Effects of alertness management training on sleepiness among long-haul truck drivers: A randomized controlled trial

Abstract

Education is a frequently recommended remedy for driver sleepiness in occupational settings, although not many studies have examined its usefulness. To date, there are no previous on-road randomized controlled trials investigating the benefits of training on sleepiness among employees working in road transport. To examine the effects of an educational intervention on long-haul truck drivers' sleepiness at the wheel, amount of sleep between work shifts, and use of efficient sleepiness countermeasures (SCM) in association with night and non-night shift, a total of 53 truck drivers operating from southern Finland were allocated into an intervention and a control group using a stratified randomization method (allocation ratio for intervention and control groups 32:21, respectively). The intervention group received a 3.5-hour alertness management training followed by a two-month consultation period and motivational self-evaluation tasks two and 4-5 months after the training, while the control group had an opportunity to utilize their usual statutory occupational health care services. The outcomes were measured under drivers' natural working and shift conditions over a period of two weeks before and after the intervention using unobtrusive data-collection methods including the Karolinska Sleepiness Scale measuring on-duty sleepiness, a combination of actigraphy and a sleep-log measuring sleep between duty hours, and self-report questionnaire items measuring the use of SCMs while on duty. The data analysis followed a per-protocol analysis. Results of the multilevel regression models showed no significant intervention-related improvements in driver sleepiness, prior sleep, or use of SCMs while working on night and early morning shifts compared to day and/or evening shifts. The current study failed to provide support for a feasible non-recurrent alertness-management training being effective remedy for driver sleepiness in occupational settings. These results cannot, however, be interpreted as evidence against alertness management training in general but propose that driver education is not a sufficient measure as such to alleviate driver sleepiness.

Keywords: Driver education; Randomized controlled trial; Shift work; Sleep; Sleepiness; Sleepiness countermeasure.