SLEEPLESSSLEEPLESS IN IN

AMERICA AMERICA

Anita Isaacson, RRT, RPSGT

OBJECTIVESOBJECTIVES

WHO ?WHO ?

WHAT ?WHAT ?

WHY ? WHY ?

WHO?WHO?WHO?WHO?

How Much Sleep do we How Much Sleep do we need?need?

Adults…………..7 - 9 hoursAdolescents……8 - 9.5 hoursSchool age…….10 - 11 hoursPreschool……...11 -13 hoursToddlers………..12 -14 hoursInfants……….....14 – 15 hours

Nine out of ten US officer have Nine out of ten US officer have stopped driver who appear police stopped driver who appear police intoxicated and turn out to be intoxicated and turn out to be drowsy.drowsy.

100,000 reports filed annually 100,000 reports filed annually involve sleepy drivers and crashes.involve sleepy drivers and crashes.

Study Shows Connection Between Study Shows Connection Between Sleep and Childhood InjurySleep and Childhood Injury

Study Shows Connection Between Study Shows Connection Between Sleep and Childhood InjurySleep and Childhood Injury

Does your child fall down frequently or Does your child fall down frequently or have an unusual number of injuries? It have an unusual number of injuries? It may be that she or he is sleep-may be that she or he is sleep-deprived.deprived.

Children between the ages of three and five who slept less than 10 hours a day seemed to have a 86% increase of risk of injury. Within that group, boys in particular were at increased risk of injury.

Being awake for more than eight hours results in a fourfold increase of injury risk, but the risk increase seemed to be significant among males only.

DO NOT get enough sleep

Many teens suffer from treatable sleep disorders such as narcolepsy, insomnia, restless legs syndrome or sleep apnea.

Teens tend to have irregular sleep patterns across the week they typically stay up late and sleep in late on the weekends, which can affect their biological clocks and hurt the quality of their sleep.

**

Limit your ability to learn, listen, concentrate and solve problems.

Lead to aggressive or inappropriate behavior

Depression

Prone to pimples

WHAT…..WHAT…..happens happens when we don’t get the when we don’t get the

sleep we need.sleep we need.

Your eyelids droop and your head starts Your eyelids droop and your head starts to nod. Yawning becomes almost to nod. Yawning becomes almost constant and your vision seems blurry. constant and your vision seems blurry. You blink hard, focus your eyes and You blink hard, focus your eyes and suddenly realize that you’ve veered onto suddenly realize that you’ve veered onto the shoulder or into oncoming traffic for the shoulder or into oncoming traffic for a moment and quickly straighten the a moment and quickly straighten the wheel. This time you were lucky; next wheel. This time you were lucky; next time you could become the latest victim time you could become the latest victim of the tragedy of drowsy driving. of the tragedy of drowsy driving.

Sleep DebtSleep Debt

The accumulate effect of a partial The accumulate effect of a partial nights sleep.nights sleep.

All sleep loss accumulate as a debt….. All sleep loss accumulate as a debt…..

A Sleep debt can only be decreased by A Sleep debt can only be decreased by sleep…..sleep…..

Most people have a sleep debt…..Most people have a sleep debt…..

The bigger the sleep debtThe bigger the sleep debt

… ….. The more tired you are….... The more tired you are…..

… …..The more impaired you are….. ..The more impaired you are….. …..The more likely to become drowsy …..The more likely to become drowsy

………….The faster you fall asleep.The faster you fall asleep

SMALL SLEEP DEBT…… SMALL SLEEP DEBT…… usually recover with sleep……usually recover with sleep……

LARGE SLEEP DEBT…... LARGE SLEEP DEBT…... can bring on health issues…..can bring on health issues…..

HOW DO YOU KNOW IF HOW DO YOU KNOW IF YOUR GETTING YOUR GETTING

ENOUGH SLEEP?ENOUGH SLEEP?

The normal healthy adult should not The normal healthy adult should not feel tired.feel tired.

The is no change in your daytime The is no change in your daytime alertness….alertness….

Sleep DeprevationSleep Deprevation

Is Is

Sleep StarvationSleep Starvation

It’s just as serious as food It’s just as serious as food starvation….starvation….

