Sleep deprivation

[CanadianEh]

An interesting article I wanted to share from the Globe and Mail. Please feel free to share your thoughts and stories.

Sleep deprivation is a national epidemic. And it's killing us
By Ian Brown
From Saturday's Globe and Mail
The data is piling up about the profound effects of lack of sleep on our abilities and health. But since time is money, many people and businesses would rather have sleep debt than the financial kind. All well and good, reports Ian Brown, until someone crashes a plane

Get some sleep. That's the urgent advice the newly refreshed science of slumber has for North Americans.

Never mind the majority who got less than the recommended eight hours of sleep last night. In April, yet another air-traffic controller - the fifth in as many months - was suspended for falling asleep on the job, leaving a plane circling Reno, Nev., for 16 minutes with no one in the control tower to talk to.

A more alert tin-pusher on duty in neighbouring California eventually talked down the pilot - who, unlike several infamous colleagues last year, was awake. A British pilots-union survey recently discovered that 20 per cent of pilots pass out on the job.

We live under the enduring spell of The Warrior Who Does Not Sleep, believing that many accomplished people survive on no more than 4.5 hours of "core sleep" a night. It's a myth.

Many heroic non-sleepers used pills (John F. Kennedy was a walking pharmacy and once fell asleep interviewing a prospective secretary of agriculture) or were inveterate nappers (Napoleon, Ronald Reagan, Bill Clinton and even Winston Churchill, who used sleeping tablets and survived his famous midnight meetings by climbing into bed for an hour every single afternoon).

And as David Dinges, chief of the division of sleep and chronobiology at the University of Pennsylvania School of Medicine, points out: "There are lots of other heroic, high-achieving figures - Einstein, Albert Schweitzer - who got their sleep."

But we want to believe we're big kids who don't need to go to bed.

Our stubborn refusal is making the world a measurably more dangerous place. Sleep scientists make few exceptions - most of us need 7½ hours in bed, and preferably eight, to be fully capable. Top performers (such as violinists) often need more than eight, plus an afternoon nap.

Human sleep is regulated by a circadian clock located in a tiny, cone-shaped but essential intersection of cells in the hypothalamus called the suprachiasmatic nucleus. It is in turn fed by ganglion cells in the retina, which take their cues from light and dark cycles - that is, the rising and setting sun, the main determinant of when we want to wake up and when we want to sleep.

The farther we stray from that simple schedule, the more we pay.

In a 2007 study, U.S. Army researchers found that two sleepless nights impaired the prefrontal cortex's ability to integrate cognitive and emotional processes, which in turn interfered with the ability to make moral judgments. Sleeplessness, in other words, makes the mind one-dimensional, which is why it was used at Abu Ghraib. Sleep deprivation as a torture dates at least as far back as medieval Italy, when Ippolito Marsili invented the so-called alarm clock: The victim could avoid anal penetration if he stayed awake. (If you work in a modern corporation, this may sound familiar.) We need one hour of sleep for every two we stay alert.

Because sleep is when the body and especially the brain regenerate and repair themselves, sleeplessness has been identified as a factor in an endless list of afflictions, including hypertension, heart disease, diabetes, obesity, memory loss, bipolar disorder, reduced immunity, mood swings, impaired carbohydrate metabolism and increased heart-rate variability. Not to mention depression and substance abuse and the impairment of memory, self-expression and the ability to read emotions in others. Oh, and a hundred thousand motor-vehicle accidents a year

A hamster kept awake for three days will die. Randy Gardner, a high-school student, stayed awake for a record of just over 11 days as part of a 1964 Stanford University study. By the end, he couldn't talk. Former prime minister Kim Campbell blamed the implosion of the Conservative Party under her leadership on sleep deprivation. Yasser Arafat slept only three to five hours a day - yet another model human being. We stay awake at our peril.

