Mark Rosekind - Academia.edu (original) (raw)
Papers by Mark Rosekind
NASA Technical …, 2001
... is an entity very much defined by the energetic, hardworking, and dedicated people actively i... more ... is an entity very much defined by the energetic, hardworking, and dedicated people actively involved in the program: Donna Miller, Kevin Gregory, Roy Smith, Lissa Webbon, Keri Weldon, Julie M. Johnson, Ray Oyung, Roxanne M. Johnson, Ron Anguilar, and Malachi Boyle. ...
Sleep, Feb 1, 2017
Drowsy driving is a dangerous behavior that leads to thousands of deaths and injuries each year. ... more Drowsy driving is a dangerous behavior that leads to thousands of deaths and injuries each year. It is also a controllable factor for drivers. Drivers are capable of modifying this behavior if given sufficient information and motivation. Our goal is to establish a comprehensive and strategic effort to end drowsy driving crashes and deaths. This article highlights some of the conclusions of a unique recent meeting of sleep experts and highway safety professionals and describes the first steps the community has taken and plans to take in the future to address this issue.
Anesthesiology, 2002
#In this manuscript, the word fatigue is used as the summary or synthesis descriptor for the vari... more #In this manuscript, the word fatigue is used as the summary or synthesis descriptor for the varied effects and labels used to describe the cognitive, behavioral, and physiologic outcomes of sleep loss and circadian disruption. The term sleepiness as used in this manuscript describes the changes in physiologic alertness measured by standardized, objective sleep laboratory methodology.
: To document the psychophysiological effects of flying overnight cargo operations, 41 B-727 crew... more : To document the psychophysiological effects of flying overnight cargo operations, 41 B-727 crew members (average age 38 yr) were monitored before, during, and after one of two typical 8-day trip patterns. During daytime layovers, the average sleep episode was 3 hr (41%) shorter than nighttime sleeps and was rated as lighter, less restorative, and poorer overall. Sleep was frequently split into several episodes and totaled 1.2 hr less per 24 hr than on pretrip days. Each trip pattern included a night off, which was an effective countermeasure against the accumulating sleep debt. The organization of sleep during daytime layovers reflected the interaction of duty timing with circadian physiology. The circadian temperature rhythm did not adapt completely to the inverted wake-rest schedule on duty days, being delayed by about 3 hr. Highest subjective fatigue and lowest activation occurred around the time of the temperature minimum. On duty days, reports of headaches increased by 400%, ...
Journal of Clinical Sleep Medicine, 2021
Obstructive sleep apnea (OSA) is a common, identifiable, and treatable disorder with serious heal... more Obstructive sleep apnea (OSA) is a common, identifiable, and treatable disorder with serious health, safety, and financial implications - including sleepiness-related crashes and incidents - in workers who perform safety-sensitive functions in the transportation industry. Up to one third of crashes of large trucks are attributable to sleepiness, and large truck crashes result in more than 4,000 deaths annually. For each occupant of a truck who is killed, 6 to 7 occupants of other vehicles are killed. Treatment of OSA is cost-effective, lowers crash rates, and improves health and well-being. A large body of scientific evidence and expert consensus support the identification and treatment of OSA in transportation operators. An Advanced Notice of Proposed Rulemaking regarding the diagnosis and treatment of OSA in commercial truck and rail operators was issued by the Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA), but it was later withdrawn. This reversal of the agencies' position has caused confusion among some, who have questioned whether efforts to identify and treat the disorder are warranted. In response, we urge key stakeholders, including employers, operators, legislators, payers, clinicians, and patients to engage in a collaborative, patient-centered approach to address the disorder. At a minimum, stakeholders should follow the guidelines issued by a Medical Review Board (MRB) commissioned by the FMCSA in 2016 alone, or in combination with the 2006 criteria developed by a joint task force. As research in this area continues to evolve, waiting is no longer an option, and the current standard of care demands action to mitigate the burden of serious health and safety risks due to this common, treatable disorder.
