Impaired Performance in Commercial Drivers: Role of Sleep Apnea and Short Sleep Duration
Sleepiness plays an important role in major crashes of commercial vehicles. Because determinants are likely to include inadequate sleep and sleep apnea, we evaluated the role of short sleep durations over 1 wk at home and sleep apnea in subjective sleepiness (Epworth Sleepiness Scale), objective sle...
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Veröffentlicht in: | American journal of respiratory and critical care medicine 2006-08, Vol.174 (4), p.446-454 |
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creator | Pack, Allan I Maislin, Greg Staley, Bethany Pack, Frances M Rogers, William C George, Charles F. P Dinges, David F |
description | Sleepiness plays an important role in major crashes of commercial vehicles. Because determinants are likely to include inadequate sleep and sleep apnea, we evaluated the role of short sleep durations over 1 wk at home and sleep apnea in subjective sleepiness (Epworth Sleepiness Scale), objective sleepiness (reduced sleep latency as determined by the Multiple Sleep Latency Test), and neurobehavioral functioning (lapses in performance, tracking error in Divided Attention Driving Task) in commercial drivers. Studies were conducted in 247 of 551 drivers at higher risk for apnea and in 159 of 778 drivers at lower risk. A multivariate linear association between the sets of outcomes and risk factors was confirmed (p < 0.0001). Increases in subjective sleepiness were associated with shorter sleep durations but not with increases in severity of apnea. Increases in objective sleepiness and performance lapses, as well as poorer lane tracking, were associated with shorter sleep durations. Associations with sleep apnea severity were not as robust and not strictly monotonic. A significant linear association with sleep apnea was demonstrated only for reduced sleep latency. The effects of severe apnea (apnea-hypopnea index, at least 30 episodes/h), which occurred in 4.7%, and of sleep duration less than 5 h/night, which occurred in 13.5%, were similar in terms of their impact on objective sleepiness. Thus, addressing impairment in commercial drivers requires addressing both insufficient sleep and sleep apnea, the former being more common. |
doi_str_mv | 10.1164/rccm.200408-1146OC |
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P ; Dinges, David F</creator><creatorcontrib>Pack, Allan I ; Maislin, Greg ; Staley, Bethany ; Pack, Frances M ; Rogers, William C ; George, Charles F. P ; Dinges, David F</creatorcontrib><description>Sleepiness plays an important role in major crashes of commercial vehicles. Because determinants are likely to include inadequate sleep and sleep apnea, we evaluated the role of short sleep durations over 1 wk at home and sleep apnea in subjective sleepiness (Epworth Sleepiness Scale), objective sleepiness (reduced sleep latency as determined by the Multiple Sleep Latency Test), and neurobehavioral functioning (lapses in performance, tracking error in Divided Attention Driving Task) in commercial drivers. Studies were conducted in 247 of 551 drivers at higher risk for apnea and in 159 of 778 drivers at lower risk. A multivariate linear association between the sets of outcomes and risk factors was confirmed (p < 0.0001). Increases in subjective sleepiness were associated with shorter sleep durations but not with increases in severity of apnea. Increases in objective sleepiness and performance lapses, as well as poorer lane tracking, were associated with shorter sleep durations. Associations with sleep apnea severity were not as robust and not strictly monotonic. A significant linear association with sleep apnea was demonstrated only for reduced sleep latency. The effects of severe apnea (apnea-hypopnea index, at least 30 episodes/h), which occurred in 4.7%, and of sleep duration less than 5 h/night, which occurred in 13.5%, were similar in terms of their impact on objective sleepiness. Thus, addressing impairment in commercial drivers requires addressing both insufficient sleep and sleep apnea, the former being more common.</description><identifier>ISSN: 1073-449X</identifier><identifier>EISSN: 1535-4970</identifier><identifier>DOI: 10.1164/rccm.200408-1146OC</identifier><identifier>PMID: 16690976</identifier><language>eng</language><publisher>New York, NY: Am Thoracic Soc</publisher><subject>Abdomen ; Adult and adolescent clinical studies ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anxiety disorders. Neuroses ; Automobile Driving ; Biological and medical sciences ; H. Sleep and Control of Ventilation ; Humans ; Intensive care medicine ; Laboratories ; Least-Squares Analysis ; Male ; Medical sciences ; Middle Aged ; Neurosciences ; Occupational Health ; Post-traumatic stress disorder ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Questionnaires ; Risk Factors ; Sleep ; Sleep apnea ; Sleep Apnea Syndromes - psychology ; Sleep Deprivation - psychology ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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P</creatorcontrib><creatorcontrib>Dinges, David F</creatorcontrib><title>Impaired Performance in Commercial Drivers: Role of Sleep Apnea and Short Sleep Duration</title><title>American journal of respiratory and critical care medicine</title><addtitle>Am J Respir Crit Care Med</addtitle><description>Sleepiness plays an important role in major crashes of commercial vehicles. Because determinants are likely to include inadequate sleep and sleep apnea, we evaluated the role of short sleep durations over 1 wk at home and sleep apnea in subjective sleepiness (Epworth Sleepiness Scale), objective sleepiness (reduced sleep latency as determined by the Multiple Sleep Latency Test), and neurobehavioral functioning (lapses in