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Understanding Sleep Behaviors and Barriers to OSA Evaluation and Treatment Among Highway Maintenance Vehicle

Rebecca Robbins¹, Andrea B Troxel, Stuart F Quan

¹From the Division of Sleep and Circadian Disorders, Department of Medicine (R.R., S.F.Q., L.K.B., C.A.C.), Brigham and Women's Hospital, Boston, Massachusetts; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts (R.R., S.F.Q., L.K.B., C.A.C.); Division of Biostatistics, Department of Population Health, NYU School of Medicine, New York, New York (A.B.T.); School of Global Public Health, New York University, New York, New York (R.D.); School of Social Work and the School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania (M.F.-W.); Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida (G.J.-L.); and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (D.M.R.).

Journal of Occupational and Environmental Medicine

|September 15, 2025

Abstract

Objective:

Poor sleep and obstructive sleep apnea (OSA) are prevalent among transportation workers.

Methods:

Forty-five transportation workers from worksites in the Northeast US completed surveys assessing (1) sleepiness, (2) OSA, and (3) OSA stage of change and then participated in focus groups or interviews.

Results:

Participants were 93.2% male, and 90.1% were White non-Hispanic. Furthermore, 77.8% scored high risk for OSA, whereas 11.1% of those at risk reported an OSA diagnosis. Only 31.4% of high-risk participants reported having contemplated OSA evaluation or treatment. Qualitative themes pertained to difficulty unwinding, uncertain work hours, fears about and barriers to OSA treatment, and misinformation about OSA.

Conclusions:

Results reveal a high prevalence of OSA risk and a low rate of diagnosis and OSA readiness to change. We identify themes for future interventions to improve awareness about OSA among transportation workers.

Keywords:

Transtheoretical Model of change barriers to treatment obstructive sleep apnea obstructive sleep apnea assessment obstructive sleep apnea treatment sleep health transportation workers

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