A commentary on this article appears in this issue on page 1171.

BackgroundRecent research has found evidence of an association between motor vehicle accidents (MVAs) or near miss accidents (NMAs), and excessive daytime sleepiness (EDS) or its main medical cause, Obstructive Sleep Apnea (OSA). However, EDS can also be due to non-medical factors, such as sleep debt (SD), which is common among professional truck drivers. On the opposite side, rest breaks and naps are known to protect against accidents.Study ObjectivesTo investigate the association of OSA, SD, EDS, rest breaks and naps, with the occurrence of MVAs and NMAs in a large sample of truck drivers.Methods949 male truck drivers took part in a cross-sectional medical examination and were asked to complete a questionnaire about sleep and waking habits, risk factors for OSA and EDS.ResultsMVAs and NMAs were reported by 34.8% and 9.2% of participants, respectively. MVAs were significantly predicted by OSA (OR = 2.32 CI95% = 1.68–3.20), SD (OR = 1.45 CI95% = 1.29–1.63), EDS (OR = 1.73 CI95% = 1.15–2.61) and prevented by naps (OR = 0.59 CI95% = 0.44–0.79) or rest breaks (OR = 0.63 CI95% = 0.45–0.89). NMAs were significantly predicted by OSA (OR = 2.39 CI95% = 1.47–3.87) and SD (OR = 1.49 CI95% = 1.27–1.76) and prevented by naps (OR = 0.52 CI95% = 0.32–0.85) or rest breaks (OR = 0.49 CI95% = 0.29–0.82).ConclusionsWhen OSA, SD or EDS are present, the risk of MVAs or NMAs in truck drivers is severely increased. Taking a rest break or a nap appear to be protective against accidents.

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Poor sleep is associated with bad health outcomes, worse wellbeing and decreases in performance, productivity and safety at work. Police officers are exposed to several risk factors including extended work schedules, shift work, occupational stress, dangerous and traumatic events and can, as such, develop sleep problems. The aim of the present study was to analyze the sleep quality among police officers. A systematic literature search, in PubMed/MEDLINE, PsycINFO, Scopus, ISI/Web of Science (WoS) and the Cochrane Library was conducted. Original articles, published in English, French, Italian, Spanish and Portuguese, the primary objective of which was the evaluation of the quality of sleep through the Pittsburgh Sleep Quality Index (PSQI) in Police Forces, were selected. From an initial sample of 1,149 studies, 13 articles were included in the meta-analysis (3,722 police officers). The pooled prevalence of bad sleep quality in police officers was 51% [95%CI 42–60%]. The pooled global score of the PSQI was 5.6 [95%CI 5.0–6.3], corresponding to a low average quality. At the meta-regressions, statistically significant associations could be found for work seniority (in terms of years of service) and being on shift. The poor quality of sleep in police officers could have negative consequences for workers’ health and for the safety of third parts. The implementation of health and sleep hygiene promotion programs in police forces is strongly recommended.

BackgroundSleep-related problems are known risk factors for road accidents. However, very few studies have investigated the role played by insomnia and its components, and no data are available for a population of occupational drivers at risk, such as the truck driver category.ObjectiveTo measure the prevalence and impact of insomnia on motor vehicle accidents (MVAs) and near-miss accidents (NMAs) in 949 truck drivers.DesignCross-sectional survey.ResultsInsomnia affected 27.5% of the sample. Compared to other drivers, in the 3 years prior to the study, truck drivers with insomnia had reported a significantly higher number of MVAs; they had also reported a greater number of NMAs in the previous 6 months. After correction for the presence of obstructive sleep apnea, excessive daytime sleepiness, short sleep duration, and other concurrent diseases, insomniac truck drivers had an almost two-fold risk of driving accidents (OR: 1.82, CI 95%:1.33–2.49) and a more than three-fold increased risk of near-miss accidents (OR: 3.35, CI95%:2.06–5.45) compared to non-insomniac drivers.ConclusionInsomnia emerged as an independent risk factor for MVAs and NMAs. We strongly advise screening commercial drivers for signs and symptoms of insomnia in order to improve health and safety on the road.

The high prevalence of sleep problems, especially suspected OSA, and low quality of sleep in truck drivers can worsen the general and psychological wellbeing of the workers. Educational programs focusing on sleep hygiene and behavioral interventions are needed to promote adequate sleep habits and improve individual and public health.

Background: Professional truck drivers (TDs) are exposed to stressful working (and living) conditions and are vulnerable. They report physical and mental health problems and psychological distress more frequently than the general population and their problems can affect safety on the roads. Actions to improve TDs’ health and reduce the risks of (co-)morbidity or unsafe driving are imperative. Methods: The published studies dealing with the TDs’ sleep habits and mental health were reviewed to define the scenario and organize the preventive strategies proposed thus far. Results: Awareness among TDs of the high risk for health and safety due to (often co-existing) untreated sleep and mental health problems is critical. Alcohol and prescribed or illicit drugs are often misused to compensate for depression, anxiety, job strain, fatigue, and social isolation. Polypharmacy and dependence increase the chance of unsafe behaviors on the road. The TDs’ access to healthcare services is scant, and participation in industry-sponsored wellness programs is limited. Conclusions: Primary prevention is a first unavoidable step to deal with sleep and mental health problems. Educational programs, online support and tele-health assessment/monitoring would help improve the well-being, safety and health of professional TDs and increase safety on the road.

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