Sleep and Shift Work Blog

This page features current research findings and popular press articles regarding sleep and shift work concerns, initially taken from articles by or featuring the faculty of the 2012 HSPH IPHM Conference: “Sleep and Shift Work: Optimizing Productivity and Health Management in the 24/7 Global Economy.” We continue to update this blog with relevant sleep and shift work news, particularly as it pertains to the transportation industry.

Chicago Train Operator Admits She Fell Asleep Before Crash

Maya Rhodan, TIME
“The woman operating the Chicago commuter train that derailed and injured more than 30 people on Monday morning has admitted she fell asleep before the early accident and only woke up on impact, investigators said Wednesday.”
Click here for more details.
Posted: Friday, March 28, 2014

NTSB Calls on Metro-North to Take Action on Recorders and Speed Signs

National Transportation Safety Board Office of Public Affairs
“The National Transportation Safety Board today issued a series of safety recommendations to the Metro-North Railroad calling for the use of inward and outward facing audio and image recorders and the installation of approach permanent speed restrictions signs along the right-of-ways. These safety recommendations were developed from information learned during the ongoing investigation into the December 1, 2013 derailment of a Metro-North passenger train in Bronx, New York.
Click here for more details.
Posted: Thursday, February 27, 2014

Article Published: “Obstructive Sleep Apnea in North American Commercial Drivers”

Stefanos N. Kales, MD, MPH, FACP, FACOEM; Madeleine Straubel
“The most common medical cause of excessive daytime sleepiness (EDS) is obstructive sleep apnea (OSA). Specifically, among an estimated 14 million US commercial drivers, 17-28% or 2.4 to 3.9 million are expected to have OSA. Based on existing epidemiologic evidence, most of these drivers are undiagnosed and not adequately treated. Untreated OSA increases the risk of vehicular crashes as documented in multiple independent studies and by meta-analysis. Therefore, identifying commercial drivers with OSA and having them effectively treated should decrease crash-related fatalities and injuries. Several strategies are available for screening and identifying drivers with OSA. The simplest and most effective objective strategies use body mass index (BMI) cutoffs for obesity. Functional screens are promising adjuncts to other objective tests. The most effective approach will likely be a combination of a good questionnaire; BMI measures; and a careful physician-obtained history complemented by a functional screen.” The full-text article is freely available through the link below.
Click here for more details.
Posted: Tuesday, February 25, 2014

William Rockefeller, Engineer In Fatal NYC Train Crash, Likely Won’t Be Charged With A Crime

Murray Weiss, Huffington Post
“Investigators looking at the Metro-North train wreck that killed four people have yet to uncover evidence that motorman William Rockefeller committed a crime when he dozed off before the train flew off the tracks, DNAinfo New York has learned.”
Click here for more details.
Posted: Thursday, January 9, 2014

Article on OSA and Truck Drivers Released

Stefanos N. Kales, MD, MPH, FACP, FACOEM; Madeleine Straubel
“The most common medical cause of excessive daytime sleepiness (EDS) is obstructive sleep apnea (OSA). Specifically, among an estimated 14 million US commercial drivers, 17-28% or 2.4 to 3.9 million are expected to have OSA. Based on existing epidemiologic evidence, most of these drivers are undiagnosed and not adequately treated. Untreated OSA increases the risk of vehicular crashes as documented in multiple independent studies and by meta-analysis. Therefore, identifying commercial drivers with OSA and having them effectively treated should decrease crash-related fatalities and injuries.”
A notice of the official publication will follow when applicable.
Click here for more details.
Posted: Friday, December 13, 2013

Dutch Bus Drivers to Test Fatigue Warning Tech

Toby Sterling, Associated Press
“A Dutch luxury bus company is testing technology that monitors whether a driver is becoming drowsy.”
Click here for more details.
Posted: Thursday, December 12, 2013

New York Train Wreck Raises Questions about “Alerter” Devices

Ray Sanchez, CNN
“Rail experts Tuesday questioned the effectiveness of one step being taken by New York’s Metro-North Railroad to ensure safety one week after the derailment of a speeding commuter train killed four people and injured dozens of others.”
Click here for more details.
Posted: Thursday, December 12, 2013

