The purpose of this pilot study was to explore the relationships between sleep, work practices, speed of processing, and 5-year motor vehicle crash risk among a group of older truck drivers. Anthropometric, demographic, and psychological data were recorded, along with health, sleep, and work histories from a sample of 23 truck drivers. Results from this pilot study suggest that physical fatigue may play a role in processing speed. Future studies should be designed with adequate power and include objective measures of sleep and repeated measures over time to determine 5-year MVC rates. Implications for occupational health nursing research, practice, and education are presented.