Are long-haul truck drivers unusually alert? A comparison with long-haul airline pilots

Sallinen, Mikael; Pylkkönen, Mia; Puttonen, Sampsa; Sihvola, Maria; Åkerstedt, Torbjörn

doi:10.1016/j.aap.2020.105442

Cited by 14 publications

(11 citation statements)

References 12 publications

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“…Future studies employing similar approaches should account for such moderating factors. A recent study also showed that the drivers participating in this study may have been sleepier than what their subjective ratings suggested (Sallinen et al 2020).…”

Section: Discussionsupporting

confidence: 50%

Accumulation of sleep loss among shift-working truck drivers

Onninen

Pylkkönen

Tolvanen

et al. 2021

Chronobiology International

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Sleep loss is known to contribute to road traffic accidents. Professional drivers are vulnerable to curtailment of sleep due to long driving bouts and shift work. To fill in the gap in the literature related to the build-up of sleep loss in irregular shift systems, we recorded the sleep and working hours of 47 shift-working long-haul truck drivers during a twoweek period. Sleep (time in bed) was verified by actigraphy and sleep logs. Sleepiness was measured using the Karolinska Sleepiness Scale (KSS). Individual sleep need was based on self-assessments. We examined the accumulated sleep versus self-reported sleep need across the study period, using midnights as points of observation, and the accumulated sleep loss within 72h prior to shift end (sleep versus need, SVN72). Across the study period, the drivers' sleep was close to their self-reported sleep need, but 45% of the drivers showed accumulated sleep loss of >6h at least once. SVN72 averaged -1.5h and was 2.87h shorter in connection with morning shifts compared to day or evening shifts. Night shifts showed no such difference. During days off, sleep exceeded sleep need by 1.13h and was not dependent on the type of preceding work shift. SVN72showed small-to-medium negative associations with on-duty KSS even after accounting for sleep within the 24h prior to shift end. Our results show that long-haul truck drivers are exposed to severe levels of accumulated sleep loss while working irregular shifts, but they can catch up on their lost sleep especially during days off.

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Section: Discussionsupporting

confidence: 50%

Accumulation of sleep loss among shift-working truck drivers

Onninen

Pylkkönen

Tolvanen

et al. 2021

Chronobiology International

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“…Sleepiness, impaired cognition and performance are common in shift workers, and have been reported in numerous studies, including in nurses (Behrens et al, 2019;Ganesan et al, 2019;Wilson et al, 2019), medical residents (Basner et al, 2017), police officers (Boivin et al, 2012a;Boudreau et al, 2013a), miners (Ferguson et al, 2010(Ferguson et al, , 2011, marine pilots (Boudreau et al, 2018), professional truck drivers (Anund et al, 2018), train drivers (Jay et al, 2006), and airline pilots (Ingre et al, 2014;Sallinen et al, 2017;Aljurf et al, 2018;Sallinen et al, 2020). Extended wakefulness, lack of adequate recovery sleep between shifts, and being awake during the circadian trough of alertness, at night or in the early morning, lead to excessive sleepiness in shift workers (Mullins et al, 2014).…”

Section: Sleepinessmentioning

confidence: 99%

Disturbance of the Circadian System in Shift Work and Its Health Impact

2021

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The various non-standard schedules required of shift workers force abrupt changes in the timing of sleep and light-dark exposure. These changes result in disturbances of the endogenous circadian system and its misalignment with the environment. Simulated night-shift experiments and field-based studies with shift workers both indicate that the circadian system is resistant to adaptation from a day- to a night-oriented schedule, as determined by a lack of substantial phase shifts over multiple days in centrally controlled rhythms, such as those of melatonin and cortisol. There is evidence that disruption of the circadian system caused by night-shift work results not only in a misalignment between the circadian system and the external light-dark cycle, but also in a state of internal desynchronization between various levels of the circadian system. This is the case between rhythms controlled by the central circadian pacemaker and clock genes expression in tissues such as peripheral blood mononuclear cells, hair follicle cells, and oral mucosa cells. The disruptive effects of atypical work schedules extend beyond the expression profile of canonical circadian clock genes and affects other transcripts of the human genome. In general, after several days of living at night, most rhythmic transcripts in the human genome remain adjusted to a day-oriented schedule, with dampened group amplitudes. In contrast to circadian clock genes and rhythmic transcripts, metabolomics studies revealed that most metabolites shift by several hours when working nights, thus leading to their misalignment with the circadian system. Altogether, these circadian and sleep-wake disturbances emphasize the all-encompassing impact of night-shift work, and can contribute to the increased risk of various medical conditions. Here, we review the latest scientific evidence regarding the effects of atypical work schedules on the circadian system, sleep and alertness of shift-working populations, and discuss their potential clinical impacts.

