Cited by 173Sleep and Work-Related FatigueObstructive Sleep Apnea ResearchSleep and related disorders

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Impaired Performance in Commercial Drivers

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Pack, Allan I., Maislin, Greg, Staley, Bethany, Pack, Frances M., Rogers, William C., George, Charles F. P., Dinges, David F.·2006·American Journal of Respiratory and Critical Care Medicine

DOI 10.1164/rccm.200408-1146ocPMC PMC2648121

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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.

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Authors: Pack, A. I., Maislin, G., Staley, B., Pack, F. M., Rogers, W. C., George, C. F. P., & Dinges, D. F.
Affiliations: Western University (CA)
ORCID: Pack, Allan I.
Maislin, Greg
Pack, Frances M.
Dinges, David F.
Venue: American Journal of Respiratory and Critical Care Medicine
Publisher: Oxford University Press (OUP)
Published: 2006-08
Volume: 174
Issue: 4
Pages: 446-454
ISSN: 1073-449X (ISSN-L)
1535-4970
DOI: 10.1164/rccm.200408-1146oc
PMC: PMC2648121
OpenAlex: W2026091188
Cited by: 173
References: 47
Citations by year: 2026: 1 · 2025: 5 · 2024: 7 · 2023: 3 · 2022: 5 · 2021: 11 · 2020: 11 · 2019: 5 · 2018: 4 · 2017: 7 · 2016: 13 · 2015: 13 · 2014: 11 · 2013: 10 · 2012: 11
FWCI: 11.31
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations: American Journal of Respiratory and Critical Care Medicine (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
National Heart, Lung, and Blood Institute (P50HL060287, HL60287)
National Center for Research Resources (RR 00040)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords: commercial drivers, sleepiness, sleep apnea, sleep duration, Epworth Sleepiness Scale, multiple sleep latency test, neurobehavioral performance, lane tracking, driving impairment, apnea-hypopnea index, traffic accidents
MeSH terms: Automobile Driving, Humans, Male, Middle Aged, Risk Factors, Sleep, Sleep Apnea Syndromes, Sleep Deprivation, Task Performance and Analysis, Time Factors, Least-Squares Analysis, Occupational Health

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