chief executive of the National Safety Council.

The Transportation Department has proposed that all interstate commercial truck and bus companies be required to use electronic logging devices to increase compliance with driving-hour rules. Paper logs are easier to manipulate and more difficult for law enforcement officials to verify. The comment period for the rule is scheduled to end this month. Some commercial truck fleets already such devices. For instance, Walmart’s trucks have GPS and electronic logging systems, which track where the vehicles are and what they are doing. A Walmart spokeswoman said the truck involved in the accident that injured Mr. Morgan, who remains in a New Jersey hospital, was also outfitted with anti-collision technology, which is supposed to alert drivers if there is a car in a neighboring lane when they activate their turn signal, for example. It is also supposed to slow the truck down automatically if it is approaching slow-moving or stopped traffic. Citing the incomplete investigation, Walmart declined to provide specifics on the accident or the driver’s schedule in the days leading up to the crash.

Excessive daytime sleepiness is a common problem in today's society. It is so common that in some circles people almost consider it a normal aspect of a productive society. The fact is that daytime sleepiness and fatigue are leading causes of accidents, both on the job and on the road. The cost to society is estimated in billions of dollars per year. There are several common causes for increased daytime sleepiness. The simplest cause of daytime sleepiness that can be corrected results from insufficient sleep. The average person requires 7 to 8 hours of sleep per night. If a person routinely gets less than this, it will most likely cause excessive daytime sleepiness. Another common problem can be sleeping in a noisy environment. This can cause many short awakenings, so brief that a person doesn't remember them the next morning. This results in non-restful sleep with resulting excessive daytime sleepiness. If a person gets 8 hours of sleep a night and still feels sleepy during the day, one should consider that they may have a medical problem which hinders their ability to obtain restful sleep.
For more information on the causes of "drowsy driving" and how you can get treatment for the sleep-related issues involved, visit Dr.Simmon's website at houstonsleep.net.

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References:
Truckers Resist Rules on Sleep, Despite Risks of Drowsy Driving (NYT, June 16, 2014

F.D.A. Recommends Lower Dose of Lunesta Sleeping Pill

As part of the agency’s continuing effort to reduce sleep aids’ risky side effects such as drowsiness while driving, the Food and Drug Administration has announced that people prescribed the sleeping pill Lunesta should be starting with half the current recommended dose of two milligrams.

The dosage change is based, in part, on findings from a study of 91 healthy adults ages 25 to 40. The study shows, compared to an inactive pill (placebo), Lunesta 3 mg was associated with severe next-morning psychomotor and memory impairment in both men and women 7.5 hours after taking the drug. The study found that recommended doses can cause impairment to driving skills, memory, and coordination as long as 11 hours after the drug is taken. Despite these long-lasting effects, patients were often unaware they were impaired.

Taken at bedtime, the recommended starting dose of Lunesta (eszopiclone) has been decreased from 2 milligrams to 1 mg for both men and women. The 1 mg dose can be increased to 2 mg or 3 mg if needed, but the higher doses are more likely to result in next-day impairment of driving and other activities that require full alertness. Using lower doses means less drug will remain in the body in the morning hours.
Patients currently taking the 2 mg and 3 mg doses of Lunesta should contact their health care professional to ask for instructions on how to continue to take their medicine safely at a dose that is best for them.

According to IMS Health, a health care services company, about 55 million prescriptions for sleep aids were dispensed in the United States in 2013. Lunesta represents a relatively small part of that market, with about three million pills prescribed.

It was not the first time the agency has reduced the recommended dose of sleeping pills. In January 2013, the FDA said that doses of Ambien and other sleeping pills that contain zolpidem should be halved for women. The agency also told manufacturers that labels should recommend that health care providers “consider” prescribing lower doses for men.

Drowsiness is listed as a common side effect for all insomnia drugs, along with warnings that people may still feel drowsy the next day after taking one of these products. The FDA is continuing to evaluate the risk of impaired mental alertness with the entire class of sleep drugs, including over-the-counter drugs, and will update the public as new information becomes available.

Studies show that sleepiness can impair driving performance as much or more so than alcohol; the American Automobile Association (AAA) estimates that one out of every six (16.5%) deadly traffic accidents, and one out of eight (12.5%) crashes requiring hospitalization of car drivers or passengers is due to drowsy driving.  To learn more about the dangers of poor sleep habits and how you can get a better night's sleep, visit us at the HoustonSleepNet.

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Source:
FDA News Release: May 15, 2014