Lyznicki J M, Doege T C, Davis R M, Williams M A
Council on Scientific Affairs, American Medical Association, Chicago, IL 60610, USA.
JAMA. 1998 Jun 17;279(23):1908-13. doi: 10.1001/jama.279.23.1908.
To assess the contribution of driver sleepiness to highway crashes and review recent recommendations to change federal hours-of-service regulations for commercial motor vehicle drivers.
Information was derived from a search of the MEDLINE, Transportation Research Information Service (TRIS), and Bibliographic Electronic Databases of Sleep (BEDS) databases from 1975 through 1997 and from manual review of the reference lists in relevant journal articles, government publications, conference proceedings, and textbooks.
Driver sleepiness is a causative factor in 1% to 3% of all US motor vehicle crashes. Surveys of the prevalence of sleepy behavior in drivers suggest that sleepiness may be a more common cause of highway crashes than is reflected in these estimates. About 96% of sleep-related crashes involve passenger vehicle drivers and 3% involve drivers of large trucks. Risk factors include youth, shift work, alcohol and other drug use, over-the-counter and prescription medications, and sleep disorders.
Increased awareness of the relationship between sleepiness and motor vehicle crashes will promote the health and safety of drivers and highway users. Physicians can contribute by encouraging good sleep habits, recognizing and treating sleep-related problems, and counseling patients about the risks of driving while sleepy. To protect public health and safety, the American Medical Association recommends continued research on devices and technologies to detect the signs of sleepiness and prevent the deterioration of driver alertness and performance. Educational programs about the risks of falling asleep while driving are needed for physicians, the public, and commercial truck drivers.
评估驾驶员困倦对高速公路撞车事故的影响，并回顾近期关于更改商用机动车驾驶员联邦服务时长规定的建议。
信息来自于对1975年至1997年的医学文献数据库（MEDLINE）、交通研究信息服务数据库（TRIS）以及睡眠文献电子数据库（BEDS）的检索，以及对相关期刊文章、政府出版物、会议论文集和教科书中参考文献列表的人工查阅。
在美国，驾驶员困倦是所有机动车撞车事故中1%至3%的致因。对驾驶员困倦行为发生率的调查表明，困倦可能是高速公路撞车事故比这些估计所反映的更为常见的原因。约96%与睡眠相关的撞车事故涉及乘用车驾驶员，3%涉及大型卡车驾驶员。风险因素包括年轻、轮班工作、酒精和其他药物使用、非处方和处方药以及睡眠障碍。
提高对困倦与机动车撞车事故之间关系的认识将促进驾驶员和高速公路使用者的健康与安全。医生可以通过鼓励良好的睡眠习惯、识别和治疗与睡眠相关的问题以及就困倦驾驶的风险向患者提供咨询来做出贡献。为保护公众健康和安全，美国医学协会建议继续研究检测困倦迹象以及防止驾驶员警觉性和表现下降的设备和技术。医生、公众和商用卡车驾驶员都需要接受关于困倦驾驶风险的教育项目。
