Journal article

Objective and subjective measures of sleepiness, and their associations with on-road driving events in shift workers

Suzanne Ftouni, Tracey L Sletten, Mark Howard, Clare Anderson, Michael G Lenne, Steven W Lockley, Shantha MW Rajaratnam



To assess the relationships between sleepiness and the incidence of adverse driving events in nurses commuting to and from night and rotating shifts, 27 rotating and permanent night shift-working nurses were asked to complete daily sleep and duty logs, and wear wrist-activity monitors for 2 weeks (369 driving sessions). During all commutes, ocular measures of drowsiness, including the Johns Drowsiness Scale score, were assessed using the Optalert™ system. Participants self-reported their subjective sleepiness at the beginning and end of each drive, and any events that occurred during the drive. Rotating shift nurses reported higher levels of sleepiness compared with permanent night shift nur..

View full abstract

University of Melbourne Researchers


Funding Acknowledgements

Financial support for this study was provided by the Monash University, Faculty of Medicine, Nursing & Health Sciences Strategic Grant Scheme and VicRoads. Optalert (TM) equipment was provided by Optalert (TM) Pty Ltd. We would also like to thank Dr Matthew Naughton for contribution to study grant.Dr Rajaratnam reports that he has served as a consultant through his institution to Vanda Pharmaceuticals, Philips Respironics, EdanSafe, The Australian Workers' Union, Rail, Bus and Tram Union, and National Transport Commission, and has through his institution received research grants and/or unrestricted educational grants from Vanda Pharmaceuticals, Takeda Pharmaceuticals North America, Philips Lighting, Philips Respironics, Cephalon and ResMed Foundation, and reimbursements for conference travel expenses from Vanda Pharmaceuticals. His institution has received equipment donations or other support from Optalert (TM), Compumedics, and Tyco Healthcare. He has also served as an expert witness and/or consultant to shift work organizations.Ms Ftouni reports her institution has received equipment donations or other support from Optalert (TM) and Compumedics.Dr Anderson has served as consultant to the Rail, Bus and Tram Union through an agreement between Monash University and the Rail, Bus and Tram Union. She has also received research support from VicRoads, and research funds from Sanofi-Aventis. She has received lecturing fees from Brown Medical School/Rhode Island Hospital and Ausmed.Dr Sletten reports her institution has received equipment donations or other support from Optalert (TM) and Compumedics. Dr Lockley reports that he received two investigator-initiated research grants from the ResMed Foundation and an unrestricted equipment gift from ResMed Inc, in support of the studies described in this article; receiving consulting fees from Apollo Lighting, Naturebright, Sound Oasis, and Wyle Integrated Science and Engineering, and federally funded projects at Brigham and Women's Hospital, Thomas Jefferson University, and Warwick Medical School; lecture fees from Takeda Pharmaceuticals North America, I Slept Great/Euforma, LLC and Emergency Social Services Association Conference, UK; unrestricted equipment gifts from Philips Lighting and Bionetics Corporation; an unrestricted monetary gift to support research from Swinburne University of Technology, Australia; a fellowship gift from Optalert, Pty Ltd, Melbourne, Australia; advance author payment and royalties from Oxford University Press, and honoraria from Servier Inc for writing an article for Dialogues in Clinical Neuroscience and from AMO Inc, for writing an educational monograph, neither of which refer to the companies' products; honoraria or travel and accommodation support for invited seminars, conference presentations or teaching from the Second International Symposium on the Design of Artificial Environments, Eighth International Conference on Managing Fatigue, American Academy of Sleep Medicine, American Society for Photobiology, Apollo Lighting, Bar Harbor Chamber of Commerce, Bassett Research Institute, Canadian Sleep Society, Committee of Interns and Residents, Coney Island Hospital, FASEB, Harvard University, Illinois Coalition for Responsible Outdoor Lighting, International Graduate School of Neuroscience, Japan National Institute of Occupational Safety and Health, Lightfair, National Research Council Canada, New York Academy of Sciences, North East Sleep Society, Ontario Association of Fire Chiefs, Philips Lighting, Thomas Jefferson University, University of Montreal, University of Tsukuba, University of Vermont College of Medicine, Utica College, Vanda Pharmaceuticals, Velux, Warwick Medical School, Woolcock Institute of Medical Research, and Wyle Integrated Science and Engineering (NASA); investigator-initiated research grants from Respironics Inc, Philips Lighting, Apollo Lighting and Alcon Inc; and a service agreement and sponsor-initiated research contract from Vanda Pharmaceuticals. Dr Lockley also holds a process patent for the use of short-wavelength light for resetting the human circadian pacemaker and improving alertness and performance, which is assigned to the Brigham and Women's Hospital per Hospital policy and has received revenue from a patent on the use of short-wavelength light, which is assigned to the University of Surrey. Dr Lockley has also served as a paid expert witness on behalf of two public bodies on arbitration panels related to sleep, circadian rhythms and work hours.