Circadian sleep-wake disorders and professional driving.

ABSTRACT

The changes in work organization have significantly modified our lifestyle and increased the number of workers with shift-work schedules, staggered hours and sleep debt. Professional drivers are particularly at risk of excessive sleepiness due to circadian factors (such as night driving), sleep deprivation (professional obligations) and sleep disorders (i.e. obstructive sleep apnea syndrome). About 5% of the population is supposed to suffer from Excessive Daytime Sleepiness (i.e. difficulty staying awake). Public health studies have shown that sleepiness at the wheel is responsible for 5% to 30% of road accidents, depending on the type of driver and/or road. Excessive sleepiness in professional drivers can thus depend on homeostatic process (for a sleep debt related to extended work time or to sleep disorders) and on circadian process (such as in shift-work syndrome or in delayed phase shifts). Strategies to reduce accidents related to sleepiness include reliable diagnosis and treatment of sleep disorders, management of chronobiological conflicts, adequate recovery sleep and countermeasures against sleepiness at the wheel.