Get Your Rest
Galen C. Bosley, D.H. Sc.

On a stretch of interstate in Maine late one night, a car filled with five high school students developed mechanical problems. Pulling the vehicle to the shoulder of the roadway, the driver got out and lifted the hood in an attempt to locate the problem. The others remained in the vehicle. At that moment, on the same stretch of interstate a tired trucker fell asleep. The truck drifted off the main roadway striking the auto and killing four of the five students. The weather and driving conditions were good. This accident spawned the organization Parents Against Tired Truckers.

This event is not an isolated occurrence. Statistics show that for every trucker killed in a trucking accident four other people are also killed. The American Automobile Association has estimates that fatigue is the primary factor in 43% of heavy truck accidents. Many experts now believe that fatigue may be second only to alcohol as a cause of accidents and death on the nation’s highways.

The problem of falling asleep at the wheel or at work is not confined to truckers. It involves all of us—young and old, automobile drivers, pilots of aircraft and ships, factory workers, engineers of trains. It involves you and me.  The major cause of the problem is that most of us in the industrial nations are trying to cram too much into a 24-hour day at the expense of our sleep.  We are then chronically sleep-deprived and that sets the stage for the carnage occurring on the road, and even on into the workplace.  Unlike driving while under the influence of alcohol, the main problem that prevents improvement in this matter is that most people do not see themselves as dangerous, just tired.  And being tired is not a crime.

To illustrate this, a fellow worker recently told of how he traveled several hundred miles while frequently dosing off at the wheel.  He never even considered pulling off the road to sleep.  Yet this same person would have considered it criminal for him or someone else to be under the influence of alcohol while driving.  Is there really any difference?  Being sleepy is natural.  Yes!  But it is also as dangerous as alcohol when it comes to operating a vehicle or any other equipment.  Consider the Exxon Valdez; this incident alone has cost the nation nearly five billion dollars and untold hardships to families that make their living from the waters and islands, not to mention the immeasurable loss of wildlife, habitat, and natural beauty.  Few people have not heard of this major disaster that occurred in the Alaskan waters, nor have they forgotten the major cover story of the captain being drunk or at least under the influence of alcohol.  But who ever heard of the conclusion of the National Transportation Safety Board investigation as to why the vessel struck Big Reef?  The official investigation discovered that the third mate was in charge of the helm that fateful night, and had been on duty for some 32 hours, overseeing the filling of the giant supertanker and its preparation for sailing.  In the quiet stillness of the night, despite the magnitude of his responsibilities, he failed to recognize and respond to two signals to turn the mammoth tanker back into the shipping channel.  He was literally “asleep on his feet.”

Fatigue can be likened to a phantom killer.  Unlike alcohol or drugs there is no test to determine blood levels in one killed in an accident due to fatigue.  In today’s society the interaction between man and machine is becoming more complex and mentally demanding.  Training to keep up-to-date is becoming a continuous task and with the responsibilities of these positions comes a greater price when errors occur.  The pace of life is the fastest ever in human history.  With jet planes to travel long distances in hours, with telephones, computers, and FAX we communicate with those thousand of miles away in just seconds.  All these fast-paced avenues of transportation and communication drive the economy faster and faster.  This in turn increases the pace of life for the individual and the family.  Because of this pace, fatigue has become one of the most frequent complaints in physicians’ office visits.  Many feel fatigue regularly because of excess cares and duties.  This is especially prevalent in single parents and working mothers with small children.  Trying to keep up the house, maintain the family, and hold down a job, but also keeping up to date with the changing demands of one’s job, leaves little time for rest and sleep.  These situations break down communication in families leaving heavy tolls on the relationships within them.

Fatigue has an insidious effect on our lives, both temporally and spiritually.  While it affects the brain’s ability to make fast decisions, it also causes the brain to process a decreasing percentage of the information it constantly receives through the five senses. The frontal lobes of the brain that house the spiritual center of the individual experience compromise in function: increasing mistakes are made, there is a decreased capacity to make decisions, a weakening of the power of self-control over our weaker traits and all these are accompanied by a sense of depressed mood. Fatigue may be as effective in disabling the moral discernment of the pastor or church member as is alcohol.  And it is universally happening.  In the past, few stayed up much past sunset but with travel times shortened and daylight hours extended we have reduced our total sleep by twenty percent from that of our grandfathers just over a century ago.  It has been a long and escalating process of change which has left more than a whirlwind impact on the individual, the family, the church, and society.

Then there is the account related to me by an army officer of how extreme fatigue left young men standing facing a tree, waiting for it to move, thinking it was the man in front of them, or putting quarters into the bark of trees then looking in the bushes around the base for the soda they had just purchased.  Discernment gone, they knew not the difference between a tree and a soda vending machine or a man.

