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Physicians who are alert to the possible neurologic, psychiatric, general medical, and pharmacologic causes of excessive daytime somnolence are in a position to prevent at least some of the automobile accidents that result from falling asleep at the wheel. In addition, physicians have a vested interest in the related legal and ethical concerns. As the authors point out, giving appropriate advice, diagnosing and treating conditions causing somnolence, and exercising care in prescribing medications are important preventive measures.