Humans are wired to sleep at night and be awake during the day. When schedules upset our sleep, sleep quality can suffer, along with safety and health. - Photo: Jim Park

Humans are wired to sleep at night and be awake during the day. When schedules upset our sleep, sleep quality can suffer, along with safety and health.

Photo: Jim Park

Even though it's slightly overshadowed by that other big national event this week, the National Sleep Foundation reminds us that this week (Nov. 1-8) is Drowsy Driving Prevention Week. NSF says drowsy driving is reaching epidemic proportions in 2020, with an estimated 100,000 police-reported crashes involving drowsy driving every year in the U.S. According to one report from the Governors Highway Safety Association, an estimated 5,000 people died in 2015 in crashes involving drowsy driving.

The frightening thing is many drivers admit to drowsy driving and even falling asleep at the wheel. According to the NSF, about half of U.S. adult drivers admit to consistently getting behind the wheel while feeling drowsy. About 20% admit to falling asleep behind the wheel at some point in the past year, with more than 40% admitting this has happened at least once in their driving careers.  

According to the National Highway Traffic Safety Administration, every year about 100,000 police-reported crashes involve drowsy driving. These crashes result in more than 1,550 fatalities and 71,000 injuries. The real number may be much higher, however, as it is difficult to determine whether a driver was drowsy at the time of a crash.

And beyond the human toll is the economic one. NHTSA estimates fatigue-related crashes resulting in injury or death cost society $109 billion annually, not including property damage.

The NSF doesn't mention truck drivers in particular in its statistics on drowsy driving, but surely there are a few incidents within these numbers. Commercial drivers are, of course, subject to hours of service rules intended to mitigate the impact of fatigue, but they don't always have the intended effect. In some cases, they can exacerbate the problem for drivers whose schedules are turned upside-down.

Nor do the rules account for individuals' need for sleep. Some people biologically require six or seven hours of sleep, while others may require eight or nine. Nor do the rules — and probably few fleet operations departments — account for drivers' personal chronotypes, whether they are a night owl or a morning person.

"Some of the rules that are intended to protect drivers are great, but some of these duty-cycles create consequences and problems because they're not particularly well thought out," says Chris Winter, a board-certified neurologist and an internationally recognized sleep expert with his own practice, Charlottesville Neurology and Sleep Medicine, in Charlottesville, Virginia. "The rules don't take individual chronotypes into account. For example, I'm a much more dangerous driver in the morning than I am at night. But if you restrict my ability to drive at night, are we really making things that much safer for me and for the people on the road when I'm driving?"

Winter was the subject of our latest HDT Talks Trucking podcast episode, The Need for Sleep. He describes some of the problems that can arise from not getting sufficient sleep over a long period.

He says lack of sleep can affect almost every organ and system in the body in some way, including our immune systems, cardiovascular system, and even our moods. Do you ever wonder why you feel a bit grumpy on Fridays? Lack of sleep may have something to do with it.

"When individuals don't get the sleep they need, they tend not to make great decisions," he says. "Sleep-deprived individuals tend to suffer a decline in short-term concentration, as well as their ability to focus. It also affects their mood and interestingly, the ability to interpret the moods or the feelings of somebody that we're talking to."

Those are common but lesser-known manifestations of a lack of sleep. Some of the more commonly associated problems can be the vascular effects, like hypertension, and the risk of heart attacks and strokes.

"You can go all the way down the list to even how we look," he says. "Lack of sleep tends to age our appearance. I tell people that sleep loss is sort of like rust; it just kind of eats away at whatever you're talking about."

If insufficient sleep isn't enough a problem, irregular sleep schedules can wreak havoc on our bodies, too. Everything that happens inside us is based on a highly regulated internal clock, called a circadian rhythm. We are biologically wired to sleep at night and be awake and alert during the day, which is pretty obvious. What's not so obvious is what happens to digestion and other processes when you eat a meal at 3 a.m., when your system thinks it should be sleeping.

"And so, what happens with a truck driver who is driving all around the clock? If you ask them when they go to bed, when do they wake up, when do they drive, when do they rest, they can't answer the question because every day is different," Winter observes. "If you could peer deep inside that individual's brain and body, you'd see all these other processes – digestion, metabolism, cognition – are all going to be sort of haphazard as well."

Even shift workers have a fighting chance of regulating some bodily functions if they stay on a certain shift for a period of time, but drivers who start and stop and different times of the day quickly throw those functions into disarray.

6 Tips for More Restorative Sleep

1. Get the Amount of Sleep You Personally Need

Photo: Jim Park

Photo: Jim Park

We are used to hearing experts say that most people need between seven and nine hours of sleep per night, but Dr. Winter admits some people are genetically wired for less. They can wake fully rested and restored in perhaps six hours with no consequences.

"If you are somebody who genetically needs six or six and a half hours of sleep, you can't sleep eight," Winter says. "That genetic need for sleep we all carry around is pretty set in stone, and trying to sleep more can lead to incredible frustration."

When someone tells him that they get by on five hours sleep a night, Winter usually puts them into one of two categories. One is the group that needs seven hours, but can deal with five effectively, while the other group might need eight hours but tries to function on something less.