Going, going, yawn

But we stay awake nonetheless. The once-drowsy world of sleep research is currently engaged in a raging debate about whether we sleep more or less than we used to, historically. Diane Lauderdale, a sleep researcher at the University of Chicago, studied the sleep patterns of early-middle-aged adults, and found that average sleep duration ranged from 6.7 hours for white women to 5.1 hours for African-American men - well below the big eight.

Most people overestimate the amount they have slept: Pennsylvania's Dr. Dinges estimates that 7½ to eight hours in bed snuggles down to 6.3 hours of actual shut-eye.

Even the "circadian larks" - the 20 per cent of the population who are early risers and can resist the effects of sleeplessness better than others - "eventually have problems," he says.

It is Dr. Dinges and a group of colleagues who demonstrated over the past decade just how impairing sleep loss can be. In one of the most extensive sleep studies ever undertaken, the researchers restricted the sleep of their subjects continuously for two weeks, while administering psychomotor vigilance tests every day. The PVT requires a subject to press a button every time a signal appears on a screen. It's not a hard test.

The findings were terrifying. The performances of people who got four to six hours of sleep a night declined steadily with every passing day. By the sixth day, a quarter of the six-hours group was falling asleep at the computer, lapsing into five times as many "microsleeps" as they had on Day 1. Working memory, accuracy and speed collapsed.

By the end of the two-week period, the six-hour-a-nighters were as impaired as they would have been staying up 24 hours straight - the equivalent, in performance terms, of being legally drunk.

This is not a trivial result: A two-second delay in response is enough to veer into oncoming traffic. Imagine the effects of six hours of sleep a night for four nights in a row combined with talking on a cellphone while driving (which, of course, no one does any more).

But six hours isn't much sleep. Another researcher, Gregory Belenky, a psychiatrist who now heads the Sleep and Performance Research Centre at Washington State University in Spokane, performed much the same experiment on subjects who got seven hours sleep a night - more than the average North American. The seven-hour crowd's scores slowed for three days, then plateaued at a lower rate of performance.

They insisted they were not impaired in any way, despite their drooping PVT scores. The first thing sleep deprivation knocks out, in other words, is your ability to tell if you're sleep-deprived.

And forget about paying off your sleep debt. "It'll take several weeks to get performance back," Dr. Belenky says. "And it isn't enough to sleep in on the weekends."

Rattled on the 'rattler' shift

A deeper cause of sleeplessness - and a more serious safety issue - is the growing popularity of night shifts, early starts and extended hours. All three are popular cost-saving devices in a recession-conscious, union-wary economy.

Night shifts are particularly nasty because they shorten the light-dark cycle of our circadian clocks - the same effect as the jet lag produced by flying west to east. Most shift workers get off at 6 a.m., drive home to a rising run, fall asleep at 8 a.m., but then wake up at 1 p.m., as their circadian body temperature rises. As a result, Dr. Belenky estimates, the average shift worker gets five hours sleep a night - "which is not enough."

Which workers are most affected by 24-hour shift work? Precisely the ones you want at their sharpest - train and truck drivers, pilots, police officers, nurses and physicians, financial traders and power-plant and utility workers.

If the night shifts are staggered, they're even more pernicious. The "rattler" shift brings an air-traffic controller in from 4 a.m. to midnight on Monday, and then earlier and earlier each day until Thursday, when he finishes his shift at 2 p.m. and comes back in to do an all-night shift at midnight. Air-traffic controllers average just over two hours of sleep before such a midnight shift.

In other words, you might not want to arrive on a red-eye flight before 8 on a Friday morning - "not if it takes more than 10 minutes from top of descent to landing," Dr. Belenky says. One solution that has been successful in Europe is controlled on-the-job naps.

When the latter idea was introduced in the United States, government-spending hawks laughed the idea out of Congress. Better, apparently, to die in a plane crash.

