WEDNESDAY, Nov. 4 (HealthDay News) -- One percent of U.S. drivers -- 1.9 million people -- have had accidents or near-misses over the past year because they were driving while sleepy, a new survey finds.

Also, more than half of drivers surveyed admitted that they've driven over the last year while feeling drowsy, and 28 percent said they drive while sleepy at least once a month, according to the survey sponsored by the National Sleep Foundation.

"People underestimate how tired they are and think that they can stay awake by sheer force of will," Thomas Balkin, chairman of the National Sleep Foundation, said in a news release about the 2009 Sleep in America poll. "This is a risky misconception. Would there be 1.9 million fatigue-related crashes or near misses if people were good at assessing their own ability to drive when fatigued?" he asked.

"The problem is that although we are pretty good at recognizing when we feel sleepy, we do not recognize the process of actually falling asleep as it is happening," Balkin said. "The process robs us of both self-awareness and awareness of our environment. All it takes is a moment of reduced awareness to cause a crash."

Research has suggested that not sleeping for more than 20 hours can make people as impaired as if they were drunk. Sleepiness slows reaction times, makes people less aware and impairs their judgment, researchers say.

What do the experts suggest? The National Sleep Foundation recommends that you watch out for these warning signs:

• Difficulty focusing, heavy eyelids and difficulty avoiding daydreams
• Nodding, forgetting the last few miles you've driven, and repeated yawning
• Restlessness and irritability

If you do feel sleepy on the road, turn the wheel over to a buddy and take a nap.

Caffeinated beverages or caffeinated gum can keep you more alert for a few hours. You could even drink a caffeinated beverage and take a quick nap -- 20 to 30 minutes -- before it kicks in.

But remember, caffeine is no replacement for sleep. You'll still need to get some shuteye.

More information

Learn more about sleep from the National Sleep Foundation  .

TUESDAY, Nov. 3 (HealthDay News) -- Depressed people tend to report more physical symptoms than they actually experience, a new study finds.

The study involved 109 women who completed questionnaires designed to assess their levels of neuroticism and depression. For the next three weeks, they kept daily records of whether they felt any of 15 common physical symptoms, including aches and pains, gastrointestinal problems and upper-respiratory issues.

At the end of the three-week period, the women were asked to recall how often they'd experienced each symptom. Those who had a higher depression score at the start of the study were more likely to overstate the frequency of their symptoms.

"People who felt depressed made the most errors when asked to remember their physical symptoms," psychologist Jerry Suls, a professor and collegiate fellow at the University of Iowa said in a university news release. "They tended to exaggerate their experience."

It's long been believed that a high level of neuroticism -- a general disposition that includes irritability, sadness, anxiety and fear -- is associated with exaggerated reporting of physical symptoms. But the study suggests that a more likely reason is depression.

"For 30 years, the hypothesis has been that neuroticism is behind inflated reports of symptoms," Suls said. "We're saying no -- depression appears to be the big player. We discovered that people high in neuroticism but low in depression are not likely to mis-remember symptoms."

The findings, published online Oct. 15 in Psychosomatic Medicine, are important, Suls said, because symptoms reported by patients play a major role in doctors' diagnosis and treatment decisions.

"Depressed individuals and their physicians shouldn't discount common symptoms because they can indicate serious problems," he said. "However, since we now know that depressed individuals tend to over-remember the frequency of symptoms, it wouldn't hurt to encourage patients to write down their symptoms as they're happening. That way the patient and doctor have an accurate record of what has been going on, rather than relying on memory."

More information

The U.S. National Institute of Mental Health has more about depression.

MONDAY, Nov. 2 (HealthDay News) -- The first head-to-head comparison of different quit-smoking products finds that a nicotine patch combined with a nicotine lozenge had the most success.

More than other methods, including antidepressants, this combination best mimics the actual highs and lows of smoking to help smokers kick their habit, experts said.

"The study shows that, yes, one therapy came out on top, the patch and the lozenge [together]," said Dr. Jonathan H. Whiteson, co-director of the Joan and Joel Smilow Cardiopulmonary Rehabilitation and Prevention Center at NYU Langone Medical Center in New York City.

"The reasoning behind it is that the patch supplies a steady supply of nicotine replacement and the lozenges give a boost of nicotine which you can use when you have an extra craving. It gives people control," said Whiteson, who was not involved in the research.

"If you combine these different types of nicotine replacement you're going to get the best bang for your buck," added Megan E. Piper, lead author of the new study and an assistant professor at the Center for Tobacco Research and Intervention at the University of Wisconsin, Madison. "But also remember that in this study people got a lot of counseling. It was that combination that resulted in a 40 percent quit rate [at six months out]."

In fact, coupling the patch with the lozenge was the only intervention that performed better than a placebo, reported the study, which appears in the November issue of the Archives of General Psychiatry.

The study adds insight to a field that's long suffered from too little research. "As each medication comes out, it is tested against a placebo," but not against other methods, Piper explained. "There just hasn't been the funding or the availability of a program to do something like that."

This research was funded by the U.S. National Institutes of Health. Medication was provided free by drug maker GlaxoSmithKline. Several of the study authors reported financial ties to different pharmaceutical companies.

For this study, 1,504 adults who had smoked at least half a pack a day for the past six months and wanted to quit were randomly assigned to a placebo or one of five different quit-smoking interventions: nicotine lozenge, nicotine patch, bupropion (Wellbutrin, an antidepressant), nicotine patch plus nicotine lozenge, and bupropion plus nicotine lozenge. All groups received six individual counseling sessions with a case manager.

