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The Forum at Harvard T.H. Chan School of Public Health
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On-Demand Video: Asleep at the Wheel--Drowsy Driving and Public Health

Event held May 10, 2016
For immediate release

In the latest in a series of live webcasts by The Forum at Harvard T.H. Chan School of Public Health, a panel of experts discussed the public health implications of driving while sleepy. Some 83,000 vehicle collisions involving drowsy driving occurred yearly between 2005 and 2009, according to the National Highway Traffic Safety Administration. The panel agreed that these are not "accidents" but fully preventable "crashes." Sleep disorders are widespread and under-diagnosed, while American culture wrongly devalues sleep. We stigmatize naps instead of recognizing them as performance enhancers and lifesavers. The panel called for more rumble strips along highways, media efforts to promote better sleep strategies, laws mandating teen driver education on sleep needs, and apnea testing plus longer rest times for commercial drivers and pilots. 

Below are highlights of the conversation for media use.

This Forum was presented in collaboration with The Huffington Post.

EXPERT PARTICIPANTS

Arianna Huffington, Editor-in-Chief of The Huffington Post and Author of The Sleep Revolution

Mark R. Rosekind, Administrator, National Highway Traffic Safety Administration

Jay A. Winsten, Frank Stanton Director of the Center for Health Communication at Harvard School of Public Health and Associate Dean for Health Communication

Charles Czeisler, Chief, Division of Sleep and Circadian Disorders at Brigham and Women's Hospital; Frank Baldino Professor of Sleep Medicine; and Director, Division of Sleep Medicine, Harvard Medical School

MODERATOR

Richard Knox, Health and Science Journalist; Senior Correspondent, WBUR; and Contributor to CommonHealth
 

HIGHLIGHTS OF THE DISCUSSION
Driving while drowsy is common because our culture has idealized wakefulness and devalued sleep, and paid a heavy price for it. Some 8 million Americans admit to falling asleep at the wheel every month, causing a million crashes per year and at least 6,400 deaths, according to Dr. Czeisler. The tally may be higher but measuring an individual's sleepiness is difficult.

Those are not "accidents" but "crashes" that are 100 percent preventable. Saying "drowsy" driver trivializes the problem.

Young people, night shift workers and people with sleep disorders such as apnea are particularly vulnerable to sleep-impaired driving, especially in mid-afternoon. One in three men and one in six women have sleep apnea but 85 percent are undiagnosed and untreated.

The National Highway Transportation Safety Administration (NHTSA) has extended its definition of impaired driving (drunk, drugged or distracted) to include a fourth D, drowsy. It's just as life-threatening as the other and will soon be the subject of a new national safe-driving public education effort.

The cultural and behavioral change needed may take years or decades; the panel disagreed on whether to call for small steps at first, like one night of good sleep per week, or try for a fundamental nationwide attitude shift immediately.

Driverless cars might eventually remove fallible humans from the equation, but regulatory and consumer acceptance obstacles mean we should take other steps while we're waiting: mandate drowsy-driving education for teens; promote ride-sharing; and lower work-hour limits for doctors, truckers and pilots.

Athletes are learning that adequate sleep enhances performance. A NASA study of pilots found that a 26-minute nap boosts performance 34 percent, but American law still forbids cockpit naps. Prevention of drowsiness should be the goal.

Politicians often brag about sacrificing sleep and health for the public. "Why would we want an exhausted sick leader?" Huffington asked.

So-called "high-energy drinks" full of caffeine and sugar push drowsy people to be even more sleep-deprived and interfere with the restorative value of the sleep they do get. Drowsiness should be "a red alert" not to drive.

To watch the full one-hour Forum, visit ForumHSPH.org.

Contact: Christina Roache, croache@hsph.harvard.edu  tel. 617-432-7094
Click the links below to watch clips from the event.
Regulatory Responses: Highlight from Asleep at the Wheel

"Crashes" -- not accidents
Rosekind: "Well, let's start with -- driving impaired is life-threatening...this is a cultural change that has to take place...education...strategies...research...people are looking for biomarkers...language can be everything....in my agency, 'crash' is not an 'accident.' When you use the word 'accident' it's like God made it happen...'Drowsy' may not be the right one to go after [on] this issue, alliteration or not."

The Toll of Drowsy Driving: Highlight from Asleep at the Wheel
The toll of drowsy driving
Knox: "I'd be surprised if there's anybody in our audience today who hasn't at one time or another had to struggle to keep his or her eyes open behind the wheel...a sleepy driver is even harder for a police officer to spot than one distracted by a smartphone."
Our Culture Devalues Sleep: Highlight from Asleep at the Wheel
Our culture devalues sleep 
Huffington: "Contrary to our collective delusion that sleep deprivation is going to make us more productive...the opposite is the truth...Adequate sleep is actually a performance enhancement tool...things are changing...we have a lot of the wind on our back for a successful campaign against drowsy driving."
Vulnerable Groups and Times: Highlight from Asleep at the Wheel
Vulnerable groups and times 
Czeisler: "So there are three groups that are particularly vulnerable...young people...night shift workers...people with sleep disorders, particularly sleep apnea....most [accidents] are happening during the daytime where they're nodding off and falling asleep."
Creating Culture Change: Highlight from Asleep at the Wheel
Creating culture change 
Winsten: "I happen to think that media can play a very important role...we need to start with baby steps..."
Huffington: "I don't think we can afford baby steps...we need to change the way we live...to create a critical mass and see a fundamental shift now, not 28 years from now."
Driverless Cars and Other Possible Solutions: Highlight from Asleep at the Wheel
Driverless cars and other possible solutions 
Knox: "One possible way that's getting a lot of attention lately is driverless cars..."
Rosekind:  "So technology offers a great opportunity. But...we're in a crisis mode now...there is no magic bullet...rumble strips...can literally decrease drowsy driving accidents and fatalities by 50 percent...automatic emergency braking...pockets of progress...[but it is] cultural change that's going to really matter."
Expert Recommendations: Highlight from Asleep at the Wheel
Expert recommendations
Each expert offered a single policy recommendation at the end of the show.
Through in-person events paired with state-of-the-art interactive webcasting, The Forum at Harvard T.H. Chan School of Public Health convenes the best-informed and most influential scientists, policymakers, and practitioners to address worldwide health problems that require immediate decisions and practical solutions.

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