On the red-eye

If we aren't sleeping, what are we doing? Mathias Basner, a medical researcher at the University of Pennsylvania School of Medicine, conducted a time-use survey of nearly 50,000 people. He found that the biggest sleep bandits in North America are work, travel (including commuting and grocery shopping) and social and leisure activities such as family time.

The study didn't look at the time-eating capacity of online activity, but "it's a reasonable hypothesis," Dr. Dinges says.

The biggest sleep losers are men between the ages of 45 and 54. Remember that, darling, the next time you wake me up at 3 a.m. for snoring.

But "the real issue" as to why we are so sleep-challenged today, Dr. Dinges argues, "is the value of time. Because it's under our discretionary control, time becomes a commodity, and it becomes a great deal more valuable. For many people these days, time is worth more than money. Anything that keeps time trapped in, that eludes our discretionary ability to control time, is seen as something that's expendable."

Thus to maximize our time-use profits, we sleep less and work and shop and Facebook more. "Social factors now control time, asleep and awake," Dr. Dinges says, "even though sunset and sunrise were what we evolved by."

The true north, sleepy and free

There was a lot of yammer about national economic productivity during the recent election campaign, but in terms of addressing our fundamental capacity to be productive by getting enough sleep, Canada is still snoozing.

Sleep medicine is a board-certified medical subspecialty in the U.S., but not so here, where the Calgary police force and hospital nurses are among the few professional groups to have openly addressed the exhaustion issue. The rest of us have just grown used to being a sleepy society.

"Sleep is the No. 1 performance enhancer for meeting the challenge of the next day," Dr. Dinges says. "We need to reprioritize sleep - make it more important than TV, more important than long commutes, more important than a lot of irrelevant social-networking activities that make us feel good. Ten minutes a day on e-mail may be enough." Radical!

His cause may be helped by sleep's emergence as one of the new darlings of scientific research. The slowly dawning recognition that sleep is essential to both self-reliance and public performance, no matter what the boss says, has "made sleep medicine kind of a fair-haired child, scientifically," Dr. Dinges declares.

"But it's also up against this huge social desire to be awake. Basically we've become addicted to a 24-hour cycle that challenges our biology."

More sleep? Perchance we dream.

[Expat]

[CanadianEh]

Looks like the Globe and Mail is doing it's part!

[mike123]

I agree. Our greed is killing us. Not only sleep deprivation can result in accidents, it cause our health to deteriorate and ultimately shortens our lives.

[CanadianEh]

I agree. Our greed is killing us. Not only sleep deprivation can result in accidents, it cause our health to deteriorate and ultimately shortens our lives.

It almost makes you wonder if that's one of the major reasons why pilot's die so soon after retirement... It might be a shock to the system after a career of messed up circadian rhythms to actually be able to have a normal schedule

[ahramin]

http://www.ted.com/talks/lang/eng/arian ... sleep.html

When we move the clocks ahead in spring the auto accident rate for commuters goes up 7%. It goes back to normal after a week.

In the fall the extra hour of sleep causes a decrease of 7%. Back to normal within a week.

But what I'm really glad to see addressed in the article is the effect of sleep deprivation on decision making ability. Think of how much better shape our society would be in if the decision makers were firing on all 8 cylinders (those that have 8).

The worst though are the doctors. This has to be the most stupid group of professionals in the country when it comes to fatigue issues. I really wished they'd give up the idea that you can train to perform while sleep deprived and start working intelligently.

[hz2p]

It is considered normal and reasonable (nay, expected) to fly when you are:

- exhausted
- dehydrated
- low blood sugar

yielding similar performance to when you are drunk.

However, in our bizarre and puritanical society, if you have a glass of wine with lunch, and you go flying fully rested and nourished, you will never, ever fly an aircraft ever again because you are an alcoholic in need of rehab treatment.

Is this supposed to be a joke? Because it is.

