Sleep tight: Helping drivers rest

The human need for sleep is simply not optional. It is as important as the air we breathe.

“Sleep is a necessity, as essential as food and oxygen,” explains Nancy Rothstein, director of corporate sleep programs for fatigue risk management firm Circadia. “Irrefutable scientific evidence reveals that the one-third of our lives that we spend sleeping profoundly impacts the two-thirds we spend awake. Thus, sleep is critical to virtually all aspects of our functioning and affects the performance, safety and health of every member of your workforce.”

And the costs of poor sleep to the business world as a whole can be extremely expensive, she stresses. For example, a Harvard Medical School study found that one in four U.S. workers suffer from insomnia—costing U.S. employers $63 billion in lost productivity each year.

While insomniacs were no more likely than their well-rested peers to miss work, they proved to be so consistently tired on the job that they cost their employers the equivalent of 7.8 days of work in lost productivity per year, an amount equal to an average of about $2,280 per person.

Yet the amount of sleep a human being needs not only varies between individuals but changes over time. The National Institute of Health (NIH) suggests that school-age children need at least 10 hours of sleep daily, with teenagers requiring nine to 10 hours, and adults needing less, between seven and eight hours.

An NIH survey determined that nearly 30% of U.S. adults reported an average of less than six hours of sleep per day. A similar survey conducted with high school students found that 31% only get eight hours of sleep on an average school night.

Dean Croke, vice president of Omnitracs Analytics, notes that when it comes to trucking, carriers tend to treat every hour of a driver’s day the same in terms of productivity, without consideration given to length of time behind the wheel or differentiation between day and night driving.

“Obtaining good sleep also requires training, just like you would train a driver how to shift gears for the best fuel economy, how to hook up and detach trailers to prevent injuries, etc.,” he argues. “For example, sleep is best achieved in a sleeper berth so dark a driver can’t see their hand in front of their face with an air temperature of around 65 deg. F.”

Alan Lankford, chief science officer for SleepSafe Drivers, also stresses that the quality of sleep—usually referred to as “restorative” sleep—is almost as critical as the number of hours clocked with the eyelids closed.

“For sleep to be restorative, it must be consolidated with few interruptions, and it must not be restless with frequent movements or disruptions in breathing,” he says. “When sleep is non-restorative, it contributes to a host of cognitive and physical health problems [with] a negative impact on attention, decision-making and alertness. It also can contribute to weight gain/obesity by increasing the body’s production of hormones that increase hunger.”

As a rule of thumb, many pre-existing conditions will be made worse when adequate restorative sleep is not present, Lankford notes. Heart disease, chronic pain and diabetes are all conditions that can be made worse by non-restorative sleep.

Timing is everything

Drivers of commercial vehicles must be alert and must be able to exercise good judgment in response to often rapidly changing roadway conditions. If they don’t get restorative sleep, those abilities may be completely compromised—without the driver even knowing it.

“For example, obstructive sleep apnea (OSA) can cause a driver to awaken briefly 50 to 100 times a night or more, yet he or she will not be aware that this is going on,” Lankford says. “That leads to poor quality sleep, making them sleepy and increasing the risk of errors.”

He points to a recent study that found commercial vehicle drivers with untreated OSA were over three times more likely to be involved in a crash than drivers without OSA.

Audrey Peters, a registered dietician and health coach for the on-site clinic operated by trucking conglomerate Celadon Group at its Indianapolis headquarters, adds that good restorative sleep does more than just improve alertness in drivers.

“It is very important for overall body function,” she stresses. “During the phases of sleep that are restorative in nature, blood pressure drops, breathing becomes slower, and muscles are relaxed. The blood supply to muscles increases, tissue growth and repair occurs, energy is restored, and hormones essential for growth and development are released.”

To help prepare for a good night’s rest, Peters recommends drivers take a series of actions over the course of their day, including the following:

Take a hot bath/shower.
Dim/eliminate lights in the sleeping area.
Take a 15-30 minute “winding down” period to facilitate the shift from wakefulness to sleep.
Keep in mind that there is not one bed that is right for everyone. Some people prefer a hard surface while others like a soft bed, so find the type you prefer.
Make sure the temperature of the sleeper berth and home bedroom is properly adjusted. Body temperature drops slightly when humans sleep, so an environment that is too warm is detrimental to achieving restorative shut eye.
Avoid stimulants like caffeine and nicotine, especially eight to 10 hours prior to sleeping. While caffeine is helpful in increasing alertness during wakefulness, it stays in a driver’s system for four to six hours. If a driver has trouble getting to sleep, limiting coffee, tea and soft drinks before bedtime can be very helpful.
Turn off electronics, including the TV, as lit screens are more likely to stimulate the brain and cause it to “wake up.”
Wear socks to bed, especially in the winter.
Limit eating and drinking during the two hours prior to bedtime.

