Not Fit to Fly

Photo Credit: Josh Hallett

It's hard to legislate sleep. As an employer you can certainly set rules and guidelines, hoping your employees show up refreshed and ready to perform, but you can't really enforce or police it - even when lives depend on it.

Hearing about the fatigue factor involved in Continental's February plane crash on a cold, icy night near Buffalo, New York has been horrifying. According to the latest reports from the NTSB, the main cause of the crash is being blamed on the crew's lack of experience and lack of sleep (lack of proper conduct in the cockpit, too, which certainly stems from a lack of experience and sleep).

Have you ever wondered:

• When you step on to a plane, how alert are your pilots?


• Have they just gotten off a transcontinental flight and haven't slept in a day - or two?


• Have they been working the graveyard shift and catching some Zs on a couch in the terminal before taking control of your plane?


• Are they feeling fuzzy and spacey as they continue to fight a nagging cold bug (which really prefers them to be sleeping more)?


• How much does sleep factor into performance...even when an emergency happens suddenly?

To quickly answer that last question, sleep plays a huge role in the ability to perform, even when it comes to basic skills we've done over and over again. And thinking about our pilots' alertness is probably not something that enters our minds as we're boarding planes and getting organized in our seats, but the thoughts are crossing millions of grounded minds this week as more news emerges about the fate of that February ride.

The history books are loaded with similar stories: the 1989 Exxon Valdez oil spill off Alaska, the Challenger space shuttle disaster, and the Chernobyl nuclear accident have all been attributed to human errors in which sleep-deprivation played a role.

The NRMA (National Roads and Motorists Association) estimates fatigue is involved in one in 6 fatal road accidents. In fact, 17 hours of sustained wakefulness leads to a decrease in performance equivalent to a blood alcohol-level of 0.05%. Too bad "sleepy driving" doesn't have the same buzz to it as "drunk driving."

Sorry, but sleep deprivation - regardless of your job - is not a badge of honor. Pilots aside, think of all the jobs that rely on alertness in critical, potentially life-threatening scenarios: ER doctors, surgeons, ground transportation drivers, air-traffic controllers, freight train engineers, etc. The sad part is the challenge of ensuring our pilots, drivers, controllers, and so forth are indeed fit to be at the helm. What can we do?

• Have them keep journals of their sleep/wake cycles?


• Invent a test they can take to measure their alertness prior to clocking in?


• Enforce stricter guidelines for when, say, a pilot, can be in the cockpit after a certain stretch of wakefulness?

It's all a hotly contested debate. No one is perfect. But we demand perfection in certain situations when the lives of people are at stake. May this recent incident and ongoing investigation shed a brighter light on the importance of sleep hygiene and the value of ensuring our public servants get all the sleep they need.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

This article on sleep is also available at Dr. Breus's official blog, The Insomnia Blog.

Related Topics:

• Sinus, Snoring, Sleep Apnea: Jordan S. Josephson, MD
• Sleep Disorders: Member Discussion
• Get the Sleep Well newsletter in your inbox weekly

Stormy Weather, Stormy Sleep

Photo Credit: TysonA

Have you ever had trouble sleeping when a storm blows through? (No, I don't mean being awakened by the sound of thunder or the pelts of rain on your window.) If you suffer with obstructive sleep apnea, listen up: there's new evidence that the weather can worsen your sleep-disordered breathing. In other words, when the pressure drops, so does your ability to achieve smooth, restful breathing during the night.

Surprisingly, not much has been studied when it comes to connections between the weather and sleep. Lots of studies have been done to show the effects of high-altitude, which also worsens sleep apnea; but weather-related changes in atmospheric pressure and breathing during sleep has been a neglected area of study. Until now.

I've written a lot about obstructive sleep apnea (OSA), a common sleep disorder whereby one briefly stops breathing multiple times during the night when the muscles in the back of the throat fail to keep the airway open. This results in:

• fragmented, poor sleep
• low blood oxygen levels
• an increased risk for myriad health problems, including hypertension, heart disease, mood and memory problems
• the recommendation from your doctor to use a machine called a CPAP at night to keep your airway open for sound sleep

This new wrinkle in the mystery of sleep opens the door wide open for much more exploration. We have no idea how the atmospheric pressure could affect apnea. It's still a big question that researchers are now going to investigate. Weather has always carried with it an aura of mystique. People have blamed it on everything from bad moods to joint and muscle pain. I predict that some of those connections are very real.

Something to think about this week as we watch wicked weather pass through parts of the US.

And blame it on the rain.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

Related Topics:

• Sinus, Snoring, Sleep Apnea: Jordan S. Josephson, MD
• Sleep Disorders: Member Discussion
• Get the Sleep Well newsletter in your inbox weekly

Short Sleeper: Are You Fooling Yourself?

