Posted by David on January 18, 2001 at 22:13:53:

In Reply to: Rotating shifts and health posted by bcsteamer on January 17, 2001 at 15:15:24:

I'm a correctional officer sergeant employed with the state for almost 10 years. I remember when I was just an officer, and when I was much happier than I am now. I wanted the promotion, the stripes, and responsibilities that went with it. Little did I know what was waiting for me. I was on a steady shift (4pm 12 mid), with Saturdays, and Sundays off. When I got promoted, I went to a "swing shift" which is 3 days on 4-12, and 2 days on the 12mid to 8am. I did this for two years, and noticed the slow approach of insomnia, where I am now. I had to go on medication for depression for about 6 months, and I've been on Xanax, and Ambien for almost a year now. Recently I was moved to a steady shift, but the working environment is much worse. For example, I'll work 4-12, I have to pull a double shift 12-8, and travel an hour back home. I get home at 9:00AM, take off my uniform, eat breakfast, and I'm in bed by 10:00AM. I have to be up by 2:00PM "the same day" to go back to work again. That's only 4 hours of sleep ... 4 very short hrs. I watch the hrs go by, tired and growing frustrated because I can't go to sleep. So I call my boss, and tell him I can't make back in because I've worked a double shift, and haven't slept for over 31.5 hrs. Despite having to drive to work 51 miles, what do they say ... "calling in and saying you're too tired to come into work because you've worked a double shift is unacceptable..." They would prefer I drive, half asleep, endangering myself, and the general public. So far, I haven't returned because I've been to tired and impaired, but I anticipate some kind of discipline soon.

Currently, I must take; 6 Melatonin tabs, Nyquil, 2 Xanax, 2 Ambien, and 2 Tylenol PMs in order for me to even start feeling sleepy. My life is consumed by this lack of sleep, I feel horrible, and I'm only 40 years old. I try to hide this from my Wife and 3 small children because I don't want them to see what I'm going through. My kids are small, ages 12, 10, and 6. Sometimes they can't understand why daddy is so cranky at times. I go into my son's bedroom at night, and watch him, and how peaceful he sleeps. I only wish I could do the same. I'm currently looking for another job, and have gone to various interviews. Unfortunately, I'm going to have to take a drastic pay cut, if I start over somewhere else. We've just built a home, and I would hate to lose it.. I'll work two jobs if I have to, but I will not let my wife and children lose the home we've worked so hard to obtain. In closing, can a state agency FORCE an Officer to drive 51+ miles back to work, despite the officer making them aware s/he is impaired due to sleep depravation? I feel trapped, and smothered. Sometimes the simplest thoughts appear confusing to me. I don't know what to do, or say anymore. I feel like I'm being punished somehow, and I can't understand why. Here's an exact copy of a letter I sent to my Warden (Top Boss) explaining my situation. I sent it certified mail and also had it notarized. I'm simply trying to find out if they (my employer) can get away with asking an Officer to drive on a public street, despite not having sufficient rest. I have no-body to talk with. God Bless you all. Here's the letter I sent my boss. Please, any input, advise, or leads on anyone who can help me, will be greatly appreciated:
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Dear Sir:

I am respectfully resubmitting this letter, with additional information I obtained from various experts (listed), which illustrate the importance of being 100% mentally alert while performing the duties of a Correctional Officer -- and while driving a vehicle to and from work. Once again, I’d like to reiterate, I have no problem performing the duties of a Correctional Officer Sergeant. In fact, both my Shift Supervisors have advised me they’re very well pleased with my work performance. I am a firm believer in giving 110% in what I do, always have -- always will. However, I believe a well rested, focused, alert, and responsive employee is more of an asset to the department, than one who is half asleep and who’s decisions and actions, or lack of ... could potentially place us all in liability.

What happens when we're deprived of the restful sleep we need? We're less alert and attentive, more inclined to irritability and other mood problems that can make our relationships with family, friends and co-workers difficult. Our concentration and judgment suffer, our ability to perform even simple tasks declines, our productivity is sabotaged. Sleeplessness, whether it's the result of a sleep disorder or an overextended lifestyle, invites diminished quality of life and deteriorating health.

