Driver sleepiness is known to be a major contributor to road traffic incidents (RTIs). An initial literature review identified many studies reporting untreated obstructive sleep apnoea (OSA) sufferers as having impaired driving performance and increased RTI risk. It is consistently reported that treatment with continuous positive air pressure (CPAP) improves driving performance and decreases RTI risk, although most of these studies are conducted less than one year after starting treatment. UK law allows treated OSA patients to continue driving if their doctor states that treatment has been successful. Despite the wealth of publications surrounding OSA and driving, 6 key areas were identified from the literature review as not fully investigated, the: (i) prevalence of undiagnosed OSA in heavy goods vehicle (HGV) drivers in the UK; (ii) impact of sleep restriction on long term CPAP treated OSA compared with healthy controls; (iii) ability of treated OSA participants to identify sleepiness when driving; (iv) impact of one night CPAP withdrawal on driving performance; (v) individual difference in driving performance of long term CPAP treated OSA participants; (vi) choice of countermeasures to driver sleepiness by two groups susceptible to driver sleepiness, OSA and HGV drivers. Key areas (i) and (vi) were assessed using questionnaires. 148 HGV drivers were surveyed to assess OSA symptoms and preference of countermeasures to driver sleepiness. All participants completing the driving simulator study were also surveyed. 9.5% of HGV drivers were found to have symptoms of suspected undiagnosed OSA. Additionally the OSA risk factors were more prevalent for HGV drivers than reported in national statistics reports for the general population. The most effective countermeasures to driver sleepiness (caffeine and a nap) were not the most popular. Being part of a susceptible group (OSA or HGV driver) and prior experience of driver sleepiness did not promote effective choice of countermeasure. Key areas (ii) to (v) were assessed using a driving simulator. Driving simulators present a safe environment to test participants in a scenario where they may experience sleepiness without endangering other road users.

Nurses are largely unaware of the problems of night-shift-nurse sleepiness and available strategies to manage night-shift sleepiness. The purpose of this project was to examine nurses' self-perception, awareness of sleepiness, and current strategies to manage this problem in the emergency medicine department of a major academic hospital in the western United States. The validated de-identified Karolinska Sleepiness Scale (KSS) was used to measure the prevalence and intensity of night shift nurses' sleepiness prior to the development of an educational program on strategies to manage sleepiness. Of the 164 registered nurses surveyed, 72 (43.9%) reported sleepiness greater than 7 on the KSS. An educational program was developed and evaluated by a panel of 6 experts who were selected on their clinical, educational, quality improvement, and research in sleep studies. Expert reviews indicated that the education program was 100% relevant, appropriate, and understandable, and provided adequate information on the topic with no recommended changes. The education program was presented to 16 night shift nurses with a pre/posttest survey completed by 14 nurses. Results indicated that participating nurses increased their knowledge of managing strategies for sleepiness from 69% (agree or strongly agree) preintervention to 92% postintervention. Postintervention, there was a 50% increase in the number of nurses who reported benefits from the education intervention. The findings of this project contribute to positive social change by improving nurses' health and quality patient care by advancing nurses' awareness of night shift sleepiness and countermeasure management strategies.