"Forty million Americans are chronically ill with various sleep disorders; an additional 20-30 million experience intermittent sleep-related problems. In the US, Sleep Apnea alone is the cause of excessive daytime sleepiness in almost 20 million people. Millions more are severely sleep-deprived as a result of demanding work schedules and various other life-style factors. One estimate of the cost of sleep related workplace productivity is $150 BILLION."

--Report of the National Commission on Sleep Disorders Research submitted to the U.S. Congress and Department of Health and Human Services, April, 1993.

Some Alarming Facts:

Sleep apnea has been found in up to 10% of men over age 40. A workplace survey reported in 1995 found that in a sample of 1,658 Franklin County, Ohio businesses, only 5% of employees tested positive for drug abuse. Hence, a higher percentage of workers may suffer from a sleep disorder that causes dangerous workplace impairment very similar to that of substance abuse--but which is much more readily and rapidly treatable.

Sleepiness among workers was cited as a primary factor in causation of the disasters at Chernobyl, Three Mile Island and Bhopal.

The Nuclear Regulatory Commission closed Philadelphia Electric Company's Peach Bottom nuclear plant because night shift workers were found to be sleeping repeatedly on the job. The Davis-Besse nuclear reactor in Oak Harbour, Ohio, went into shutdown at 1:35 a.m. An operator then responded by pushing two wrong buttons: thereby disabling its safety backup provisions. Nightshift worker errors were cited as factors in the automatic tripping at California's Rancho Seco nuclear reactor and subsequent failure to regain prompt control of the plant.

Marked increases in human job-related errors during the second half of night shift have been documented in studies of gas works employees, drivers, pilots and train engineers.

Eighty percent of policemen admitted to falling asleep at least once a week on night shift. An estimated 50% of night shift workers fall asleep on the job at least weekly, and 75% fight sleepiness each night shift. An estimated 20% of workers on any given night shift fall asleep.

A U.S. Bureau of Mines investigation found that shift workers have more frequent and severe individual accidents.

Night shift workers obtain 1.5-4 hours less sleep per 24-hour period than day shift workers, and their sleep is more fragmented and more physiologically abnormal: even if noise and other interruptions are eliminated.

The U.S. Department of Transportation has estimated that up to 200,000 motor vehicle accidents per year may be sleep-related.

One of every five drivers admits to having fallen asleep at least once behind the wheel, and 69% of motorists report drowsiness while driving.

The U.S. National Transportation Safety Board found that nearly one-third of all fatal-to-driver traffic accidents had sleepiness as their probable cause. The NTSB investigated 107 single-vehicle accidents in which the driver survived and discovered that 58% were related to fatigue--with 18% of the drivers admitting they had fallen completely asleep. The drivers in this sample had obtained only 5.5 hours of sleep during their preceding sleep periods: 2.5 hours less than the average reported by truckers with non-fatigue related accidents.

One British study found that 16-20% of all police-reported MVAs were sleep-related.

Sleep-related highway crashes caused 1.55 deaths/week in another British study, versus none in accidents caused by heart attacks or convulsions while driving. Such was attributed to these being high-velocity crashes, typically occurring on freeways, without driver awareness of impairment or impending sleep.

Sleep apnea, an extremely prevalent but treatable disorder, has been associated with an up to nine-fold increased incidence of motor vehicle accidents. In a Swedish study, after correcting for miles driven, individuals with full sleep apnea symptoms had twelve times as many accidents as controls. A British study showed that 93% of sleep apneics were at fault in one or more accidents. The significance of these figures is increased by indications of a markedly greater prevalence of sleep apnea among distance truck drivers: who recently were reported as having the highest on-the-job mortality rate of any profession for the third straight year! 

Shift workers are reported to have twice as many auto accidents. 

The NTSB cited pilot fatigue as a cause or contributing factor in 69 plane accidents, with 67 deaths between 1983-1986 alone.

Night shift flight simulator performance has been found to be impaired to a degree comparable to that produced by a blood alcohol level of 0.05%.

Operator fatigue was a major factor in the near-disastrous attempted launch of the space shuttle Columbia in 1986. Accidental drainage of 18,000 lbs of liquid oxygen escaped detection until only 31 seconds before lift-off. Just three weeks later, the space shuttle Challenger exploded with loss of lives. Key managers of that launch had been seriously sleep-deprived. A Presidential Commission cited ground crew fatigue as a significant factor in causation of that disaster.

The skipper of the World Prodigy, which dumped 300,000 barrels of oil into Narragansett Bay, admitted to not having slept for 36 hours. The NTSB ultimately determined that a primary cause of the Exxon Valdez disaster was sleepiness on the part of its third mate.

Sleep attacks on the job have been documented via EEG monitoring of night shift workers: including locomotive engineers.