[ahramin]

It is considered normal and reasonable (nay, expected) to fly when you are:

- exhausted
- dehydrated
- low blood sugar

With one notable exception, not anywhere I have ever flown. In the one exception I was asked to lie about a duty day to get an aircraft home. I said no.

There is a very simple way to avoid flying fatigued:

Don't fly fatigued.

[railker]

According to a 2000 study published in the British Medical Journal, researchers in Australia and New Zealand reported that sleep deprivation can have some of the same hazardous effects as being drunk. People who drove after being awake for 17–19 hours performed worse than those with a blood alcohol level of .05 percent, which is the legal limit for drunk driving in most western European countries and Australia. Another study suggested that performance begins to degrade after 16 hours awake, and 21 hours awake was equivalent to a blood alcohol content of .08 percent, which is the blood alcohol limit for drunk driving in Canada, the U.S., and the U.K.

I lost the sheet from human factors training that put it in more detail, but I also remember it mentioning that hours of sleeplessness (bad sleep, etc.) count just as much cumulatively over the week as in one night, so sleeping for an hour or two every night ain't gonna cut it.

[Gannet167]

This is a bigger problem than anyone wants to admit. An interesting study was done by Professor Hal Weinberg, found here:

http://www.cbc.ca/thenational/includes/ ... xerpts.pdf

That excerpt comes from this story: http://www.cbc.ca/news/canada/story/201 ... ue025.html

Which I am sure was discussed to death on this forum. However, TC redacted Wienburg's work considerably and denied having any data on this stuff, when in fact they did - they commissioned the study and then asked Weinberg to remove 4 of his 6 recommendations until "further study."

The CBC article suggests that Canadian regulations are quite lax in comparison to Euro standards (for what it's worth, CBC is not known for their accuracy or perspective on reporting aviation related stories.) I believe than in time (probably measured by crashes rather than years) this whole issue will be viewed quite differently. When there's more understanding of the issue, more appreciation for the human factors and related safety issues involved, then we'll all look back at how it used to be in the same way we look back at the days when drinking and driving was considered alright: as long as you didn't have too many - you know, probably ok to drive...

[again]

Having flown in a few different types of operations at what most would consider to be reputable operators, I believe that fatigue issues are one of, if not the largest threat to safety that the industry currently faces. It is widespread and Transport has completely dropped the ball on this issue. Wake up, TC!

[Beefitarian]

Wake up, TC!

They can't, they're sleep deprived!

[ahramin]

Wake up, TC!

They can't, they're sleep deprived!

Ha. Call at 9:00, not in the office yet. Call at 12:00, gone for lunch. Call at 1:00, not back from lunch. Call at 4:00, GONE. Not much chance of sleep deprivation on that schedule.

[mike123]

News: Sleep deprivation can make you deviant


A study done by business school professors and published in the Academy of Management Journal that looked at the behaviour sleep-deprived students and nurses found that those who lacked sufficient shut-eye increased bad behaviour such as rudeness, inappropriate responses and even stealing.

Anyone who has pulled an all-nighter can understand why sleep deprivation can lead to poor performance on the job. But why would it turn a someone into a jerk? The study's authors suggest that lack of sleep results in lower functioning of the prefrontal cortex, the part of the brain that controls how you inhibit emotion and behaviour, the Post reports

http://www.besthealthmag.ca/blog/post/n ... ou-deviant

[trey kule]

I realize that the mob has its pitchforks out and is searching for the lax Tc monster and the evil employers, but how about a little balance.

Exactly who is at fault when a pilot stays out to 3.00 am when they have a duty day starting at 0700? It seems from the comments here that the employer should say, "oh well, you are fatigued, so we will call in a replacement". and if they do not do that, then you would suggest TC should crucify them. Yes , they are not up to par, but how much of that personal lack of resposability should a an employer be expected to compensate for?

