Additive interactions of sleep disorders, insufficient sleep, and shift work on road and workplace safety incidents: A sufficient cause approach with overlap weights.

BACKGROUND

Behavioural and biological factors impacting healthy sleep can influence road and workplace safety. This study investigated the additive interactions of sleep-disrupting factors (sleep disorders, insufficient sleep, and shift work) on road and workplace safety in young adults (22 years) from the Raine Study.

METHODS

Employed participants (n = 439, median age 22.0 years, IQR 21.6-22.3) were assessed for common sleep disorders (obstructive sleep apnoea, insomnia, restless legs syndrome). They provided information on shift work status, habitual sleep duration (insufficient sleep <7 h), and self-reported road and work incidents. A sufficient cause approach with inverse probability of overlap weights and logistic regression was used to study additive interactions.

RESULTS

Sleepiness while driving was reported by 16 % and while at work by 11 % of participants. Insufficient sleep alone increased the odds of falling asleep while driving (OR 2.29; 95 % CI 1.17, 4.32). Three sleep-disrupting factors additively increased the risk of near-miss road incidents (β, 1.40 > 0). Sleep disorders with shift work was associated with the highest risk of falling asleep at work (relative excess risk due to interaction, RERI; 4.86; 95 % CI, 2.9, 6.81).

CONCLUSION

The combined burden of multiple sleep-disrupting factors including sleep disorders, insufficient sleep and shift work, is associated with an increased risk of near-miss road incidents and falling asleep at work. Given that sleepiness, both on the road and in the workplace, is common in young adults, there is a need for greater awareness and intervention to address the associated risks.