Recognize the signs in:

12. Recognize the signs in: • Yourself • As a Passenger • Other Drivers The National Road Safety Foundation, Inc.

18. How much sleep did you get last night? How much should you have? How much should a teenager have?

19. Would you believe 9 to 10 hours?

21. Did you know? • 85% of adolescents get less than recommended sleep on school nights • 56% of teens report getting less sleep than they need • By 12th grade average sleep on school nights is 6.9 hrs. • By end of week sleep debt=10.5 hours

22. Good Sleep • Healthier • Attractive • Taller • Stronger • Faster • More athletic • Smarter

23. NSF poll • 28% fall asleep at least one time per week • 22% fall asleep doing homework • Less sleep • Lower grades • Depressed mood • “A” Students • Sleep 15 min more than B students • 26 min more than C students • 36 min more than D students • Teachers were able to predict students sleep amounts by academic and classroom behavior

25. Primary Symptoms of ADHD Sleep Deprivation in Kids Hyperactivity Inattention Impulsivity Distractibility Difficulty concentrating Forgetful Oppositional behavior Moodiness and irritability • Hyperactivity • Inattention • Impulsivity • Distractibility • Difficulty concentrating • Forgetful • Difficulty waiting or taking turns

26. Did you know? • It is estimated that at least 50% of kids diagnosed with ADHD actually have sleep disorder.

28. What happens when you don’t sleep?

30. Consequences of Sleep Deprivation • Cognitive and social impairment • Decreases ability to think • Creative • Problem solving • Abstract thought • Decision making/judgement • Mood and depression • Reduced endurance • Increased risk seeking behavior • Impaired motor function • Decreased coordination • Blurred vision • Prolonged reaction time • Delayed visual reaction time • Delayed auditory reaction time

31. Fatigue vs. Alcohol • 17 hours sustained wakefulness produces performance impairment = .08% BAC • 24 hours = .10% BAC (Dawson & Reid, 1997; Williamson & Feyer, 2000). • Synergistic effect • On 4 hours sleep, 1 beer can have the impact of a six-pack (Roehrs et al., 1994)

32. Hours of Sleep and Equivalent Blood Alcohol Level for Sedative Effects Legal Intoxication† BrEC, %* Sleep time (hours in bed) *Approximate breath ethanol concentration (BrEC) at peak; †Above 0.05% for legal intoxication in many states. N=32 healthy subjects without prior sleep deprivation and with 85% sleep efficiency. Sleep loss group (n=12) was tested in all 4 conditions, with 3 to 7 days of recovery time between tests, and compared with ethanol group (n=20). Roehrs T, et al. Sleep. 2003;26:981-985.

33. Why don’t you get enough sleep? Not a priority

34. Not enough sleep • Sleep just is not set as a priority • School • Homework • Sports • Social life • Television • Internet • Etc all get in the way

35. They want to sleep, but aren’t able • Their internal clock is shifted several hours later. • Bedtimes shifts to 11-1am • Trying to go to bed at 10 is similar to adult trying to go to bed at 8 pm • Wake up times shift accordingly • Shortened sleep time

38. Junk sleep • 98.5% have at least one electronic device in their bedroom (TV, Phone or mp3 player) • 65% had all 3 • Greater number of items • Less amount of sleep • Greater amount of daytime sleepiness

39. Sleep Disorders • Obstructive sleep apnea syndrome • Restless Legs/Periodic Limb Movement • Parasomnias • Insomnia • Stress/worry/body clock

40. Tips to help sleep • Make sleep a priority!!!!! • Establish regular sleep schedule and routine • Encourage relaxing, non-alerting activity • Read • Write • Avoid TV and PC • Make Bedroom a NO gadget zone. • Place recharging station in kitchen not bedroom. • Avoid Caffeine. • Expose yourself to light in the morning. • Exercise, but not too close to bedtime. • Avoid late naps

42. What are signs of Drowsy Driving? • Difficulty focusing • Frequent blinking • Daydreaming at the wheel • Drifting from your lane • Swerving or tailgating • Can’t remember last few miles driven • Yawning and head snaps • Missing exits or traffic signs

43. Who drives drowsy?

44. Who Drives Drowsy? • By age • 30-64, 52% • 65+, 19% • 18-29, 71% • 51% of adolescents who drive report that they have driven drowsy in the past year • 16% of 11th graders and 20% of 12th graders drive drowsy once a week or more. * * NSF's 2006 Sleep in America poll

45. Indicators of Typical Drowsy Driving Crash (Pack, 1995, Knipling & Wang 1995) • Between midnight and 6:00 am • Secondary peak in midafternoon • Lone, Male driver • A single vehicle drifts off the road • Hits stationary object • Or rolls vehicle • Most are rear-end or head-on collisions • Many involve serious injuries and/or fatalities • No severing or skid marks

46. Drift-off crashes as Self Report • Driver ASLEEP, DROWSY • Driver DISTRACTED - 82% - 18% (As specified on 1043 reports)

47. This suggests that drivers are able to accurately assess sleepiness while driving but do not act accordingly • Nabi, Et al 2006, BMJ

48. How do YOU stay awake while driving?

49. Which of these work? • Energy Drinks • Roll down the windows • Turn up the radio (49%) • Talk on cell phone (22%) • Change radio station, CD or MP3 • Turn down the air conditioning • Sing along with the radio • Speed (11%) • Text Message (11%)

50. Countermeasures • Watch for the warning signs of fatigue • Co-pilot • If sleepy STOP DRIVING • Take a 20-30 minute nap • Consume at least 200 mg of caffeine prior GET ENOUGH SLEEP!!!!!