When we lose sleep or our sleep is poor, we also put ourselves and those around us at high risk for accidents. Major industrial catastrophes such as the Three Mile Island incident have been attributed to human error that occurred during times when the body is at its sleepiest. If we ignore our sleep needs and get behind the wheel of a car, lives may be at stake. It only takes a few seconds-just long enough for a tired body to steal a needed “microsleep"- to run off the road or into an oncoming car.

Sleep needs and patterns are regulated by an internal biological "clock" that's located in the brain. Most people's clock runs on a cycle of about 24 hours, but some of us are morning people, or "larks," and some of us "owls," who find ourselves more alert late in the day. For the 20 percent of American employees who work non-traditional schedules, getting enough sleep is a common problem. Shift workers need to sleep when their clocks are set for wakefulness, so they tend to sleep badly and not enough. They're more prone to falling asleep on the job than the 9-to-5 worker, and are at high risk for crashes while driving home in the morning. Maintaining a rigorously regular schedule (for both sleeping and waking activities), even on the weekends, can help the body to adapt.

The human body naturally follows a 24-hour period of wakefulness and sleepiness that is regulated by an internal circadian clock. In fact, the circadian clock is linked to nature's cycle of light and darkness. The clock regulates cycles in body temperature, hormones, heart rate, and other body functions. For humans, the desire to sleep is strongest between midnight and six a.m. Many people are alert in the morning, with a natural dip in alertness in the mid-afternoon. It is difficult to reset the internal circadian clock. It is not surprising that 10-20% of night shift workers report falling asleep on the job, usually during the second half of the shift. That's why shift workers who work all night may find it difficult to sleep during the day, even though they are tired.

Sleep deprived people think and move more slowly, make more mistakes, and have difficulty remembering things. These negative effects lead to lower job productivity and can cause accidents. Lack of sleep is associated with irritability, impatience, anxiety, and depression. These problems can upset job and family relationships, spoil social activities, and cause unnecessary suffering.

Most shift workers have at least occasional sleep disturbances, and approximately one-third complain of fatigue. Older shift workers appear to have more sleep-related difficulties than do younger workers, but no gender differences have been found. Night shift workers typically get 1.5 fewer hours of sleep per 24 hours as compared with day workers. The midnight to 8 a.m. shift carries the greatest risk of sleep disruption because it requires workers to contradict circadian patterns in order to sleep during the day.

Investigations have demonstrated that circadian phase disruptions caused by rotating shift work are associated with lapses of attention, increased reaction time, and decreased performance. A study of hospital nurses reached similar conclusions based on "real world" experiences. Rotating shifts (working four or more day or evening shifts and four night shifts or more within a month) caused the most severe sleep disruptions of any work schedule. Nurses on rotating schedules reported more "accidents" (including auto crashes, on-the-job errors, and on-the-job personal injuries due to sleepiness) and more near-miss crashes than did nurses on other schedules. About 95 percent of night nurses working 12-hour shifts reported having had an automobile accident or near-miss accident while driving home from night work.

Although this evidence does not demonstrate a conclusive association between shift work and crashes, the panel believes that shift workers' increased risks for sleepiness are likely to translate into an increased risk for automobile crashes. Competing demands from family, and recreation often further restrict the hours available for sleep and further disrupt the sleep schedule.

Countermeasures for drowsy driving aim either to prevent it or to ameliorate it after it occurs. The panel concluded that preventing drowsiness with adequate sleep before driving is both easier and much more successful than any remedial measure reviewed. Methods of obtaining adequate sustained sleep include creating a positive sleep environment (a room that is cool, quiet, and dark) and sleeping at regularly scheduled times. Such measures are often promoted as "sleep hygiene" and make intuitive sense; however, few rigorous studies support all sleep hygiene claims.

Shift work may increase the risk of drowsy-driving crashes. Night-, early morning-, and rotating-shift workers are often sleepy because their work times are inconsistent with the natural sleep-wake cycle. Workers on these shifts routinely get less sleep and lower quality sleep than do day workers. Driving while sleepy is a risky behavior that leads to many serious crashes each year.

Sleep-restrictive work patterns. Working the night shift, overtime, or rotating shifts is a risk for drowsy driving that may be both chronic and acute.

