Sleepiness and Fatigue Melanie Moylan Email: melaniemoylan@ICLOUD.com Tel: 021-024-19044

Sleepiness vs Fatigue: How do they differ? Sleepiness/drowsiness is the desire to fall asleep. When we are sleepy it can interfere with normal day-to-day activities affecting concentration, reaction time, productivity and safety and is alleviated by restorative sleep Fatigue is extreme tiredness following mental or physical exertion or illness and is relieved by rest and inactivity We have no control over “sleepiness” Consequently, sleepiness is much more dangerous than fatigue from a safety perspective The words sleepiness or drowsiness and fatigue or tiredness are frequently interchangeable but it is important to differentiate between them.   Sleepiness/drowsiness is the desire to fall asleep. When we are sleepy it can interfere with normal day-to-day activities affecting concentration, reaction time, productivity and safety and is alleviated by restorative sleep Fatigue is extreme tiredness following mental or physical exertion or illness and is relieved by rest and inactivity We have no control over “sleepiness” Consequently, sleepiness is much more dangerous than fatigue from a safety perspective Often, when companies talk about fatigue management, they are really talking about prevention of sleepiness/drowsiness because that is the dangerous state before sleep. This distinction is important so individuals and group policies protect their workers from harm, not just tiredness or exhaustion from exercise or exertion.

Causes of Sleepiness Some medications Poor sleeping habits Underlying and undiagnosed sleep conditions Illness What causes sleepiness? **Awareness** Some medications – sleeping tablets, antihistamines, painkillers **Self- management** Poor sleeping habits – short sleep duration, inconsistent bedtimes, **Need to be treated** Underlying and undiagnosed sleep conditions – OSA, insomnia, RLS, Narcolepsy Illness – cancer, flu, diabetes, depression

Selby Train Crash, UK 2001 Driver fell asleep at wheel of car Land Rover and trailer ran off motorway and on to the railway track 10 fatalities, 82 injured Intercity 9 carriage passenger train destroyed/freight train derailed Driver fell asleep at wheel of car Land Rover and trailer ran off motorway and on to the railway track 10 fatalities, 82 injured Intercity 9 carriage passenger train destroyed/freight train derailed

M62 Motorway Crash, UK 2006 Driver fell asleep at wheel of truck Truck ploughed into a queue of stationary traffic on the motorway in Merseyside One fatality A total of nine vehicles were damaged Driver fell asleep at wheel of truck Truck ploughed into a queue of stationary traffic on the motorway in Merseyside One fatality A total of nine vehicles were damaged

What is the difference? Selby Train Crash Car driver due to ‘up all night’ talking on phone CAUSE: Poor sleeping habits M62 Motorway Crash Truck driver had slept for 8 hours CAUSE: Undiagnosed sleep condition (OSA) Same motorway Both drivers fell asleep at the wheel Both caused fatalities Both had sleep deprivation Same motorway Both drivers fell asleep at the wheel Both caused fatalities Both had sleep deprivation Selby Train Crash Car driver due to ‘up all night’ talking on phone CAUSE: Poor sleeping habits M62 Motorway Crash Truck driver had slept for 8 hours CAUSE: Undiagnosed sleep condition (OSA)

Warning Signs Too much sleepiness with an adequate amount of time spent sleeping may suggest a sleep disorder. Excessive daytime sleepiness, is a common complaint in people with obstructive sleep apnea Fatigue may represent a separate set of medical conditions (e.g. anemia, hypothyroidism, and depression). In the realm of sleep problems, fatigue is a common complaint of insomnia Too much sleepiness with an adequate amount of time spent sleeping may suggest a sleep disorder. Excessive daytime sleepiness, is a common complaint in people with obstructive sleep apnea Fatigue may represent a separate set of medical conditions (e.g. anemia, hypothyroidism, and depression). In the realm of sleep problems, fatigue is a common complaint of insomnia

Managing the Risk Fatigue Management Plan (drivers hours, shift patterns, breaks, holidays) Clinical Screening (education, questionnaires, diagnostic testing, treatment and management) Drug, Alcohol and Sleep Policy??? Managing the Risk Fatigue Management Plan (drivers hours, shift patterns, breaks, holidays) Clinical Screening (education, questionnaires, diagnostic testing, treatment and management) Drug, Alcohol and Sleep Policy???