The nicotine patch, which has been available for more than two decades, is currently the most widely used pharmacotherapy to help people quit smoking.

However, only the combination of the nicotine patch and the lozenge performed significantly better than placebo six months after the person smoked their last cigarette, the team found.

People taking the patch-lozenge combination were also more likely to have sworn off cigarettes after one week and were more likely to have attained one full day without smoking, the researchers said.

The 40 percent (at six months) success rate reported here will decline as time goes on, Whiteson noted. He added, however, that in the smoking cessation arena, "even the 30 percent range is very good."

Another expert said the study raised some key concerns. "The question is, how many of them had to continue on the lozenge in order to stay off cigarettes? I always tell people not to do the lozenge alone because it mimics the very thing that smoking does, which gives you a spike. Then, when you reach a trough, you pick up a lozenge -- or cigarette," said Dr. Len Horovitz, a pulmonary specialist with Lenox Hill Hospital in New York City. "Once they stopped everything, could they do without the spikes and troughs [of the lozenge], which mimics physiologically everything the cigarette is doing? Smoking is a two-pronged problem. There's nicotine dependence and a behavioral aspect to it."

Dr. Elliot Wineburg, assistant clinical professor of psychiatry at Mount Sinai School of Medicine in New York City, felt the study suffered from some limitations, namely lack of individual attention to individual smokers' habits.

"The authors said that they gave the patients lozenges according to the company's [instructions]," he said. But this doesn't take into account how much people smoke or how strong their cigarettes are. "They don't even look into the amount of nicotine a person takes."

More information

There's more tips on successfully quitting smoking at the American Cancer Society  .

FRIDAY, Oct. 30 (HealthDay News) -- The emergence of antibiotic-resistant bacteria continues to present a major public health problem, said scientists gathering at one of the world's largest infectious diseases meetings Friday.

Chief among the concerns are resistant gram-negative bacteria and bacteria that appears to be infecting younger and otherwise healthier people. The troubling trend is compounded by another concerning fact: a paucity of new antibiotics coming down the pipeline, they added.

"Antibiotic development is dying, and we are running out of drugs. We have organisms that are already resistant to every antibiotic we can throw at them," said Dr. Brad Spellberg, a member of the Infectious Diseases Society of America's (IDSA) Antimicrobial Availability Task Force and an assistant professor of medicine at UCLA. "What will be increasingly seen in the coming decade is a dramatic decline in the availability of new antibiotics, which are desperately needed."

Spellberg spoke during a teleconference from the IDSA annual meeting in Philadelphia.

Antibiotic resistance, even to new drugs, has become such an issue with nasty gram-negative bacteria that clinicians have had to reach back into the arsenal, resurrecting a drug that hadn't been used much in 20 years, polymyxin.

But now pathogens are becoming resistant to that drug as well, analysis of lab samples at one New York City hospital showed.

"Although the prevalence of gram-negative bacteria resistant to polymyxin is currently at a relatively low level of around 6 percent, we noted over a relatively short two-year timeframe that the prevalence of resistance to that agent increased by about 50 percent," said Dr. Jason Kessler, lead author of a study detailing the findings, which are scheduled to be presented at the meeting.

"In addition, amongst all of the isolates we evaluated, more than 30 percent demonstrated resistance to at least five classes of antibiotics, meaning that most of those isolates or most of those bacteria probably could only be treated with polymyxin, suggesting the prevalence of very highly drug-resistant gram-negative infection is on the rise in our facility," added Kessler, who is a clinical fellow in the division of infectious diseases at Columbia University in New York City.

Other infections are targeting younger people and moving from hospitals into the community and back into hospitals.

Clostridium difficile, a common hospital infection, for instance, is now hitting people who have not been in the hospital. These patients have a median age of 53, versus a median age of 70 in hospitals, said Dr. Ghinwa Dumyati, lead author of this study and an associate professor of medicine at the University of Rochester School of Medicine and Dentistry.

It's not clear exactly where these community cases are coming from, but many of the people, although healthy, were taking antibiotics, suggesting that the medications "are still an important factor in the development of C. difficile in the community," Dumyati said.

Similarly, methicillin-resistant Staphylococcus aureus (MRSA) is causing severe illness in younger, healthy people, although the infections are not resulting in either death or long hospital stays, according to another study. The fact that the patients were younger and healthier may have decreased the risk of death," said study author Dr. Fernanda Lessa, of the U.S. Centers for Disease Control and Prevention.

MRSA infections in emergency rooms have increased 211 percent between 2000 and 2008, another study found. The incidence in multi-drug-resistant Acinetobacter baumannii, a gram-negative bacteria, is also on the rise, largely in the hospital, said researchers from Henry Ford Hospital in Detroit.

On the more positive side, a meta-analysis of studies on extremely drug-resistant tuberculosis found that newer versions of antibiotics known as fluoroquinolones did seem to help people with this infection.

These findings are ironic, said Dr. Neil Fishman, chair of the IDSA Antimicrobial Resistance Work Group and director of the Antimicrobial Management Program for the University of Pennsylvania Health System. "Fluoroquinolones have been implicated in causing a lot of problems with resistance and, to some extent, fluoroquinolones are the schoolyard bully of resistance," he said. Proper "stewardship," or prudent use of antibiotics would help curb this trend, he added.

Experts at the teleconference also expressed hope that the attention being focused on H1N1 (swine) flu right now could act as a "wedge" issue, to further spotlight the antibiotic problem. For the moment, however, H1N1 is eclipsing the resistance issue, even though many people succumbing to H1N1 also end up with bacterial infections.

More information

The U.S. Centers for Disease Control and Prevention has more on antibiotic resistance.