title: Understanding the role of sleep quality and sleep duration in commercial driving safety.
abstract: BACKGROUND
  Long-haul truck drivers in the United States suffer disproportionately high injury rates. Sleep is a critical factor in these outcomes, contributing to fatigue and degrading multiple aspects of safety-relevant performance. Both sleep duration and sleep quality are often compromised among truck drivers; however, much of the efforts to combat fatigue focus on sleep duration rather than sleep quality. Thus, the current study has two objectives: (1) to determine the degree to which sleep impacts safety-relevant performance among long-haul truck drivers; and (2) to evaluate workday and non-workday sleep quality and duration as predictors of drivers' safety-relevant performance.
  
  
  METHODS
  A non-experimental, descriptive, cross-sectional design was employed to collect survey and biometric data from 260 long-haul truck drivers. The Trucker Sleep Disorders Survey was developed to assess sleep duration and quality, the impact of sleep on job performance and accident risk, and other relevant work organization characteristics. Descriptive statistics assessed work organization variables, sleep duration and quality, and frequency of engaging in safety-relevant performance while sleepy. Linear regression analyses were conducted to evaluate relationships between sleep duration, sleep quality, and work organization variables with safety composite variables.
  
  
  RESULTS
  Drivers reported long work hours, with over 70% of drivers working more than 11h daily. Drivers also reported a large number of miles driven per week, with an average of 2,812.61 miles per week, and frequent violations of hours-of-service rules, with 43.8% of drivers "sometimes to always" violating the "14-h rule." Sleep duration was longer, and sleep quality was better, on non-workdays compared on workdays. Drivers frequently operated motor vehicles while sleepy, and sleepiness impacted several aspects of safety-relevant performance. Sleep quality was better associated with driving while sleepy and with job performance and concentration than sleep duration. Sleep duration was better associated with accidents and accident risk than sleep quality.
  
  
  CONCLUSIONS
  Sleep quality appears to be better associated with safety-relevant performance among long-haul truck drivers than sleep duration. Comprehensive and multilevel efforts are needed to meaningfully address sleep quality among drivers.
authors: Complexity & Computational Population Health Group, Department of Health & Kinesiology, Texas A&M University, 4243 TAMU, College Station, TX 77843-4243, United States. Electronic address: michael.lemke@hlkn.tamu.edu.
authors: Michael K
authors: MK
authors: Lemke
authors: Complexity & Computational Population Health Group, Department of Health & Kinesiology, Texas A&M University, 4243 TAMU, College Station, TX 77843-4243, United States. Electronic address: yaposto@hlkn.tamu.edu.
authors: Yorghos
authors: Y
authors: Apostolopoulos
authors: Department of Health & Exercise Science, Appalachian State University, 111 Rivers Street, Boone, NC 28608, United States. Electronic address: hegeba@appstate.edu.
authors: Adam
authors: A
authors: Hege
authors: Rosen College of Hospitality Management, University of Central Florida, 9907 Universal Blvd., Orlando, FL 32819, United States. Electronic address: Sevil.Sonmez@ucf.edu.
authors: Sevil
authors: S
authors: Sönmez
authors: Department of Kinesiology, University of North Carolina Greensboro, P.O. Box 26170, Greensboro, NC 27402-6170, United States. Electronic address: l_widema@uncg.edu.
authors: Laurie
authors: L
authors: Wideman
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data; D000328:Adult; D001288:Attention; D001334:Automobile Driving / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000453:epidemiology; D006801:Humans; D018986:Motor Vehicles / Q000706:statistics & numerical data; D012890:Sleep; D012894:Sleep Stages; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D014481:United States; D000066477:Work Performance / Q000706:statistics & numerical data*; D014940:Work Schedule Tolerance
keywords: Accidents; Commercial drivers; Sleep duration; Sleep quality