WHY……WHY……

Don’t we get a good nights sleep?Don’t we get a good nights sleep?

GOOD SLEEP HYGIENEGOOD SLEEP HYGIENE

Regular bedtime scheduleRegular bedtime schedule Regular exerciseRegular exercise Decrease CaffeineDecrease Caffeine Conducive atmosphereConducive atmosphere Allow time for sleepAllow time for sleep

SLEEP WITH AGESLEEP WITH AGE

Changes to our sleep patterns are a part of Changes to our sleep patterns are a part of the normal aging process. As people age they the normal aging process. As people age they tend to have a harder time falling asleep and tend to have a harder time falling asleep and more trouble staying asleepmore trouble staying asleep

Common misconception that sleep needs Common misconception that sleep needs decline with age. In fact, research decline with age. In fact, research demonstrates that our sleep needs remain demonstrates that our sleep needs remain constant throughout adulthood.constant throughout adulthood.

Sleep architecture,Sleep architecture, older people spend more older people spend more time in the lighter stages of sleep than in deep time in the lighter stages of sleep than in deep sleep. sleep.

SHIFT WORKERSSHIFT WORKERS A shift worker is anyone who follows a work schedule A shift worker is anyone who follows a work schedule

that is outside of the typical "9 to 5" business day that is outside of the typical "9 to 5" business day

Most serious and persistent problems shift workers face are frequent sleep disturbance and associated excessive sleepiness.

Sleepiness/fatigue in the work place can leadto poor concentration, absenteeism, accidents,errors, injuries, and fatalities.

SHIFT WORKSHIFT WORK

According to the International According to the International Classification of Sleep Disorders, shift Classification of Sleep Disorders, shift work sleep disorder is a circadian rhythm work sleep disorder is a circadian rhythm sleep disorder. Circadian rhythm refers sleep disorder. Circadian rhythm refers to the ~24hr rhythmic output of the to the ~24hr rhythmic output of the human biological clock. It is considered a human biological clock. It is considered a disorder because of the frequency with disorder because of the frequency with which people suffer from sleep which people suffer from sleep disturbance and excessive sleepiness in disturbance and excessive sleepiness in trying to adapt to a shift work schedule.trying to adapt to a shift work schedule.

COPINGCOPING

If you are a shift worker and have If you are a shift worker and have difficulty sleeping during the day, difficulty sleeping during the day, chances are you also have difficulty chances are you also have difficulty staying awake at work. Also, the staying awake at work. Also, the more sleepy/fatigued you are, the more sleepy/fatigued you are, the more likely you are to experience a more likely you are to experience a "microsleep," an involuntary bout of "microsleep," an involuntary bout of sleep brought on by sleep deprivation sleep brought on by sleep deprivation that lasts for a few seconds. that lasts for a few seconds.

Risk to Shift WorkersRisk to Shift Workers

shift workers are at increased risk shift workers are at increased risk for a variety of chronic illnesses for a variety of chronic illnesses such as cardiovascular and such as cardiovascular and gastrointestinal diseases. gastrointestinal diseases.

Shift workers are at elevated risk for Shift workers are at elevated risk for obstructive sleep apnea. Sleep obstructive sleep apnea. Sleep Apnea is found in approximately 5% Apnea is found in approximately 5% of the general population, but 11.6% of the general population, but 11.6% of the shift work population.of the shift work population.

SLEEP SLEEP DISORDERSDISORDERS

PLM’s / RLSPLM’s / RLS

PLMPLM’s’s Periodic limb movements in sleep are Periodic limb movements in sleep are

the occurrence of periodic episodes of the occurrence of periodic episodes of repetitive leg jerks.repetitive leg jerks.

Formerly know as Nocturnal Formerly know as Nocturnal MyoclonusMyoclonus

RLSRLS Unpleasant sensation to move legs Unpleasant sensation to move legs

when sitting or lying down.when sitting or lying down.