Sleep apnea has now been documented in up to a startling ten percent of adult men - for example, in unselected electrical technicians and in a general practice study. It has been noted in 27 to 47.8% of people with high blood pressure. Nearly 80% of distance truckers in one study showed repeated drops in oxygen levels during sleep, consistent with sleep apnea.

Sleep apnea occurs with greatest frequency in overweight individuals. Thus, one could reasonably anticipate that its prevalence will increase progressively as a result of the rapidly escalating prevalence of obesity.  While identified most often in men over age 40, sleep apnea also afflicts younger workers and women--particularly if obese or post menopausal. It is more likely in people with short, thick necks, nasal congestion and "sinus trouble", and it can be aggravated by alcohol and sleeping pills.

Sleep apnea has been associated with an up to 23-fold increased risk of heart attack, an up to nine-fold increased risk of motor vehicle accidents, and a 2.7 fold increased risk of vascular deaths. Sleep apnea was also found in 73.8% of male stroke victims.

Another study found mortality rates in severe and mild untreated sleep apneics of 10.6% and 2.1%, respectively, versus 0% in treated sleep apneics.

Sleep apnea also has been implicated in heart failure, sleep related convulsions and cardiac arrests, as well as irritability, mood swings, and difficulty with memory. One study found impaired concentration, memory and problem solving ability in 89% of untreated sleep apneics.

Workplace Risk Factors:

SLEEP DISORDERS AND PERFORMANCE

Sleep Apnea & Automobile Crashes, George, and Smiley, SLEEP- September 1999

Findings: “This Study confirms, using objective accident data, that OSA patients have more accidents than age and sex matched controls.  These conclusions are strengthened by our sample size (460) which is by far the largest reported using driving records from patients with laboratory confirmed OSA.”

Time-on-Task Decrements in “Steer Clear” Performance of Patients with Sleep Apnea and Narcolepsy, Findley, Suratt and Dinges, SLEEP-September 1999

Findings: “Persons with untreated sleep apnea or narcolepsy had poorer performance overall and greater time-on-task decrements on a 30-minute “Steer Clear” test than did comparably-aged control subjects.”

DRIVER TALK

Overweight, middle-aged men with thick necks are the type of people most likely to suffer from sleep apnea, a disorder that makes them chronically exhausted and puts them at risk of suddenly nodding off during waking hours.

Sleep apnea is caused by a disorder involving the muscles at the back of the throat. Everybody loses some muscle tone in these muscles while sleeping, narrowing the air passage. Amongst people who have sleep apnea, the airway is closed off entirely for brief periods. Lacking needed oxygen, their brains automatically trigger night-time arousals. Robbing them of deep, restful sleep. Often, it is discovered only when a partner is bothered by constant breathing interruptions, usually accompanied by loud snoring or thrashing about in bed.

In a study conducted by Dr. William Dement, director of the Sleep Research Center at the Stanford University School of Medicine, it was found that 78 percent of 159 commercial truckers he tested suffered from sleep apnea. The incidence is three times higher than in the general population.

In another study, Dr. William Dement taped the eyelids open of a volunteer who had been allowed only four hours of sleep the night before, He was asked to press a button every time an irregular strobe light flashed. For a few minutes he pressed the switch after each flash, on average every six seconds. Then a bright flash surged into his pupils-but he did nothing. “Why didn’t you press the switch just now?”, he was asked. “Because there was no flash”, he replied. The machines attached to his body used to monitor brain activity showed that at the very moment the light had flashed, the young man had fallen asleep, with his eyes wide open, for two seconds, without him being aware of it. If he had been behind the wheel of a motor vehicle, those two seconds could have meant disaster.

The National Sleep Foundation has also identified commercial truck drivers among its top five groups of people at risk of falling asleep while driving.

With regards to accidents involving Trucks citing sleepiness as the primary cause, the most frequently cited study was conducted by the National Transportation Safety Board. In 1990, the board found that trucker fatigue was a primary accident cause in 31 percent of accidents studied in which the trucker died.

In another study the NTSB investigated 107 single-vehicle accidents in which the driver survived and discovered that 58% were related to fatigue-with 18% of the drivers admitting they had fallen completely asleep. The drivers in this sample had obtained only 5.5 hours of sleep during their preceding sleep periods: 2.5 hours less than the average reported by truckers with non-fatigue related accidents.

The U.S. Department of Transportation has estimated that up to 200,000 motor vehicle accidents per year may be sleep-related.

One of every five drivers admits to having fallen asleep at least once behind the wheel, and 69% of motorists report drowsiness while driving.

Sleep apnea has been associated with an up to nine-fold increased incidence of motor vehicle accidents. In a Swedish study, after correcting for miles driven, individuals with full sleep apnea symptoms had twelve times as many accidents as controls. A British study showed that 93% of sleep apneics were at fault in one or more accidents. The significance of these figures is increased by indications of a markedly greater prevalence of sleep apnea among distance truck drivers: who recently were reported as having the highest on-the-job mortality rate of any profession for the third straight year!

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Last modified: October 17, 2007