Abstract
INTRODUCTION: Taxi drivers are a low income population with long work hours, a high-stress sedentary occupation, and varied work shifts, augmenting their risk for sleep disorders. We evaluated sleep quality among New York City (NYC) taxi drivers, a predominantly immigrant/minority population, for associations with sleep outcomes and examined intervention development and policy implications. METHODS: A cross-sectional survey was conducted at driver-frequented locations with 211 consenting NYC taxi drivers and included the 12-item Medical Outcomes Study Sleep Scale and the Perceived Stress Scale-10. For five domains (sleep disturbance, snoring, shortness of breath, sleep adequacy, and somnolence) and Sleep Problems Index-II, self-reported scores were calculated and normed against a nationally representative 2009 US sample to obtain standardized t-test scores. Scores <47 were lower than US averages, indicating worse sleep quality. Results were explored in multivariable linear and logistic regression models. RESULTS: Almost one-half (47%) of drivers had scores indicating sleep quality below US averages for snoring, 36% for shortness of breath/obstruction, and 19% for somnolence. There were significant associations of perceived stress with Sleep Problems Index II (p<0.001), sleep disturbance (p<0.001), somnolence (p<0.001), and sleep adequacy (p<0.05). Stress was predictive of sleep adequacy (p<0.05, bivariate; p<0.05, multivariate) and shortness of breath/obstruction (p<0.01, bivariate; p<0.001, multivariate). Nightshift drivers had significantly worse sleep disturbance scores than dayshift drivers (p<0.05). Taxi drivers were more likely to get an inadequate amount of daily sleep (<7 hours) than the average US male (48.5% vs. 38.3%). CONCLUSIONS: Sleep hygiene and stress management interventions could benefit the health of this population and improve driver and public safety. The associations of taxi driver sleep quality and stress indicate an opportunity for targeted intervention. Further research into sleep as an important determinant of taxi driver health is needed, especially in the burgeoning for-hire vehicle (Uber, Lyft, etc) sector.