A good night’s sleep seems to elude many of us. A recent study conducted by the Consumer Reports National Research Center found that about half of respondents either had trouble falling asleep, difficulty staying asleep, or wake up too early. Sleeplessness can affect your daily performance at work, school, and on the road. Drowsy driving crashes can be hard to detect due to difficult and unreliable reporting, but the National Highway Traffic Safety Administration (NHTSA) estimates there are about 100,000 sleep-related crashes per year and 1,550 fatalities.

A 2005 survey from the National Sleep Foundation found 60 percent of drivers (168 million people) drove while drowsy in the past year and more than a third have fallen asleep behind the wheel. Four percent of these people, or 11 million drivers say they have either been in an accident or almost had an accident.

We’ve all been there—trying to stay awake while driving. Using all the tactics such as opening the window, playing loud music, and drinking caffeine, but the best and safest remedy is to pull over and take a short snooze or not drive at all if you’re tired.

Sleeplessness can lead to slow reaction time, poor vision, missed exits or traffic signs, and trouble staying in the lane. This puts the driver, as well as others on the road, in serious danger. The effects have been compared to driving while drunk.

The groups that are most at risk for drowsy driving are young males under age 26, shift workers, commercial drivers, and those with untreated or undetected sleep disorders. However, there are some things that can be done.

A number of trucking companies are screening their drivers for sleep disorders, such as apnea and helping them to receive treatment. They are also looking at studying the effects of installing a drowsy driving warning system in their rigs. NHTSA recently conducted a prototype study on these devices and found that it could have a positive impact on driver safety, but there are still a number of considerations such as cost to companies and driver acceptance.

For young people, a number of states have instituted graduated licensing laws that help build driving experience through a multi-stage program. One part of the program is a restriction on nighttime driving, which has helped to reduce accidents and deaths by up to 60 percent.

So, what else can be done? Here are some tips to help reduce or prevent drowsy driving.

• Get adequate sleep before you get in the car.
• Take breaks—especially if driving a long distance.
• Arrange for a travel companion to swap driving duties.
• Avoid alcohol and/or medications that can cause drowsiness.
• If feeling tired, pull off the road and nap for 15-20 minutes.
• Caffeine may help, but can take some time to get into your system and when it wears off can leave you even more tired.
• If you have a teen driver, implement your own nighttime driving restrictions.
• Drinking a good quantity of water helps as it prevents dehydration that can cause drowsiness. It also requires you to pull over regularly and stretch your legs for a bathroom break.

—Liza Barth

New York City has a number of nicknames such as the Big Apple and Gotham, but now it can add another distinction—America’s Road Rage capital. According to the annual study by the Affinion Group, NYC tops the list as the least courteous U.S. city to drive in, up from its third place finish last year. It rudely took the title away from Miami. The city with the least road rage was Portland, Oregon, up from second place last year. See the list of top five best and worst cities below.

Cities with the worst road rage:

1. New York City
2. Dallas/Ft. Worth
3. Detroit
4. Atlanta
5. Minneapolis/St. Paul

Cities with the least angry drivers:

1. Portland, OR
2. Cleveland
3. Baltimore
4. Sacramento
5. Pittsburgh

The study was conducted via telephone (though not while driving!) between January and March 2009 with 2,518 interviews in 25 major metro areas.

Besides determining the best and worst cities for driving, the study also looked at driving habits and attitudes. The major causes of road rage, as determined by the study, includes aggressive driving, angry drivers, people in a hurry, traffic problems, and selfish drivers who are inconsiderate on the road.

The respondents noted behaviors by other drivers that can lead to road rage such as drivers who talk on the cell phone (which 84 percent of respondents see every day), speeding (58 percent), tailgating (53 percent), eating or drinking behind the wheel (48 percent), or texting while driving (37 percent).

In response to bad driving by others, those surveyed admitted to honking their horn (which 43 percent say they do every month), cursing, waving arms or fists, or making obscene gestures.

Road rage is a dangerous issue that can lead to car crashes, violence, and even death. In order to avoid becoming a victim of road rage, here is some advice for motorists:

• Stay in the right lane when not passing.
• Don’t tailgate.
• Use your directional signal when changing lanes or turning.
• Don’t honk your horn unnecessarily.
• If you see an aggressive driver, move out of the way.
• Be courteous to other drivers.
• Pay attention to the road.
• Never get out of your car to confront an aggressive driver.

While drivers who resort to violence on the road clearly have issues, aggressive driving behavior is mostly caused by stress. Here are some tips to avoid a meltdown behind the wheel.

• Plan ahead. If you’re not rushed, you won’t be as stressed.
• Get plenty of rest. (See our report on drowsy driving.)
• Know how you will get to your destination. (See our Ratings of GPS navigation systems.)
• Make sure your car is in good shape. (See our guide to car maintenance.)
• Try to wind down before your get behind the wheel.
• Develop coping strategies to avoid a blow up such as listening to calming music or a book on tape. Making good use of your time will reduce the stress delays cause.
• If you find yourself reaching a boiling point, pull over and take a break.

--Liza Barth