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“…Furthermore, studies comparing sleepiness ratings of long-haul airline pilots with those of long-haul truck drivers showed that heavy vehicle drivers self-estimate their sleepiness during night and non-night duties unexpectedly low. 60 Professional truck drivers rated lower levels of Notes: The Spearman correlation showed a highly significant moderate to strong correlation between the PVT reaction time and the TAP "alertness" (with and without auditive signal). In the TAP "divided attention" patients had to react on visual and acoustic signals in parallel.…”

Section: Discussionmentioning

confidence: 97%

“…Some researchers explained this by a lack of education and training on sleepiness among truck drivers. 60 The PVT normally takes 10 minutes (as described in the original article in 1985 by Dinges and Powel), but due to time constraints, a 2-minute, 3-minute, and 5-minute version has been validated, which are less sensitive compared to the 10-minute version. 25,27,31,33,[61][62][63][64] In this situation we recommend, on the contrary, to investigate OSA patients compared to sex and age matched controls longitudinally (untreated OSA patients versus healthy controls and with CPAP therapy versus healthy controls) using a longer version of the PVT up to 40 minutes (as in the MWT).…”

Section: Discussionmentioning

confidence: 99%

<p>The Psychomotor Vigilance Test Compared to a Divided Attention Steering Simulation in Patients with Moderate or Severe Obstructive Sleep Apnea</p>

Huang¹,

Hennig²,

Fietze³

et al. 2020

NSS

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Background: Sleepiness at the wheel affects 10% to 15% of drivers and is one major cause of death on highways with one-third of fatal accidents. Obstructive sleep apnea (OSA) is one of the most common sleep disorders leading to sleepiness at the wheel. The aim of this study was to compare the psychomotor vigilance test reaction time (PVT RT) in OSA patients and controls (morning and afternoon) with the results of a divided attention steering simulator (DASS). A second purpose was to compare these results with the mean sleep latencies in the multiple sleep latency test (MSLT), the Epworth Sleepiness Scale (ESS) values and a neurocognitive test (test of attentional performance, TAP). Patients and Methods: Thirty eight OSA patients and 16 age and sex matched healthy controls were investigated by ESS, PVT, TAP, MSLT, and DASS (response time, failed responses, lane deviation, and off-road-events). Results: With increasing age, the performance in the DASS decreased. There was no correlation between the DASS and the results of the MSLT and ESS. The controls showed a significantly faster DASS response time in the morning compared to OSA patients (median 2.1 versus 3.0; p=0.044) and fewer off-road events (9 versus 37; p=0.042). We found a moderate correlation between the PVT RT and all parameters of the DASS, as well as the TAP "alertness" subtest. Conclusion: The increase of PVT RT as well as the decreased tonic alertness in the TAP in untreated OSA patients correlated with an impairment of simulated driving performance. The PVT and the TAP are both suitable diagnostic tools for measuring impaired driving ability in OSA patients. The MSLT did not correlate with the simulated driving performance. We recommend investigation of a longer version of the PVT in order to increase its sensitivity.

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Are long-haul truck drivers unusually alert? A comparison with long-haul airline pilots

Cited by 14 publications

References 12 publications

Accumulation of sleep loss among shift-working truck drivers

Accumulation of sleep loss among shift-working truck drivers

Disturbance of the Circadian System in Shift Work and Its Health Impact

<p>The Psychomotor Vigilance Test Compared to a Divided Attention Steering Simulation in Patients with Moderate or Severe Obstructive Sleep Apnea</p>

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