Awake at the wheel: how auto technology innovations present ongoing sleep challenges and new safety opportunities.

Individuals and society are dependent on transportation. Individuals move about their world for work, school, healthcare, social activities, religious and athletic events, and so much more. Society requires the movement of goods, food, medicine, etc.

Obstructive sleep apnea screening, diagnosis, and treatment in the transportation industry.

Unlabelled: Obstructive sleep apnea (OSA) is a common, identifiable, and treatable disorder with serious health, safety, and financial implications-including sleepiness- related crashes and incidents-in workers who perform safety-sensitive functions in the transportation industry. Up to one-third of crashes of large trucks are attributable to sleepiness, and large truck crashes result in more than 4,000 deaths annually. For each occupant of a truck who is killed, 6 to 7 occupants of other vehicles are killed.

Enhancing public health and safety by diagnosing and treating obstructive sleep apnea in the transportation industry: an American Academy of Sleep Medicine position statement.

Unlabelled: Obstructive sleep apnea (OSA) may lead to serious health, safety, and financial implications-including sleepiness-related crashes and incidents-in workers who perform safety-sensitive functions in the transportation industry. Evidence and expert consensus support its identification and treatment in high-risk commercial operators. An Advanced Notice of Proposed Rulemaking regarding the diagnosis and treatment of OSA in commercial truck and rail operators was issued by the Federal Motor Carrier Safety Administration and Federal Railroad Administration, but it was later withdrawn.

Asleep at the Wheel-The Road to Addressing Drowsy Driving.

Drowsy driving is a dangerous behavior that leads to thousands of deaths and injuries each year. It is also a controllable factor for drivers. Drivers are capable of modifying this behavior if given sufficient information and motivation.

Fatigue in transportation: NTSB investigations and safety recommendations.

Objective: We aim to place into the scientific literature information on the prevalence of operator fatigue as a factor in causing transportation mishaps, and the categories of improvements identified to address fatigue in transportation.

Methods: We analyzed the number of major National Transportation Safety Board (NTSB) investigations that identified fatigue as a probable cause, contributing factor, or a finding. We divided all NTSB recommendations addressing fatigue issued since the agency was founded into 7 subject categories, and placed each recommendation into the appropriate category.

Pilot fatigue survey: exploring fatigue factors in air medical operations.

Introduction: Humans confront significant physiological challenges with sleep and alertness when working in 24/7 operations.

Methods: A web-based national survey of air medical pilots examined issues relevant to fatigue and sleep management.

Results: Six hundred ninety-seven responses were received, with a majority of rotor wing pilots working 3/3/7 and 7/7 duty schedules.

Sleep disorders and work performance: findings from the 2008 National Sleep Foundation Sleep in America poll.

Chronic sleep deprivation is common among workers, and has been associated with negative work outcomes, including absenteeism and occupational accidents. The objective of the present study is to characterize reciprocal relationships between sleep and work. Specifically, we examined how sleep impacts work performance and how work affects sleep in individuals not at-risk for a sleep disorder; assessed work performance outcomes for individuals at-risk for sleep disorders, including insomnia, obstructive sleep apnea (OSA) and restless legs syndrome (RLS); and characterized work performance impairments in shift workers (SW) at-risk for shift work sleep disorders relative to SW and day workers.

Insomnia risks and costs: health, safety, and quality of life.

The effect of insomnia on next-day functioning, health, safety, and quality of life results in a substantial societal burden and economic cost. The annual direct cost of insomnia has been estimated in the billions of US dollars and is attributed to the association of insomnia with the increased risk of certain psychiatric and medical comorbidities that result in increased healthcare service utilization. It is well known that psychiatric conditions, anxiety and depression in particular, are comorbid with insomnia.

Impact of nighttime awakenings on worker productivity and performance.

Objective: To describe the relationship between nighttime awakenings and work performance.

Methods: Employees (N = 4188) at four US companies described their sleep patterns and completed the Work Limitations Questionnaire. Participants were categorized by number of nighttime awakenings: 0 (n = 464; 11%), 1 to 2 (n = 2373; 58%), 3 to 4 (n = 984; 24%), or > or =5 (n = 289; 7%).

The cost of poor sleep: workplace productivity loss and associated costs.

Objective: To assess the impact of sleep disturbances on work performance/productivity.

Methods: Employees (N = 4188) at four US corporations were surveyed about sleep patterns and completed the Work Limitations Questionnaire. Respondents were classified into four categories: insomnia, insufficient sleep syndrome, at-risk, and good sleep.

Alertness management in aviation operations: enhancing performance and sleep.

Introduction: Fatigue is an acknowledged safety risk in diverse operational settings. As a result, there has been growing interest in developing and implementing activities to improve alertness, performance, and safety in real-world operations where fatigue is a factor.

Methods: A comprehensive Alertness Management Program (AMP) that included education, alertness strategies, scheduling, and healthy sleep was implemented in a commercial airline.

Improving alertness and performance in emergency department physicians and nurses: the use of planned naps.

Study Objective: We examine whether a 40-minute nap opportunity at 3 AM can improve cognitive and psychomotor performance in physicians and nurses working 12-hour night shifts.

Methods: This is a randomized controlled trial of 49 physicians and nurses working 3 consecutive night shifts in an academic emergency department. Subjects were randomized to a control group (no-nap condition=NONE) or nap intervention group (40-minute nap opportunity at 3 AM=NAP).

Underestimating the societal costs of impaired alertness: safety, health and productivity risks.

Modern society now operates on a 24/7 global basis, with around-the-clock requirements that often ignore sleep, circadian rhythms, irregular work schedules and geographical time zones. Despite overwhelming evidence, there is gross underestimation and very little acknowledgement of the risks and costs related to sleep loss, circadian disruption, sleep disorders, reduced alertness and performance. Understanding the specific factors that impede our progress in addressing impaired alertness as an important societal issue could lead to raised awareness of the risks and costs and subsequent implementation of change.