In the New York State survey, nearly one-half the drowsy drivers who crashed (and more than one-third of those who drove drowsy without crashing) reported having worked the night shift or overtime prior to the incident. In addition, a higher reported frequency of driving drowsy was associated with working a rotating shift, working a greater number of hours per week. The return to day work and morning shifts starting between 4 a.m. and 7 a.m. also may lead to sleepiness. EEG studies of sleep in rotating shift workers in both the natural environment and the laboratory have shown that day sleep after night work and early night sleep before morning work (e.g., going to sleep at 7 or 8 p.m. before a 4 a.m. shift) is 2 to 4 hours shorter than night sleep. Sleepiness leads to crashes because it impairs elements of human performance that are critical to safe driving. Relevant impairments identified in laboratory and in-vehicle studies include:

· Slower reaction time. Sleepiness reduces optimum reaction times, and moderately sleepy people can have a performance- impairing increase in reaction time that will hinder stopping in time to avoid a collision (Dinges, 1995). Even small decrements in reaction time can have a profound effect on crash risk, particularly at high speeds.

· Reduced vigilance. Performance on attention- based tasks declines with sleepiness, including increased periods of nonresponding or delayed responding.

· Deficits in information processing. Processing and integrating information takes longer, the accuracy of short-term memory decreases, and performance declines.

Short duration of sleep appears to have the greatest negative effects on alertness. Although the need for sleep varies among individuals, sleeping 8 hours per 24-hour period is common, and 7 to 9 hours is needed to optimize performance. Experimental evidence shows that sleeping less than 4 consolidated hours per night impairs performance on vigilance tasks. Acute sleep loss, even the loss of one night of sleep, results in extreme sleepiness. The effects of sleep loss are cumulative. Regularly losing 1 to 2 hours of sleep a night can create a "sleep debt" and lead to chronic sleepiness over time. Only sleep can reduce sleep debt. In a recent study, people whose sleep was restricted to 4 to 5 hours per night for 1 week needed two full nights of sleep to recover vigilance, performance, and normal mood.

Both external and internal factors can lead to a restriction in the time available for sleep. External factors, some beyond the individual's control, include work hours, job and family responsibilities, and school bus or school opening times. Internal or personal factors sometimes are involuntary, such as a medication effect that interrupts sleep. Often, however, reasons for sleep restriction represent a lifestyle choice-sleeping less to have more time to work, study, socialize, or engage in other activities.

Increased demands on many people to work instead of sleep, and work hours and demands are a major cause of sleep loss. For example, respondents to the New York State survey who reported drowsy-driving

incidents cited a variety of reasons related to work patterns. These included working more than one job, working extended shifts (day plus evening plus night), and working many hours a week.

Sleep is an active process, and adequate time in bed does not mean that adequate sleep has been obtained. Sleep disruption and fragmentation cause inadequate sleep and can negatively affect functioning. Similar to sleep restriction, sleep fragmentation can have internal and external causes. The primary internal cause is illness, including untreated sleep disorders. The National Transportation Safety Board (1995) concluded that the critical factors in predicting crashes related to sleepiness (which this report called "fatigue") were duration of the most recent sleep period, the amount of sleep in the previous 24 hours, and fragmented sleep patterns.

As noted earlier, the circadian pacemaker regularly produces feelings of sleepiness during the afternoon and evening, even among people who are not sleep deprived. Shift work also can disturb sleep by interfering with circadian sleep patterns.

Expert Panel On Driver Fatigue and Sleepiness
Kingman P. Strohl, M.D.Panel Chairman Director, Center for Sleep Disorders ResearchDivision of Pulmonary and Critical Care MedicineCleveland Veterans Administration Hospital Sharon L. Merritt, Ed.D., R.N.Director Department of Medical-Surgical Nursing Center for Narcolepsy Research University of Illinois
Jesse Blatt, Ph.D. Senior Research Psychologist Office of Research and Traffic Records National Highway Traffic Safety Administration Allan I. Pack, Ph.D., M.D. Director Center for Sleep and Respiratory NeurobiologyUniversity of Pennsylvania Medical Center
Forrest Council, Ph.DDirector University of North Carolina Highway Safety Research Center Susan Rogus, R.N., M.S. Coordinator, Sleep Education Activities Office of Prevention, Education, and Control National Heart, Lung, and Blood Institute
Kate Georges Special Assistant to Executive Deputy Commissioner Department of Motor Vehicles State of New York Thomas Roth, Ph.D. Division HeadSleep Disorders and Research Center Henry Ford Hospital
James Kiley, Ph.D. Director National Center on Sleep Disorders Research National Heart, Lung, and Blood InstituteNational Institutes of Health Jane Stutts, Ph.D. Manager, Epidemiological Studies University of North Carolina Highway Safety Research Center

