d05a.jpg (10826 bytes)State Considers Stiffer Sentences for Sleep-Deprived Drivers
Nearly 2 years after Amy Huther’s fiancé, 37-year-old Army Major Robert Raneri, was killed in an accident caused by a driver who had not slept in 24 hours, Huther and Raneri’s family are awaiting the fate of a Massachusetts bill that would raise the penalty for fatal accidents caused by sleep deprivation.

“[Driver Christopher Chickering] took my future, he took my dreams, he took my fiancé a week before our wedding, and he took a wonderful and loving father away from an unborn child,” says Huther, who discovered 2 weeks after Raneri’s death that she was pregnant with their child.

On June 26, 2002, Holliston, Mass-native Raneri was driving his motorcycle along Route 111 in Pepperill, Mass. Nineteen-year-old Chickering, of Merri-mack, NH, who was traveling in the opposite direction, crossed the median and hit Raneri’s Harley-Davidson head on. The impact threw Raneri from the motorcycle, and he was pronounced dead shortly thereafter.

If the drowsy driving House bill, sponsored by state Representative Marie Parente (D-Milford), passes, it would allow courts to sentence drowsy drivers who cause fatal accidents with up to 15 years in prison and fine them up to $5,000.

Chickering, who was charged with a misdemeanor, received a 10-year license suspension, 5 years of probation, and 140 hours of community service.

Better methods of determining sleep deprivation’s role in fatal accidents is needed, however, state Representative James Vallee (D-Franklin) told The Boston Globe in a February 22 article. Vallee cochairs the Joint Committee on Criminal Justice and served with Raneri in the Army Reserve.

Sleep experts told the Globe that researchers are examining eyelid movement and other roadside procedures for determining a driver’s sleepiness.

‘’My sense is that we will eventually have something, but a biological marker is still going to be difficult,” said David Dinges, chief of the division of sleep and chronobiology in the Department of Psychiatry at the University of Pennsylvania, Philadelphia, in the article. “It’s just finding something that’s easily measurable without taking blood or without doing something invasive.”

At press time, the bill was in a study seeking more information on the issue, according to Vallee.

Schools Differ on Student Rest Requirements
While some major educational institutions seem to be paying attention to reports on the damaging effects of sleep deprivation, some organizations have yet to open their eyes to the problem.

At Duke University, Durham, NC, anecdotal evidence of sleep-deprived students and the waning popularity of early-morning classes convinced administrators to push 8 am courses back to 8:30 am, according to The Associated Press (AP).

“[Students are] coming in to see us, and they’re ragged,” Ryan Lombardi, assistant dean of students, told AP. “We get emails and calls in the middle of the night at ungodly hours.”

Lombardi says the university is considering individual health assessments to help first-year students develop better sleep, exercise, and nutrition habits.

On the other end of the spectrum, the Accreditation Council for Graduate Medical Education (ACGME), whose standards govern medical education in the United States, is considering changing a recently approved regulation that limits residents’ work weeks to 80 hours. Responding to feedback from program directors, the ACGME may raise the weekly average for chief residents to 88 hours, according to American Medical News (AMNews). The news service also reported that the ACGME is negotiating allowing residents to count sleep acquired during on-call periods toward the 10-hour rest period following in-hospital call.

The ACGME will consider changes during its June meeting, and revisions could take effect as soon as July 1, according to AMNews.

“Less than a year after introducing the regulations, it is outrageous that the ACGME is considering an increase in the required work hours,” says Lauren Oshman, MD, MPH, American Medical Student Association National President. “By proposing increases in work hours, the ACGME appears to be unconcerned about patient safety and reducing medical errors caused by long work hours.” The organization says more than 41% of resident-physicians attribute their most serious mistakes to fatigue and cites a recent report from The Institute of Medicine that nearly 100,000 annual deaths result from medical errors.

Ford Study Fuels Use of Drowsy Driving Warning Technology
So many sleep-deprived drivers veered off the virtual track created by Ford Motor Co to test the effects of drowsy driving that the Dearborn, Mich-based automaker reports there would have been numerous serious accidents had the drivers actually been on the road. Ford released the results of a deprivation study in April at the New York Auto Show. Study participants stayed up all night and consumed no caffeine after 6 pm the night before embarking on a 3-hour drive behind the wheel of Ford’s driving simulator.