Journal of Clinical Sleep Medicine, 2021
Obstructive sleep apnea (OSA) may lead to serious health, safety, and financial implications - in... more Obstructive sleep apnea (OSA) may lead to serious health, safety, and financial implications - including sleepiness-related crashes and incidents - in workers who perform safety-sensitive functions in the transportation industry. Evidence and expert consensus support its identification and treatment in high-risk commercial operators. An Advanced Notice of Proposed Rulemaking (ANPRM) regarding the diagnosis and treatment of OSA in commercial truck and rail operators was issued by the Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA), but it was later withdrawn. This reversal has led to questions about whether efforts to identify and treat OSA are warranted. In the absence of clear directives, we urge key stakeholders, including clinicians and patients, to engage in a collaborative approach to address OSA by following, at a minimum, the 2016 guidelines issued by a Medical Review Board (MRB) of the FMCSA, alone or in combination with 2006 guidance by a joint task force. The current standard of care demands action to mitigate the serious health and safety risks of OSA.
Sleep, 1993
Summitry: A national survey was conducted of 126 accredited medical schools in the United States ... more Summitry: A national survey was conducted of 126 accredited medical schools in the United States to evaluate physician education in sleep and sleep disorders and to identify potential obstacles to effective teaching in the area. Parallel survey instruments were designed to evaluate preclinical and clinical training in sleep. Instructors indicated the specific courses in which this material is taught, the format of teaching, methods of student evaluation, assigned readings and clinical experience and educational resources provided. A total of 545 responses were received, which represents an 82.6% overall response rate. Responses were obtained from all accredited medical schools, and the sample was about equally divided between preclinical and clinical course directors. Less than 2 hours of total teaching time is allocated to sleep and sleep disorders, on average, with 37 schools reporting no structured teaching time whatever in this area. Only 8% of medical students are trained in the use of sleep laboratory procedures, and 11 % have participated in the clinical evaluation of sleep-disordered patients. Less than 5% of medical schools offer 4 or more hours of didactic teaching on sleep, most of which consists of 4th year elective experiences. More than two-thirds of the survey respondents stated that current education is inadequate and that additional time should be devoted to this area. The major obstacles reported are the unavailability of qualified faculty, lack of curriculum time and the need for additional clinical and educational resources. Overall, it appears that physician education in sleep and sleep disorders is largely inadequate, despite increasing evidence of the role of sleep in patient health and well-being.
Sleep, 2003
The issue of sleep and fatigue in medical training has evolved within specific historical, politi... more The issue of sleep and fatigue in medical training has evolved within specific historical, political, and scientific contexts. In particular, three
We would like to thank the many individuals who provided their expertise, insight, and time in or... more We would like to thank the many individuals who provided their expertise, insight, and time in order to help us create a document that is scientifically based, informative, and operationally relevant. These individuals include Dr. Mary Connors, Dr. Key Dismukes, Dr. Steve Casner and Mike Feary (NASA Ames Research Center); Bob Vandel (Flight Safety Foundation); Jay Evans and Eli Cotti (National Business Aviation Association); Elizabeth Dornak (Av Safety); Debbie McElroy and Scott Foose (Regional Airline Association); Abegael Autry (Aviation Safety Reporting System). In addition, it is the efforts of the hard working and dedicated staff of the Fatigue Countermeasures Group that drives the daily activities that help increase the safety margin for us all: Sandy
We would like to thank the many individuals who provided their expertise, insight, and time in or... more We would like to thank the many individuals who provided their expertise, insight, and time in order to help us create a document that is scientifically based, informative, and operationally relevant. These individuals include Dr.
Lung Biology in Health and Disease, 2004
The American journal of managed care, 2010
The effect of insomnia on next-day functioning, health, safety, and quality of life results in a ... more The effect of insomnia on next-day functioning, health, safety, and quality of life results in a substantial societal burden and economic cost. The annual direct cost of insomnia has been estimated in the billions of US dollars and is attributed to the association of insomnia with the increased risk of certain psychiatric and medical comorbidities that result in increased healthcare service utilization. It is well known that psychiatric conditions, anxiety and depression in particular, are comorbid with insomnia. However, emerging data have shown links with several common and costly medical conditions such as heart disease and diabetes. Furthermore, studies show that patients who have insomnia have more emergency department and physician visits, laboratory tests, and prescription drug use than those who do not have insomnia, increasing direct and indirect consumption of healthcare resources. Insomnia also has been shown to negatively affect daytime functioning, including workplace p...
