Wednesday, 29 June 2011

SWSD: Shift Work Sleep Disorder and Trucking

On behalf of the “Life on the Road” blog, I recently participated in a “Shift Work Sleep Disorder” roundtable to provide some insight from a truck driver’s perspective on unusual and inconsistent sleep cycles.

Some of the other participants were, John Marx, “Cops Alive” a former police officer for 23 years and a hostage negotiator who currently is a security/customer service consultant. Rosalind Buchage, an American missionary living in Croatia whose husband is a shift worker. Mike Qualtiere a veteran bartender “Life on a Cocktail Napkin” and Jeff Shannon, also in law enforcement who is a licensed family medical therapist that runs a private practice focused on police officers and their families. Jeff’s blog is “Police Mental Health“.

The event was hosted by “The Wake Up Squad” , “Cephalon” through the WCG Communications company. We were joined by Dr. Mary Umlauf an expert in circadian rhythm disorders and shift work disorder, and Dr. Chip Altman Medical Director at Cephalon.

Discussion ranged from the hospitality industry, law enforcement, fire rescue, hospital staff, other emergency workers and trucking.

I had never heard the term “Shift Work Sleep Disorder” (SWSD) which is sometimes referred to as “Shift Work Disorder” (SWD) but before I entered the trucking industry I had worked odd hours for a good portion of my life in the hospitality industry. I quickly recognized the symptoms they were talking about.

Circadian Rhythms are your body’s natural clock. Humans, animals, plants, fungi and even bacteria have these rhythms. By working hours that are unnatural we have to take extra steps to get proper rest and this is much easier said than done when the majority of the world lives while you are trying to get restful sleep.

For the purpose of this conference I wanted to identify to the group that not all truck drivers go home each night and not all of them drive solo. I used some specific examples for “team driving” in addition to general “Over the Road” (OTR) trucking. I also wanted to identify how “Hours of Service” (HOS) put drivers in a difficult spot.

Applying this term SWSD or SWD to trucking brought up additional issues because of the potential movement of the vehicle in a team driving operation. SWD can be treated but in my experience in working third shifts it takes discipline to teach your body how to adapt. I would not specifically identify trucking as a “Third Shift” because it tends to be more like an inconsistent rotating shift with an added burden of stress. A truck driver must learn to adapt to life around the load and federal regulations.

For Instance: What if I you ran out legal hours to drive just 40 miles from the delivery destination? Would you risk getting caught by proceeding with the load or park as soon as possible? Both scenarios contribute to a stressful sleep break.

What about having to park in an unsafe place?  What if you park where you shouldn’t but have no choice? What if law enforcement comes banging on the door and disturbs the rest break to tell you to move it? These daily dilemmas add stress to sleep breaks.

Sleep disturbances, rotating shifts, they’re a big part of trucking due to irregular delivery times that suit the shippers and receivers, therefore inconsistent sleep patterns are part of the job. This is especially true for “team driving” because one person must manage to rest while the other person is navagating traffic, stopping for fuel and occasionally running over the rumble strip that is bound to wake up the person in the sleeper with a disturbance. It can be difficult to resume sound sleep after such an event and can be just as disruptive as a solicitor banging on your door in a parked space.

That information alone elicited a response from John Marx “Cops Alive” who admitted that Umm … they we’re probably the people that come to wake us up and tell us to move. But he did apologize on behalf of all of law enforcement for that. THANKS JOHN! , that was classy and appreciated… we are all just trying to do our jobs.

According to the Cephalon website: “Shift Work Sleep Disorder“, sometimes known as shift work disorder (SWD) affects some people who work irregular, rotating, or night shifts, and are required to stay awake during hours most people sleep. This disrupts the normal sleep/wake cycle, sometimes causing excessive sleepiness, sleep disturbances, difficulty concentrating, diminished alertness, and impaired functioning at work, home, and in social settings. Possible consequences may include depression, gastrointestinal problems, increased risk of cardiovascular disease, and drug and alcohol use that may result from attempts to improve sleep.

(SWD) is a recognized medical condition that can be diagnosed and treated by a doctor, it occurs when your body’s internal clock, or circadian rhythm is out of sync with your work schedule.”

Sleep time remedies include a cool, quiet, dark environment. You should shut off all devices that might cause you to wake up, such as: televisions, telephones and have an agreement that you should not be disturbed during this sleep period. This obviously presents an issue for a truck driver.

Idle issues come to mind and most civilians do not realize that new idle laws were created before a solution was designed for the hardworking truckers who need restful sleep in a climate controlled environment like everyone else.