Diet and exercise play a key role in the length and quality of an individual’s sleep. “Drivers can be mentally exhausted by the end of the day but may not be physically exhausted,” Peters explains. “By incorporating regular exercise, they are more likely to fall asleep faster and have sounder sleep.”
Drivers should not eat in the two-hour window prior to bedtime to ensure that the digestion process does not interfere with sleeping patterns.

SleepSafe’s Lankford cautions, however, that while exercise can contribute to getting a good night’s sleep, the timing of the exercise is important.

“Exercise releases adrenaline production in the body, which has an alerting effect, and it also increases body temperature,” he explains. “For those reasons, strenuous exercise right before bed can actually make one sleep less well. As a rule, people who exercise regularly tend to sleep better, but it is important to allow a one- to two-hour break between exercise and lights out.”

In general, Lankford says carbohydrates seem to help facilitate processes in the brain that help with sleep, while proteins can have the opposite effect.

Like Peters, though, he warns that a large meal too close to bedtime can contribute to “gastroesophageal reflux” and heartburn, both of which disrupt sleep.

“Foods that contain caffeine, like chocolate and iced tea, can keep a driver from falling asleep and staying asleep. Alcohol is a sedative and will put people to sleep, but if consumed too close to bedtime, it will actually make sleep less restful,” Lankford warns. “In fact, a driver with OSA who drinks alcohol too close to bed will actually make his apnea worse.”

Spec’ing for sleep

Spec’ing the right equipment can also help drivers feel more refreshed.

“We’re not a fleet that sits around a lot; we’re loading and unloading and doing quick turnarounds,” explains James Sorrels, director of transportation for Heartland Catfish in Itta Bena, MS. “We wanted to reduce the daily wear and tear on our drivers—from physically operating the truck as well as providing them with a sleeper where they can get the best rest possible.”

When the company purchased new Kenworth T680s for its 22-tractor fleet, two key specs included automated manual transmissions and the “Diamond VIT” premium package for its 76- and 52-in. sleepers.

The Diamond VIT package Heartland spec’d for its sleepers included a refrigerator, TV package, rotating table, and microwave.

“That cab is a driver’s office and home away from home. They need to be able to climb in there and easily relax,” he says. “That is what helps them feel rested for the next haul.”

Holland Enterprises, a Fargo, ND-based refrigerated carrier operating 220 tractors, recently installed 175 EpicVue satellite TV systems in its trucks.

“As a 48-state, long haul trucking company with an average length of haul of 1,550 mi., we need … drivers who are willing to be on the road 14 to 21 days at a time,” Brad Schemel, Holland’s vice president, says. “Satellite TV gives them the option of sitting in the comfort of their truck and doing things there that they may otherwise do inside a truck stop. It gives them the flexibility of watching what they want, when they want. It’s a definite creature comfort for drivers and provides a greater level of satisfaction with the job.”

Still, there are drawbacks to technology when it comes to sleep. Lankford points out that the brain’s biological clock is primarily regulated by light, which is why minimizing light is key to getting a good sleep.

“When the sun goes down and the lights are dim, the brain produces melatonin, which facilitates sleep,” he says. “Artificial light prior to the sleep period, especially light in the blue wave length, suppresses this melatonin production—and this is the type of light emitted by cell phones, computer screens and televisions.”

Minimizing the use of these devices close to bedtime can be helpful if a driver has trouble sleeping.
“If this is not practical, reducing the brightness of the screen or putting it in night mode can also be beneficial,” Lankford adds.

Rhonda Otto, a risk management associate with Averitt Express, points out that sleep management doesn’t end when a driver gets off the road.

“Professional drivers must plan and manage their sleep at all times. They’ve chosen a career where they are held accountable for their decisions away from work just as much as they are during on-duty driving,” she says. “They should be aware of the peak times for fatigue even when returning to work from a long break [and] should never sleep or take a power nap in the driving position as this will only train the body to sleep in this position.”

Otto notes that to better protect the lives of Averitt’s drivers and those with whom they share the road, a “stronger awareness” regarding the subject of fatigue and the need for good sleep needs to be advocated.