SNORINGSNORING

Cardinal sign of sleep apneaCardinal sign of sleep apnea Produced by a vibration of soft upper Produced by a vibration of soft upper

airway tissueairway tissue Varies in intensity depending on position, Varies in intensity depending on position,

time of night, anatomical obstructiontime of night, anatomical obstruction Once thought benign, however, alone it Once thought benign, however, alone it

can lead to HYPERTENSION due to can lead to HYPERTENSION due to partial obstruction and nocturnal partial obstruction and nocturnal hypoventilation hypoventilation

INSOMNIAINSOMNIA

DyssomniasDyssomnias

Insomnia Insomnia – disorder associate with – disorder associate with falling asleep or maintaining sleepfalling asleep or maintaining sleep

HypersomniaHypersomnia- too much sleep or - too much sleep or sleepiness when you don’t want to sleepiness when you don’t want to sleepsleep

IntrinsicIntrinsic- originating within the - originating within the bodybody

ExtrinsicExtrinsic- originating outside the - originating outside the bodybody

The prevalence of insomnia The prevalence of insomnia is also higher among older is also higher among older adults 44% of older persons adults 44% of older persons experience one or more of experience one or more of the nighttime symptomsthe nighttime symptoms

NARCOLEPSYNARCOLEPSY

Neurological disorderNeurological disorder Uncontrollable sleep attacksUncontrollable sleep attacks CataplexyCataplexy Hypnagogic hallucinationsHypnagogic hallucinations Usually occurs adolescence/ young Usually occurs adolescence/ young

adulthoodadulthood amphetaminesamphetamines

Sleep apneaSleep apnea

Results in excessive daytime Results in excessive daytime sleepiness that increases the sleepiness that increases the likelihood of accidents, hinders likelihood of accidents, hinders productivity and makes relationships productivity and makes relationships more difficult. more difficult.

OBSTRUCTIVE SLEEP APNEAOBSTRUCTIVE SLEEP APNEA

•The word "apnea" literally means "without breath." Apnea is defined as a cessation of breath that lasts at least ten seconds.

•The combination of sleep disturbance and oxygen starvation can result in multiple problems, including hypertension, heart disease, and mood and memory problems.

SYMPTOMS:SYMPTOMS:

Chronic snoring is a strong indicator of sleep apnea Chronic snoring is a strong indicator of sleep apnea and should be evaluated by a health professional.and should be evaluated by a health professional.

Since people with sleep apnea tend to be sleep Since people with sleep apnea tend to be sleep

deprived, they may suffer from sleeplessness and a deprived, they may suffer from sleeplessness and a wide range of other symptoms such as difficulty wide range of other symptoms such as difficulty concentrating, depression, irritability, sexual concentrating, depression, irritability, sexual dysfunction, learning and memory difficulties, and dysfunction, learning and memory difficulties, and falling asleep while at work, on the phone, or driving.falling asleep while at work, on the phone, or driving.

Left untreated, symptoms of sleep apnea can include Left untreated, symptoms of sleep apnea can include

excessive sleepiness during the day, high blood excessive sleepiness during the day, high blood pressure, heart attack, congestive heart failure, pressure, heart attack, congestive heart failure, cardiac arrhythmia, stroke or depression.cardiac arrhythmia, stroke or depression.

Factors that increase Factors that increase risk risk

Small upper airway (or large tongue, tonsils or Small upper airway (or large tongue, tonsils or uvula)uvula)

Being overweightBeing overweight Having a recessed chin, small jaw or a large Having a recessed chin, small jaw or a large

overbite overbite A large neck size (17 inches or greater in a A large neck size (17 inches or greater in a

man, or 16 inches or greater in a woman)man, or 16 inches or greater in a woman) Smoking and alcohol useSmoking and alcohol use Age 40 or older,Age 40 or older, Ethnicity (African-Americans, Pacific-Islanders Ethnicity (African-Americans, Pacific-Islanders

and Hispanics). and Hispanics). OSA seems to run in some families, suggesting OSA seems to run in some families, suggesting

a possible genetic basis. a possible genetic basis.

UPPER AIRWAY UPPER AIRWAY RESISTANCERESISTANCE

Also results from partial upper Also results from partial upper airway obstructionairway obstruction

Identified by increased respiratory Identified by increased respiratory effort leading to arousalseffort leading to arousals

No significant SaO2 dropNo significant SaO2 drop No clear respiratory eventNo clear respiratory event Can lead to the same medical Can lead to the same medical

complications as SDBcomplications as SDB

HOW… …can we make a HOW… …can we make a difference ?difference ?

