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Pages 12-26

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From page 12...
... If commercial drivers cannot obtain 7 to 8 h of continuous sleep, they then need to augment the sleep they obtain by taking supplemental naps each day (O'Neill et al. 1996; Krueger 1989, 1997, 2003)
From page 13...
... NIDA lists the following as street names for benzodiazepines: candy, benzos, downers, nerve pills, sleeping pills, and tranks. Benzodiazepines are marketed as mild or minor tranquilizers, sedatives, hypnotics, or anticonvulsants based to some extent on differences in their time-of-action, which ranges from less than 6 h to more than 24 h.
From page 14...
... reported 10 mg of zaleplon was without effect on cognitive performance measured 4 h after ingestion. To avoid any possible memory difficulties, zaleplon can be taken up to 4 h before planned time of arising and returning to work (Paul et al.
From page 15...
... offers potential in select commercial driving applications for initiating naps of from 1 to 4 h, especially at times when it is otherwise difficult to fall asleep. Research specific to the commercial driving needs must confirm that there are no residual inertia effects that could interfere with safe applications meeting the needs of the commercial driving sector.
From page 16...
... In contrast, triazolam showed dose-related effects on a wide range of subject-rated, observer-rated, and motor and cognitive performance measures, consistent with its profile as a sedative drug with abuse liability. Johnson et al.
From page 17...
... and lorazepam (2 mg, twice per day) driving performance was impaired more than it was by a BAC of 1 mg/mL (O'Hanlon et al.
From page 18...
... These are outlined here. Alterialâ„¢ Alterial is an OTC, all-natural sleep inducer, which claims to help people fall asleep fast, stay asleep longer, and improve the quality of sleep all night long.
From page 19...
... . The benefits of both natural secretions of melatonin and applications of synthetic melatonin (available in pill or tablet form in health food stores)
From page 20...
... In some European countries, synthetic melatonin is classified as a neurohormone and it cannot be sold over the counter. In the United States, synthetic melatonin is readily available in pill form and is inexpensive (a month's supply costs $12 to $20 at many health food stores)
From page 21...
... Melatonin offers promise as a sleep-inducing aid for commercial drivers, especially for their use as an aid to induce naps during the daytime. Importantly, this topic suggests that some additional research may be needed to work out "sleep and alertness management protocols and fatigue countermeasures" for proper and appropriate use of synthetic melatonin in the particular work settings of commercial drivers.
From page 22...
... For example, when it is being used as a sleep aid, 50 mg diphenhydramine should be taken approximately 30 min before bedtime. Taking diphenhydramine while also taking other sleep medicines or alcohol is not recommended, as 22 these drugs interact in the body.
From page 23...
... Such cautions are issued because maintenance levels of all first-generation antihistamines have been demonstrated to have antagonist effects on cognitive performance and because in using them as sleep aids most have been demonstrated to leave a person with hangover inertia effects long after the sleep period has ended. Commercial drivers must be properly informed of the hazards and risks of using antihistamines both for allergy relief and for use as a sleep aid.
From page 24...
... Gary Kay and his colleagues conducted laboratory experiments comparing the effects of first- with second-generation antihistamines. In a comprehensive review, Kay and colleagues reported impairments to cognitive performance attributable to second-generation nonsedating antihistamines that ranged from none to mild (Kay et al.
From page 25...
... . Cetirizine, which is demonstrated to be more sedating than the other nonsedating antihistamines, has been reported to impair cognitive performance in a number of studies (Ramaekers et al.
From page 26...
... It is not within the scope of this synthesis to propose "treatment protocols" regarding whether antihistamines could or should be used by commercial drivers, nor to be specific about when one should consider taking a particular antihistamine. Because so many commercial drivers experience seasonal discomfort attributable to allergies, rhinitis, and other ailments treatable with antihistamines, more performanceoriented research should be done with second-generation, and eventually third-generation antihistamines to determine their potential efficacy for allergy treatment (relief)


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