The fatigue discussed in this article does not focus on “chronic fatigue syndrome” but the everyday variety of fatigue experienced daily by everyone.  Although scientists in various fields of endeavor may define fatigue in different ways, the most general definition says, “fatigue denotes a state represented by a loss of efficiency and general disinclination to work.”  Fatigue is a state that no one can escape any more than any of us can escape death.  It is a daily recurring state that has a major impact on our lives and the quality of our job performance.  If our work environment is conducive to fatigue it invariably can progress into sleep.  Our ancestors worked hard at manual labor, which masks and even combats fatigue and prevents sleep from occurring on the job.  But our sedentary jobs are the perfect environment for fatigue to express itself.  In a society that is increasingly operating on a 24-hour-a-day schedule, this presents a serious problem.  

Causes Of Fatigue

Fatigue is not a physiological state that can be blamed on just one cause.  Long continued physical work can cause fatigue, but so do jobs with inadequate stimulation or overstimulation by excess mental processing.  In other words a job with either a very high or very low level of mental taxation can be very fatiguing.  Also considerably fatiguing are jobs over which one has little control; this probably results from the constant uncertainty of the situation with its attendant emotional drain of the brain. Working women with children also complain of being fatigued.  Studies show that even though women work outside the home they report doing household duties another 25 hours per week where the men may help for only five hours per week.  Mothers in single-parent families probably experience the greatest amount, reporting often feeling tired or fatigued.

Fatigue is also affected by our circadian rhythm.  This rhythm gears up the body’s physiological process with each dawn and gears down with the nightfall.  In a 24-hour-a-day society this creates some problems.  From midnight to 6 am the alertness of night workers is decreased.  A twenty-year study of meter reading in a gas company shows pronounced peak in reading errors on the night shift compared to the daytime.  During night shifts trained engineers fail to operate their alerting safety devices more often than during the day.  And night-shift nurses have been found in a recent study to have twice the medication errors than day shift nurses.  Flight simulation studies have shown that the ability to “fly” a simulator at night may decrease to a level corresponding to that of moderate alcohol consumption with a resulting blood alcohol of 0.05 percent.

Avoiding Fatigue On Your Trip

Behavioral studies of trucking accidents can teach all of us more about safe driving.  Fatigue appears much more rapidly in an individual who has irregular work schedules.  One study found that those on a regular work schedule began showing significant signs of fatigue after 8 to 9 hours of driving whereas drivers on an irregular schedule showed the same signs after 5-6 hours.  Although fatigue can manifest itself at any time of the day there are some periods of the day and night that show very high risk of accidents involving a drowsy or fatigued driver.  The primary period is between midnight and 6am and a secondary peak is between noon and 4pm.  The risk of having an accident is 7 times more likely between midnight and 8am than during other hours of the day.  Though not as high as the early morning hours, from noon to 4pm is also characterized by increased accidents due to drowsiness.

Accidents are also found to increase with the increasing number of hours on the road. Bright sun, especially afternoon sun, coupled with fatigue has a strong sleep-inducing effect so when driving into the sun make sure you have a good pair of sunglasses.  Keep the temperature cool and humidity low inside your vehicle.  If you know that you are going to be traveling long monotonous stretches, plan some diversions or take along some good company who can keep you awake with a stimulating conversation.  Having another individual in the vehicle who is sleeping has a hypnotic effect on the driver.  A two-man team driving in a truck equipped with sleeper berths where one man sleeps while the other drives has a three times greater risk of having an accident.  The sleep obtained while traveling is not as restful as that obtained in a bed, thus some level of sleep debt is still accumulated.  When sleeping and traveling, schedules are usually irregular which further decreases the quality and quantity of sleep.

In general, fatigue decreases performance and mood, and increases the chance of making an error or accident.  The effects of physical fatigue resulting from long or heavy exertion can be remedied by simply sitting in an easy chair and allowing the body to rid itself of lactic acid accumulations in the muscles and blood.  The effects of mental fatigue and sleep loss are not as easily dealt with short of a good night’s sleep.

Most people think of fatigue as a physical state - and it is!  But the physical feeling of fatigue is more brain-related than muscle-induced.  Many researchers today realize that sleep is a process that has much restorative value at the brain level. One long-term researcher of fatigue put it this way, “It is a frontal lobe problem and sleep is a frontal lobe restorative process.”  As people tire, the speed at which information is obtained via the senses declines.  To understand better the importance of the frontal lobes Dr. Daniel Weinberger, of the National Institute of Mental Health, says,

“In some ways, it is almost easier to characterize frontal lobe function by saying what it doesn’t do.  It’s not the part of the brain that allows us to hear; it’s not the part that allows us to touch something and recognize what it is that we’ve touched.  It’s not really, by itself, the part of the brain that remembers.  It doesn’t seem to be involved in any particular discrete perceptual, sensory, or motor function.  But in spite of this, it seems to have a very critical role in how we use the kinds of information that other parts of our brain are dedicated to determining.”  