Lawyer: Engineer in “Daze” before NYC Train Crash

Jennifer Peltz and Jim Fitzgerald, Associated Press
“[Train driver William] Rockefeller had begun running that route on Nov. 17, two weeks before the wreck. [Union leader Anthony] Bottalico said Rockefeller was familiar with the route and qualified to run it. He said Rockefeller had switched just weeks earlier from the night shift to the day shift, ‘so he did have a change in his hours and his circadian rhythms with regard to sleep.’”
Click here for more details.
Posted: Wednesday, December 4, 2013

NTSB Kicks Train Union out of Crash Investigation

Shimon Prokupecz, Mike Ahlers, and Ray Sanchez, CNN
“The NTSB said it has booted the rail union from its investigation into the weekend’s deadly train derailment for violating confidentiality rules.”
Click here for more details.
Posted: Wednesday, December 4, 2013

Train Engineer was Dazed before Crash, Lawyer Says

Matt Flegenheimer and William K. Rashbaum, The New York Times
“The engineer who operated the Metro-North Railroad train that derailed over the weekend, killing four people and injuring more than 70, told the authorities on Tuesday that he had become dazed before the accident, suffering what his lawyer referred to as ‘highway hypnosis.’”
Click here for more details.
Posted: Wednesday, December 4, 2013

Dr. Kales’ Remarks from IATSS Published

Stefanos N. Kales, MD, MPH, FACP, FACOEM
Dr. Kales presented the talk, “Preventing Accidents in North American Commercial Drivers with Obstructive Sleep Apnea,” at the International Association of Traffic and Safety Sciences (IATSS), Japan, in May 2013. The IATSS subsequently published these remarks.
Click here for the resulting publication of Dr. Kales’ remarks.
Posted: Wednesday, December 4, 2013

New Obstructive Sleep Apnea Policy for FAA

Fred Tilton, Federal Air Surgeon
Mike M. Ahlers and Rene Marsh, CNN
“OSA is almost universal in obese individuals who have a body mass index over 40 and a neck circumference of 17 inches or more, but up to 30% of individuals with a BMI less than 30 have OSA….Airman applicants with a BMI of 40 or more will have to be evaluated by a physician who is a board certified sleep specialist, and anyone who is diagnosed with OSA will have to be treated before they can be medically certificated.”
Click here for the Federal Air Surgeon’s Medical Bulletin, page 2 for the editorial.
Click here for the CNN article.
Posted: Monday, November 25, 2013

Sleep Problems in Police Officers Take Heavy Toll

Anahad O’Connor
“More than a third of police officers have a sleep disorder, and those who do are more likely to experience heart disease, problems with job performance and rage toward suspects and citizens, a new study suggests.”
Click here for more details.
Posted: Wednesday, September 26, 2012

Insomnia Risks and Costs: Health, Safety, and Quality of Life

Mark R. Rosekind, PhD; Kevin B. Gregory, BS
“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.”
Click here for more details.
Posted: Tuesday, September 25, 2012

Driver Medical Examiner Registry Released; Careers in Gear; April 2012

Heather
“The Federal Motor Carrier Safety Administration released its long-anticipated national registry for certified medical examiners last week, requiring medical professionals who examine commercial drivers to receive training on driver health issues.”
Click here for more details.
Posted: Monday, September 24, 2012

Railroaders’ Guide to Healthy Sleep Website; 2012

Division of Sleep Medicine at Harvard Medical School
“Steps to improve your sleep and make a real difference in your life.”
Click here for more details.
Posted: Thursday, September 20, 2012

Insomnia and the Performance of US Workers: Results from the America Insomnia Survey; September 2011; Sleep

Ronald C. Kessler, PhD; Patricia A. Berglund, MBA; Catherine Coulouvrat, MD; Goeran Hajak, MD; Thomas Roth, PhD; Victoria Shahly, PhD; Alicia C. Shillington, PhD; Judith L. Stephenson, SM; James K. Walsh, PhD
“We address the limitations of currently available estimates of the workplace costs of insomnia in the current report by using survey data collected in the America Insomnia Survey (AIS),1 a national survey of employed subscribers to a very large US national health plan (over 34 million members) who were selected using probability methods that did not oversample subscribers with a diagnosis of or treatment for insomnia. We estimate the associations of insomnia with work performance controlling for a wide range of comorbid conditions.”
Click here for more details.
Posted: Wednesday, September 19, 2012