performance, tracking error in Divided Attention Driving Task) in commercial drivers. Studies were conducted in 247 of 551 drivers at higher risk for apnea and in 159 of 778 drivers at lower risk. A multivariate linear association between the sets of outcomes and risk factors was confirmed (p < 0.0001). Increases in subjective sleepiness were associated with shorter sleep durations but not with increases in severity of apnea. Increases in objective sleepiness and performance lapses, as well as poorer lane tracking, were associated with shorter sleep durations. Associations with sleep apnea severity were not as robust and not strictly monotonic. A significant linear association with sleep apnea was demonstrated only for reduced sleep latency. The effects of severe apnea (apnea-hypopnea index, at least 30 episodes/h), which occurred in 4.7%, and of sleep duration less than 5 h/night, which occurred in 13.5%, were similar in terms of their impact on objective sleepiness. Thus, addressing impairment in commercial drivers requires addressing both insufficient sleep and sleep apnea, the former being more common.</description><subject>Abdomen</subject><subject>Adult and adolescent clinical studies</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anxiety disorders. Neuroses</subject><subject>Automobile Driving</subject><subject>Biological and medical sciences</subject><subject>H. Sleep and Control of Ventilation</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Laboratories</subject><subject>Least-Squares Analysis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurosciences</subject><subject>Occupational Health</subject><subject>Post-traumatic stress disorder</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Questionnaires</subject><subject>Risk Factors</subject><subject>Sleep</subject><subject>Sleep apnea</subject><subject>Sleep Apnea Syndromes - psychology</subject><subject>Sleep Deprivation - psychology</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Questionnaires</topic><topic>Risk Factors</topic><topic>Sleep</topic><topic>Sleep apnea</topic><topic>Sleep Apnea Syndromes - psychology</topic><topic>Sleep Deprivation - psychology</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Task Performance and Analysis</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pack, Allan I</creatorcontrib><creatorcontrib>Maislin, Greg</creatorcontrib><creatorcontrib>Staley, Bethany</creatorcontrib><creatorcontrib>Pack, Frances M</creatorcontrib><creatorcontrib>Rogers, William C</creatorcontrib><creatorcontrib>George, Charles F. 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P</au><au>Dinges, David F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impaired Performance in Commercial Drivers: Role of Sleep Apnea and Short Sleep Duration</atitle><jtitle>American journal of respiratory and critical care medicine</jtitle><addtitle>Am J Respir Crit Care Med</addtitle><date>2006-08-15</date><risdate>2006</risdate><volume>174</volume><issue>4</issue><spage>446</spage><epage>454</epage><pages>446-454</pages><issn>1073-449X</issn><eissn>1535-4970</eissn><abstract>Sleepiness plays an important role in major crashes of commercial vehicles. Because determinants are likely to include inadequate sleep and sleep apnea, we evaluated the role of short sleep durations over 1 wk at home and sleep apnea in subjective sleepiness (Epworth Sleepiness Scale), objective sleepiness (reduced sleep latency as determined by the Multiple Sleep Latency Test), and neurobehavioral functioning (lapses in performance, tracking error in Divided Attention Driving Task) in commercial drivers. Studies were conducted in 247 of 551 drivers at higher risk for apnea and in 159 of 778 drivers at lower risk. A multivariate linear association between the sets of outcomes and risk factors was confirmed (p < 0.0001). Increases in subjective sleepiness were associated with shorter sleep durations but not with increases in severity of apnea. Increases in objective sleepiness and performance lapses, as well as poorer lane tracking, were associated with shorter sleep durations. Associations with sleep apnea severity were not as robust and not strictly monotonic. A significant linear association with sleep apnea was demonstrated only for reduced sleep latency. The effects of severe apnea (apnea-hypopnea index, at least 30 episodes/h), which occurred in 4.7%, and of sleep duration less than 5 h/night, which occurred in 13.5%, were similar in terms of their impact on objective sleepiness. Thus, addressing impairment in commercial drivers requires addressing both insufficient sleep and sleep apnea, the former being more common.</abstract><cop>New York, NY</cop><pub>Am Thoracic Soc</pub><pmid>16690976</pmid><doi>10.1164/rccm.200408-1146OC</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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source | MEDLINE; Journals@Ovid Complete; American Thoracic Society (ATS) Journals Online; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
subjects | Abdomen Adult and adolescent clinical studies Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anxiety disorders. Neuroses Automobile Driving Biological and medical sciences H. Sleep and Control of Ventilation Humans Intensive care medicine Laboratories Least-Squares Analysis Male Medical sciences Middle Aged Neurosciences Occupational Health Post-traumatic stress disorder Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Questionnaires Risk Factors Sleep Sleep apnea Sleep Apnea Syndromes - psychology Sleep Deprivation - psychology Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Task Performance and Analysis Time Factors |
title | Impaired Performance in Commercial Drivers: Role of Sleep Apnea and Short Sleep Duration |
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