Arrive Alive: Don’t Fall Victim to Drowsy Driving

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We’ve all been there. On a long, tedious car trip, we yawn, our eyelids droop, and we nearly nod off at the wheel. Lucky drivers jolt awake just in time. Not everyone is that fortunate.

According to the National Highway Traffic Safety Administration, about 100,000 police-reported crashes each year involve drowsy driving. The AAA Foundation for Traffic Safety estimates the actual number of fatigue-related crashes to be three times higher.

Teen drivers, shift workers, commercial drivers, people with untreated sleep disorders, and sleep-deprived individuals are more likely to experience drowsy driving crashes. Driving while sleep-deprived is not that different from drunk driving, as far as how it affects our ability to focus and react. Some people experience “micro-sleep” – a short, involuntary lapse of attention. It might last only four to five seconds, but at highway speed, that’s enough time to travel the length of a football field.

What causes drowsy driving?

Most sleep-related crashes occur between midnight and 6 a.m., or in the late afternoon, when most people are sleeping and when their circadian rhythm slows down.* There are other physiological reasons we experience fatigue, says Alexandre Abreu, M.D., a pulmonologist and sleep medicine specialist at the University of Miami Health System. “Our bodies secrete a substance; a hormone called adenosine. The longer we’re awake, there is a higher concentration of this substance in our body.”

Physiology aside, Dr. Abreu says there is a bigger culprit to blame. “The biggest mistake people make is being tired before they start a road trip. When you sleep less than six hours, you’re sleep-deprived. Sleep deprivation increases fatigue, delays response time, and decreases reflexes. Ideally, you should get seven to eight hours of sleep, but no less than six hours, before driving.” His sleep recommendations change depending on your age. “Teenagers need nine hours; seven hours is fine for the elderly.”

Stay alert on the road

After a year of sticking close to home due to COVID-19, many of us look forward to seeing family and friends again. If they live far away and you’re dreading the long drive, follow Dr. Abreau’s strategies for staying awake on the road.

Plan and prepare.

“Don’t stay up until midnight packing for the trip. Get everything ready two nights before you leave. The night before you leave, eat dinner at six or seven, be in bed by nine, awake by four, and leave by five.” This schedule allows you to “de-stress” before traveling. Adjust your schedule accordingly, depending on your departure time and the length of your drive. Just aim to get a solid seven to eight hours of sleep before driving.

Truckers and other commercial drivers should plan sleep breaks to coincide with their regular sleep schedule. Sleeping close to the same time every day improves the ability to fall asleep and stay asleep.

Skip the screens.

Whether traveling or not, your body needs a break from electronic devices at least two hours before bed. Electronic blue light disrupts your circadian rhythm and diminishes the quality of your sleep.

When adopting an “early to bed, early to rise” schedule, get the whole family on board. “Teens now have a delayed circadian phase because they’re staying up later, using electronic devices. Parents need to be more assertive when enforcing sleep time by having teens shut off their cell phones and computers. I tell my kids, ‘The growth hormone happens when you sleep. You will be taller and will have a better attention span with more sleep.’”

Avoid sleep aids.

It’s tempting to pop a sleeping pill the night before traveling, but Dr. Abreu cautions against it. Over-the-counter sleep aids, as well as allergy and cold medicines, can cause drowsiness. If you take any prescription medication, read the label to see if drowsiness is a side effect.

If pre-trip anxiety keeps you wakeful, Dr. Abreu advises removing your stress factors, packing and preparing ahead, and giving yourself time to wind down before going to bed.

Eat light.

“Plenty of people get sleepy after a meal. Listen to your body; you know what foods make you sleepy. Eat small meals while traveling, but do not eat while driving; it’s not safe. Stop, get out of the car, and take time to have a snack.”

Use the buddy system to avoid drowsy driving.

It’s hard to stay alert as the miles stretch on. When the whole family is dozing in the car, it’s even harder. Switch drivers every so often so you can snooze while your spouse or travel partner takes the wheel.

Driving solo?

For trips lasting four or more hours, stop every two hours, get out of the car, and walk around. You’ll return refreshed and ready to tackle the next stretch of highway.

Create teachable moments.

Family road trip? Get everyone engaged in and talking about the experience. “When families interact, it helps the driver stay focused and less sleepy. Take advantage of the moment so the trip becomes something the whole family can grow from,” Dr. Abreu says. Put down the phones and notice what’s outside the car windows.

Use caffeine wisely.

Remember adenosine, the hormone that accumulates the longer we’re awake? “Caffeine works as an alert agent by blocking this substance,” Dr. Abreu says. He suggests drinking coffee or tea early to mid-afternoon to fight fatigue and stay alert. Be mindful of your caffeine intake if it interferes with your ability to sleep. Consuming too much caffeine without taking time to relax or nap may lead to jittery nerves and dehydration, neither of which improves your driving.

Plan your drive time.

“Midnight to six a.m. is the most vulnerable time for sleep-deprived drivers,” Dr. Abreu says. When possible, drive during daylight hours, especially if you’re older. Elderly drivers with slower reflexes should avoid driving around sunset and after dark when vision becomes less sharp. Dr. Abreu advises more senior people to leave the house at 8 a.m., take a break around noon, and stop driving by five. He also says that older drivers who take medication that causes drowsiness or dizziness should talk to their doctor about upcoming travel plans. It may be possible to take medicine at bedtime.

Power nap.

Never underestimate the power of a quick snooze to fight off drowsy driving, especially if you’re a shift worker, a single parent, or driving long distances. “One of the best ways to prevent car accidents is getting enough sleep,” Dr. Abreu says. His advice to night shift workers also applies to distance drivers. “Go to a safe rest area, not a parking garage. Get into the passenger’s seat, put the seat down, and take a 30-minute nap. The back seat is even better. Don’t nap in the driver’s seat. Sleep deprivation creates abnormal behavior; you may start driving while asleep. Or, the police may stop by and think you’re drunk.” He encourages night shift workers like nurses to take a 30-minute nap about four or five hours into their shift. “As humans, we’re afraid to ask for this, but a nap readies you for the rest of the shift and your drive home and is the best way to prevent medical errors.”

For a list of rest areas, service plazas, truck comfort stations, and welcome centers throughout Florida, visit fdot.gov.

Recognize abnormal sleep behavior.

As the miles tick by, fatigue and boredom sets in, and we expect drowsiness. That’s true, up to a point. “On a 30-minute drive, if you experience micro-sleep, something is wrong. You may suffer from a sleep disorder. Reach out to your doctor or a sleep specialist for help.”

With the pandemic slowly receding into the rearview mirror, the open road awaits. Include Dr. Abreu’s tips in your travel plan, and you’ll avoid drowsy driving and arrive ready for whatever adventures lie ahead.

*National Highway Traffic Safety Administration


Nancy Moreland is a regular contributor to UMiami Health News. She has written for several major health care systems and the CDC. Her writing also appears in the Chicago Tribune and U.S. News & World Report.


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