“Better education about those subjects for all drivers, both the professional truck driver and the general motorist alike, will make the highways safer for everyone,” she says.

The dangers of sleep deprivation

According to studies by the Centers for Disease Control and Prevention (CDC), some 63% of Americans report that their sleep needs aren’t met during the week. This leads to chronic sleep deprivation that is frequently a root cause of decreased productivity, accidents, incidents, and mistakes costing billions of dollars each year, notes Nancy Rothstein, director of corporate sleep programs for fatigue risk management firm Circadian.

For that reason, Circadian compiled a list of the top 10 dangers posed by chronic sleep deprivation in the workforce. These include:

Decreased communication: When workers are tired, they become poor communicators. The intensity of their voices drops; they pause for long intervals without apparent reason; they enunciate very poorly or mumble instructions inaudibly; they mispronounce, slur, or run words together; they repeat themselves or lose their place in a sentence sequence.

Performance deteriorations: The average functional level of any sleep-deprived individual is comparable to the ninth percentile of non-sleep-deprived individuals. Sleep-deprived individuals also don’t recognize such performance deficits are occurring, and those deficits worsen as time on task increases.

Increased risk of becoming distracted: Sleep-deprived individuals have been shown to have trouble with maintaining focus on relevant cues, developing and updating strategies, keeping track of events, maintaining interest in outcomes, and attending to activities judged to be non-essential. In fact, Circadian noted that some research suggests that there is a symbiotic relationship between sleep deprivation and attention-deficit hyperactivity disorder (ADHD) due to the overlap in symptoms.

Driving impairments: Data indicates 22 hours of sleep deprivation results in neurobehavioral performance impairments that are comparable to a 0.08% blood alcohol level; in other words, that level of sleep deprivation is equivalent to being legally drunk according to U.S. driving laws.

Increased number of errors: The cognitive detriments of sleep deprivation increase concurrently with a worker’s time on a given task, resulting in an increased number of errors including mistakes of both commission (i.e., performing an act that leads to harm) and omission (i.e., not performing an expected task), which can wreak havoc at any work facility. Errors are especially likely in subject-paced tasks, in which cognitive slowing occurs, and with tasks that are time-sensitive which cause increases in cognitive errors.

Poor cognitive assimilation and memory: Short-term and working memory declines are associated with sleep deprivation and result in a decreased ability to develop and update strategies based on new information, along with the ability to remember the temporal sequence of events.

Poor mood-appropriate behavior: Inappropriate mood-related behavior often occurs in outbursts with sleep-deprived individuals, including irritability, impatience, childish humor, lack of regard for normal social conventions, inappropriate interpersonal behaviors, and unwillingness to engage in forward planning.

Greater risk-taking behavior: Brain imaging studies have shown that sleep deprivation is associated with increased activation in regions related for risky decision-making, while areas that control rationale and logical thinking show lower levels of activation. In fact, sleep deprivation increases one’s expectation of gains while diminishing the implications of losses. Thus, sleep-deprived workers may be making riskier decisions, ignoring the potential negative implications, and taking gambles in scenarios in which the losses outweigh the benefits.

Inability to make necessary adjustments: Flexible thinking, preservation on thoughts and actions, updating strategies based on new information, ability to think divergently, and innovation are all negatively impacted by sleep deprivation.

Effects of sleep deprivation compound across nights: Four or more nights of partial sleep deprivation containing less than seven hours of sleep per night can be equivalent to a total night of sleep deprivation. A single night of total sleep deprivation can affect, thus impact, proper functioning for up to two weeks.

Averitt's fatigue fighting five

Rhonda Otto, a risk management associate with Averitt Express, explains that the carrier developed a five-point “fatigue fighting” strategy several years ago to help its 6,200-plus drivers recognize the danger signs of fatigue and also help them get better sleep as well. This includes:

Get a Good Start

Get plenty of sleep before your trip begins.
Report for work mentally and physically
prepared.
Plan your trip properly.

Manage Life on the Road

Rest on your breaks and off-duty time.
Get exercise, eat right, and take power naps.
Beware of eyestrain and limit caffeine, tobacco and sugar intake.

Know the Danger Signals

Mental signals of fatigue: sleepiness,
apathy, lethargy, irritability
Physical symptoms: eye issues, frequent yawning, head nods or jerks, trouble getting comfortable.
Performance issues: forgetfulness, delayed reactions,
muddled thinking.
Erratic driving: speed variances, drifting, tailgating.

Take Action as Soon as Symptoms Appear