Psychophysiology, 2001
The present study assessed alertness, memory, and performance following three schedules of ;8 hr ... more The present study assessed alertness, memory, and performance following three schedules of ;8 hr of sleep loss~slow, intermediate, and rapid accumulation! in comparison to an 8-hr time in bed~TIB! sleep schedule. Twelve healthy individuals aged 21-35 completed each of four conditions according to a Latin Square design: no sleep loss~8-hr TIB for 4 nights; 2300-0700!, slow~6-hr TIB for 4 nights; 0100-0700!, intermediate~4-hr TIB for 2 nights; 0300-0700!, and rapid~0-hr TIB for 1 night! sleep loss. On each day, participants completed a multiple sleep latency test~MSLT!, a probed-recall memory task, a psychomotor vigilance task, a divided attention task, and the Profile of Mood States. "Rapid" sleep loss produced significantly more impairment on tests of alertness, memory, and performance compared to the "slow" accumulation of a comparable amount of sleep loss. The impairing effects of sleep loss vary as a function of rate, suggesting the presence of a compensatory adaptive mechanism operating in conjunction with the accumulation of a sleep debt.
Journal of Sleep Research, 2010
SUMMAR Y Chronic sleep deprivation is common among workers, and has been associated with negative... more SUMMAR Y Chronic sleep deprivation is common among workers, and has been associated with negative work outcomes, including absenteeism and occupational accidents. The objective of the present study is to characterize reciprocal relationships between sleep and work. Specifically, we examined how sleep impacts work performance and how work affects sleep in individuals not at-risk for a sleep disorder; assessed work performance outcomes for individuals at-risk for sleep disorders, including insomnia, obstructive sleep apnea (OSA) and restless legs syndrome (RLS); and characterized work performance impairments in shift workers (SW) at-risk for shift work sleep disorders relative to SW and day workers. One-thousand Americans who work 30 h per week or more were asked questions about employment, work performance and sleep in the National Sleep FoundationÕs 2008 Sleep in America telephone poll. Long work hours were associated with shorter sleep times, and shorter sleep times were associated with more work impairments. Thirty-seven percent of respondents were classified as at-risk for any sleep disorder. These individuals had more negative work outcomes as compared with those not at-risk for a sleep disorder. Presenteeism was a significant problem for individuals with insomnia symptoms, OSA and RLS as compared with respondents not at-risk. These results suggest that long work hours may contribute to chronic sleep loss, which may in turn result in work impairment. Risk for sleep disorders substantially increases the likelihood of negative work outcomes, including occupational accidents, absenteeism and presenteeism.
Journal of Occupational & Environmental Medicine, 2010
To assess the impact of sleep disturbances on work performance/ productivity. Methods: Employees ... more To assess the impact of sleep disturbances on work performance/ productivity. Methods: Employees (N ϭ 4188) at four US corporations were surveyed about sleep patterns and completed the Work Limitations Questionnaire. Respondents were classified into four categories: insomnia, insufficient sleep syndrome, at-risk, and good sleep. Employer costs related to productivity changes were estimated through the Work Limitations Questionnaire. Performance/productivity, safety, and treatment measures were compared using a one-way analysis of variance model. Results: Compared with at-risk and good-sleep groups, insomnia and insufficient sleep syndrome groups had significantly worse productivity, performance, and safety outcomes. The insomnia group had the highest rate of sleep medication use. The other groups were more likely to use nonmedication treatments. Fatigue-related productivity losses were estimated to cost $1967/employee annually. Conclusions: Sleep disturbances contribute to decreased employee productivity at a high cost to employers.
Journal of Occupational & Environmental Medicine, 2010
To describe the relationship between nighttime awakenings and work performance. Employees (N = 41... more To describe the relationship between nighttime awakenings and work performance. Employees (N = 4188) at four US companies described their sleep patterns and completed the Work Limitations Questionnaire. Participants were categorized by number of nighttime awakenings: 0 (n = 464; 11%), 1 to 2 (n = 2373; 58%), 3 to 4 (n = 984; 24%), or > or =5 (n = 289; 7%). Work Limitations Questionnaire performance and productivity measures were compared among the groups using a one-way analysis of variance model. Thirty-one percent of the sample averaged > or =3 nighttime awakenings. Compared with respondents with fewer nighttime awakenings, these respondents had the greatest work performance and productivity impairments across a wide range of dimensions. Workers who experienced > or =3 nighttime awakenings have poorer work productivity and performance than do workers who experience fewer awakenings.
