Sleep, driving and the workplace.

Sleepiness is increasingly recognised as a major preventable cause of accidents on the road and in the workplace.1-23 It contributes to up to 20% of road traffic accidents (RTAs), with sleep-related RTAs claiming an excess morbidity and mortality similar to that from alcohol-related accidents. Sleepy driving is a known risk factor for RTAs: sleepy drivers have more frequent RTAs, and drivers at fault in RTAs are more likely to be sleepy. RTAs and occupational accidents are associated with sleep deprivation, both quantity and quality, arising from various lifestyle and occupational causes, either social (work/recreational pattern, shift work) or medical sleep disorders. Extended night driving and short sleep duration are linked with sleep-related RTAs by younger drivers, and sleep-related breathing symptoms with those of older professional drivers. Shift working, long hours and short sleep have deleterious effects on accident rates across demographic categories. Driving impaired by sleepiness of any cause is an offence, but most causes of persistent excessive daytime sleepiness are treatable with psychological or medical interventions.