title: Excessive sleepiness, sleep hygiene, and coping strategies among night bus drivers: A cross-sectional study.
abstract: BACKGROUND
  Sleep disruption and excessive sleepiness are the known consequences of shift work. The recent spate of night-time road and air accidents, with some being directly attributed to driver sleepiness prompted us to undertake this study.
  
  
  OBJECTIVE
  To screen for excessive sleepiness, coping practices, and post-shift sleep hygiene in night bus drivers.
  
  
  METHODS
  This prospective study was carried out on night bus drivers of a public transport organization in Bengaluru, Karnataka, India.
  
  
  METHODS
  Bus drivers driving for ≥8 h at night were screened with the Epworth Sleepiness Scale (ESS) and a prevalidated shift work questionnaire.
  
  
  METHODS
  Descriptive statistics were used to analyze the compiled data using Statistical Package for the Social Sciences (SPSS) version 20.
  
  
  RESULTS
  One hundred and eighty bus drivers aged 22-63 years were screened.
  Although only 2 (1.1%) drivers scored above the cutoff on ESS, 10 (5.6%) and 103 (57.2%) drivers admitted to feeling sleepy during daytime and night driving respectively. None of the drivers admitted to causing accidents related to sleepiness. The coping strategies for nocturnal sleepiness included consuming coffee/tea (16.7%), chewing tobacco (12.8%), smoking (6.1%), and walking (3.9%).
  Post-shift sleep duration ranged between 1 h and 10 h. Twenty-six (14.4%) and 16 (8.9%) drivers had difficulty initiating and maintaining sleep, respectively, while 9 (5%) reported frequent awakening during daytime sleep.
  
  
  CONCLUSIONS
  This study has demonstrated a high incidence of nocturnal sleepiness and daytime sleep disruption among night bus drivers, thus necessitating the need for education about shift work and alertness testing among shift workers in critical professions.
authors.affiliation: Department of Pulmonary Medicine, St. John's National Academy of Health Sciences, Bangalore, Karnataka, India.
authors.forename: Uma Maheswari
authors.initials: UM
authors.lastname: Krishnaswamy
authors.affiliation: Department of Respiratory Medicine, MS Ramaiah Medical College, Bangalore, Karnataka, India.
authors.forename: Mamta S
authors.initials: MS
authors.lastname: Chhabria
authors.affiliation: Department of Respiratory Medicine, MS Ramaiah Medical College, Bangalore, Karnataka, India.
authors.forename: Aditi
authors.initials: A
authors.lastname: Rao
keywords: Bus drivers; excessive sleepiness; shift work; sleep hygiene