Systems and methods are disclosed for occupant alertness-based navigation. An example vehicle includes a camera and an occupant monitor. The example camera is affixed to a rear-view mirror of the vehicle to detect drowsiness events associated with a driver. The example occupant monitor is to, in response to detecting, with the camera, a first drowsiness event, provide feedback to a driver. Additionally, the example occupant monitor is to, in response to detecting a second drowsiness event after the first, select an accommodation in the geographic vicinity of the vehicle, and set a navigation system to navigate to the selected accommodation.