13 July 2011

Brake, the road safety charity

Tel: 01484 559909 Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

It only takes seconds of sleep behind the wheel to cause a fatal crash, but research out today by Brake and Cambridge Weight Plan reveals one in eight drivers (12%) has ‘head-nodded’ at the wheel in the past year[1]. Head-nodding occurs when someone nods off to between two and 30 seconds, often without realising that they have been asleep.

The survey of 1,000 drivers also revealed risky behaviour among many that can contribute to tiredness, with one in four admitting embarking on a journey when they already felt drowsy. The vast majority (86%) are also failing to follow best practice advice on dealing with tiredness at the wheel, by stopping somewhere safe for a nap. More than a quarter (29%) put their own and others’ lives on the line by continuing their journey after they notice the first signs of drowsiness.

In addition, one in seven drivers surveyed (13%) reported suffering from a health condition such as sleep apnoea that makes them tired during the day. Sleep apnoea can cause daytime sleepiness, and in some cases can cause the sufferer to fall asleep without warning.

Brake will present the research results at a Parliamentary reception on 13 July attended by MPs, fleet and road safety professionals and civil servants. At the reception, Brake and families bereaved through tired driving crashes will call on the Government to renew efforts to raise awareness of driver tiredness as a major cause of death and serious injury, and improve motorway facilities so that responsible drivers are able to stop when they need to. Read more about Brake’s Wake up! campaign.

Julie Townsend, Brake’s campaigns director, said: “Tiredness at the wheel kills. Driving a vehicle is a huge responsibility that must be taken seriously. That means stopping when we feel drowsy and certainly never starting a journey tired. It’s a matter of life and death. We still have widespread misunderstanding of how to prevent driver tiredness, and ignorance about factors like sleep apnoea, a condition that can be treated. These messages still need to get through to the public, which is why we are calling for renewed efforts from the Government to tackle this issue urgently.”

Professor Tony Leeds, Medical Director, Cambridge Weight Plan, said: “Driver tiredness can have devastating results, but it is avoidable if drivers follow road safety and medical advice. I urge drivers to manage their sleep needs: make sure you get sufficient rest each night, and stop and rest if you feel sleepy at the wheel. If you often feel tired, there might be an underlying medical problem, so you should seek appropriate professional advice. A common cause of tiredness is obstructive sleep apnoea, which is more common among commercial drivers, and is linked to greater risk of crashing. Sleep apnoea is linked to body mass index, so overweight drivers should be particularly alert to the possibility of suffering from this disorder, but aware that it is treatable.”

Experts estimate that tired drivers cause one in five fatal crashes on motorways and other monotonous trunk roads[2]. Crashes caused by drivers falling asleep at the wheel tend to be high-speed crashes, because drivers do not brake before crashing, so the risk of death or serious injury occurring is greater than in other types of crashes[3].

Brake and Cambridge Weight Plan’s survey reveals that youth and gender are both factors in the prevalence of tired driving. Young drivers [4] are more likely to drive tired and more likely to nod off at the wheel. One in four 18 – 24 year olds (25%) have head-nodded in the past year and more than half (55%) admit setting off on a journey when already drowsy. 50% more male drivers admit to setting off on a drive when they feel tired and more than twice as many males admit to head-nodding as females.

The causes of tiredness while driving are numerous and complex. Factors that may contribute include insufficient sleep, sleep disorders, time spent driving, alcohol and other drugs and monotony[5]. However, research shows sleep does not occur without warning. Warning signs include: increased difficulty concentrating; yawning; heavy eyelids; eyes starting to ‘roll’; and neck muscles relaxing, making the head droop. If drivers experience these symptoms, they should find somewhere safe to rest as soon as possible, rather than trying to fight off tiredness and continue.

Head-nodding, referred to by clinicians as ‘microsleeps’, often occurs when people are tired but trying to stay awake, such as if they are trying to fight off sleep to continue their journey. Nodding off for just a few seconds at the wheel can be fatal: if you are driving on a motorway at 70mph and nod off for six seconds you would travel nearly 200 metres, which could take you across three lanes of traffic and down an embankment onto another road or train track[6].

DRIVER ADVICE

Get plenty of sleep before a journey, plan your journey to include time for adequate rest and don’t set out if you are already tired.

Take rest breaks at least every two hours for a minimum of fifteen minutes.

If you feel tired when you are driving, listen to the warning signs and stop for a break somewhere safe as soon as you can. Sleep ensues faster than you think – trying to fight off sleep by opening the window or listening to the radio puts you at risk of ‘microsleeps’, when you nod off for two to 30 seconds without remembering it. Microsleeps can be fatal: at 70mph a driver travels 200m in six seconds.

