What is Fatigue?

Feelings – tired (sleepy) – apathetic (don’t care) – lethargic (can’t be bothered) – irritable (grouchy) Feelings – tired (sleepy) – apathetic (don’t care) – lethargic (can’t be bothered) – irritable (grouchy) Performance – forgetful – slower reactions – slower, muddled thinking – harder to pay attention Performance – forgetful – slower reactions – slower, muddled thinking – harder to pay attention

Job Demands –workload & breaks –shift work –schedule Job Demands –workload & breaks –shift work –schedule Human Biology –sleep –body clock –health, age Human Biology –sleep –body clock –health, age Life Outside Work –family & friends –commuting –lifestyle Life Outside Work –family & friends –commuting –lifestyle What Causes Fatigue? Employee Fatigue Employee Fatigue

More truck drivers are killed on the job than any other type of employee 24 hours without sleep = 0.10 BAC In the USA 20% of motorists have fallen asleep at the wheel Nearly 100% of drivers surveyed have experienced “micro-sleeps” Most sleeping disorder diseases go undiagnosed for 10 years after symptoms first appear More truck drivers are killed on the job than any other type of employee 24 hours without sleep = 0.10 BAC In the USA 20% of motorists have fallen asleep at the wheel Nearly 100% of drivers surveyed have experienced “micro-sleeps” Most sleeping disorder diseases go undiagnosed for 10 years after symptoms first appear Hard Facts

Not enough sleep leads to: –feeling sleepier –harder to pay attention –slower reaction times –slower, muddled thinking –erratic speed control –sloppy steering Effects of sleep loss build up Recovery usually takes two full consecutive nights of sleep NO SLEEP = DEATH !!!!! Not enough sleep leads to: –feeling sleepier –harder to pay attention –slower reaction times –slower, muddled thinking –erratic speed control –sloppy steering Effects of sleep loss build up Recovery usually takes two full consecutive nights of sleep NO SLEEP = DEATH !!!!! Sleep is Vital

Sleep - How Much Do We Get? % Respondents Usual sleep (hours) >10 <

Non-REM sleep –deeper as brainwaves slow down (stages 1,2,3,4) –sleep inertia waking from stages 3-4 –slow, regular heart rate –slow, regular breathing Non-REM sleep –deeper as brainwaves slow down (stages 1,2,3,4) –sleep inertia waking from stages 3-4 –slow, regular heart rate –slow, regular breathing REM sleep –rapid brain waves –eyes moving under eyelids –vivid dreaming –uneven heart rate –uneven breathing –twitching –paralysis REM sleep –rapid brain waves –eyes moving under eyelids –vivid dreaming –uneven heart rate –uneven breathing –twitching –paralysis Two Kinds of Sleep

Time of day (hours) Stage Wake REM Stage 1 Stage 2 Stage 4 A Good Night’s Sleep

Biological sleepiness (need for sleep) gets stronger –if you haven’t had enough sleep –as you stay awake longer –in the early hours of the morning –in the middle of the afternoon How sleepy you feel –a combination of biological sleepiness AND… –how physically active you are AND… –stimulation from the environment (including caffeine) Biological sleepiness (need for sleep) gets stronger –if you haven’t had enough sleep –as you stay awake longer –in the early hours of the morning –in the middle of the afternoon How sleepy you feel –a combination of biological sleepiness AND… –how physically active you are AND… –stimulation from the environment (including caffeine) Sleepiness: Two Kinds

The body has its own internal clock It programs us to sleep at night Without outside time cues, it runs on a “biological day” lasting about 25 hours It is normally synchronized to 24-hours by outside time cues – the day/night cycle (light/dark) – social cues from the day-active community – work patterns The body has its own internal clock It programs us to sleep at night Without outside time cues, it runs on a “biological day” lasting about 25 hours It is normally synchronized to 24-hours by outside time cues – the day/night cycle (light/dark) – social cues from the day-active community – work patterns The Body Clock

The Biological Clock Circadian Rhythm The Biological Clock Circadian Rhythm am lowest core temperature maximum sleepiness poorest performance (mental and physical) am lowest core temperature maximum sleepiness poorest performance (mental and physical) pm high sleepiness hard to stay vigilant pm high sleepiness hard to stay vigilant The body’s core temperature cycle The body’s core temperature cycle

What is it ? Do you have it ? What can you do about it ? What is it ? Do you have it ? What can you do about it ? Sleep Debt

Sleep Apnea Narcolepsy Chronic Fatigue Syndrome (CFS) Sleep Apnea Narcolepsy Chronic Fatigue Syndrome (CFS) Sleeping Disorders

Alcohol –can help you fall asleep BUT… –blocks REM sleep early in the night –withdrawal later in the night - dreams, disturbed sleep Sleeping pills –most don’t give normal sleep structure (non-REM / REM) –effects can last too long and make you sleepy at work –can have side effects –smallest dose, shortest time, supervised by your doctor Other medicines –can disturb sleep –if in doubt, ask your doctor Alcohol –can help you fall asleep BUT… –blocks REM sleep early in the night –withdrawal later in the night - dreams, disturbed sleep Sleeping pills –most don’t give normal sleep structure (non-REM / REM) –effects can last too long and make you sleepy at work –can have side effects –smallest dose, shortest time, supervised by your doctor Other medicines –can disturb sleep –if in doubt, ask your doctor Drugs and Sleep

Use caffeine to increase alertness when you need it –usually takes minutes to take effect Don’t use it when you are already alert –at the beginning of a shift or straight after a nap Avoid caffeine near bedtime –effects usually last 3-5 hours Know your own limits Drink enough other liquids Think about what you eat –if necessary, bring your own food and drinks Use caffeine to increase alertness when you need it –usually takes minutes to take effect Don’t use it when you are already alert –at the beginning of a shift or straight after a nap Avoid caffeine near bedtime –effects usually last 3-5 hours Know your own limits Drink enough other liquids Think about what you eat –if necessary, bring your own food and drinks Use of Caffeine