Anesthesiology, 2003
Background Sleep deprivation causes physiologic and subjective sleepiness. Studies of fatigue eff... more Background Sleep deprivation causes physiologic and subjective sleepiness. Studies of fatigue effects on anesthesiologist performance have given equivocal results. The authors used a realistic simulation environment to study the effects of sleep deprivation on psychomotor and clinical performance, subjective and objective sleepiness, and mood. Methods Twelve anesthesia residents performed a 4-h anesthetic on a simulated patient the morning after two conditions of prior sleep: sleep-extended (EXT), in which subjects were allowed to arrive at work at 10:00 AM for 4 consecutive days, thus allowing an increase in nocturnal sleep time, and total sleep deprivation (DEP), in which subjects were awake at least 25 h. Psychomotor testing was performed at specified periods throughout the night in the DEP condition and at matched times during the simulation session in both conditions. Three types of vigilance probes were presented to subjects at random intervals as well as two clinical events. ...
Air Medical Journal, 2010
Introduction: Humans confront significant physiological challenges with sleep and alertness when ... more Introduction: Humans confront significant physiological challenges with sleep and alertness when working in 24/7 operations. Methods: A web-based national survey of air medical pilots examined issues relevant to fatigue and sleep management. Results: Six hundred ninety-seven responses were received, with a majority of rotor wing pilots working 3/3/7 and 7/7 duty schedules. Over 84% of the pilots reported that fatigue had affected their flight performance; less than 28% reported "nodding off" during flight. More than 90% reported a separate work site "rest" room with a bed available. Over 90% reported no company policies restricting on-duty sleep. Approximately half of the pilots reported getting 4 hours or more sleep during a typical night shift. Approximately half reported that sleep inertia had never compromised flight safety. Over 90% reported that it was better to sleep during the night and overcome sleep inertia if necessary. Discussion: Survey results reflected practices that can mitigate the degrading effects of fatigue, including the availability of designated work-site sleep rooms. As demands continue to evolve, the need remains for sustained efforts to address fatigue-related risks in the air medical transport industry. This includes further study of sleep inertia issues and the need for alertness management programs.
NASA Technical …, 2001
... is an entity very much defined by the energetic, hardworking, and dedicated people actively i... more ... is an entity very much defined by the energetic, hardworking, and dedicated people actively involved in the program: Donna Miller, Kevin Gregory, Roy Smith, Lissa Webbon, Keri Weldon, Julie M. Johnson, Ray Oyung, Roxanne M. Johnson, Ron Anguilar, and Malachi Boyle. ...
Sleep, Feb 1, 2017
Drowsy driving is a dangerous behavior that leads to thousands of deaths and injuries each year. ... more Drowsy driving is a dangerous behavior that leads to thousands of deaths and injuries each year. It is also a controllable factor for drivers. Drivers are capable of modifying this behavior if given sufficient information and motivation. Our goal is to establish a comprehensive and strategic effort to end drowsy driving crashes and deaths. This article highlights some of the conclusions of a unique recent meeting of sleep experts and highway safety professionals and describes the first steps the community has taken and plans to take in the future to address this issue.
Anesthesiology, 2002
#In this manuscript, the word fatigue is used as the summary or synthesis descriptor for the vari... more #In this manuscript, the word fatigue is used as the summary or synthesis descriptor for the varied effects and labels used to describe the cognitive, behavioral, and physiologic outcomes of sleep loss and circadian disruption. The term sleepiness as used in this manuscript describes the changes in physiologic alertness measured by standardized, objective sleep laboratory methodology.
: To document the psychophysiological effects of flying overnight cargo operations, 41 B-727 crew... more : To document the psychophysiological effects of flying overnight cargo operations, 41 B-727 crew members (average age 38 yr) were monitored before, during, and after one of two typical 8-day trip patterns. During daytime layovers, the average sleep episode was 3 hr (41%) shorter than nighttime sleeps and was rated as lighter, less restorative, and poorer overall. Sleep was frequently split into several episodes and totaled 1.2 hr less per 24 hr than on pretrip days. Each trip pattern included a night off, which was an effective countermeasure against the accumulating sleep debt. The organization of sleep during daytime layovers reflected the interaction of duty timing with circadian physiology. The circadian temperature rhythm did not adapt completely to the inverted wake-rest schedule on duty days, being delayed by about 3 hr. Highest subjective fatigue and lowest activation occurred around the time of the temperature minimum. On duty days, reports of headaches increased by 400%, ...