Whether you are fortunate enough to be able to afford and maintain an “auxiliary power unit’ (APU) or you have to continue to idle your truck in order to have a comfortable sleeping environment, both emit noise and possibly a knock at the door to receive a ticket if you are in one of the states that has implemented such ordinances.  Truck drivers are required to take a 10 hour sleep break after every 11 hours of driving but in practice how often are you really able to sleep undisturbed?

I personally find the humming engine soothing for my sleep unless the weather is especially nice out and I can get away with just a fan in the cab giving me some light air circulation. The downside: the entire row of trucks who are idling and using their APU’s emitting fumes that floats into the cab. I became quite ill on one occasion from such an event and I am probably lucky I did not go to sleep and never wake up.

When I worked the third shift and lived in a stationary building, getting a restful sleep each day was a challenge and I quickly recognized the symptoms mentioned in this SWD roundtable conference but if you are a truck driver you will recognize that some of the standard remedies may be difficult to apply for this profession, especially for a team driving operation.

During the conference we watched the following two-minute video created by Cephalon that recognizes the 15 million people who work while the rest of the population is sleeps. It aims to educate the public about shift work disorder which is a medical condition that they say might impact up to 25% of shift workers.

Annually, the second Wednesday in May has been designated National Shift Workers Day (May 11, 2011)
YouTube Preview Image

The goals for the conference were to discuss the impact of working non-traditional hours and what coping skills we had acquired.

My past history of working a third shift helped me make a smoother transition into team driving in trucking because I knew how to trick my own body into adapting quickly to rotating shifts. Others may not have acquired these skills or understand that it is a process of discipline you must master for yourself, not everyone adapts quickly.

My personal regime for sleeping in the day is a snug dark eye mask, keeping A/C high enough you can sleep in comfort but not freezing and 25 decibel silicon earplugs. You can buy these at any CVS/Walgreens/Walmart for about $3.00 for a 2 pack. I replaced them every few weeks. I like the silicone because they form fit into your ear and don’t pop out like foam. You can hear yourself breathing much like you would if you are Scuba Diving and this can have a calming effect.

Shift Work Disorder is treatable, however, you need to go and see your primary care physician to discuss options that are right for you. What works for me, may not work for someone else. I know people who cannot sleep without having the television on, I am totally opposite. Using medications while trucking is not acceptable so although there was mention that there could be particular products that might help; I doubt they would be legal for truck drivers to have onboard.

In the case of a tragic accident if such sleep medications were found on a rig we know that the entire focus would shift to fault of the driver. The concern is that many people aren’t aware that this is a treatable condition though, therefore they don’t report that they are experiencing the symptoms.

I did mention in the conference the recent Sleep Apnea issues that have come up during CSA that are impacting the trucking community. I wanted to relay to this group that it does cause concern when study disorders arise because the trucking industry is weak on representing driver concerns and providing solid preventative assistance to protect their jobs before regulations. Many times, these studies are interpreted by drivers as yet another witch-hunt to eliminate veteran drivers to make way for lesser paid students.

This suspicion has been a contributor in my opinion to keeping closed ranks among drivers to the non-trucking community about what issues should be addressed in the name of health and safety. I find it more beneficial to have such roundtable discussions that bring other industries together to better understand one another.

Last week Allen and Donna Smith happen to have a radio program called “Examining Truck Drivers Medical Certification Regulations” that reviewed the attention to the testing of sleep apnea as related to the trucking industry. I happened to catch the tail end and I am including a link here for the replay archive. (LINK: Radio Replay “Examining Truck Drivers Medical Certification Regulations“)

Drivers do have true concerns about job loss with so many new regulations over the past year so it is understandable they get nervous when they hear about yet another sleep disorder that can translate to trucking because they are bound to federal laws to be in the sleeper with the curtain closed for 10 hours.

If a person who lives in a house has difficulty getting their spouse and children to cooperate you can imagine how difficult it is to get the public to cooperate with truck drivers who sometimes have to park their bedroom on the side of the road.

This was the point I wanted to make for the conference attendees and hosts.  I wanted to share the information here for truckers to know that if they are feeling the symptoms of fatigue from such rotating sleep cycles there is hope to make some adjustments that could help.
Identifying this issue is a step forward, applying it to trucking is a challenge but educating the public that it exists for all third shift workers will ultimately help the trucking community to be recognized for their vital rest needs.

Opening this dialogue to law enforcement is very important because we should be working on the same side not at odds. Education is a path to solutions.

If you are a truck driver who has been struggling with fatigue from constant rotating shifts, third shift driving or have a member in your family such as a Nurse, EMT, Fire/Rescue, Law Enforcement who show signs of SWD, I encourage you to take a look at the links I have provided to learn more.

I want to thank Cephalon for inviting the “Life on the Road” blog to share insight on trucking for the roundtable discussion and esspecially Jennifer and Brad for back up materials and links.

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