Comment

Fatigue can creep up on anyone

Chris Langer, human factors advisor at CIRAS, the confidential incident and reporting analysis system for the rail industry, looks into the issue of fatigue and under-reporting. 

Whatever time of day it is where you are, try going to sleep before reading any more of this article. 

Still here? Assuming you’re wide awake, and not watching the pendulum swing of a gold watch before your eyes, it’s highly unlikely you can just fall asleep ‘at will’ like this. Very few individuals could manage this feat using willpower alone. Herein lies one of the problems of getting high-quality sleep, with the intention of arriving at work the next day as fresh as a daisy. You can’t just order ‘sleep to go’. 

Fatigue can be defined fairly simply as ‘extreme tiredness which affects one’s ability to concentrate and work effectively’. Individual differences play a key part, since fatigue can be experienced in unique ways, both physically and psychologically. Older individuals typically experience greater issues with sleep, finding it both harder to concentrate on the night shift and sleep afterwards. 

Some individuals appear to have a greater resilience to the effects of fatigue. I recently spoke to a railway worker who survived on less than five hours’ sleep a night, had two young children, and still managed to visit the gym every day for an hour-and-a-half. This had been his routine for more than a decade. That might sound ill-advised, but the amazing thing was that he claimed he never really felt fatigued. Such claims often make us feel like we should be doing more with our lives, but do they really stand up to closer inspection? They may just be a cultural myth. 

Many world leaders on the political stage have earned their hardworking reputations, at least in part, from having as little as four hours’ sleep. This elite club of sleep-deprived individuals includes presidents Barack Obama and Bill Clinton, surviving on six or less hours’ sleep, and Margaret Thatcher, who apparently only needed four. In the business world, similar stories abound, with the CEOs of AOL, PepsiCo, Fiat and the founder of Twitter all burning the candle at both ends – and apparently achieving great things.

Sleep debt 

But a closer look reveals ‘sleep debt’ may be a less-than-perfect advert for high-flying endurance. Poor decision-making and errors of judgment are the likely consequences of a lack of sleep. We may occasionally like to boast chirpily how little sleep we have had, but our assumed mental alertness is often betrayed by bloodshot eyes, along with impaired job performance. Being awake for 17 hours can impair our performance to the same degree as two units of alcohol, or a pint of lager. 

The general consensus is that individuals need an average of seven to eight hours of sleep per night. If this biological need for sleep is reduced by one or two hours, the typical result is a deterioration in alertness and performance the next day. If sleep deprivation continues in the longer term, it can contribute to poor physical and mental health, as well as ongoing difficulty concentrating on the job in hand. 

Research by the US military shows how productivity falls rapidly for people restricted to less than eight hours of sleep – the less sleep, the bigger the fall over the next few days. Surviving on four hours’ sleep caused a 100% productivity fall by Day 5. 

Biologically, we have evolved a ‘circadian’ rhythm affecting our physiological processes over the course of a day. In practice, the circadian rhythm effect means that mental alertness in fully rested individuals tends to be lowest around 4am. Our biological need for sleep is greatest in the early hours of the morning, but we also experience a noticeable drop in alertness mid-afternoon. 

Even if you have never done shift work, you are likely to have experienced the same effects on your body from a long-haul flight. Disrupted sleep and hunger patterns are the usual consequences as the body attempts to adjust itself to a new routine. Our body clock is largely governed by daylight, rather than an oscillating quartz crystal, so it is far more difficult to regulate than a standard clock. With a standard, analogue clock you can often just reposition the hands to set a new time – its performance is unaffected. Fly to a different time zone, or change your shift pattern, and attempting to move the hands of your body clock meets with stubborn resistance as the brain plays catch-up. 

It is no surprise, then, that shift workers are more likely to build up a sleep debt. In fact, research shows that shift workers who sleep in the daytime will experience lower-quality sleep, typically sleeping for a third less than they would at night. What tends to happen is that they wake up spontaneously after only a few hours’ sleep. Siestas in Mediterranean countries can be viewed not just as culture-bound adaptations to a hotter climate, but also as a way of accommodating the body’s need to replenish its energy supplies. Even if we don’t live in the Mediterranean, shift permitting, many railway workers might benefit from a ‘siesta style’ afternoon nap, especially if we are suffering from a lack of sleep.

An hour’s extra sleep can make all the difference 

Modern Britain is a sleep-deprived nation. According to the Sleep Council, the average Briton gets just six-and-a-half hours sleep a night. Sleeping just an hour less than the recommended amount each night can actually impact our health at the genetic level. 

The University of Surrey carried out some research into this, comparing a randomly allocated group of volunteers receiving six-and-a-half hours sleep with another receiving seven-and-a-half hours’ sleep over a period of week. At the end of the week, the groups were asked to switch sleep patterns. Blood tests revealed that around 500 genes were switched on or off by changes in sleeping patterns. Most worryingly, there were increases in the activity of genes associated with heart disease, diabetes and the risk of cancer. 

The advice for most, then, is to have more frequent lie-ins. Burning the candle at both ends, and then attempting to erase the sleep debt at the weekend, is not the answer either. Important night-time brain processing, such as the consolidation of memories, needs to happen within 24 hours of the memories being formed, otherwise those memories can be lost. An hour of extra sleep makes all the difference, also improving cognitive functioning the next day. 

Why fatigue is under-reported in the rail industry 

There is no doubt in my mind that fatigue is grossly under-reported through conventional reporting channels. Train drivers are less likely to report fatigue through company channels, because there is often a fear that if they have a safety incident, it may indicate personal lifestyle habits are to blame. The contribution of fatigue to signals passed at danger (SPADs) in investigations tends to be understated for the same reason – admitting fatigue immediately implies culpability. 

The effects of fatigue whilst driving on the roads before and after shifts has also been the subject of many reports to CIRAS. I recently spoke to a track worker who was actually involved in a serious road accident whilst working for a subcontractor. Understandably, he was at the end of his tether and intent on handing in his notice. He had been regularly commuting for almost four hours to and from work, on top of a 10-hour shift. 

The reporter’s colleagues found the issue of fatigue and the risk on the roads too difficult to raise. Understandably, they were worried about their job security. He could only muster up the courage to report because he was going to leave the company, and his confidentiality was guaranteed by CIRAS. We were quick to raise awareness of this issue at a higher level after we received a spate of reports, also helping to trigger a research project on the fatigue risk associated with work-related driving. 

It is recognised that more road traffic accidents are reported to local management than entered into the industry’s Safety Management Information System. Until there is a national pool of data on work-related road traffic accidents, CIRAS will continue to support the rail industry by highlighting the issue of fatigue where it comes to our attention.

Tell us what you think – have your say below or email [email protected]