Fatigued Railroad Workers Led to Cause of 2011 Train Collision in Iowa, says NTSB; April 2012; Official NTSB Press Release

NTSB Office of Public Affairs
“The National Transportation Safety Board (NTSB) today determined that the probable cause of a rear-end collision between two BNSF Railway trains was the striking train crew’s fatigue. Both crewmembers had fallen asleep, which led to their failure to comply with the signal indication requiring them to operate at a restricted speed and stop short of the standing train.”
Click here for more details.
Posted: Tuesday, September 18, 2012

Insomnia with Objective Short Sleep Duration is Associated with a High Risk for Hypertension; April 2009; Sleep

Alexandros N. Vgontzas, MD; Duanping Liao, PhD; Edward O. Bixler, PhD; George P. Chrousos, MD; Antonio Vela-Bueno, MD
“Based on these observations, we speculate that objective short sleep duration may be an index of the biological severity of the disorder and that insomniacs with short sleep duration are at high risk for adverse medical outcomes. To test this hypothesis, we examined the joint effect of the complaints of chronic insomnia and poor sleep (a milder form of insomnia), and objective sleep duration on the prevalent hypertension in a large cross-sectional population-based sample from central Pennsylvania. We hypothesized that chronic insomnia is associated with a significant risk of hypertension, and that the comorbidity of insomnia and hypertension is enhanced by objective short sleep duration.”
Click here for more details.
Posted: Monday, September 17, 2012

A Serious Approach to Sleep: Brigham and Women’s Hospital Division of Sleep Medicine and Interview with Paul S. Valentine, MBA (scroll to bottom); September 2009; Sleep Review

Greg Thompson
“As a newly minted Sleep Program of Distinction, Brigham and Women’s Hospital affirms the growing importance of sleep medicine across the health care spectrum.”
“As president and CEO of Sleep HealthCenters LLC for the past 6 years, Paul S. Valentine, MBA, says the ‘one location’ for all services model has served patients well.”
Click here for more details.
Posted: Friday, September 14, 2012

The Effect of Rest Breaks on Time to Injury – A Study on Work-Related Ladder-Fall Injuries in the United States; 2006; Scandinavian Journal of Work, Environment, & Health

Wirtz A; Lombardi DA; Courtney TK; Christiani DC; Folkard S; Perry MJ
“Rest breaks and other work-related temporal factors, such as time spent on task, influence the accumulation of fatigue, and thus impact occupational injury risk. The aim of this study was to investigate the effect of rest breaks on “time to injury” (the time between start of work and injury) for injured workers treated in a nationally representative sample of US emergency departments.”
Click here for more details.
Posted: Thursday, September 13, 2012

A Method for Measuring and Modeling the Physiological Traits Causing Obstructive Sleep Apnea; Journal of Applied Physiology

Andrew Wellman; Danny J. Eckert; Amy S. Jordan; Bradley A. Edwards; Chris L. Passaglia; Andrew C. Jackson; Shiva Gautam; Robert L. Owens; Atul Malhotra; David P. White
“In this study, we present a noninvasive method for measuring four important physiological traits causing OSA: 1) pharyngeal anatomy/collapsibility, 2) ventilatory control system gain (loop gain), 3) the ability of the upper airway to dilate/stiffen in response to an increase in ventilatory drive, and 4) arousal threshold.”
Click here for more details.
Posted: Wednesday, September 12, 2012

Sleep Deprivation: What Does It Mean for Public Safety Officers?; March 2009; National Institute of Justice Journal

Bryan Vila, PhD
“When I speak to police officers about my research on sleep, job performance and shift work, they always ask, ‘What’s the best shift?’ I always answer, ‘That’s the wrong question. Most shift arrangements have good and bad aspects.’ The right question is this: ‘What is the best way to manage shift work, keep our officers healthy and maintain high performance in our organization?’”
Click here for more details.
Posted: Tuesday, September 11, 2012

Sleep Apnea and Daytime Sleepiness and Fatigue: Relation to Visceral Obesity, Insulin Resistance, and Hypercytokinemia; March 2000; Journal of Clinical Endocrinology & Metabolism

