title: Assessing sleepiness and sleep disorders in Australian long-distance commercial vehicle drivers: self-report versus an "at home" monitoring device.
abstract: OBJECTIVE
  As obstructive sleep apnea (OSA) is associated with a higher risk of motor vehicle crashes, there is increasing regulatory interest in the identification of commercial motor vehicle (CMV) drivers with this condition. This study aimed to determine the relationship between subjective versus objective assessment of OSA in CMV drivers.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Heavy vehicle truck stops located across the road network of 2 large Australian states.
  
  
  METHODS
  A random sample of long distance commercial vehicle drivers (n = 517).
  
  
  METHODS
  None.
  
  
  RESULTS
  Drivers were interviewed regarding their driving experience, personal health, shift schedules, payments, and various questions on sleep and tiredness in order to describe their sleep health across a range of variables. In addition, home recordings using a flow monitor were used during one night of sleep. Only 4.4% of drivers reported a previous diagnosis of sleep apnea, while our at home diagnostic test found a further 41% of long-distance heavy vehicle drivers likely to have sleep apnea. The multivariable apnea prediction index, based on self-report measures, showed poor agreement with the home-monitor detected sleep apnea (AUC 0.58, 95%CI = 0.49-0.62), and only 12% of drivers reported daytime sleepiness (Epworth Sleepiness Scale score > 10). Thirty-six percent of drivers were overweight and a further 50% obese; 49% of drivers were cigarette smokers.
  
  
  CONCLUSIONS
  Sleep apnea remains a significant and unrecognized problem in CMV drivers, who we found to have multiple health risks. Objective testing for this sleep disorder needs to be considered, as symptom reports and self-identification appear insufficient to accurately identify those at risk.
authors.affiliation: The George Institute for Global Health, Sydney, Australia. lsharwood@george.org.au
authors.forename: Lisa N
authors.initials: LN
authors.lastname: Sharwood
authors.forename: Jane
authors.initials: J
authors.lastname: Elkington
authors.forename: Mark
authors.initials: M
authors.lastname: Stevenson
authors.forename: Ronald R
authors.initials: RR
authors.lastname: Grunstein
authors.forename: Lynn
authors.initials: L
authors.lastname: Meuleners
authors.forename: Rebecca Q
authors.initials: RQ
authors.lastname: Ivers
authors.forename: Narelle
authors.initials: N
authors.lastname: Haworth
authors.forename: Robyn
authors.initials: R
authors.lastname: Norton
authors.forename: Keith K
authors.initials: KK
authors.lastname: Wong
mesh_terms: D000328:Adult; D001315:Australia; D001334:Automobile Driving; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D017286:Polysomnography / Q000295:instrumentation*; D015203:Reproducibility of Results; D057566:Self Report; D012680:Sensitivity and Specificity; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*