Avoid Fatigue Risks While Behind the Wheel Published Sept. 24, 2008 By CAPT. BARRY R. REEDER 711th Human Performance Wing Wright-Patterson AFB, Ohio -- The Big Squeeze You've had a long, tough work week. The weather is perfect (finally), it's nearly quitting time Friday afternoon, and you can't wait to get to your weekend destination. You packed the night before and the family is waiting for you to pick them up so you can hit the road ASAP. The goal is to squeeze every possible minute out of your weekend before you have to return to the grindstone Monday. After an hour or two on the interstate, your excitement wanes as you struggle to keep your eyes open and stay in your own lane and off the rumble strip. Sound familiar? As Air Force professionals, we try to maximize every 24-hour period to get in as much work and play as possible. Striking a balance between working long hours and shift work, completing PME and college requirements, and spending time with our families typically requires us to neglect one of our most important physiological needs ... sleep. Sleep is a basic need, no different from food or water. When we get hungry, only food will suffice, ditto thirst and drink. Not satisfying these physiological drives will result in weakness and dehydration after several hours, and after a few days, death. The effects of continuing to neglect your drive to sleep can also result in serious consequences that can occur much sooner than you think. What is Fatigue? Fatigued, groggy, sleepy and drowsy are not four of the Seven Dwarfs. These terms all have the same meaning. These terms describe a physiological state associated with reduced overall alertness and performance, poor motivation and reduced output. "Red flag" symptoms of fatigue include increased yawning, problems focusing, forgetfulness, and involuntarily closing your eyes, also known as microsleep. These performance decrements typically follow periods of reduced sleep or prolonged wakefulness, and can affect your ability to safely operate a vehicle. Symptoms of fatigue are more prevalent between 2 a.m. and 6 a.m., and between noon and 4 p.m. A driver who is already sleep-deprived will find it especially difficult to remain alert during these periods. In their 2003 book, "Fatigue in Aviation: A Guide to Staying Awake at the Stick," Dr. John Caldwell and Dr. Lynn Caldwell explain that many people have the misconception that fatigue is merely a state of mind. Further, they outline how many individuals with this opinion incorrectly think that dedicated and professional Airmen can overcome the problems associated with fatigue by simply gutting it out. Such attitudes toward fatigue risks can lead to an exhausted workforce and subsequent mishaps, both on and off duty. How Big a Problem is Fatigue? The Air Force Safety Center reports that fatigue was present in 21 percent of the Class A Aviation mishaps in fiscal year 2006, and 23 percent of the Class A mishaps in fiscal year 2007. Off duty, fatigue was a contributing factor to 22 percent of 166 Airmen fatalities between 2005 and 2007. The National Highway Traffic Safety Administration reports that fatigued driving causes more than 100,000 vehicle accidents annually, resulting in 40,000 injuries and 1,550 fatalities per year. NHTSA and the Virginia Department of Transportation released a report in 2006 entitled, "The Impact of Driver Inattention on Near-Crash/Crash Risk: An Analysis Using the 100-Car Naturalistic Driving Study Data." The study collected 43,300 hours of video and other sensor data over a one-year period, when 82 crashes, 761 near-crashes and 8,295 critical incidents were recorded. The report said that driver drowsiness caused more crashes and near-crashes than any other event. Percentage of driving behavior contributing to crashes and near-crashes: 22.16 Drowsiness 3.58 Dialing hand-held devices 3.56 Talking/listening to hand-held devices 2.85 Reading 2.15 Eating 1.41 Applying makeup 1.23 Reaching for objects 1.11 Reaching for moving objects 0.91 Looking at external objects 0.35 Insects in vehicle A 2006 follow-on report linked to this study, "Phase II - Results of the 100-Car Field Experiment," focused on specific driving behaviors and related risks. The report indicated that driving drowsy increases the risk of a crash or near-crash by at least a factor of four. This isn't hard to imagine, considering that drowsy driving can have the same effect on your alertness and performance as having too much alcohol. I Don't Drink and Drive, So I'm a Safe Driver ... Right? Driving drowsy is just as dangerous as driving while intoxicated. If you stay awake for 17 hours, your cognitive psychomotor performance, or ability to see-and-avoid, is decreased to a level equivalent to the performance impairment observed of someone with a blood alcohol concentration of 0.05 percent (Dawson & Reid, 1997, p. 235). Remaining awake for 24 hours will produce the same performance problems as having a blood alcohol concentration of 0.10 percent, which is beyond the legal limit in most states. Remember the Air Force professional who departed his duty station Friday afternoon immediately after work? This is a common scenario, and many Airmen drive for 12 hours or more without a rest break. That's 12 hours plus an eight-hour duty period, totaling 20 hours of sustained wakefulness. Remaining awake for that long places them in the same see-and-avoid category as someone who is legally intoxicated! What Can I Do? The good news is that driving safety risks associated with fatigue-induced alertness and performance problems can be avoided. Getting adequate sleep and keeping your sleep time sacred are critical to staying alert behind the wheel. Additionally, following the guidelines below will help to reduce the performancesapping effects of fatigue and will help you to stay off the rumble strip. Sleep Hygiene Considerations ✓ Establish consistent sleep/wake times and stick to them (even on the weekends) ✓ Use the bedroom for sleep only ✓ Develop a soothing before-bed routine (take a bath, read, etc.) ✓ Don't engage in aerobic exercise within three hours of bedtime ✓ Stop caffeine use four hours before bedtime ✓ Don't use alcohol to induce sleep ✓ Don't smoke within an hour of going to sleep Fatigue Risk-Control Measures Before and During the Trip ✓ Always get a good night's rest before a long road trip ✓ For long trips, plan your breaks ✓ Recognize fatigue "red-flags" (heavy eyelids, increased yawning, wandering thoughts) ✓ Travel with a companion and switch driving tasks when you get sleepy ✓ Make frequent rest stops (every two hours) ✓ During the rest stops, get out of the vehicle and walk around for a few minutes if possible ✓ Use caffeine strategically (a cup of coffee or soda every three hours), but not in lieu of rest ✓ Avoid taking medicines that cause drowsiness (check the bottle) ✓ Micro-sleep is bingo-fuel. If traveling solo and your eyes get heavy, find a safe place to take a nap Note: Rolling down the window, using air conditioning, and turning the radio up are NOT effective risk-control measures. Take-Home Points Fatigue causes thousands of driving accidents and fatalities each year. Airmen are vulnerable to fatigue due to mission requirements, long duty hours, and shift-work. Neglecting your drive to sleep and "pushing through it" puts you at greater risk of being involved in a traffic accident. Getting adequate sleep before a long road trip and being sensitive to the warning signs of fatigue while driving are the most effective risk-control measures.