Alexandros N. Vgontzas; Dmitris A. Papanicolaou; Edward O. Bixler; Kenneth Hopper; Angela Lotsikas; Huong-Mo Lin; Anthony Kales; George P. Chrousos
“We conclude that there is a strong independent association among sleep apnea, visceral obesity, insulin resistance and hypercytokinemia, which may contribute to the pathological manifestations and somatic sequelae of this condition.”
Click here for more details.
Posted: Monday, September 10, 2012

Deadliest Danger Isn’t at the Rig but on the Road; May 2012; Nytimes.com

Ian Urbina
“Over the past decade, more than 300 oil and gas workers like Mr. Roth were killed in highway crashes, the largest cause of fatalities in the industry. Many of these deaths were due in part to oil field exemptions from highway safety rules that allow truckers to work longer hours than drivers in most other industries, according to safety and health experts.”
Click here for more details.
Posted: Friday, September 7,2012

Response Surface Mapping of Neurobehavioral Performance: Testing the Feasibility of Split Sleep Schedules for Space Operations; Fall 2008; Acta Astronautica

Daniel J. Mollicone; Hans P.A. Van Dongen, PhD; Naomi L. Rogers, PhD; David F. Dinges, PhD
“The results suggest that reductions in total daily sleep result in a near-linear accumulation of impairment regardless of whether sleep is scheduled as a consolidated nocturnal sleep period or split into a nocturnal anchor sleep period and a diurnal nap. Thus, split sleep schedules are feasible and can be used to enhance the flexibility of sleep/work schedules for space operations involving restricted nocturnal sleep due to mission-critical task scheduling.”
Click here for more details.
Posted: Thursday, September 6, 2012

Fatigued Driver, An Unsafe Operator, and Ineffective Oversight Caused Deadly Virginia Motorcoach Crash; July 2012; Official NTSB Press Release

NTSB Office of Public Affairs
“A severely fatigued motorcoach driver who lost control of the vehicle, the failure of Sky Express Inc. to manage safe driving practices and a lack of adequate regulatory oversight was the probable cause of a fatal motorcoach crash in Doswell, Va., last May, the National Transportation Safety Board said today.
Click here for more details.
Posted: Wednesday, September 5, 2012

Impact of Sleepiness and Sleep Deficiency on Public Health—Utility of Biomarkers; October 2011; Journal of Clinical Sleep Medicine

Charles A. Czeisler, PhD, MD
“Sleep disorders and sleep deficiency are important causes of adverse health effects and increased mortality in the United States and worldwide. Sleep deficiency can also result in myriad adverse behavioral consequences, including profound sleepiness, cognitive slowing, automatic behavior, attentional failures and performance degradation, errors, and accidents. It is important to recognize that sleepiness and sleep deficiency are not synonymous.”
Click here for more details.
Posted: Tuesday, September 4, 2012

911 Dispatcher Caught Snoring on the Job; May 2012; NBC Washington

Tisha Thompson; Rick Yarborough
“Imagine if in your moment of need, you call 911 and you get…a snoring dispatcher. That’s what happened to this woman.”
Click here for more details.
Posted: Friday, August 31, 2012

Biomarkers of Sleep Apnea; July 2012; CHEST

Sydney B. Montesi, MD; Ednan K. Bajwa, MD, MPH; Atul Malhotra, MD
The discovery of an ideal biomarker for OSA [obstructive sleep apnea] has the potential to provide information related to diagnosis, severity, prognosis, and response to treatment. In addition, because large-scale randomized controlled trials are both ethically and logistically challenging in assessing hard cardiovascular outcomes, certain biomarkers may be reasonable surrogate outcome measures. This article reviews the literature related to potential biomarkers of OSA with the recognition that an ideal biomarker does not exist at this time.
Click here for more details.
Posted: Wednesday, August 29, 2012

NTSB: Driver Fatigue Led to Deadly Bronx Bus Crash; June 2012; abclocal.go.com

Joan Lowy
“A tour bus crash last year that claimed 15 lives was caused by a driver suffering from too little sleep and a bus company that provided too little safety oversight, the National Transportation Safety Board said Tuesday.”
Click here for more details.
Posted: Friday, August 24, 2012