If you start to feel sleepy while driving:

• Stop for a 15 minute break somewhere safe as soon as possible.
• If you drink caffeine, drink two cups of coffee or a high-caffeine drink, such as an energy drink, then take a 10-15 minute rest or snooze.
• By the time you wake up any caffeine will have kicked in and you may feel alert enough to continue your journey. If you still feel tired, or you still have a long way to go, you should stay put and try to find somewhere to get a good night’s sleep.
• Remember caffeine is a temporary drug and its effects do not last long. Sleep is the only long-term cure to tiredness.

If you notice that you are feeling tired during the day, go and see your doctor. You may have a treatable sleep disorder such as obstructive sleep apnoea. Other symptoms include snoring, depression, high blood pressure and poor concentration.

ACTION FROM THE GOVERNMENT

Brake’s Wake up! campaign calls for the following action to prevent and detect tired driving; and to stop deaths caused by drivers falling asleep at the wheel.

• Run widespread educational campaigns warning of the dangers of driving tired, stating what drivers can do to prevent tired driving crashes, and raising awareness about sleep disorders such as Obstructive Sleep Apnoea. Campaigns should target at-risk groups such as young drivers, commercial drivers and males.
• Require the National Institute for Clinical Excellence to publish clinical guidelines on the management of sleep apnoea and similar disorders to aid doctors in diagnosing and treating the disorder.
• Introduce regular screening of drivers, particularly people who drive for work, for sleep apnoea, a medical condition that makes falling asleep at the wheel much more likely.
• Make traffic policing a national policing priority, and ensure there are more patrols to spot and stop weaving vehicles driven by tired drivers.
• Introduce better and longer safety barriers to minimise the consequences of crashes caused by tired drivers on motorway and trunk roads.
• Audit rest areas on motorways and trunk roads, to ensure they provide adequate provision for our road network, enabling drivers to always find somewhere to stop and rest.
• Extend rules controlling hours that can be driven legally by large vehicle drivers to fleet drivers in vans and cars, and encourage companies to use trains more instead of cars for long distance journeys.

THE CONSEQUENCES – CASE STUDY

Toby Tweddell, aged 25, was travelling to work in Liverpool when he was killed on 8 August 2006. He was waiting in a queue of traffic on the M62 when he was shunted from behind. His car was hit with such force that it rammed right under the pickup truck in front.

The damage to Toby's car was so great that it took an hour for rescue services to cut him free. Surgeons at Whiston Hospital, Liverpool, battled to save Toby's life but he died that afternoon. A total of nine cars were involved in the crash. An articulated lorry, driven by Colin Wrighton, had caused the crash. Wrighton had fallen asleep at the wheel. After the crash Wrighton was diagnosed with Obstructive Sleep Apnoea, an easily treatable disorder.

Four months earlier Wrighton had visited his doctor complaining of tiredness. Blood and urine samples were taken to ascertain if he was a diabetic; when these indicated that Wrighton did not suffer from diabetes, his doctor advised him he was probably suffering from stress. No diagnosis of sleep apnoea was made, nor was Wrighton referred to a consultant in sleep medicine.

Following the inquest into Toby's death, the coroner made recommendations to Government including better screening for OSA among truck drivers and greater education.

Toby's family want it to be better known that undiagnosed and untreated sufferers are a great danger to themselves and others while driving, whereas a diagnosed and treated sufferer is as safe on the road as any other driver. They have been campaigning for better awareness of sleep apnoea, and for changes to medical licensing of drivers so as to improve the identification of undiagnosed sufferers.

In his short career, Toby had already proven himself to be a talented journalist and website designer. His father says: "He was a very sociable and immensely kind person. He was always doing things for other people. Most of all he loved Jenny, his fiancée. The two of them had just returned from travelling together in South East Asia. It is difficult to believe that it has really happened. Toby was a lovely young man. His death is an enormous loss to our family and a devastating one to Jenny."

References:

[1] A survey of 1,000 drivers conducted by Redshift Research for Brake and Cambridge Weight Plan in June 2011.

[2] Department for Transport, www.thinkroadsafety.gov.uk

[3] Department for Transport, www.thinkroadsafety.gov.uk

[4] Young drivers refers to drivers aged 18 – 24

[5] An investigation of differences in crash characteristics between males and females involved in a fatigue-related crash or close call event, Queensland University of Technology, 2009.

[6] Department for Transport Tiredness Kills campaign, launched 2008, www.dft.gov.uk/think