Journal of Clinical Sleep Medicine, 2021
Obstructive sleep apnea (OSA) is a common, identifiable, and treatable disorder with serious heal... more Obstructive sleep apnea (OSA) is a common, identifiable, and treatable disorder with serious health, safety, and financial implications - including sleepiness-related crashes and incidents - in workers who perform safety-sensitive functions in the transportation industry. Up to one third of crashes of large trucks are attributable to sleepiness, and large truck crashes result in more than 4,000 deaths annually. For each occupant of a truck who is killed, 6 to 7 occupants of other vehicles are killed. Treatment of OSA is cost-effective, lowers crash rates, and improves health and well-being. A large body of scientific evidence and expert consensus support the identification and treatment of OSA in transportation operators. An Advanced Notice of Proposed Rulemaking regarding the diagnosis and treatment of OSA in commercial truck and rail operators was issued by the Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA), but it was later withdrawn. This reversal of the agencies' position has caused confusion among some, who have questioned whether efforts to identify and treat the disorder are warranted. In response, we urge key stakeholders, including employers, operators, legislators, payers, clinicians, and patients to engage in a collaborative, patient-centered approach to address the disorder. At a minimum, stakeholders should follow the guidelines issued by a Medical Review Board (MRB) commissioned by the FMCSA in 2016 alone, or in combination with the 2006 criteria developed by a joint task force. As research in this area continues to evolve, waiting is no longer an option, and the current standard of care demands action to mitigate the burden of serious health and safety risks due to this common, treatable disorder.
Journal of Clinical Sleep Medicine, 2021
Obstructive sleep apnea (OSA) may lead to serious health, safety, and financial implications - in... more Obstructive sleep apnea (OSA) may lead to serious health, safety, and financial implications - including sleepiness-related crashes and incidents - in workers who perform safety-sensitive functions in the transportation industry. Evidence and expert consensus support its identification and treatment in high-risk commercial operators. An Advanced Notice of Proposed Rulemaking (ANPRM) regarding the diagnosis and treatment of OSA in commercial truck and rail operators was issued by the Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA), but it was later withdrawn. This reversal has led to questions about whether efforts to identify and treat OSA are warranted. In the absence of clear directives, we urge key stakeholders, including clinicians and patients, to engage in a collaborative approach to address OSA by following, at a minimum, the 2016 guidelines issued by a Medical Review Board (MRB) of the FMCSA, alone or in combination with 2006 guidance by a joint task force. The current standard of care demands action to mitigate the serious health and safety risks of OSA.
Sleep, 1993
Summitry: A national survey was conducted of 126 accredited medical schools in the United States ... more Summitry: A national survey was conducted of 126 accredited medical schools in the United States to evaluate physician education in sleep and sleep disorders and to identify potential obstacles to effective teaching in the area. Parallel survey instruments were designed to evaluate preclinical and clinical training in sleep. Instructors indicated the specific courses in which this material is taught, the format of teaching, methods of student evaluation, assigned readings and clinical experience and educational resources provided. A total of 545 responses were received, which represents an 82.6% overall response rate. Responses were obtained from all accredited medical schools, and the sample was about equally divided between preclinical and clinical course directors. Less than 2 hours of total teaching time is allocated to sleep and sleep disorders, on average, with 37 schools reporting no structured teaching time whatever in this area. Only 8% of medical students are trained in the use of sleep laboratory procedures, and 11 % have participated in the clinical evaluation of sleep-disordered patients. Less than 5% of medical schools offer 4 or more hours of didactic teaching on sleep, most of which consists of 4th year elective experiences. More than two-thirds of the survey respondents stated that current education is inadequate and that additional time should be devoted to this area. The major obstacles reported are the unavailability of qualified faculty, lack of curriculum time and the need for additional clinical and educational resources. Overall, it appears that physician education in sleep and sleep disorders is largely inadequate, despite increasing evidence of the role of sleep in patient health and well-being.
