Author Contributions: Drs Rajaratnam and Barger had full access to all of the data and take responsibility for integrity of the data and the accuracy of the data analysis. Drs Rajaratnam and Barger as co-first authors contributed equally to this article.
Study concept and design: Rajaratnam, Barger, Lockley, Landrigan, O’Brien, Cade, White, Czeisler.
Acquisition of data: Rajaratnam, Barger, Lockley, Landrigan, O’Brien, Qadri, Sullivan, Cade, Czeisler.
Analysis and interpretation of data: Rajaratnam, Barger, Shea, Wang, Landrigan, Qadri, Sullivan, Epstein, Czeisler.
Drafting of the manuscript: Rajaratnam, Barger, Shea, Wang, O’Brien, Qadri, Czeisler.
Critical revision of the manuscript for important intellectual content: Rajaratnam, Barger, Lockley, Shea, Landrigan, Sullivan, Cade, Epstein, White, Czeisler.
Statistical analysis: Rajaratnam, Barger, Wang, Landrigan, Qadri, Sullivan.
Obtained funding: Rajaratnam, Lockley, Landrigan, Czeisler.
Administrative, technical, or material support: Rajaratnam, Barger, Shea, Landrigan, O’Brien, Qadri, Cade, Epstein, Czeisler.
Study supervision: Rajaratnam, Landrigan, O’Brien, Epstein, White, Czeisler.
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Rajaratnam reported that he has served as a consultant through his institution to Vanda Pharmaceuticals, Philips Respironics, EdanSafe, the Australian Workers' Union, and National Transport Commission, and has through his institution received research grants and unrestricted educational grants from Vanda Pharmaceuticals, Takeda Pharmaceuticals North America, Philips Lighting, Philips Respironics, Cephalon, and ResMed Foundation, and reimbursements for conference travel expenses from Vanda Pharmaceuticals. His institution has received equipment donations or other support from Optalert, Compumedics, and Tyco Healthcare. He has also served as an expert witness and consultant to shift work organizations. Dr Barger reported receiving a research grant through her institution from Cephalon, receiving payment for lectures from Vital Issues in Medicine and National Sleep Foundation, and serving as a consultant for Alertness Solutions. Dr Lockley reported that he received 2 investigator-initiated research grants from the ResMed Foundation and an unrestricted equipment gift from ResMed Inc, in support of the studies described in this article; receiving consulting fees from Apollo Lighting, Naturebright, Sound Oasis, and Wyle Integrated Science and Engineering, and federally funded projects at Brigham and Women's Hospital, Thomas Jefferson University, and Warwick Medical School; lecture fees from Takeda Pharmaceuticals North America, I Slept Great/Euforma, LLC, and Emergency Social Services Association Conference, UK; unrestricted equipment gifts from Philips Lighting and Bionetics Corporation; an unrestricted monetary gift to support research from Swinburne University of Technology, Australia; a fellowship gift from Optalert, Pty Ltd, Melbourne, Australia; advance author payment and royalties from Oxford University Press, and honoraria from Servier Inc for writing an article for Dialogues in Clinical Neuroscience and from AMO Inc, for writing an educational monograph, neither of which refer to the companies' products; honoraria or travel and accommodation support for invited seminars, conference presentations or teaching from the Second International Symposium on the Design of Artificial Environments, Eighth International Conference on Managing Fatigue, American Academy of Sleep Medicine, American Society for Photobiology, Apollo Lighting, Bar Harbor Chamber of Commerce, Bassett Research Institute, Canadian Sleep Society, Committee of Interns and Residents, Coney Island Hospital, FASEB, Harvard University, Illinois Coalition for Responsible Outdoor Lighting, International Graduate School of Neuroscience, Japan National Institute of Occupational Safety and Health, Lightfair, National Research Council Canada, New York Academy of Sciences, North East Sleep Society, Ontario Association of Fire Chiefs, Philips Lighting, Thomas Jefferson University, University of Montreal, University of Tsukuba, University of