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Effectiveness: 2 Star Cost: Varies
Use: Unknown
Time: Short

Drowsy driving can be linked to the characteristics of a person’s job. Shift workers are one employment group at high risk for drowsy-driving crashes. This includes people who work long or irregular hours or who work at night. There are different types of shift work that contribute to drowsiness, including displaced work hours, roster work, and rotating shift work (Åkerstedt, 2019). Of these three types, the Sleep Foundation finds that rotating shift work is the most problematic (Pacheco & Singh, 2022). Professions such as medical workers, manufacturing, and first responders are jobs that include shift work (Stutts et al., 2005; Pacheco & Singh, 2022).

Those in the medical field can be at risk for higher crash rates, including nurses, interns, and EMS and support staff. Barger et al. (2005) studied medical interns, who frequently work extended shifts of 24 hours or more, by collecting monthly reports from 2,737 interns. Barger and colleagues found that medical interns were 2.3 times more likely to report a crash and 5.9 times more likely to report a near miss after an extended shift than a shorter shift. Each extended shift in a month increased the monthly risk of a crash during the commute from work by 16%. In one driving simulator study, anesthesiology residents were found to have significant increases in reaction times, attention lapses, impairments in speed and lane position maintenance, and increased risk of collisions after 6 consecutive night shifts (Huffmyer et al., 2016).

NHTSA’s Fatigue in EMS Project aimed at providing evidence-based guidelines to manage fatigue in EMS personnel. The recommendations included the use of sleepiness survey instruments to measure and monitor fatigue, limiting shifts to a maximum of 24 hours, access to caffeine as a countermeasure (although they cautioned against excessive caffeine consumption), allowing personnel the opportunity to nap while on duty, and education and training of EMS personnel to prevent and mitigate fatigue-related risks (Martin-Gill et al., 2018; Patterson et al., 2018; Patterson & Robinson, 2019).

Commercial drivers are also at risk for drowsy-driving crashes. One study of 96 truck drivers found that safety critical driving events were associated with a sleep pattern of shorter sleep duration, less sleep from 1 a.m. to 5 a.m., and sleep in the early stages of the non-work period preceding the work-related driving (Chen et al., 2016). There are many ways States can work with trucking companies to address drowsy driving. In general, work culture, adherence to hours of service rules, and employer-provided interventions and education can help address drowsy driving, including testing for medical conditions. One study found that treating obstructive sleep apnea in drivers was cost effective for trucking companies overall. Aside from reducing crash risk, it lowered overall health care expenses by $550 a month for each driver (Gurubhagavatula & Sullivan, 2019).

Even those who might not fall under one of the categories mentioned above are at risk for drowsy driving. In 2008 the NSF conducted a survey of 1,000 U.S. residents who were employed full time. Those who work 50 or more hours per week were three times as likely to report driving drowsy on a weekly basis compared to those who work 30 to 40 hours per week (Swanson et al., 2012).

There are a few organizations engaging in employer program outreach. NSF provides material for publicizing Drowsy Driving Prevention Week and information on managing shift work schedules (Pacheco & Singh, 2022). NHTSA and the National Center on Sleep Disorders Research (NCSDR) produced a comprehensive workplace education program for shift workers called Wake Up and Get Some Sleep. It includes information on sleep habits and, in particular, drowsy driving. Program material includes a video, posters, brochures for workers and their families, tip cards, a PowerPoint training session, and an administrator’s guide (NHTSA/NCSDR, 1998).


No summary of current programs exists.


There are few studies of the effectiveness of drowsy driving employer programs, and it is unknown the extent to which any drowsy driving programs have been evaluated by the employers implementing them.

The NHTSA/NCSDR program was tested by more than 20 U.S. companies and was well received by workers and management, but its effect on crashes was not evaluated (Stutts et al., 2005).

A study by Adamos and Nathanail (2019) evaluated an intervention educating Greek truck drivers about strategies to alleviate drowsy driving and then monitoring them to see if they applied this knowledge using GPS and self-report. Using data collected before and after the program, they found that knowledge of strategies for decreasing crash risk increased but behaviors did not change.

In sum, there is insufficient evaluation data available to determine the effectiveness of the countermeasure for knowledge acquisition or, more importantly, producing behavior change. The Adamos and Nathanail (2019) study demonstrates the difficulty of implementing an intervention that results in real behavior change.


NHTSA and the National Center on Sleep Disorders Research program is available at no cost. It is not known how much private companies spend on education programs. Additional expenses, beyond the programmatic costs, could be added if the employer chooses to use medical condition testing.

Time to Implement: