Sleep Deprivation: Effects on Safety, Health and the Quality of Life

Written by Farrah Hassen.

I. Introduction

A 2001 poll taken by the Washington D.C. National Sleep Foundation (NSF) reports that 63 percent of American adults don’t receive the recommended 8 hours of sleep necessary for good health, safety and optimum performance.[1] Fatigue’s consequences include higher instances of motor vehicle accidents, work-related accidents, decreased productivity and adverse health effects. Daniel O’Hearn, a Johns Hopkins University sleep disorders specialist observed, “People don’t respect sleep enough. They feel they can do more – have more time for work and family – by allowing themselves less time for sleep.”[2]

II. Sleep Deprivation and Safety Effects

Sleep deprivation instigates serious industrial accidents. “Sleep deprivation can reduce attention and vigilance by 50 percent, decision-making ability by 5 0percent, communication skills by 30 percent, and memory by 20 percent, says Mark Rosekind, board member of the NSF and president and chief scientist at Alertness Solutions.[3]

Consider the following accidents where fatigue has played a decisive role:

a.) On January 28, 1986, NASA managers preparing the space shuttle Challenger “had been working over 20-hour shifts before making the critical decision on whether or not to go and their knowledge about the O-rings.” The O-rings failed and caused the explosion, provoked by the managers’ fatigue, notes Rosekind.[4]

b.) The National Transportation Safety Board has traced the 1989 Exxon Va/dez Alaskan oil spill to the severe fatigue of the tanker’s sleep-deprived third mate (he’d slept for only six hours of the previous 48). The first mate on the Valdez had been working 30 hours, according to Mark Rosekind.[5]

c.) After completing an exhaustive 19-hour workday on the film Pleasantville, assistant camera operator Brent Hershman fell asleep at the wheel while driving home, resulting in his immediate death on March 6, 1997. Since his death, his co-workers have drafted the petition, “Brent’s Rule,” asking for a 14-hour shooting limit on film and television sets.[6]

d.) On October 23,2001, the National Transportation Safety Board concluded that mistakes by a fatigued cockpit crew caused the 1999 crash of an American Airlines jetliner in Little Rock Ark, killing 11 and injuring 105 passengers. Studies by NASA and the Battelle Memorial Institute have concurred with pilot unions that a pilot should not be on duty more than 12 hours. Incidentally, by the time the ill-fated plane neared Little Rock, the crew had been on duty for about 13 1/2 hours.[7]

1.) Shift Workers, Fatigue and Safety:

a.) Shift workers and fatigue: Over 22 million Americans are shift workers, performing important functions in hospitals, on polices forces and in transportation and manufacturing industries. Although, shift workers are not immune to fatigue, especially when their shifts fall during the 11 pm-7 am period. The worker is forced to fight the natural wake-sleep pattern and is prone to less sleep, ultimately needed to help restore and rejuvenate the brain and body.[8] In a 2001 NSF poll, more than 38 percent of Americans report working 50 hours or more, with those who work more sleeping less.[9]
b.) Commercial truck drivers: According to the NSF, deregulation of the trucking industry has led to increased competition and an upsurge in the number of small carriers. Consequently, more commercial drivers are required to travel during the night, fighting the biological clock, in order to avoid increasing daytime traffic and meet the pressing demands of a 24-hour society. Figures suggest that driver fatigue contributes to 30 to 40 percent of all heavy truck accidents. Many truck drivers can’t recognize the point that their bodies are tired enough for them to fall asleep.[10]

2.) Drivers, Fatigue and Safety: Studies have affirmed that sleep-deprived drivers are just as dangerous as drunk drivers. A study by the British journal, Occupational and Environmental Medicine, found that people who drive after being awake for 17 to 19 hours performed worse than those with a blood alcohol level of .05 percent.[11]

a.) A study sponsored by the AAA Foundation for Traffic Safety looked at 1,403 North Carolina drivers and found that among those who got into automobile accidents, half had slept less than 6 hours before the crash. According to the National Highway Traffic Safety Administration, roughly 100,000 crashes – 3 to 4 percent of accidents – occur each year as a result of drivers falling asleep, causing 76,000 injuries and approximately 1,500 deaths. [12]

b.) Furthermore, during the period 1989-1993, an estimated 56,000 crashes occurred annually on U.S. highways in which drowsiness/fatigue was cited on the Police Accident Report. During the same five-year period, drowsiness/fatigue was cited as a factor in an annual average of 1357 fatal crashes, resulting in 1544 fatalities. Based on these statistics, reducing the extent of the sleep-deprived driver problem is certainly crucial to improving the safety of U.S. highways.[13]

