Sleep: Your secret safety belt

Moderator: Thank you so much for joining us today for our webinar on sleep and safety for National Safety Month. We hope that this webinar will provide some insight and resources into how sleep impacts your safety and well-being both at work and in your home life. 

Jennifer Lindskoog: Thank you for including me on this topic because it’s definitely near and dear to me, and here’s the “why.” I grew up in a household that was in the wholesale-retail food distribution industry. So I spent a lot of time in warehouses with our commercial drivers, and still have family who drive in the transportation industry. 

I’m really honored to support SleepCharge clients, and their employees, especially those who are in safety and regulated roles. I’m thankful, quite frankly, that I made it through some of the fatigue-related safety and health issues. And I’ll share some of my own personal stories. If you think about that phrase, if I only knew then what I know now. And then, also, I have a teenager and a 20-year-old. So I’ll talk a bit about safety risks in young adults, as well, due to fatigue. 

So let’s start at the beginning. These are the basics and they seem so simple. But, again, if I only knew then what I know now, because in the early parts of my career, I really didn’t understand the value of the full duration of sleep, the ability or the need for adults to have seven to nine hours of sleep per night. I was very focused on touting how little sleep I got — I only have four hours of sleep because I’m working so hard. And in a personal story that ended up in a health situation in my early 30s, that actually was a mini stroke. And it was based on fatigue, and certainly the low duration of sleep that I had at the time. 

Sleep timing is also another piece that’s a fundamental of sleep. And it’s really how well you’re in sync with your natural circadian rhythm. But kind of the layman’s around that is really, do you wake up and go to sleep at the same times each day? Are you in sync with your circadian rhythm? Are you maximizing going to bed and waking up at the same time, even if you’re third shift.

And then, also, sleep quality, really that undisturbed sleep quality that’s the appropriate amount of time and the quality that’s needed in both REM and non-REM sleep. So maybe you have the duration and the timing, but you’re still not feeling refreshed when you are awake. So potentially there’s an issue with your sleep quality.

Let’s talk about fatigue. There are many studies or significant research on the impact of fatigue and its correlation to sleep deprivation as being equivalent to intoxication in the way that it impacts your body as well as your mental functioning. Much of this is posted on the Centers for Disease Control site. They’ve been involved in these studies, as well as the National Highway Traffic Safety Administration and other DOT sites. But the reality is when you are getting four or less hours of sleep during your appropriate sleep cycle, it is equivalent to being legally drunk. 

I’ll share a personal story because I used to be that road warrior that traveled from East Coast to West Coast just about on a weekly basis. And to make sure I was in the office on the day after one of those big travels, I would take the red eye and think that taking a nap or so on the red eye, and then getting into a car, and heading home just so I could get a quick, little nap, get ready for the next day to have that face time in the office. One evening, and now I realize what that impact was, is I had gotten home from one of these red eyes, hadn’t had alcohol on the plane, I’d taken my nap on the plane. But it was in the middle of the night. I’d worked Monday through Thursday, long days, a lot of travel, certainly had jet lag. And I remembered getting to my car at the airport. But, frankly, the next thing that I remembered was a police officer pulling me over and, in essence, testing me for being intoxicated because of the way that my driving was — this was about two o’clock in the morning. I honestly don’t remember anything between the airport and those flashing blue lights. But even to this day, knowing how that impacted or that was, for lack of a better term, a wake-up call for me. I remember what I was wearing, the car I was driving exactly on 285, which is the beltway around Atlanta, Georgia, exactly those moments when I was pulled over. And at the time, I was incensed that I could possibly be pulled over when I’d had nothing to drink. But in reality, the fatigue that I had was impacting my alertness, it was impacting my ability to stay within my lane. Those things that are equivalent to had I been out for a night of drinking. So in a personal way that connected the dots — now that I’m in this particular industry and know more about it — to the fact of being awake so much. So, little sleep, thinking that I could catch up with naps, and then being pulled over for suspicion of intoxication. 

The other thing is that when there’s fatigue, it does decrease your concentration.  Distractions increase the likelihood of errors, omissions and accidents. And I think this statistic is very telling, if you count to yourself three seconds, that three-second distraction could double the likelihood of an error. And it’s not just those errors associated with accidents and incidents, it could be errors of judgment. It could be errors in decision-making around financial transactions, or even an issue associated with creating a defect situation in a manufacturing environment. All of these can have very significant personal and business implications.

