1. Sleepiness and Fatigue
Melanie Moylan
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2. 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.

3. 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

4. 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

5. 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

6. 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)

7. 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

8. 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???