Vermont College of Medicine, Utica College, Vanda Pharmaceuticals, Velux, Warwick Medical School, Woolcock Institute of Medical Research, and Wyle Integrated Science and Engineering (NASA); investigator-initiated research grants from Respironics Inc, Philips Lighting, Apollo Lighting, and Alcon Inc; and a service agreement and sponsor-initiated research contract from Vanda Pharmaceuticals. Dr Lockley also holds a process patent for the use of short-wavelength light for resetting the human circadian pacemaker and improving alertness and performance which is assigned to the Brigham and Women's Hospital per Hospital policy and has received revenue from a patent on the use of short-wavelength light, which is assigned to the University of Surrey. Dr Lockley has also served as a paid expert witness on behalf of 2 public bodies on arbitration panels related to sleep, circadian rhythms, and work hours. Dr Shea reported receiving fees for interpretation of polysomnographic sleep studies of participants in this study from Sleep HealthCenters, a sleep medicine specialty practice group; receiving fees for attendance at directors meeting of the American Academy of Sleep Medicine; and lecture fees from Tufts University School of Dental Medicine. Dr Landrigan reported serving as a consultant for Vital Issues in Medicine, developing an educational course for physicians on Shift Work Disorder (supported by an unrestricted educational grant from Cephalon Inc to Vital Issues in Medicine); and AXDev, to assist in the development of a study of Shift Work Disorder (supported by an unrestricted research grant from Cephalon Inc to AXDev). Dr Landrigan also reported receiving monetary awards, honoraria, and travel reimbursement from multiple academic and professional organizations for delivering lectures on sleep deprivation and safety. Mr O’Brien reported receiving support for travel to meetings for the study or other purposes from National Institute of Justice and Centers for Disease Control and Prevention. Dr Cade reported receiving a monetary award from the World Sleep Federation. Dr Epstein reported being employed by Sleep HealthCenters, a sleep medicine specialty practice group. Dr White reported being employed as the chief medical officer for Philips Respironics, for which he owns stock. Dr Czeisler reported that he has received consulting fees from or served as a paid member of scientific advisory boards for: Actelion Ltd; Bombardier Inc; Boston Celtics, Celedon Trucking, Cephalon, Inc, Delta Airlines, Eli Lilly and Co, Garda Síochána Inspectorate, Gerson Lehrman Group, Global Ground Support, Johnson & Johnson, Koninklijke Philips Electronics, NV, Minnesota Timberwolves, Norfolk Southern, Novartis, Portland Trail Blazers, Philips, Respironics Inc, sanofi-aventis Group, Sepracor Inc, Sleep Multimedia Inc, Somnus Therapeutics Inc, Vanda Pharmaceuticals, Inc, and Zeo Inc. Dr Czeisler reported that he owns an equity interest in Lifetrac Inc, Somnus Therapeutics Inc, Vanda Pharmaceuticals Inc, and Zeo Inc; that he has received royalties from the Massachusetts Medical Society/ New England Journal of Medicine, McGraw Hill, the New York Times, Penguin Press, and Philips Respironics Inc. Dr Czeisler reported receiving lecture fees from the Accreditation Council of Graduate Medical Education, Alliance for Epilepsy Research, American Academy of Sleep Medicine, Cephalon Inc, Duke University School of Medicine, Harvard School of Public Health, Hokkaido University Graduate School of Medicine, Japan Aerospace Exploration Agency (JAXA), LOTTE Health Products, Mount Sinai School of Medicine, National Academy of Sciences, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK/NIH), National Sleep Foundation, New England College of Occupational and Environmental Medicine (NECOEM), North East Sleep Society, Office of Rare Diseases Resarch (NIH), Rockpointe, sanofi-aventis Inc, Sleep Research Society, Society for Obstetric Anesthesia and Perinatology (SOAP), St Lukes Roosevelt Hospital, University of Chicago, University of Colorado, University of Pittsburgh, University of Virginia Medical School, University of