So there’s, again, a lot of information as it relates to fatigue and risk. One of the greatest resources around this is drowsydriving.org. And one of the things that they listed in there is the highest risk groups associated with having a crash due to drowsiness and fatigue. So as we looked at on the previous slide, that connection between fatigue and things like your cognitive function, your judgment, your reaction to things. And in these groups, they listed out shift workers and people who work particularly long hours, commercial drivers, people with undiagnosed or untreated sleep disorders. For example, people with untreated sleep apnea have been shown to have up to seven times the increased risk of falling asleep at the wheel. Business travelers, that was the category that I was in all those many years ago. 

And then the one thing that I wanted to point out here, in particular, is young people. And in the studies and in the information that you can find on drowsydriving.org, it’s especially males under 25. Now, again, I have a teenager at 16. And I have a male, young adult in my household that’s 20. So this information really was timely and impactful. The interesting thing about this study that the CDC publishes — they analyzed over 50,000 respondents that were in high school so this is 9th through 12th grade and up to about the age 18, 19 years old. And there were two things. One is it confirmed what we may all realize that when you’re sleep deprived, you’re at a greater risk for accidents and errors. So insufficient sleep leading to more frequent driving accidents in young people, injuries in sports. But the other side of it that was most impactful to me, in particular, was that it also led to risky behavior. What these teens were reporting that were getting less than seven hours of sleep, especially on school nights, as compared to teens and young adults who are getting nine hours of sleep is that they were engaging in risky behaviors, things like infrequent use of a bicycle helmet, too infrequent seat belt usage, riding with a driver who had been drinking or drinking and driving themselves, and then texting and driving. And certainly this risky behavior, as noted here, was associated with this lack of duration in sleep and good quality of sleep. 

If we move over to the working environment, there were 27 research studies that were done and reviewed by the National Safety Council. And they found that workers with sleep problems were at 1.62 times higher injury risk, and that 13% of the work injuries were due to sleep issues. Relating a story about a family member of mine, who actually drives twins in the transportation industry, had a life-altering incident of utilizing and moving cargo out of the truck, having an injury of falling back. And it was significant to head injuries and bodily injuries. And if you were to ask him today, what precipitated that, it was really three things. I was fatigued. And I was in a hurry. And I didn’t follow a documented safety requirement. And then, I’d seen others skip this step when they were in a hurry. So one of the things that is so important here is to say this can be real, this can bring it home, it certainly brought it home for me when I heard those comments from this young man in this industry that had a near life-altering injury that kept him out of work for several months, and has continued to have some ongoing challenges.

So what do we do to combat fatigue? Here are some strategies, a couple of them that I wanted to emphasize here are around getting exercise, typically earlier in the day. So if you work on a day shift, earlier in the day is better than just before bed, since just before bed, you would tend to have higher body temperature that can impact your ability to get to sleep. Also eating healthy foods. When you’re on the road, in particular, trying to focus on foods that are less caloric in nature with sweets and sugars and whatnot, but more of complex carbohydrates and proteins that can be found in lean meat or vegetables or whole grains. Those are longer lasting to give you energy. And then, where possible and if needed, taking a nap, a brief nap, but not one that is so close to your bedtime, or so long in duration, that it actually impacts your normal desire for sleep when it’s appropriately time to sleep. 

Now having a job in shift work, especially a third shift, whether you’re driving, whether you’re working in a factory, whether you’re working in a restaurant, in a third shift has particular challenges in the amount of sleep that is lost on average in a 24-hour period. The kind of counterintuitive work schedule that works against your natural rhythm for sleep and awake, and typically those who do shift work are at a greater risk of getting in a car accident, in particular when they are heading home from their shift. This can also be associated with people that work particularly long hours. Here are some of those strategies, and it may be very difficult to do. 

I have a very close friend who works third shift driving and really wants to be with family, do more things with family, during the daylight hours on the weekends as possible. One of the things that they have done is they’ve gotten the family involved, making activities that are within the normal wake time or the front end of the normal wake time, that can personally align to the schedule as much as possible. So that if you’re on a third shift during the week, on the weekend you can enjoy family, as well as maintain the same sleeping schedule. Napping, again, it’s not a substitute, it is more of a supplement to be used if seven to nine hours is not possible. And using light to your advantage. So when we think about during the daytime, to help us get the best night of sleep, we want to incorporate as much of that good daylight and not put on the sunglasses until later in the day to give us the best possible opportunity for getting to sleep and staying asleep at night. However, if you’re on third shift, some techniques that you can use are, first of all, ensuring that you’re going to go home to a dark, cool house as much as possible. So if that’s asking your family to turn up that air conditioner, get it nice and chilly, and have a nice, dark room and home to walk into. They will work with you. The other thing can be putting on sunglasses before you walk out to your car to go home. Doing the opposite for those of us that sleep at night. If you’re trying to sleep during the day, make sure you’re closing out that light exposure as you’re heading home for a day sleep.