Sleep, 2003
The issue of sleep and fatigue in medical training has evolved within specific historical, politi... more The issue of sleep and fatigue in medical training has evolved within specific historical, political, and scientific contexts. In particular, three
We would like to thank the many individuals who provided their expertise, insight, and time in or... more We would like to thank the many individuals who provided their expertise, insight, and time in order to help us create a document that is scientifically based, informative, and operationally relevant. These individuals include Dr. Mary Connors, Dr. Key Dismukes, Dr. Steve Casner and Mike Feary (NASA Ames Research Center); Bob Vandel (Flight Safety Foundation); Jay Evans and Eli Cotti (National Business Aviation Association); Elizabeth Dornak (Av Safety); Debbie McElroy and Scott Foose (Regional Airline Association); Abegael Autry (Aviation Safety Reporting System). In addition, it is the efforts of the hard working and dedicated staff of the Fatigue Countermeasures Group that drives the daily activities that help increase the safety margin for us all: Sandy
We would like to thank the many individuals who provided their expertise, insight, and time in or... more We would like to thank the many individuals who provided their expertise, insight, and time in order to help us create a document that is scientifically based, informative, and operationally relevant. These individuals include Dr.
Lung Biology in Health and Disease, 2004
The American journal of managed care, 2010
The effect of insomnia on next-day functioning, health, safety, and quality of life results in a ... more The effect of insomnia on next-day functioning, health, safety, and quality of life results in a substantial societal burden and economic cost. The annual direct cost of insomnia has been estimated in the billions of US dollars and is attributed to the association of insomnia with the increased risk of certain psychiatric and medical comorbidities that result in increased healthcare service utilization. It is well known that psychiatric conditions, anxiety and depression in particular, are comorbid with insomnia. However, emerging data have shown links with several common and costly medical conditions such as heart disease and diabetes. Furthermore, studies show that patients who have insomnia have more emergency department and physician visits, laboratory tests, and prescription drug use than those who do not have insomnia, increasing direct and indirect consumption of healthcare resources. Insomnia also has been shown to negatively affect daytime functioning, including workplace p...
Psychophysiology, 2001
The present study assessed alertness, memory, and performance following three schedules of ;8 hr ... more The present study assessed alertness, memory, and performance following three schedules of ;8 hr of sleep loss~slow, intermediate, and rapid accumulation! in comparison to an 8-hr time in bed~TIB! sleep schedule. Twelve healthy individuals aged 21-35 completed each of four conditions according to a Latin Square design: no sleep loss~8-hr TIB for 4 nights; 2300-0700!, slow~6-hr TIB for 4 nights; 0100-0700!, intermediate~4-hr TIB for 2 nights; 0300-0700!, and rapid~0-hr TIB for 1 night! sleep loss. On each day, participants completed a multiple sleep latency test~MSLT!, a probed-recall memory task, a psychomotor vigilance task, a divided attention task, and the Profile of Mood States. "Rapid" sleep loss produced significantly more impairment on tests of alertness, memory, and performance compared to the "slow" accumulation of a comparable amount of sleep loss. The impairing effects of sleep loss vary as a function of rate, suggesting the presence of a compensatory adaptive mechanism operating in conjunction with the accumulation of a sleep debt.
Journal of Sleep Research, 2010
SUMMAR Y Chronic sleep deprivation is common among workers, and has been associated with negative... more SUMMAR Y Chronic sleep deprivation is common among workers, and has been associated with negative work outcomes, including absenteeism and occupational accidents. The objective of the present study is to characterize reciprocal relationships between sleep and work. Specifically, we examined how sleep impacts work performance and how work affects sleep in individuals not at-risk for a sleep disorder; assessed work performance outcomes for individuals at-risk for sleep disorders, including insomnia, obstructive sleep apnea (OSA) and restless legs syndrome (RLS); and characterized work performance impairments in shift workers (SW) at-risk for shift work sleep disorders relative to SW and day workers. One-thousand Americans who work 30 h per week or more were asked questions about employment, work performance and sleep in the National Sleep FoundationÕs 2008 Sleep in America telephone poll. Long work hours were associated with shorter sleep times, and shorter sleep times were associated with more work impairments. Thirty-seven percent of respondents were classified as at-risk for any sleep disorder. These individuals had more negative work outcomes as compared with those not at-risk for a sleep disorder. Presenteeism was a significant problem for individuals with insomnia symptoms, OSA and RLS as compared with respondents not at-risk. These results suggest that long work hours may contribute to chronic sleep loss, which may in turn result in work impairment. Risk for sleep disorders substantially increases the likelihood of negative work outcomes, including occupational accidents, absenteeism and presenteeism.