Washington Medical Center, University of Wisconsin Medical School, and the World Federation of Sleep Research and Sleep Medicine Societies. Dr Czeisler reported that he has received research prizes with monetary awards from the American Academy of Sleep Medicine and Sleep Research Society, a clinical trial research contract from Cephalon Inc, and an investigator-initiated research grant from Cephalon Inc and that his research laboratory at the Brigham and Women's Hospital has received unrestricted research and education funds and support for research expenses from Cephalon Inc, Koninklijke Philips Electronics NV, ResMed, and the Committee for Interns and Residents and the Brigham and Women's Hospital. The Harvard Medical School Division of Sleep Medicine (HMS/DSM), which Dr Czeisler directs, has received unrestricted research and educational gifts and endowment funds from Boehringer Ingelheim Pharmaceuticals Inc, Cephalon Inc, George H. Kidder Esq, Gerald McGinnis, GlaxoSmithKline, Herbert Lee, Hypnion, Jazz Pharmaceuticals, Jordan's Furniture, Merck & Co Inc, Peter C. Farrell, PhD, Pfizer, ResMed, Respironics Inc, sanofi-aventis Inc, Sealy Inc, Sepracor Inc, Simmons, Sleep Health Centers LLC, Spring Aire, Takeda Pharmaceuticals, and Tempur-Pedic. The HMS/DSM has received gifts from many outside organizations and individuals including: Brigham and Women's Hospital (Development Office), Catalyst Group, Cephalon Inc, Committee for Interns and Residents, Eisai Inc, Farrell Family Foundation, Fisher & Paykel Healthcare Corp, Jordan's Furniture, Lilly USA, LLC, Neurocare Center for Sleep, Philips-Respironics Inc, Praxair US Homecare, sanofi-aventis Inc, Select Comfort Corp, Sepracor Inc, Sleep HealthCenters LLC, Somaxon Pharmaceuticals, Synchrony Healthcare Communications, Vanda Pharmaceuticals Inc, Wake Up Narcolepsy Inc, Watermark Medical, and Zeo Inc. The HMS/DSM Sleep and Health Education Program has received Educational Grant funding from Cephalon Inc, Takeda Pharmaceuticals, sanofi-aventis Inc, and Sepracor Inc. Dr Czeisler is the incumbent of an endowed professorship provided to Harvard University by Cephalon Inc and holds a number of process patents in the field of sleep and circadian rhythms (eg, photic resetting of the human circadian pacemaker). Since 1985, Dr Czeisler has also served as an expert witness on various legal cases related to sleep, circadian rhythms, or both.
Funding/Support: This study was supported by grant 2004-FS-BX-0001 and grant 2010C-10002 from the National Institute of Justice, Office of Justice Programs, US Department of Justice; grants R01 OH008496 and R01 OH009403 from the Centers for Disease Control and Prevention; and grants from the ResMed Foundation.
Role of the Sponsor: The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.
Disclaimer: Points of view in this document are those of the authors and do not necessarily represent the official position or policies of the US Department of Justice.
Online-Only Material: The Author Video Interview is available here.
Additional Contributions: We thank Richard Coleman, PhD, and Frank Speizer, MD, for study design; Jeffrey Ellenbogen, MD, MMSc, for clinical investigations; and Mary Kay Landon, PhD, Sarah Edwards, MD, Marissa Moritz, PA-C, Erin Flynn-Evans, PhD, Jeff Tarpy, ALM, Amy Hallal, and Sean Bendix for Study coordination and assistance, all of which was performed as part of of their regular duties at the Division of Sleep Medicine, Brigham and Women’s Hospital. We thank Richard Allen, PhD, Johns Hopkins University, Murray Johns, PhD, Optalert Ltd, Emmanuel Mignot, MD, PhD, Stanford School of Medicine, and Kingman Strohl, MD, Case Western Reserve University, for their advice about the selection of sleep disorder screening questionnaires, and Peter Brown, Brigham and Women's Hospital, and Chief Inspector Kathleen M. O’Toole, Garda Siochana Inspectorate, for assistance in recruitment of participating police department, all without compenstion from the study sponsor. We also thank the police departments, and police unions for their participation.
This article was corrected for errors on December 20, 2011.