How about some personal responsability here. Get to bed and get some sleep if you need it.
The regulations are clear. They allow for enough time off to get the proper sleep, and dont need to be changed. TC does not have to get involved if pilots simply had the guts to stand up for themselves instead of running like a little kid to their mommy to look after their problems.
But it is up to the individual to use their off duty time to get that sleep. And it is not the company or TC's problem to help out the irresponsable.

We are so fast to blame employers and demand the regualtor get involved, but seem to completely ignore the issue of personal responsability.

[Mig29]

Trey kule,

you have a point and I'm sure we were all guilty once of abusing our rest period, saying up in the hotel room watching some stupid show way past your bed time, but you will agree that there are times when the companies blatantly disregard pilot rest period and tell you to just deal with it! Now we all know that some places don't tolerate that kind of attitude, with strong unions/contracts in place, but I bet I can name more than few who don't....

[trey kule]

You know Migster. you are quite correct, I suppose, that there are companies out there who will abuse the rest periods.. And pilots who will agree to go along with that for whatever reason. I dont think there is any need for more regulations. Just compliance on the parts of all the parties involved.

So there are two challanges. How to enforce compliance on companies who abuse rest times, and two, how to stop pilots from agreeing to these practices.

It is something worth thinking about.

[Mig29]

good point, but it's as almost the same issue as stopping pilots from paying their own type-ratings and preventing them to fly planes for dirt cheap? It's not impossible but extremely difficult.

regards

[trey kule]

In my mind there is quite a bit of difference. Pilots who will work for almost nothing or pay for their own training are stupid, and a menace to the rest of us. But they dont present a particular danger to themselves of others.

A sleep deprived pilot, on the other does present a potential danger to themselves and others., though few would admit it until after the accident. And there are regulations that apply here for a good reason.

[Mig29]

No disagreeing with you, another good point in fact.

The thing is, some guys are pressured to do it working for certain employers and they don't want or have the guts to stand up and say NO. They are too concerned about not upsetting their boss, not getting that stupid recommend letter and maybe even losing the job.

I think if we all realized that any job is just that, a job, and that there will always be another one, then things would be much simpler in life. But when the supply and demand scale tip over too much things get more complex and difficult for all of us.

[ex-NWT]

I brought up the subject today with my 2 fo's as both had bad nights last night (which for both of them was a fairly regular occurrence since flying long haul.) One even had a meditation-self hypnosis app on his iphone.
In our line of work there is almost no getting away from it.
I average 2 night shifts per rotation when compared to BC local time. 9-15 hrs of time difference, 12-16 hr working days. (though 3 or 4 cockpit crew) and sleeping doesn't come easy to me.
I tried a lot of things, but what works best for me seems to stay on Canadian time where ever I go and no alcohol 24hrs prior to flying.
I am thankful I have plenty of time off after my flights, but I am looking forward to early retirement

[RogerCheckCopy]

A lot of good points. Ultimately it is you, the pilot that is responsible for being fit for flight. TC says min 8 hrs, sometimes that might not be enough, just like driving 100km/hr on the 401 when there is freezing rain or a blizzard not be a good idea. I think what you will see in the longterm (hopefully) is limitations and restrictions on switching crews between am and pm check. This Operators think they are doing you a big favor when giving you 20 -24 hrs off between long duty days.... not the case, This is probably one of the biggest issues in my opinion. But you are getting your "8 hours of prone rest" and you are therefore in compliance with the CARS even though you are seeing double half the time. I do believe fatigue is a huge problem, and hopefully there is progress made going forward in regulations and in the industry overall with all the research underway and data being collected.

RCC

[Mig29]

This is how our European friends count duty time periods and rest times. Sorry I couldn't copy/paste from their website, but scroll to page 2 & 3 and see how we compare with them.

They even go as far as to explain how Circadian time period during your duty reduces your FDP.

.
http://www.eurocockpit.be/sites/default ... 0822_F.pdf

[CanadianEh]

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Wow, it's amazing how progressive European regs are. The pilots working under these rules could have years added on to their lives.