A report from the Governors Highway Safety Association (GHSA) states that nearly 83.6 million sleep-deprived Americans are driving every day. And it’s taking a toll—an estimated 5,000 lives were lost in drowsy driving-related crashes last year, according to Wake Up Call! Understanding Drowsy Driving and What States Can Do. The report was funded through a grant from State Farm with guidance from an expert panel.

In a newly available National Highway Traffic Safety Administration (NHTSA) estimate provided to GHSA for this report, the agency reveals the annual societal cost of fatigue-related fatal and injury crashes is $109 billion, not including property damage.

The GHSA report, which comes as US motor vehicle deaths were up 7.7% nationwide in 2015, examines the cause and effect of drowsy driving as well as how states and others can best address it. Additionally, it discusses legislative, enforcement, education, and engineering countermeasures being employed as well as in-vehicle technologies that are available today or on the horizon.

While estimates of deaths caused by drowsy drivers range from 2% to 20% of all traffic fatalities, safety officials agree that the extent of the problem is not fully known. “There are challenges associated with both measuring and combating drowsy driving,” says GHSA executive director Jonathan Adkins, who oversaw the development of the report, in a release. “Law enforcement lack protocols and training to help officers recognize drowsy driving at roadside. And if a crash occurs, the drowsy driver may not report the cause due to concerns about monetary and other penalties.”

Chris Mullen, director of technology research at State Farm, says, “Drowsy driving is a serious safety issue on America’s roadways. We encourage drivers to remember the role that rest plays in safe driving, and to prioritize getting enough sleep before getting behind the wheel. As this report highlights, learning to recognize the warning signs of drowsiness can also help us take appropriate action if we become a drowsy driver.”

To help State Highway Safety Offices (SHSOs) address the behavioral side of drowsy driving and develop strategies to combat it, the report explores the crash characteristics and drivers who are most at risk. “Teens and young adults are involved in more than half of all drowsy driving crashes annually,” Adkins says. “People who work nights or long or irregular shifts are also more likely to get behind the wheel when they are too tired to drive, along with the estimated 40 million Americans who suffer from a sleep disorder.”

That, says report author Pam Fischer, merits a change in how we view sleep. “Sleep is a restorative and life-sustaining activity that is just as important as eating right and exercising. When we skimp on sleep, we’re less able to react quickly—a critical element of safe driving. Our mental and physical health also suffers.”

The report recommends SHSOs partner with other sectors, including public health, business, academia, and nonprofits, to change the culture. “Just like drunk driving and seat belts, it’s going to take all of us to get the public to recognize the seriousness of drowsy driving,” says Fischer.

Wake Up Call! highlights some states that are working collaboratively to address the problem:

  • In Iowa, the Governor’s Traffic Safety Bureau joined with law enforcement, elected officials, community and business partners, and researchers to convene the nation’s first statewide drowsy driving summit. The summit covered research on the extent of the problem and strategies to address it, such as in-vehicle technology, stepped-up enforcement, weekly safety reminders on variable message signs, and public outreach through a partnership with one of the state’s largest supermarket chains.
  • In Utah, highway signs reminding motorists that Drowsy Driving Causes Crashes and encouraging Drowsy Drivers [to] Pull Over if Necessary are credited with reducing the incidence of these crashes by as much as 63%. Meanwhile, the Sleep Smart. Drive Smart Alliance, a public-private partnership, has been educating the public about the hazards of driving sleepy since 2005. Drowsy driving is addressed in the state’s teen driving program and at parent nights, and novice drivers must pass an online test that assesses their knowledge of drowsy driving before obtaining a permit.
  • New York State’s safety, education, and health officials are partnering to educate teens about drowsy driving through the development of a standardized driver education curriculum, an interactive school-based initiative, later school start times, and a statewide coalition.

GHSA will hold a webinar to discuss key findings and recommendations on August 11 at 2 PM EDT.