c.) In a test of reaction times, people who were tired because of disrupted sleep performed about as poorly as the legally drunk subjects, new Stanford research reports. While alcohol’s well-documented slowing effects on reaction time has lead society to aggressively demand that airline pilots, truck drivers, train engineers – those responsible for others’ safety – limit their alcohol consumption, the same vigilance can’t be said about fatigue’s harmful impacts.[14]
Herein is the crux of the problem related to fatigue and the workplace: the lack of public awareness and consequential actions taken by industry leaders to address sleep deprivation’s serious effects on safety, health and in tandem, the overall quality of life.

III. Sleep Deprivation and Health Effects

A 2001 NSF survey draws attention to several medical conditions linked directly to sleep deprivation, including depression (83 percent), nighttime heartburn (82 percent), diabetes (81 percent), hypertension (79 percent), and heart disease (78 percent). In addition, sleep deprivation can accelerate the aging process, lead to obesity and increase the risk of memory loss. The British Medical Association also reaffirms the higher levels of stress, anxiety and depression among the sleep-deprived. [15]

Recent findings in other fatigue-related health effects include the following:

1.) Decreased Brain Activity: According to the military’s leading sleep expert, Colonel
Gregory Belenky, his research indicates that “brain function is degraded by prolonged waking.” Belenky’s high-tech brain images illustrate that sleep debt decreases the entire brain’s ability to function – most importantly impairing the brain’s areas responsible for attention, complex planning and mental operations and judgment. Even more ominous is the brain’s difficulty to recover from sleep deprivation; after 48 recovery hours of sleep, Belenky’s research subjects were still performing more errors than when they started.[16]
UCSD School of Medicine researchers posit that the brain is adversely affected by sleep deprivation because certain patterns of electrical and chemical activity that typically occur during sleep are interrupted, thus impeding the brain’s ability to function normally.[17] Certainly, impaired judgment stemming from decreased brain activity would pose direct safety hazards to industrial workers, drivers and others performing high-risk activities.

2.) Diabetes: As a testimony to sleep deprivation’s direct effects on health, researchers at the American Diabetes Association reported in 2001 that getting too little sleep may in fact increase the risk of developing diabetes. In a test undertaken by 27 healthy, non-obese adults ages 23-42, the results demonstrated that chronic sleep deprivation in otherwise healthy young adults indeed impairs the ability of insulin (40 percent) to do its job.[18]

3.) Night Shifts and Breast Cancer: In a 2001 study by researchers at Seattle’s Fred Hutchinson Cancer Research Center and at Harvard Medical Center, women exposed to a large amount of light at night appeared to have a higher risk of breast cancer. This finding adds concurrence to the notion that shift-work poses health risks by disrupting the brain’s day-night clock and throwing hormone levels out of balance. Also noteworthy, women who reported not sleeping through one or more nights per week had a higher cancer risk – 14 percent for each sleepless night.[19]

IV. Sleep Deprivation and the Quality of Life

The NSF’s 2000 Sleep in America Omnibus Poll of 1,154 adults 18 years and older found that on average adults sleep just under 7 hours during the work week. One-third of adults only sleep 6.5 hours or less nightly.[20]
Negative consequences to safety, health and work performance stemming from fatigue are inevitable, considering that it’s between the seventh and eight hour when a person receives almost an hour of REM (rapid eye movement) sleep – the crucial period when the mind repairs itself, grows new connections and puts itself back together. The periods of REM only increase as the night progresses, so a six-hour sleeper – for example – is deprived of the opportunity to repair and prepare for the next day.[21]

1.) Work Performance: With respect to sleepiness and the workplace, findings of the NSF poll included the following: 51 percent of the American workplace reports that sleepiness on the job interferes with the amount of work they get done; 68 percent of adults say that sleepiness interferes with their concentration and makes handling stress (66 percent) on the job more difficult; 68 percent of shift workers report problems sleeping.[22]

2.) Economic ramifications: According to Cornell University psychologist and sleep
expert James Maas, sleep deprivation and sleep disorders cost the American economy at least $150 billion a year, as a result of decreased job productivity and fatigue-related accidents.[23]

3.) Personal effects and overall impact on society: Because fatigue is linked with irritability, impatience, anxiety and depression, such problems can directly jeopardize job and family relationships and upset social activities. The ultimate costs of time-pressured societies, where fatigue plays a constant role, include “declining health, industrial accidents, splintered families, delinquency, depression. inadequate learning, and tired and weakened communities.”[24]