"I know a truck driver who rolls his hair up into the window so if is head nods as he's falling asleep, his hair will jerk his head and keep him awake," says Winter. "I tell him he needs to work at getting more sleep. Six hours a night obviously isn't enough for him."

For the six-hour crowd, Winter recommends using the available hours during a rest break not spent sleeping as quiet down time. "Resting is extremely restorative to a body. Meditating, or if you believe in higher powers, it's a great time to pray. Or even just reading or doing quiet activities in a relatively dark environment can be really impactful," he says.

2. Aim for Consistent Sleep Times

Sleep experts realize that consistent sleep and wake times are as important and probably more important than the number of hours we spend in bed. In fact, the hours of service rules' 24-hour rotation of 14 hours on-duty and 10 hours off-duty was intended to address regular sleep times. But it doesn't always work out in real life.

"There are real health consequences to sporadic sleep schedules, even if the amounts are correct," he says. "We can see patterns in health problems with people who have done a lot of shift work over the course of their lives compared with people who routinely wake and sleep at the same time every day."  

Also be mindful of what you eat and when you eat. If you normally eat at fairly regular times, but your shift throws that schedule out of whack, eat something light at the usual time because your body is expecting something.

"If you're not hungry for lunch at lunchtime, which is when you typically eat, try eating something light, like a few crackers or half of some sort of nutrition bar, just to give your brain the signal that, hey, I'm just not that hungry for lunch, but this is lunchtime so here's some food. That's better than eating big meals at irregular times."

3. Prepare Your Body for Sleep

It's hard to switch from full on, like when driving, to full off as you prepared to sleep. Since sleep is associated with a lowering of the body's internal temperature, Winter suggests starting to drop the temperature inside the cab and hour or so before bedtime.

Winter says even with sporadic schedules, drivers can coax their bodies and brains to sleep if they follow a plan. If you're outdoors, start by trying to imitate the onset of night by wearing blue-blocker sunglasses. Also avoid screen time unless you can dial down the blue light (as with night-time settings found on many devices). If you're indoors or in the truck, close the curtain, dim the lights and read rather than watch TV. Do something that's quiet and relaxing.

4. Get Physical Activity

Exercise could not be more important for a shift worker, Winter says. And he acknowledges it's really difficult to get when you're on the road. He suggests some resistance routine with those stretchy rubber bands before you sleep or after you sleep. A brisk walk is helpful, too, to help relax and clear your mind.

5. Take Regular Naps

Napping is a topic unto itself, and worthy of a lot more words than we have room for here, but Winter says they can be very valuable for drivers as a drowsiness mitigation strategy when taken appropriately.

"For a truck driver, napping is a very important strategy for playing by the rules and staying safe, but I think you have to be careful with napping," he says. "For example, if somebody tells me they go to bed every night at 10 o'clock, but it takes four hours to fall asleep, so they often nap during the day to make up for the lost sleep at night, the napping, in that situation, might actually be perpetuating the problems with falling asleep at night."

On the other hand, when you're short on sleep or sleeping irregular hours, even 20 minutes of shut-eye can be very restorative. Many will say, however, that short naps don't work and they often leave them feeling groggy and sleepy. Winter says that's the result of sleep inertia and there are ways to deal with that. 

"Sleep inertia is where an individual sleeps for a longer period of time and tends to feel groggy afterwards," he says. "What's actually happening is rather than just skirting the lighter stage of sleep with a short nap, you descend into a deeper state of sleep with a longer nap that's difficult to awake from."

He recommends taking shorter naps on a regular schedule so the body begins to anticipate the nap, and upon waking, get out into the light as quickly as possible and/or engage in a little light physical activity, like a couple of laps around the truck or some calisthenics.

"Waking after a nap is a great time to get a little something to eat," he says. "If you always terminate your nap with a couple crackers or an apple or something of that nature, your brain starts to understand that when you go from that nap, to eating, warming your body by walking around, it's time to get back to business. All those things tend to help you shake off the effects of that nap much quicker."

6. Recognize When You Have a Problem

If you developed knee pain, you might get yourself a knee brace, or ice the knee, or take a few days off from your jogging routine. But eventually if that pain didn't go away or got worse, you'd go see an orthopedic specialist, or at least talk to your primary care doctor. "But when it comes to sleep, I think a lot of people just feel talking about sleep is lazy," Winter says. "You know, I've tried sleeping pills and they don't work. There's nothing the doctor can do, so why bother?

"There are sleep specialists out there that have a lot of great tools and techniques for individuals who are struggling with their sleep that don't necessarily involve sleep studies or elaborate investigations. If you're somebody who's been struggling, just keep that in mind. There's a bunch of us out there who are ready to help."

Dr. Chris Winter is also the author of a best-selling book on the subject, "The Sleep Solution: Why Your Sleep is Broken and How to Fix It." It's available from most book retailers and it's also on Audible, so drivers can listen to it while they drive.

About the author
Jim Park

Jim Park

Equipment Editor

A truck driver and owner-operator for 20 years before becoming a trucking journalist, Jim Park maintains his commercial driver’s license and brings a real-world perspective to Test Drives, as well as to features about equipment spec’ing and trends, maintenance and drivers. His On the Spot videos bring a new dimension to his trucking reporting. And he's the primary host of the HDT Talks Trucking videocast/podcast.

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