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It is estimated that at least 100,000 crashes a year result from tired drivers. Drowsy driving, the dangerous combination of sleepiness and driving or driving while fatigued, and can result from many underlying causes, including excessive sleepiness, sleep deprivation, changes in circadian rhythm due to shift work, fatigue, medications with sedatives and consuming alcohol when tired. The cumulative effects of these factors have severe effects on performance, alertness, memory, concentration and reaction times.