EDUCATIONEDUCATION

PUBLIC AWARENESSPUBLIC AWARENESS

SLEEP HYGEINESLEEP HYGEINE 1. Maintain a regular bed and wake 1. Maintain a regular bed and wake

time schedule including weekends.time schedule including weekends.

2. Establish a regular, relaxing 2. Establish a regular, relaxing bedtime routine such as soaking in a bedtime routine such as soaking in a hot bath or hot tub and then reading a hot bath or hot tub and then reading a book or listening to soothing music. book or listening to soothing music.

3.3. Create a sleep-conducive Create a sleep-conducive environment that is dark, quiet, environment that is dark, quiet, comfortable and cool. comfortable and cool.

4. 4. Sleep on a comfortable mattress and Sleep on a comfortable mattress and pillowpillow

5. Use your bedroom only for sleep and sex.

6. Finish eating at least 2-3 hours before your regular bedtime.

7. Exercise regularly ending your workout a few hours before bedtime

8. Avoid caffeine to close to bedtime

9. Avoid nicotine (e.g. 9. Avoid nicotine (e.g. cigarettes, tobacco products). cigarettes, tobacco products). too close to bedtime, it can lead too close to bedtime, it can lead to poor sleep. to poor sleep.

10. Avoid alcohol close to 10. Avoid alcohol close to bedtime. bedtime.

SHIFT WORKSHIFT WORK Bottom line is improve Bottom line is improve

sleepsleep addressing the issues of shift work may require addressing the issues of shift work may require

some investment up front for training and other some investment up front for training and other measures. The bottom line is that improved sleep measures. The bottom line is that improved sleep in shift workers can only lead to improved in shift workers can only lead to improved productivity.productivity.

In fact, to ignore the needs of the shift worker is reckless and irresponsible.Billions of dollars in yearly costs, thousands of deaths, and some of the most notorious of modern catastrophes human fatigue.

Here are some tips for Here are some tips for staying alert on the job:staying alert on the job:

Take short nap breaks throughout the Take short nap breaks throughout the shift. shift.

Work with others to help keep you alert. Work with others to help keep you alert. Avoid long commutes and extended Avoid long commutes and extended

hours. hours. Try to be active during breaks (e.g., Try to be active during breaks (e.g.,

take a walk, shoot hoops in the parking take a walk, shoot hoops in the parking lot, or even exercise). lot, or even exercise).

Drink a caffeinated beverage (coffee, Drink a caffeinated beverage (coffee, tea, colas) to help maintain alertness tea, colas) to help maintain alertness during the shift. during the shift.

Don't leave the most tedious or boring Don't leave the most tedious or boring tasks to the end of your shift when you tasks to the end of your shift when you are apt to feel the drowsiest. Night shift are apt to feel the drowsiest. Night shift workers are most sleepy around 4-5 workers are most sleepy around 4-5 a.m. a.m.

Exchange ideas with your colleagues on Exchange ideas with your colleagues on ways to cope with the problems of shift ways to cope with the problems of shift work. Set up a support group at work work. Set up a support group at work so that you can discuss these issues and so that you can discuss these issues and learn from each other. learn from each other.

Here are some tips for Here are some tips for sleeping during the day:sleeping during the day:

Wear dark glasses to block out the Wear dark glasses to block out the sunlight on your way home. sunlight on your way home.

Keep to the same bedtime and wake time Keep to the same bedtime and wake time schedule, even on weekends. schedule, even on weekends.

Eliminate noise and light from your sleep Eliminate noise and light from your sleep environment (use eye masks and ear environment (use eye masks and ear plugs). plugs).

Avoid caffeinated beverages and foods Avoid caffeinated beverages and foods close to bedtime. close to bedtime.

Avoid alcohol; although it may seem to Avoid alcohol; although it may seem to improve sleep initially, tolerance develops improve sleep initially, tolerance develops quickly and it will soon disturb sleep.quickly and it will soon disturb sleep.

HOW can we make a HOW can we make a difference?difference?