Patricia Goldman-Rakic, an expert in the field of the brain’s pre-frontal area, has been quoted saying, “If thinking is the process of using information to make decisions, then the frontal lobe is crucial for thinking.  Without the frontal lobes we’re at the mercy of our environment.  We respond to events without reflection.  We are unable to plan for the future.  And it is this capacity to plan for the future that distinguishes us from all other species.”  

Mental performance decreases approximately 25% per 24 hours awake in a non-stressful or mentally taxing environment.  But engage in considerable mental work and the decline accelerates.  An example of this comes from scientific literature, where it was found that after working a double shift interns take 7.3 minutes longer to read an EKG strip than when they first went on duty on the first shift.  This is nearly a 40% increase in reading time.  

Human error accounts for 70-80% of aircraft accidents.  Sleep loss is also a cumulative problem.  The loss of three half-nights of sleep is equivalent to the loss of an entire night’s sleep.  How significant that most of modern industrial populations chronically sleep-deprive themselves to work extra jobs, to extend their recreation hours, or to commute in from the suburbs.  Fatigue does not have an all-or-none effect.   It’s gradual and almost imperceptible if you are not aware of its early signs.  Cheated on daily, it accumulates.  One does not have to stay up 36 hours straight; just cheat a little each night.  It may take longer, but the end result can be just as great.

Students taking timed tests are often victims of sleep deprivation, especially when they have burnt the midnight oil trying to prepare for the exams.  What they don’t understand is that they will not be able to think as fast and therefore are cutting their margins to nearly zero.  If the test turns out to be unusually hard the result can be very unflattering.  But the effects reach far beyond exams, daily study, and comprehension; they involve the workplace and the home as well.  As people cut sleep and become more and more fatigued, their ability to grasp ideas slows.  And even though they may be good students, workers, or homemakers, their ability to keep up will steadily decline.

This says much to an executive, to a student, a driver, a pilot, or just plain everyone.  To go long periods without sleep does not make you a better worker no matter how heroic it might seem.  This was echoed in the space shuttle, Challenger, disaster.  Investigators felt that fatigue of the ground crew and space-center operation staff, who had put in many late hours, may have influenced their fateful decision to go with the launch that morning.  

The key to productivity is a good night’s rest.  You can handle the information faster and in greater quantities while still maintaining accuracy.

A Word About Napping

The Cockpit Rest Study done by the Federal Aviation Administration and National Aeronautics and Space Administration evaluated the benefit of napping by the crew during long flights of three in the cockpit.  Crews divided into Rest Group and No Rest Group.  Those in the Rest Group were permitted to take a nap during the flight.  On average those taking naps fell asleep in 5.6 minutes and slept for 26 minutes.  93% of pilots that had the opportunity to rest fell asleep.  In the No Rest Group pilots flew the route as usual and with no nap.  Alertness in the No Rest Group degraded at the end of the flight, during night flights, and after the forth leg.  Naps prevented the deterioration of vigilance in the Rest Group.  To understand the significance of this, 50% of the pilots in the Rest Group experienced these lapses of attention that are the effects of the brain momentarily shifting into a minisleep.  During these times the eyes may be wide open but the mind is receiving or registering nothing.  In the No Rest Group 78% of the pilots experienced microsleeps.  The total number of microsleep events recorded during the last 90 minutes of the flight in the Rest Group and No Rest Group was 34 and 120, respectively.  Without a nap during flight the No Rest Group experienced nearly 4 times more microsleeps in the final 90 minutes.  But even more important was the number of these events recorded during the most crucial phase of flight, that of descent and landing.  Here the No Rest Group experienced 22 events while the Rest Group experienced none.  Since this is the phase of flight that requires the highest level of mental capacity and makes up the phase of flight in which 70% of the aviation accidents occur, reducing the fatigue and lapses of alertness in this phase of flight can have a significant effect on accident prevention.

