Earlier school start time can mean more car crashes

Start changing your child's sleep schedule back to school time. - JR

Teens with an earlier school start time get into more car crashes which can indicate these teens are sleep deprived due to the earlier school start time.

A new study suggests that teen drivers who start class earlier in the morning are involved in significantly more motor vehicle accidents than peers with a later high school start time. The results underscore the importance of the "Awake at the Wheel" campaign of the National Healthy Sleep Awareness Project.

Results show that the weekday crash rate for teen drivers during the 2009 to 2010 school year was about 29 percent higher in Chesterfield County, Va., where high school classes began at 7:20 a.m., than in adjacent Henrico County, Va., where classes started at 8:45 a.m. Similar results were found for the 2010 to 2011 school year, when the weekday crash rate for 16-17 year old teens in Chesterfield County was about 27 percent higher than for those in Henrico County. In contrast, there was no difference in adult crash rates in the two counties for either year. A secondary analysis evaluating the causes and types of crashes found that Chesterfield County adolescents had a significantly higher rate of run-off-road crashes, which is a common feature of drowsy driving accidents.

"There are more and more data suggesting that insufficient sleep is common in our teens and that early high school start times are a contributor to teens' reduced sleep," said principal investigator and lead author Dr. Robert Vorona, associate professor in the Division of Sleep Medicine at Eastern Virginia Medical School in Norfolk, Va. "Insufficient sleep appears to have deleterious consequences such as decrements in mood and increased risk taking, impaired academics and increased crash rates."

The results corroborate the findings of a previous study by Vorona's team that evaluated teen crash rates from 2007 to 2008. Results of the current study are published in the November issue of the Journal of Clinical Sleep Medicine.

"When high school classes begin early in the morning, we ask teens to shine when their biological clock tells them to sleep," said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler, a national spokesperson for the Healthy Sleep Project. "Many do not get adequate sleep as a result. Smarter school start times, that are more consistent with sleep needs, will improve students' safety, overall health, mood and academic performance."

Recently the Healthy Sleep Project launched the "Awake at the Wheel" campaign to increase public awareness of the risks of drowsy driving. More details are available athttp://www.projecthealthysleep.org.

The study involved an analysis of data provided by the Virginia Department of Motor Vehicles. During both school years there were more than 520 motor vehicle accidents involving teen drivers in Chesterfield County and more than 320 teen crashes in Henrico County.

The American Academy of Sleep Medicine recommends that adolescents get a little more than nine hours of nightly sleep for optimal health and daytime alertness during the critical transition from childhood to adulthood. The AASM advises parents and local school boards to work together to implement high school start times that allow teens to get the healthy sleep they need to meet their full potential.

A new report from the AAA Foundation for Traffic Safety estimates that drowsy driving may cause 328,000 motor vehicle accidents and 6,400 fatal crashes on U.S. roads each year. Previous data analysis by AAA also shows that the prevalence of drowsy driving crashes is highest among drivers between the ages of 16 and 24 years.

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Concussions impact teen drivers

This article explains how concussions can impact teen drivers.

Researchers at Cincinnati Children's Hospital Medical Center are currently studying teenagers who have suffered concussions in order to help doctors determine when teen drivers are ready to get back behind the wheel of a vehicle.

A driving study is currently taking place that uses assessments of eye tracking within a driving simulator to evaluate potential impairments to reaction times following a concussion.

"This is the only pediatric driving study that I know of that's examining the behavior of concussed patients," said Dr. Adam Kiefer, assistant professor of pediatrics at Cincinnati Children's Sports Medicine. "We are looking for novel ways to assess these teens and to allow them to return to the road safely."

Cincinnati Children's Sports Medicine recently received a grant from the Ohio Department of Transportation to perform the study. Researchers are testing patients between the ages of 16-19 who have suffered a concussion within 7-10 days. They are comparing them to their peers of the same age who are healthy and driving.

They will collect the data over the next several months. The research team with expertise in sports medicine, behavioral medicine and neurology will then analyze the results.

"One of the biggest issues teens and adults face when dealing with concussions is a decreased ability to react quickly to objects in their environment," said Dr. Kiefer. "This can be a major problem, especially during driving, and that's why I think it's important for this type of research to be done."

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Study: Drivers with ADHD are at a greater risk for crashes

A study shows that drivers who have ADHD are significantly more likely to be in a serious car crash.

Drivers with attention-deficit/hyperactivity disorder (ADHD) are nearly 50 percent more likely to be in a serious car crash, a new study suggests.

Further, men with ADHD can dramatically decrease their risk of traffic accidents if they take medication for their condition, the Swedish researchers said.

"This study confirms the importance of treatment and medication for adults with ADHD as well as teens," said Ruth Hughes, CEO of Children and Adults With Attention-Deficit/Hyperactivity Disorder, a patient advocacy group.

"The core symptoms of ADHD include problems with sustained attention and impulsivity, which can have an adverse effect on driving safely," said Hughes, who was not involved in the new study. "All drivers with ADHD need to responsibly manage their treatment to reduce driving risks."

The new findings come from a review of more than 17,000 people in Sweden with ADHD, aged 18 to 46. Researcher Henrik Larsson and colleagues at the Karolinska Institute used databases to track whether the patients had been in a car accident between 2006 and 2009, and if they had a prescription for ADHD medication at the time.

Overall, having ADHD increased a man's risk of a traffic crash by 47 percent and a woman's risk by 45 percent, the researchers found.

They then investigated the role of medication in preventing crashes by determining whether people involved in a wreck had filled a prescription for ADHD medicine within the previous six months.

Dr. Lenard Adler, a professor of psychiatry at NYU Langone Medical Center in New York City, said despite a broad definition of taking medication, "men [who were] treated substantially lowered their risk for accidents."

Access to ADHD medication reduced men's risk of a car wreck by 58 percent compared to men who did not take medication, according to the study. Women with ADHD, however, did not receive any significant benefit from medication in terms of car crashes.

The study, published online Jan. 29 in the journal JAMA Psychiatry, did not receive any funding from drug companies.

Breaking down the numbers further, the researchers estimated that between 41 percent and 49 percent of the car accidents involving men with ADHD could have been avoided if they had been taking their medication as prescribed.

About three out of five children with ADHD carry the disorder with them into adulthood, according to the Anxiety and Depression Association of America. That amounts to about 8 million adults living with ADHD.

Previous research with ADHD patients in virtual-reality driving simulators found that they are more likely to speed, drive erratically, tap the breaks and accelerate into potential accidents, said Adler, who did not take part in the Swedish research.

"These sorts of things are more likely in individuals with ADHD than in people without ADHD," he said. "This is an important study that follows up on ... some of the shorter-term studies that have shown that people with untreated ADHD have more accidents."

Although the study found an association between having ADHD and greater risk of serious car crashes, it did not establish a cause-and-effect relationship.

Adler said, however, that you don't necessarily have to fear getting into a car with a driver who has ADHD.

"With ADHD, there tend to be two groups: a group that is distracted and impulsive, and a group that drives fine. Not everyone with ADHD has this problem, but a substantial percentage does," he said. "This study highlights another reason why getting an appropriate diagnosis for adult ADHD is important, and why it is important to get the ADHD treated."

People with ADHD also should to take extra precautions that will help them keep their mind on the road, Hughes said.

"In addition to medication, this can mean limiting distractions like texting or cell phones, fewer passengers, breaking up monotonous drives with frequent breaks and being more vigilant about driving defensively," she said.

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