As the drowsy subjects drove on a simulated darkened country road, researchers experimented with several methods of keeping them alert, such as flashing red LED lights on the windshield, a vibrating steering wheel, and the sound of running over highway rumble strips.

“We have been able to demonstrate that we have the ability to alert a drowsy driver to a lane departure and improve their performance,” says Jeff Greenberg, staff technical specialist, Vehicle Design Research, Ford Research and Advanced Engineering. “We are confident that we can do it in ways that drivers will accept. The new system will be adaptive and intelligent—to sense true driver status.”

The company says it will use what it learned from the study to incorporate lane departure warning technology into vehicles, starting with its Volvo brand.

“What we discovered,” says Greenberg, “is that not every technology that helps combat drowsy driving is tolerated or well-liked by drivers. False alerts are considered annoying and could nag drivers to the point they just turn the system off. And a system that is turned off is not serving any purpose whatsoever.”

Breaks in driving—such as stopping to use the restroom or taking a quick walk—had little effect on combating driver drowsiness during the test. Ford reported that the drivers soon reverted to their drowsy state. “Nothing beats getting some sleep—either for 30 minutes or, better yet, a few hours,” Greenberg says.

Study Shows How Stress May Affect Sleep Patterns
Stressful days equal restless nights; that much is known. But researchers are still trying to determine precisely how stress impairs sleep. One recent study suggests that acute stress may affect heart rate variability during various sleep stages.

The researchers, whose work was published in the journal Psychosomatic Medicine, examined the link between stress and sleep in 59 healthy undergraduates. To trigger stress in some of the volunteers, half of the students were told that they would deliver a 15-minute speech upon awakening. The topics were to be chosen for them in the morning.

Heart rate variability differed significantly between the stressed and nonstressed groups. The stressed group experienced changes in heart rate patterns during non-REM and REM sleep.

Insomniacs have heart rate variability patterns similar to those seen in the stressed students, which may suggest that similar pathways of nervous system disruption are at work in the disorder, according to Martica Hall, PhD, of the University of Pittsburgh, and her colleagues.

The study was supported by the National Institutes of Mental Health.

d05a.jpg (10826 bytes)Dinges Honored for Investigatory Achievements
In May, leading sleep researcher David Dinges, PhD, received the Decade of Behavior Research Award, which recognizes “high caliber research that has had a demonstrated impact on policy or society at large, has contributed to the use of social and behavioral science knowledge in policy settings, or has enhanced public understanding of behavioral or social science principles.” Dinges, a professor at the University of Pennsylvania School of Medicine, Philadelphia, and an adjunct professor at Drexel University, also in Philadelphia, has researched the effects of chronic sleep deprivation on the brain’s ability to sustain acceptable levels of attention and alertness and on the body’s ability to fight off infection and disease. The award was presented on May 10 by the Decade of Behavior organization and the Neurology Federation of Behavioral, Psychological, and Cognitive Sciences during a congressional briefing on sleep deprivation.

Sleepy Toddlers May Become Drug-Using Teens
Preschool-age kids with poor sleep habits may be more than twice as likely to drink alcohol, smoke cigarettes, and use drugs in their early teen years, according to a research team at the University of Michigan Health System, Ann Arbor. The finding, discovered as part of a family health study that followed 257 boys and their parents for 10 years, held true even after issues such as depression, aggression, attention problems, and parental alcoholism were taken into account. Long-term data on girls are not yet available.

“What’s so interesting about this finding is that the effect exists regardless of a number of other factors that previously had been identified as relating to risk for substance use and abuse,” says senior author and University of Michigan Addiction Research Center director Robert Zucker, PhD. “It appears to indicate some shared neurobiological dysfunction whose details we don’t yet know. Further studies will be crucial to our understanding.”

The finding does not mean there is a cause-and-effect relationship, notes coauthor and psychiatry professor Kirk Brower, MD, who has studied the interplay of alcohol and sleep in adults, and is executive director of the Chelsea Arbor Treatment Center, which treats teen and adult substance abusers.

“Our finding sees early childhood sleep disturbances as a marker, or predictor, for early use of drugs and alcohol in adolescence, not a predetermined trajectory,” Brower says. “But for parents, this is one more reason to take your child’s sleep problems seriously, not to dismiss them, and to talk with your child’s pediatrician or family doctor.”