Journal of Occupational & Environmental Medicine, 2010
To assess the impact of sleep disturbances on work performance/ productivity. Methods: Employees ... more To assess the impact of sleep disturbances on work performance/ productivity. Methods: Employees (N ϭ 4188) at four US corporations were surveyed about sleep patterns and completed the Work Limitations Questionnaire. Respondents were classified into four categories: insomnia, insufficient sleep syndrome, at-risk, and good sleep. Employer costs related to productivity changes were estimated through the Work Limitations Questionnaire. Performance/productivity, safety, and treatment measures were compared using a one-way analysis of variance model. Results: Compared with at-risk and good-sleep groups, insomnia and insufficient sleep syndrome groups had significantly worse productivity, performance, and safety outcomes. The insomnia group had the highest rate of sleep medication use. The other groups were more likely to use nonmedication treatments. Fatigue-related productivity losses were estimated to cost $1967/employee annually. Conclusions: Sleep disturbances contribute to decreased employee productivity at a high cost to employers.
Journal of Occupational & Environmental Medicine, 2010
To describe the relationship between nighttime awakenings and work performance. Employees (N = 41... more To describe the relationship between nighttime awakenings and work performance. Employees (N = 4188) at four US companies described their sleep patterns and completed the Work Limitations Questionnaire. Participants were categorized by number of nighttime awakenings: 0 (n = 464; 11%), 1 to 2 (n = 2373; 58%), 3 to 4 (n = 984; 24%), or > or =5 (n = 289; 7%). Work Limitations Questionnaire performance and productivity measures were compared among the groups using a one-way analysis of variance model. Thirty-one percent of the sample averaged > or =3 nighttime awakenings. Compared with respondents with fewer nighttime awakenings, these respondents had the greatest work performance and productivity impairments across a wide range of dimensions. Workers who experienced > or =3 nighttime awakenings have poorer work productivity and performance than do workers who experience fewer awakenings.
Anesthesiology, 2003
Background Sleep deprivation causes physiologic and subjective sleepiness. Studies of fatigue eff... more Background Sleep deprivation causes physiologic and subjective sleepiness. Studies of fatigue effects on anesthesiologist performance have given equivocal results. The authors used a realistic simulation environment to study the effects of sleep deprivation on psychomotor and clinical performance, subjective and objective sleepiness, and mood. Methods Twelve anesthesia residents performed a 4-h anesthetic on a simulated patient the morning after two conditions of prior sleep: sleep-extended (EXT), in which subjects were allowed to arrive at work at 10:00 AM for 4 consecutive days, thus allowing an increase in nocturnal sleep time, and total sleep deprivation (DEP), in which subjects were awake at least 25 h. Psychomotor testing was performed at specified periods throughout the night in the DEP condition and at matched times during the simulation session in both conditions. Three types of vigilance probes were presented to subjects at random intervals as well as two clinical events. ...
Air Medical Journal, 2010
Introduction: Humans confront significant physiological challenges with sleep and alertness when ... more Introduction: Humans confront significant physiological challenges with sleep and alertness when working in 24/7 operations. Methods: A web-based national survey of air medical pilots examined issues relevant to fatigue and sleep management. Results: Six hundred ninety-seven responses were received, with a majority of rotor wing pilots working 3/3/7 and 7/7 duty schedules. Over 84% of the pilots reported that fatigue had affected their flight performance; less than 28% reported "nodding off" during flight. More than 90% reported a separate work site "rest" room with a bed available. Over 90% reported no company policies restricting on-duty sleep. Approximately half of the pilots reported getting 4 hours or more sleep during a typical night shift. Approximately half reported that sleep inertia had never compromised flight safety. Over 90% reported that it was better to sleep during the night and overcome sleep inertia if necessary. Discussion: Survey results reflected practices that can mitigate the degrading effects of fatigue, including the availability of designated work-site sleep rooms. As demands continue to evolve, the need remains for sustained efforts to address fatigue-related risks in the air medical transport industry. This includes further study of sleep inertia issues and the need for alertness management programs.