Strategies In Preventing Fatigue Or Limiting Its Effects

The most obvious way of preventing fatigue is to get adequate sleep.  But what is not so obvious is that your sleeping schedule should be regular for both turning in and rising in the morning.  Also beware that if you need 8-9 hours of rest per night, when you cut back to 7 hours each day you develop a sleep debt which grows larger and will gradually begin to affect your performance on the job or while driving.  To obtain a sounder and more restful sleep, never eat prior to going to bed.  Give yourself at least 4 hours between eating your last meal of the day and going to bed.  Also, do not exercise in the evening other than a taking a light, relaxing walk for some fresh air.  Aerobic exercise is stimulating and leaves a person wide awake when he is wishing he were asleep.  Keep the temperature cool where you sleep.  Warm rooms are not conducive to good sleep and usually lead to awakening. Body temperature normally drops in the late evening and begins to rise as dawn approaches.

When traveling, take rest stops before you begin to feel tired or sleepy.  Napping for 20 minutes can be an effective means of preventing some of the signs of fatigue, if done before fatigue becomes evident.  Rest stops taken after one becomes tired do little except for the time one is taking a break.  As soon as you are back on the road the fatigue returns.  At this point the only remedy is sleep.

In an emergency, caffeine can stimulate one to stay awake but the fatigue is only masked.  Another aspect of caffeine use is that it is far more effective in those that do not use it on a regular basis.  Therefore, the habitual caffeine user gets only a mild, short-term stimulant effect.  The danger in both cases is that when the caffeine wears off, sleep may overcome the individual with little warning.  Avoid the use of caffeine and all other stimulants for the same reason.  Dehydration is known to decrease endurance and accelerate the onset of fatigue during physical activity so drinking plenty of water during the day will help prolong the time before fatigue sets in.

Alcohol, on the other hand, is a sedative and does help the individual get to sleep quickly, but it then causes disruption during the night.  On examination of the quality of sleep it was found that people who use alcohol do not obtain the restful sleep observed in those who sleep naturally without alcohol.  Long-term use of alcohol by alcoholics shows that there are permanent changes in sleep stages that do not allow them to get the quality of sleep of normal individuals.  In a fatigued person, small amounts of alcohol have a dangerous magnifying effect.  To quote one researcher, “A moderate amount of alcohol in a sleepy person produces sleepiness similar to that seen in a rested person consuming excessive amounts of ethanol.”  It increases sleepiness and decreases the period of time a person needs to fall asleep.  This does not sound like something to become overly concerned about except for the fact that this sedative effect does not diminish in spite of decreasing levels of breath ethanol content and remains even after the breath ethanol content is no longer detectable.  This shortened period to sleep onset on a standardized test was found to be less than 5 minutes, which is considered a pathologic level of sleepiness.  “Patients with such levels of sleepiness report high rates of automobile and industrial accidents.”  Modest amounts of alcohol combined with moderate sleep loss increase the risk of alcohol-related accidents.

A considerable impact on whether you feel fatigued is made by your social support system.  The effect of a lack of this may be similar to having a job where one has little or no personal control over aspects of the work.  An individual with little social support from family or friends has to deal with many uncertainties that can weary the brain and disrupt sleep.  Here it is important to recognize that help and support is needed.  Finding a family or another individual that can lend a helping hand on occasions and provide that emotional support, especially for women, is extremely important for preventing long-term fatigue.  But make this a two-way affair; Christians need to recognize that those with little support from family or friends can be greatly benefited by the supportive Christian church family.

Conclusion

Fatigue has a far greater effect on our lives than merely our ability to operate vehicles and machinery.  It affects the way we relate to others and to life in general.  In a fatigued state we become passive participants in life and allow things to unfold rather than make things happen.  As we become fatigued our weaker traits begin to surface.  The frontal lobes have less control over the indulgence of selfishness, which, in a rested state, would be subdued more readily by the voice of conscience.  Mood deteriorates and communication diminishes.  Lifestyle habits such as when we go to bed, the regularity of our habits, the amount of water we drink, the amount of exercise we get and the quality and quantity of food we eat, all affect the level of fatigue we experience.  As a nation this problem leads to billions of dollars in loss of productivity, accidents, and medical bills, as well as thousands of deaths.  

Most importantly, fatigue has the ability to cause us to miss that which the Lord is trying to tell us, to miss those things that He does for us, and to fail to recognize those times when He has touched us.  We knew Him not, because we were too involved or too fatigued to pick up on the significance of the hour and the holiness of the moment.  The most crucial aspect in turning this situation around and preventing this waste of life, loss of productivity, disintegration of the family, and personal spiritual decline is for us to grasp the true danger of continually trying to function in this state.  Then we can take the necessary steps to minimize fatigue in our lives by adopting the lifestyle necessary to accomplish this.  Christ said: “Come ye yourselves apart, and rest awhile.”  We would do well to remember that a day of rest preceded the first week of work allotted our first parents in Eden.  We were created to require, enjoy, and prosper on proper periods of rest.  How blessed it is to cooperate!
“If ye know these things, happy are ye if ye do them.”  John 13:17.