Now, if we look at drowsy driving, there are aspects to this. And there are a lot of resources for you to take advantage of, whether it’s through our SleepCharge site or resources such as the Sleep Foundation, the National Traffic Safety Administration and, as I mentioned earlier, drowsydriving.org. There’s information on not just facts about drowsy driving, but things that you can do about it. Have you ever had one of those incidences where you think you’re traveling along the highway, and then you feel those rumble strips on the side? Well, that happens in about one and 25 drivers who admitted to falling asleep at the wheel. And, thankfully in many cases, those rumble strips were enough to wake them back up. The sad part is that there are about 6,000 fatalities that occur each year due to drowsy driving. And a significant amount of those do occur. I’ve had a client tell me before, this is referred to as “the bewitching hour,” so that midnight to 6 am or 2 am to 6 am timeframe when these collisions can occur. 

So  what do you do around the drowsy driving? Again, I remember, as a kid, my dad would always say when we went on vacations, let’s beat the traffic. So we would get up at 2 am so we could get on the road at 3 am. And I remember those trips where he got pretty agitated in the afternoon after being awake for so long, as well as in those days he took something called NoDoz to keep him awake so that he could keep driving on the road. I can imagine that was not the safest travel that we went through. But I remember those moments as a child that, today, I would rethink or I’d try to say, “hey, maybe that’s not the best way to do it.” Make sure to get enough sleep before you head out. That mid-afternoon break is good, and as you’re on the road, especially long trips in particular, taking the breaks every couple of hours or 100 miles. Take a quick nap, stretch your legs, and have one of those healthy snacks.

And then one of the things that we have established in the SleepCharge program is a website for you to find out more information. I’ve mentioned some of the industry websites. But, also, we maintain a pretty robust set of education materials through sleepcharge.com. You can also access through sleepcharge.com a Sleep Checkup™. So we talked about duration, timing and quality, finding out what yours is, or connecting with your company’s SleepCharge program to find out more about the services that may be available to you both educational, as well as for testing, diagnosis and treatment of sleep disorders and disruptors. One of the great tools that has been put in place within the SleepCharge site is called The Sound Sleeper. It’s a blog type of post that has information that’s very topical in nature. And there is a catalogue or history of those. If you go to sleepcharge.com/sound-sleeper, you can sign up for it. And you will get periodic emails making you aware of when new posting material is available, you can go onto the site to gather that information. But then, also, The Sound Sleeper will send you a link that connects you to the information when new information is available for you and your family. 

The other thing is, if you have questions, and it can be questions about sleeping safety, it can be questions about sleep and your health. If you have a concern that you may be fatigued, or have a sleep disorder, please do give us a call at our 877 number. Or, we have an email that’s dedicated to the SleepCharge program for questions you may have or to engage with someone from our organization who can help. What’s important for you, too, is that we have a team of sleep specialists, both in our clinical and care teams, as well as board-certified sleep medicine physicians that you can consult with to help you not just get answers to those basic questions, but perhaps get you answers and treatment for a long undiagnosed and untreated sleep disorder.

What I’ll do is leave on the screen and I want to just share with you these three points. And this is not anything that I creatively came up with — alive, awake, aware — this actually pays tribute to a client of ours that when they launched their transportation SleepCharge program helped us develop this messaging for their team members. And it truly takes to heart what we’ve talked about, which is being there for your family, doing the right things to support yourself, your potential fatigue-related issues. Being awake for your job, so that you minimize or mitigate errors, omissions and accidents. And certainly being aware for your safety. So thanks for the time to be able to talk through our sleep and safety webinar.

Moderator: Yes, Jen, thank you so much for that information. And we actually did have a couple of questions come through, so I’m going to get through those. So the first question: My family is going on a cross-country road trip — any tips for travel?