Based on this information, and given the immense responsibilities of a Correctional Officer, I find my decision not to report for duty while impaired due to sleep depravation, resulting from working an extended word-day, a responsible one. When I’m selected to work an extended-day, the following occurs:

· I arrive home between 8:30 and 9:15 AM, depending on when I’m relieved of duty;
· It takes me approximately 45 minutes to an hour to wind down, and prepare for bed;
· At approximately 10:00 AM, I’m just getting ready for sleep;
· I have to wake up at 2:00 PM, to shower, shave, and get dressed for work - I MUST depart by 2:45 PM;
· This gives me 4 hours of TOTAL sleep time, assuming I fall asleep by 10:00 AM, which NEVER happens;
· It’s 11:30 AM, and although I’m extremely tired, I’m still unable to fall asleep and obtain sufficient rest...

If were to return to work the same day, after pulling an extended day, this would place me behind the wheel of a vehicle without sleeping approximately (31.75 hr.). That’s waking up at 7:00 AM, working straight through until 7:30 AM, the next day (24.50 hr.) -- not sleeping, then getting in my vehicle at 2:45 PM (31.75 hr.). Once at work, and at briefing, I will start my tour of duty without sleeping a total of (32.50 hr.). This would undoubtedly impair my abilities to be at 100% capacity to perform my duties, due to sleep depravation. Add another 8 hours of duty, and I’m back behind the while of a vehicle, on my way home (driving at night) without sleep a total of (40.5 hr.) combined.

This is when I must make the decision to: (1) Get up, without sleeping and drive to work while completely impaired, or (2) Call-in and advise I’m unable to report for duty due to sleep depravation resulting from working an extended work-day. My decision to call-in is based on the following ... just to name a few.

A Correctional Officer:

· Must have the ability to make split second responsible, and important decisions;
· Must be able to maintain constant observation of his/her surroundings;
· Must be able to provide assistance to fellow officers when needed;
· Must be able to drive SAFELY to and from work;
· According to Florida Administrative Code, Chapter 33-208.002 (4)(a) -- “Shall keep himself physically fit, mentally alert, and shall perform his duties fairly and impartially, and otherwise conduct himself both on-duty and off-duty so as to command the respect of fellow employees, persons on parole, probation or otherwise under his supervision, inmates and the general public.”

After staying awake for 24 hours straight, a person will be about as impaired as if he had had enough alcohol to be legally drunk in most states, a study says. In one experiment, participants stayed awake for 28 hours. In the other, they drank alcohol every half hour until they reached a blood alcohol concentration of 0.10 percent. That's the drunken-driving standard in most American states. Every half hour, the subjects took a computerized test of hand-eye coordination. Results showed that after 24 hours of sleeplessness, participants were about as impaired as they were at the 0.10 percent level of blood alcohol. After 17 hours, they were about as impaired as they were with an alcohol level of 0.05 percent.

"Driving while drowsy is no different than driving under the influence of alcohol or drugs," said Richard Gelula, the National Sleep Foundation's executive director. "Sleepiness slows reaction time, decreases awareness and impairs judgment."

These are just a few of the reasons I feel it’s important to be 100% alert when reporting for duty. A Correctional Officer is without doubt, a high liability position. In my opinion, remaining home (when unable to perform my duties at 100% capacity after working 16-17 hours -- not counting travel time), protects myself, the general public, and prevents possible liability to the department in the event of human error -- due
to impairment. I have no problem performing my duties as a Correctional Officer Sergeant. In fact, I never complain when it’s my turn to do my share of extended work-days. However, I believe the problem doesn’t
lie with those who are unable to return to work on the same day, after working an extended work-day. I believe the problem should be addressed with those who abuse their leave -- causing others to work “extended work-days.” If I am ordered to work, despite the above circumstances, I will make good-faith effort to comply with such an order. However, in the interest of my family, myself, and the general public, I respectfully ask this “order” be delivered to me in writing.

Respectfully resubmitted.
Sgt. D. Ortiz

Follow Ups:

• Re: Steamer::: You're NOT alone. Check this out, and HANG in there! bcsteamer 23:59 1/18/01 (1)
  • Re: Steamer::: You're NOT alone. Check this out, and HANG in there! David 08:42 1/20/01 (0)

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