New LawsNew Laws

"Maggie's Law" Introduced "Maggie's Law" Introduced in Congress in Congress

The first federal bill focusing on drowsy driving was The first federal bill focusing on drowsy driving was introduced in the House of Representatives in October 2002 introduced in the House of Representatives in October 2002 by Rep. Robert Andrews (D-NJ). The bill calls for incentives for by Rep. Robert Andrews (D-NJ). The bill calls for incentives for states and communities to develop traffic safety programs to states and communities to develop traffic safety programs to reduce crashes related to driver fatigue and sleep deprivation. reduce crashes related to driver fatigue and sleep deprivation. The legislation also calls for training for police officers, the The legislation also calls for training for police officers, the creation of driver's education curriculum, standardized creation of driver's education curriculum, standardized reporting of fatigue-related crashes on police report forms, reporting of fatigue-related crashes on police report forms, and the promotion of countermeasures such as continuous and the promotion of countermeasures such as continuous shoulder rumble strips and rest areas. shoulder rumble strips and rest areas.

The bill, HR 5543, is called "Maggie's Law: National Drowsy The bill, HR 5543, is called "Maggie's Law: National Drowsy Driving Act of 2002." It was named after Maggie McDonnell, a Driving Act of 2002." It was named after Maggie McDonnell, a 20-year old college student from Andrews' congressional 20-year old college student from Andrews' congressional district in New Jersey who was killed by a drowsy driver on district in New Jersey who was killed by a drowsy driver on July 20, 1997 at 11:30 a.m. when the car she was driving was July 20, 1997 at 11:30 a.m. when the car she was driving was hit head-on by a van that had crossed three lanes of traffic. hit head-on by a van that had crossed three lanes of traffic. The driver of the van told police he had not slept in 30 hours; The driver of the van told police he had not slept in 30 hours; he also admitted to smoking crack cocaine hours before the he also admitted to smoking crack cocaine hours before the accident. Since the jury wasn't allowed to consider driver accident. Since the jury wasn't allowed to consider driver fatigue as a factor, he was only convicted of careless driving fatigue as a factor, he was only convicted of careless driving and fined $200. and fined $200.

Before “hitting the road”Before “hitting the road”

Get adequate sleep—most adults need 7-9 Get adequate sleep—most adults need 7-9 hours to maintain proper alertness during hours to maintain proper alertness during the day the day

Schedule proper breaks—about every 100 Schedule proper breaks—about every 100 miles or 2 hours during long trips miles or 2 hours during long trips

Arrange for a travel companion—someone Arrange for a travel companion—someone to talk with and share the driving to talk with and share the driving

Avoid alcohol and sedating medications—Avoid alcohol and sedating medications—check your labels or ask your doctorcheck your labels or ask your doctor

Counter measures to Prevent a Counter measures to Prevent a Fall-Asleep Crash While Fall-Asleep Crash While

DrivingDriving

Difficulty focusing, frequent blinking, or heavy Difficulty focusing, frequent blinking, or heavy eyelids eyelids

Daydreaming; wandering/disconnected thoughts Daydreaming; wandering/disconnected thoughts Trouble remembering the last few miles driven; Trouble remembering the last few miles driven;

missing exits or traffic signs missing exits or traffic signs Yawning repeatedly or rubbing your eyes</LIYawning repeatedly or rubbing your eyes</LI Trouble keeping your head up Trouble keeping your head up Drifting from your lane, tailgating, or hitting a Drifting from your lane, tailgating, or hitting a

shoulder rumble strip shoulder rumble strip Feeling restless and irritable Feeling restless and irritable

Here are some signs should Here are some signs should tell a driver to stop and rest:tell a driver to stop and rest:

Stop driving—pull off at the next exit, rest area or Stop driving—pull off at the next exit, rest area or find a place to sleep for the night find a place to sleep for the night

Take a nap—find a safe place to take a 15 to 20-Take a nap—find a safe place to take a 15 to 20-minute nap minute nap

Consume caffeine—the equivalent of 2 cups of Consume caffeine—the equivalent of 2 cups of coffee can increase alertness for several hours coffee can increase alertness for several hours

Try consuming caffeine before taking a short nap Try consuming caffeine before taking a short nap to get the benefits of bothto get the benefits of both

Try consuming caffeine before taking a short nap Try consuming caffeine before taking a short nap to get the benefits of both to get the benefits of both

