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Sleepy - and dangerous - behind the wheel

In May 2011, a charter bus traveling on Interstate 95 from North Carolina to New York City left the road north of Richmond, Va., at 5 a.m. and rolled over while the passengers inside screamed in fear. Four people died and several others were injured.

The driver reportedly had fallen asleep at the wheel. Surviving passengers later told law enforcement officials they saw him gulping down energy drinks and coffee to stay awake.

Many Americans struggle with drowsiness behind the wheel but the stakes are especially high for pilots, train operators and bus, cab and limo drivers, many of whom experience sleep-related problems with job performance and safety.

Just how unsafe this can be is outlined in the National Sleep Foundation's new "Sleep In America" poll, which examines those who work in the transportation industry.

The findings are sobering. Of the 1,087 transportation workers who were surveyed, one-fourth of train operators and pilots admitted that sleepiness affects their job performance at least once a week. About one in five pilots said they had made a serious error due to sleepiness. Eighteen percent of truck drivers and 6 percent of train operators reported experiencing a close call because of sleepiness.

More disturbingly, many of them said their work schedules didn't allow enough time for sleep. The problem was worst among pilots and train operators, especially those who worked varying shifts and/or had minimal time off between shifts.

Transportation professionals also were more likely than people in other professions to take naps. For instance, 58 percent of the pilots and 56 percent of the train operators who participated in the survey said they napped at least once during the work day, compared to 25 percent of non-transportation workers.

Given the amount of research confirming the importance of adequate sleep for overall health and functioning, it's dismaying that sleep deprivation continues to be such an issue. According to the National Highway Traffic Safety Administration, drowsiness is a contributing factor to thousands of crashes each year but it often goes underrecognized and underreported, perhaps because it's more difficult to objectively determine than impairment due to alcohol consumption.

There's enough data available to predict, however, who's most likely to be at risk of dozing off behind the wheel. Sleep loss and untreated sleep disorders such as obstructive sleep apnea are two big factors, as are the use of alcohol and/or sedating medications. Driving between midnight and 6 a.m. and driving for long periods of time without a break also can predispose drivers to drowsiness.

Specific population groups that seem to be most are risk are young adults ages 16 to 29, especially men; drivers with untreated sleep apnea syndrome; and shift workers whose sleep often is disrupted by irregular hours or working at night, a category that frequently includes transportation workers.

Some of these risk factors are difficult to modify. The transportation industry can't simply shut down at night, and many airline flights or over-the-road truck trips can't be shortened.

Other risks can be reduced - resting before or during a road trip, for instance, or seeking a medical evaluation if sleep apnea is suspected.

Sleep researchers say the transportation industry also can do more to accommodate the sleep needs of workers and promote alertness on the job. "Employers should put more effort into designing work/rest schedules that facilitate sleep and minimize workers' exposure to irregular, variable schedule changes," Patrick Sherry, a sleep researcher and professor with the University of Denver Intermodal Transportation Institute said in a news release accompanying the Sleep in America" poll.

How drowsy are you during the daytime? Find out how you score on the Epworth Sleepiness Scale, an assessment often used by doctors to test sleepiness. Those who score high on the scale should talk to their doctor about their sleep problems.