There are plenty of stories about famous short sleepers to go around. Among those who claim (or claimed, as some are no longer with us) that they do perfectly well on four hours of sleep are Jay Leno, Madonna, Michelangelo, Napoleon Bonaparte, Florence Nightingale, and Thomas Edison (whose invention - the light bulb - forever changed our sleep habits). Winston Churchill got by on six hours, and Leonardo DaVinci kept one of the most outrageously crazy sleep schedules, sleeping 15 minutes every four hours day and night.

If you're a short sleeper, which is technically defined as someone who gets fewer than 6 hours a night, are you living well off that brief sleep? Are you catching more Zs during the day in the form of a nap? (Which, by the way, is how some of the aforementioned geniuses got by. Churchill took a complete 1.5- to 2-hour nap in the afternoon-and he undressed and got into bed.)

Well, if you think you could use more sleep time, you're probably right. And science continues to reveal what sleep deprivation can do to us (other than make us tired and cranky). The National Sleep Foundation recently released an alert pointing to new evidence: people who average fewer than six hours a night could develop prediabetes. And you know what that leads to: full-fledged diabetes.

Granted, some people actually can do well with fewer than four hours of sleep, and those people are probably genetic anomalies - people programmed to avoid all the risks related to insufficient sleep. For them, four to six hours is sufficient.

But that, unfortunately, is not the case for the vast majority of the rest of us. Just as you don't hear about people who drink, smoke, and eat poorly living to the ripe old age of 100 very often, you don't hear about too many people who live like vampires and escape the ravages of that lifestyle. Those who claim they "get by" on little sleep are likely fooling themselves, but their bodies won't fool them.

So I ask you:

• How many hours of sleep are you getting on a regular basis?


• Do you feel refreshed when you wake up?


• Do you reach for caffeine, an energy drink, or a sugary snack in the afternoon?


• Are you having trouble losing weight or maintaining your ideal weight?


• Have you been diagnosed as prediabetic or diabetic but haven't changed your sleep habits?

May those answers inspire a lunch pad for making change. I'll give you wiggle room if you're about to change the world with an incredible invention you've been working on like mad, or if you're ruling the world as a great leader. But if you are... then it's highly unlikely - I'll make that impossible - that you're reading this blog.

Got ya. Now go get some more sleep!

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

This sleep article is also available at Dr. Breus's official blog, The Insomnia Blog.

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• Insomnia Raises Risk of High Blood Pressure
• Late Bedtimes Linked to Heart Disease
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• Get the Sleep Well newsletter in your inbox weekly

Tips for Sleepless Mariah Carey

I'm not usually the sort to wade through celebrity gossip pages, but this one came across my desk because it is, well, directly related to my area of expertise... and I am compelled to reach out and offer some advice.

Word travels fast: no sooner did Mariah Carey Twitter about her sleep problems did her issues show up on various websites. Here's what she apparently wrote on her Twitter page:

"I just finished working out. Whooo! Quite naturally, 'its 5am and I still can't sleep' Who's up? Nick is too cute when he's sleep! I wish he didn't have to work tomorrow so he could help me sleep all day and I could sing all nite [sic]!"

How many red flags can you find in that tweet? Did she work out just before 5 AM and is only now trying to go to bed while the rest of the world (and the sun, let's not forget) is about to get up? And does she normally live like a vampire - going to bed in the morning and getting up in the evening to sing all night long?

There's nothing "quite naturally" about any of that. Her body is rebelling, thrown totally off key (pun intended) by the crazy break in its natural rhythm that wants to sleep at night and sing during the day. I help lots of jet setters and shift workers who struggle with weird working hours and blocks of time when they do, in fact, live during the night and sleep during the day due to their job.

Being a rock star (or singing sensation or pop queen or however you categorize Ms. Mariah is your choice) has its downsides. The music industry has to be one of the worst fields to work in if you love your sleep. I honestly don't know how some musicians do it when they travel constantly across continents and time zones-going from one late-night show to the next. And I have no idea how someone living on such a schedule can find time to exercise. It's hard enough for the rest of us.

The three simple things Mariah should heed:

• Exercise can be stimulating for some people, making it hard to fall asleep soon thereafter. She might want to try scheduling in her exercise earlier in the day (er, I mean night - maybe before her show?). Or exercise first thing after waking.


• Jumping right into bed and expecting to fall asleep quickly is unrealistic. It can take time for the body to unwind and prepare for sleep. This is when having good sleep hygiene is key.


• Consider re-calibrating the body clock for the short-term when there will be days when she expects her body to keep up with an unusual sleep-wake cycle

I wonder how her hubby fares once Mariah gets into bed. Does his sleep get disturbed? And when he rises, does it disturb Mariah? Ah, the joys of marriage. Hopefully they can sync up their schedules once in a while to enjoy one another.

Sweet Dreams,

Michael J. Breus, PhD, FAASM
The Sleep Doctor

This article on sleep is also available at Dr. Breus's official blog, The Insomnia Blog.

Related Topics:

• WebMD Video: Insomnia - What to Do About It
• Sleep Disorders: Member Discussion
• Get the Sleep Well newsletter in your inbox weekly