Countermeasures to Countermeasures to Prevent a Fall-Asleep Prevent a Fall-Asleep Crash While DrivingCrash While Driving

The National Highway TrafficThe National Highway TrafficSafety Administration (NHTSA)Safety Administration (NHTSA)estimates conservatively that estimates conservatively that each year drowsy driving "iseach year drowsy driving "isresponsible for at least 100,000 responsible for at least 100,000 automobile crashes, 71,000 automobile crashes, 71,000 injuries, and 1,550 fatalities." injuries, and 1,550 fatalities." But among all the major factors But among all the major factors that cause or contribute to crashes, like that cause or contribute to crashes, like

speeding, alcohol use, and weather speeding, alcohol use, and weather situations, drowsiness is the most difficult for situations, drowsiness is the most difficult for police and other crash investigators to detect police and other crash investigators to detect and quantify.and quantify.

Please take all possible precautions to protect Please take all possible precautions to protect yourself and your loved ones from a drowsy yourself and your loved ones from a drowsy driving crash. driving crash.

Caffeine -- does it help?Caffeine -- does it help?

Caffeine promotes short-term Caffeine promotes short-term alertness. It takes about 30 minutes alertness. It takes about 30 minutes for caffeine to begin working so the for caffeine to begin working so the best thing to do is pull over for a best thing to do is pull over for a coffee or other caffeinated beverage, coffee or other caffeinated beverage, take a short nap, and then get back take a short nap, and then get back on the road. Keep in mind that on the road. Keep in mind that caffeine won’t have much of an effect caffeine won’t have much of an effect on people who consume it regularly.on people who consume it regularly.

How much do How much do you you reallyreally know know about caffeine? about caffeine?

Let’s your Let’s your Caffeine IQ right Caffeine IQ right

now!now!

1. Caffeine can take 1. Caffeine can take effect in as little as effect in as little as 15 minutes.15 minutes.

True True

FalseFalse Caffeine enters the bloodstream through Caffeine enters the bloodstream through

the stomach and small intestine and in the stomach and small intestine and in most cases it takes about 30 minutes to most cases it takes about 30 minutes to take effect. The equivalent of 2 cups of take effect. The equivalent of 2 cups of coffee can increase alertness for several coffee can increase alertness for several hours.hours.

2. If you drink too much alcohol, 2. If you drink too much alcohol, make coffee. The caffeine will make coffee. The caffeine will help you sober up.help you sober up.

True True

FalseFalse Caffeine will not reduce the effects of Caffeine will not reduce the effects of

alcohol, although it is a common myth alcohol, although it is a common myth that a cup of coffee will "sober up" an that a cup of coffee will "sober up" an intoxicated person.intoxicated person.

3. There is reason to restrict your 3. There is reason to restrict your children's caffeine consumption.children's caffeine consumption.

True True FalseFalse Although caffeine is safe to consume in Although caffeine is safe to consume in

moderation, it may negatively affect a child's moderation, it may negatively affect a child's nutrition. Caffeinated beverages may be nutrition. Caffeinated beverages may be replacing nutrient-dense foods such as milk replacing nutrient-dense foods such as milk and calcium also blocks absorption of some and calcium also blocks absorption of some nutrients, like calcium. A child may also eat nutrients, like calcium. A child may also eat less because caffeine acts as an appetite less because caffeine acts as an appetite suppressantsuppressant

4. Chocolate has the same amount 4. Chocolate has the same amount of caffeine as a soda or tea.of caffeine as a soda or tea.

True True

FalseFalse According to the International Food Information According to the International Food Information

Council (IFIC) Foundation, chocolate does contain Council (IFIC) Foundation, chocolate does contain caffeine, but not much. An 8-ounce carton of caffeine, but not much. An 8-ounce carton of chocolate milk contains about 5 milligrams of chocolate milk contains about 5 milligrams of caffeine and an 8-ounce milk chocolate bar caffeine and an 8-ounce milk chocolate bar contains about 40 milligrams of caffeine, contains about 40 milligrams of caffeine, compared with a typical range of 88-160 compared with a typical range of 88-160 milligrams of caffeine in 8 ounces of regular-brew milligrams of caffeine in 8 ounces of regular-brew coffee.coffee.