Fact vs. Fiction

If you need 8 hours of sleep, then 8 hours of rest is enough If you need 8 hours of sleep, then 8 hours of rest is enough The Fact is: You need time –to commute to and from work –to relax, eat, and sleep –for household tasks and recreation The body clock won’t always let you sleep Rest is not the same as sleep The Fact is: You need time –to commute to and from work –to relax, eat, and sleep –for household tasks and recreation The body clock won’t always let you sleep Rest is not the same as sleep Mistaken Ideas

I’ve been this tired before, and I can cope I’ve been this tired before, and I can cope The Fact is: When you are sleepy –you tend to over-estimate your own alertness –your judgement isn’t as good When you are very sleepy, motivation can’t stop you from falling asleep It is harder to cope with fatigue as you get older The Fact is: When you are sleepy –you tend to over-estimate your own alertness –your judgement isn’t as good When you are very sleepy, motivation can’t stop you from falling asleep It is harder to cope with fatigue as you get older Mistaken Ideas

There is a quick-fix that will solve all sleepiness problems There is a quick-fix that will solve all sleepiness problems The Fact is: Human biology is complex People are not all the same Different jobs and different schedules have different demands Stimulants are not an effective or safe solution The Fact is: Human biology is complex People are not all the same Different jobs and different schedules have different demands Stimulants are not an effective or safe solution Mistaken Ideas

So What? So what’s that got to do with me?

Lawsuits involving fatigue are rising Driving Without Awareness (DWA) is becoming a reality California and Arizona leading the way Other states following along Lawsuits involving fatigue are rising Driving Without Awareness (DWA) is becoming a reality California and Arizona leading the way Other states following along Impaired Driving Laws

Health / Wellness Lifestyle Coping Family Safety Health / Wellness Lifestyle Coping Family Safety Personally

Performance Safety (not just drivers) Influence on others’ activities –24 / 7 business –Who do I influence – how do I influence them? Performance Safety (not just drivers) Influence on others’ activities –24 / 7 business –Who do I influence – how do I influence them? Professionally

Things to do at home –good advice on how to improve your sleep –currently no practical advice on how to force the body clock to follow changing work schedules –these help you to arrive at work as well-rested as possible Things to do at work –ways to temporarily reduce the effects of fatigue –these help you to do the job safely and efficiently, and –help you to get home safely Things to do at home –good advice on how to improve your sleep –currently no practical advice on how to force the body clock to follow changing work schedules –these help you to arrive at work as well-rested as possible Things to do at work –ways to temporarily reduce the effects of fatigue –these help you to do the job safely and efficiently, and –help you to get home safely Two Kinds of Strategies

At Home: Getting Enough Sleep At Home: Getting Enough Sleep Days off –get the best sleep possible before starting your shift –repay your sleep debt While on shift work –on a day off, try to get as much sleep in 24 hours as you need to be rested Listen to your body –if you feel sleepy and circumstances allow … sleep! –if you wake up spontaneously and can’t go back to sleep in about 30 minutes … get up! Days off –get the best sleep possible before starting your shift –repay your sleep debt While on shift work –on a day off, try to get as much sleep in 24 hours as you need to be rested Listen to your body –if you feel sleepy and circumstances allow … sleep! –if you wake up spontaneously and can’t go back to sleep in about 30 minutes … get up!

Naps improve your functioning even if you don’t feel great Short naps –less than 40 minutes works best –avoids sleep inertia Longer naps –people sleep in 90 minute cycles –allow time for 1 or 2 cycles (2 hours or 3.5 hours) Some sleep is always better than none –particularly before a night shift Naps improve your functioning even if you don’t feel great Short naps –less than 40 minutes works best –avoids sleep inertia Longer naps –people sleep in 90 minute cycles –allow time for 1 or 2 cycles (2 hours or 3.5 hours) Some sleep is always better than none –particularly before a night shift At Home: Naps

Sleep environment dark room –use mask or heavy curtains quiet room –turn off the phone –use ear plugs –use white noise machines cool temperature comfortable surface Sleep environment dark room –use mask or heavy curtains quiet room –turn off the phone –use ear plugs –use white noise machines cool temperature comfortable surface Lifestyle have a regular sleep pattern for each shift exercise regularly eat a balanced diet take warm bath/shower before bed don’t go to bed too full or too hungry avoid caffeine or alcohol before bed no stimulating activity Lifestyle have a regular sleep pattern for each shift exercise regularly eat a balanced diet take warm bath/shower before bed don’t go to bed too full or too hungry avoid caffeine or alcohol before bed no stimulating activity At Home: Good Sleep Habits At Home: Good Sleep Habits

Schedule special and regular times with family and friends Schedule home activities around sleep, not sleep around activities Discuss importance of quality sleep with family Schedule special and regular times with family and friends Schedule home activities around sleep, not sleep around activities Discuss importance of quality sleep with family Balancing Home and Work Life

Fatigue has biological causes The effects of sleep loss build up If you ignore sleepiness, in the end you will fall asleep uncontrollably Two full consecutive nights of good sleep are needed for full recovery The body clock programs us to sleep at night The clock does not adapt to night work There is no single, simple answer to fatigue problems Fatigue has biological causes The effects of sleep loss build up If you ignore sleepiness, in the end you will fall asleep uncontrollably Two full consecutive nights of good sleep are needed for full recovery The body clock programs us to sleep at night The clock does not adapt to night work There is no single, simple answer to fatigue problems Key Points

Stay Rested… Stay Safe