V. Conclusion

Sleep is the only way to beat fatigue, complimented by a greater educational emphasis on recognizing the signs of being gravely sleep-deprived. In a 24-hour-a-day society that places productivity on the highest pedestal, the correlated safety, health and personal costs of fatigue are easily overlooked.
National Sleep Foundation polls have consistently pointed to a majority number of sleep-deprived Americans. They are truck-drivers, doctors, university students, camera operators and entertainment-industry workers, cops, pilots and other shift-workers. The Challenger explosion. Exxon Valdez oil spill, tragic death of camera operator Brent Hershman and the recent American Airlines Arkansas crash represented a varied spectrum of the labor force. Nevertheless, they all shared the same destructive contributing factor of fatigue.
The question remains how much more devastation to human life will it take before industry leaders respond to the ever-present seriousness and reality of fatigue’s detrimental effects in the workplace?

[1] National Sleep Foundation “Less Fun, Less Sleep, More Work: An American Portrait.” Mar. 27,2001. www.sleepfoundation.org.
[2] FDA Consumer Magazine. “Sleepless Society,” July-August 1998
[3] Carvalko, Debbie. “Sleep Deprivation: ‘Public Enemy Number 1’ for Cops.” Medscape Health, July 2001
[4] ibid
[5] Wald, Matthew L. “The Costs of Sleeping on the Job.”
[6] Masters, Kim. “The Longest Day.” Time. April 21, 1997.
[7] Malnic, Eric. “Crew Fatigue Cited in Fatal 1999 Crash of Jetliner in Ark.” Los Angeles Times. Oct.24, 2001, A28.
[8] National Sleep Foundation www.sIeepfoundation.org/about.html
[9] National Sleep Foundation. “Less Fun, Less Sleep, More Work: An American Portrait.” Mar. 27, 2001. www.sleepfoundation.org
[10] “Lack of Sleep America’s Top Health Problem, Doctors Say.” CNN Health. March 17, 1997. www.cnn.com/HEALTH.
[11] “Sleep Deprivation as Bad as Alcohol Impairment, Study Suggests.” CNN Health. Sept. 20,2000. www.cnn.com/2000/HEALTH.
[12] Greenberg, Bridgette. “Drowsy Drivers a Danger.” ABCNEWS.COM. Dec. 21, 2000. www.abcnews.go.com
[13] Peters, Robert D. and Esther Kloeppel. “Effects of Partial and Total Sleep Deprivation on Driving Performance.” Turner-Fairbank Highway Research Center. www.tfhrc.gov/humanfac/sleep/sleepweb.htm.
[14] “Sleep Deprivation shown to have as much impact on reaction time as alcohol.” Sept 28, 1999. www.med.stanford.edu.
[15] “Sleep Deprivation as Bad as Alcohol Impairment, Study Suggests.” CNN Health. Sept 20, 2000. www.cnn.com/2000/HEALTH.
[16] “Risks of Sleeping Short.” 20/20: Sleep Debt. 2001.http:/fmy.abcnews.go.com
[17] “Brain Activity is Visibly Altered Following Sleep Deprivation.” Feb. 9. 2000. http://health.ucsd.edu/news/2000.
[18] “Getting Your ZZZ’s to Help Avoid Diabetes.” CNN Health. June 26, 2001. www.cnn.com/HEALTH.
[19] Hall, Carl T.”Night Work Adds to Breast Cancer Risk, Studies Say.” Santa Barbara News-Press. Oct, 2001.
[20] National Sleep Foundation. “National Sleep Foundation Releases New Statistics on ‘Sleep in America.'” Mar. 3, 2000 www.sleepfoundation.org.
[21] “National (sleep) Debt is Killing Americans and Hurting Economy, Cornell Psychologist Says.” Jan. 19, 1998. www.news.cornell.edu/releases/Jan98/sleep_dep.hrs.html.
[22] National Sleep Foundation. “National Sleep Foundation releases new statistics on ‘sleep in America.'” Mar. 28, 2000. www.sleepfoundation.org.
[23] “National (sleep) Debt is Killing Americans and Hurting Economy, Cornell Psychologist Says.” Jan. 19, 1998. www.news.cornell.edu/releases/Jan98/sleep_dep.hrs.htm1.
[24] Running Out of Time. Dir. Johnde Graaf. Oregon Public Broadcasting. KCTS/Seattle, 1994.

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