5. A 16-ounce coffee has more 5. A 16-ounce coffee has more caffeine thancaffeine than

a No-Doze pill.a No-Doze pill.

True True FalseFalse A maximum strength No-Doze pill has A maximum strength No-Doze pill has

200mg of caffeine compared with 200mg of caffeine compared with about 220mg found in a 16-ounce cup about 220mg found in a 16-ounce cup of brewed coffeeof brewed coffee

True True FalseFalse

Although caffeine is not inter-changeable with Although caffeine is not inter-changeable with sleep, it can promote short-term alertness. If you sleep, it can promote short-term alertness. If you begin to feel fatigued, pull over to a safe place to begin to feel fatigued, pull over to a safe place to drink coffee or another caffeinated beverage, take a drink coffee or another caffeinated beverage, take a short nap (15-30 minutes) and then get back on the short nap (15-30 minutes) and then get back on the road. Keep in mind that if you regularly consume road. Keep in mind that if you regularly consume caffeine it may not have as strong an effect. caffeine it may not have as strong an effect. Ultimately, the best thing to do if you become Ultimately, the best thing to do if you become drowsy while driving is to change drivers or pull off drowsy while driving is to change drivers or pull off the road to a rest area and find a place to sleep.the road to a rest area and find a place to sleep.

6. Caffeine can act as a countermeasure to6. Caffeine can act as a countermeasure to prevent a fall-asleep crash.prevent a fall-asleep crash.

7. Over-the-counter pain medication has 7. Over-the-counter pain medication has more caffeine than brewed tea.more caffeine than brewed tea.

True True FalseFalse According to the Excedrin web site, each According to the Excedrin web site, each

extra strength pill has 65 milligrams of extra strength pill has 65 milligrams of caffeine. An 8-ounce brewed tea typically caffeine. An 8-ounce brewed tea typically contains 40 milligrams of caffeine, though contains 40 milligrams of caffeine, though the range of caffeine content can be the range of caffeine content can be anywhere between 20 and 90 mg depending anywhere between 20 and 90 mg depending on how it is brewed. If you take the on how it is brewed. If you take the recommended two capsules of Excedrin you recommended two capsules of Excedrin you will consume the equivalent of almost one will consume the equivalent of almost one and a half Red Bull drinks.and a half Red Bull drinks.

Typically 8-ounce caffeinated soft drinks contain between 20 and 40 mg of caffeine, compared to an 8-ounce coffee which could contain as much as 160 milligrams of caffeine. Caffeine is found naturally in coffee, tea and chocolate and added to cola products.

8. An 8-ounce cup of coffee contains 3 or 4 times more caffeine than a caffeine cola.

True False

9. It is more healthy to quit 9. It is more healthy to quit caffeine altogether.caffeine altogether.

TrueTrue

FalseFalse

In 1958, the U.S. Food and Drug Administration In 1958, the U.S. Food and Drug Administration (FDA) classified caffeine as Generally Recognized (FDA) classified caffeine as Generally Recognized As Safe (GRAS). In 1987, the FDA reaffirmed its As Safe (GRAS). In 1987, the FDA reaffirmed its position that normal caffeine intake produced no position that normal caffeine intake produced no increased risk to health. In addition, both the increased risk to health. In addition, both the American Medical Association and the American American Medical Association and the American Cancer Society have statements confirming the Cancer Society have statements confirming the safety of moderate caffeine consumption. safety of moderate caffeine consumption. Nevertheless, if caffeine is being used as a Nevertheless, if caffeine is being used as a substitute for sleep or for more nutritious substitute for sleep or for more nutritious beverages this is not recommended.beverages this is not recommended.

Finally, if you have trouble falling Finally, if you have trouble falling asleep, maintaining sleep, awaken asleep, maintaining sleep, awaken earlier than you wish, feel unrefreshed earlier than you wish, feel unrefreshed after sleep or suffer from excessive after sleep or suffer from excessive sleepiness during the day or when you sleepiness during the day or when you wish to be alert, you should also consult wish to be alert, you should also consult your physician. Be sure to tell him/her your physician. Be sure to tell him/her the efforts you have made to achieve the efforts you have made to achieve better sleep and for how long you have better sleep and for how long you have tried them. tried them.