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To the Editor: The article on sleepiness, driving, and motor vehicle crashes by the Council on Scientific Affairs¹ is extremely important. The conclusions about the importance of increased awareness of the relationship between sleepiness and motor vehicle crashes, the role of physicians in providing advice that will help prevent the problem, and the importance of further research on the topic cannot be denied. However, several issues require additional comment.

First, the crucial problem is fatigue (or reduced alertness), and sleepiness is one specific example of this. The article cites a number of factors that can increase fatigue (eg, prolonged work, circadian factors, sleep loss, drug use) but does not acknowledge that minor illnesses, such as the common cold, are a frequent cause of reduced alertness and efficiency.² Second, the impaired performance efficiency in states of reduced alertness is not restricted to driving; sleepiness and driving represent just one example of . . . [Full Text of this Article]

RELATED ARTICLE

Sleepiness, Driving, and Motor Vehicle Crashes
James M. Lyznicki, Theodore C. Doege, Ronald M. Davis, Michael A. Williams, and for the Council on Scientific Affairs, American Medical Association
JAMA. 1998;279(23):1908-1913.
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