Jennifer Lindskoog: Okay, so, you know, Jessica, I’ll reveal a little bit more about us. We are, if you know those vacation movies, we are the Griswold family. So we do a lot of road trips with our family. We’ve been doing this since our children were very small. And we have to keep our family safe on the roads and ourselves, as well as our sanity, especially when the children were young. So there are probably four things that I think are most helpful if you’re doing one of those road trips with your family. Definitely start your journey after you get good sleep, and it’s not just the night before. I know there’s packing and preparing and whatnot. Make sure several days leading up to your journey you get good, quality sleep. 

When you’re on the road, I remember we used to say, after two take 10 to 20. So definitely when you are on the road, make time for breaks. It’s a great way to get out of the car, run around, have a snack, have a picnic with your family at a rest area to make it fun. Avoid things that make you tired. So if there’s medication that you know of that causes drowsiness, listening to something that is very calm, is not necessarily the best timing for when you’re on one of these long road trips. 

Get some fun books that you can listen to, through your Bluetooth or through CD, if you still have that. As a family, we used to get some that were more fun for the kids, but turned out to be fun for us. So we ended up with a lot of those Harry Potter listening sessions. But it definitely kept us going for the trip. And then, again, that enables you to increase some of that more wakeful stimuli. And then we also would do games. We would have at times, which the kids thought was kind of funny, we would allow them to put on their music and, you know, sing it loudly. So those are just some of the ways to not just have fun with family but to help prepare yourself and keep you safe while you’re on the road for one of those Griswold-type vacation journeys.

Moderator: Love that. Thank you so much. Okay, we have two more questions. One is: I am a shift worker and work unusual hours. What can I do to promote healthy sleep?

Jennifer Lindskoog: Okay, we talked about a few of them earlier, which is using light to your advantage. Coming home to a dark and cool home, making your home like it’s night, nighttime blocking or masking out any sounds. It definitely maintains your overall health and well-being. Just like if you’re awake in the day and going to sleep at night, you want to follow some of those same rules that help you get to sleep and stay asleep. Things like avoiding alcohol several hours before bedtime or watching your caffeine intake to minimize it. And, certainly, also avoiding caffeinated beverages too close to bedtime. So limiting those several hours before you go to bed. 

One of the things that’s on the National Transportation Safety Administration site is they have these really neat “do not disturb” signs. If you have kids at home, get them involved, have them color it. So it’s not that it’s a punitive message not to disturb you when you’re asleep. But they’ve gotten involved in helping you be a part of your care and your shift. 

You know, unplug the use of the phone. Or, just like we’ve said, when you have a night sleep schedule, same for day sleep schedule, avoid that blue light 30 to 60 minutes before you’re about to go to sleep, so that you don’t inhibit your production of melatonin. And then make a ritual and, as best as possible, stay to that sleep-wake ritual on the weekends, as much as you do during the week.

Moderator: Perfect, thank you. And then our last question that came in is, can you truly catch up on sleep?

Jennifer Lindskoog: Catching up on the sleep on the weekends is an interesting one. So if you think about what we talked about earlier on duration, timing and quality, on the weekend, if you can stay in that timing that you have during the week, but maybe within an hour each side of that, versus the sleeping in of, say, three to four hours past the time that you would normally wake up during the week — maybe sleeping in an extra hour is okay. What you will notice or what you may have noticed previously is when you are trying to “catch up” on a weekend, which sometimes is referred to as catching up on your “sleep debt,” you actually feel more groggy. And what you’ve done is you have interfered with the natural rhythm or the rhythm that you’ve created during the week and taken that off. There is a difference between the amount of sleep that you need and the amount you actually get. There’s, again, some really good information through the Sleep Foundation about sleep debt and what you can do relative to using naps. And some of that is just a slight change in your timing for the weekend versus when you have an actual issue with sleep deprivation. 

Moderator: Yes, perfect. Thank you so much, Jen. And thank you everyone for taking the time to learn more about sleep and how it impacts other areas of your life. A link to this webinar will be sent out by email later this week or early next week. Feel free to share it with friends and family members. We also encourage you, like Jen mentioned, to take your Sleep Checkup™ to determine your personal sleep health. As she mentioned, feel free to reach out to us at sleepcharge.com if you have any other questions, and thank you and have a great day. 

Jennifer Lindskoog

Jennifer Lindskoog is the vice president of client operations at SleepCharge. Her experience spans three decades working in employer environments delivering technology and business solutions. She has held several sales and operational leadership positions at multinational corporations.