Sleep Deprivation vs. Effectiveness
To show the importance of sleep and how sleep deprivation can affect performance, let’s examine a study performed by the military.[1] In this study, they modeled the effects of sleep deprivation on artillery company performance. The study contained four groups, having 4, 5, 6, or 7 hours of sleep each night respectively, and for 20 days (and nights). They measured artillery company performance in rounds per tube (artillery piece) per day accurately delivered to the target.
The conclusion of this study showed deliberately restricting soldiers’ sleep in the hopes of greater output is unproductive.
For 2–3 days, the units sleeping 1 to 3 fewer hours could put more rounds accurately on target in any 24-hour period. This is simply because there were more hours available in which to work. However, after the third day, the efficiency of those having fewer than seven hours sleep diminished to where even with the extra hours to work their output was less. Even though one unit slept for only four hours each night, giving them three hours more in each 24-h period in which to work, their output for any 24-hour period fell below that of the unit sleeping seven hours after only two days in the study.
It is important to note the collective drop in performance below the 7-hour group was not only seen by day-3 of operations, but we see the decline in performance in the second day of operation! The unit’s aggregate output continued to fall as the days passed. The results in the report provide a qualitative evidence of the effects of partial sleep deprivation on unit performance over days and weeks of continuous operations.
Data from individual subjects in prolonged sleep deprivation shows a progressive, methodical decline in performance. Modeling of unit performance during continuous operations when subjects have 4, 5, 6, or 7 hours sleep each night shows the same gradual, systematic decline. In realistic operational simulations and in actual operations, these systematic declines in performance may be of no great consequence for a few days. This is true only if the task at hand is simple and familiar, and if an accurate although a slower response suffices to complete the task. However, if the task may be a complex, unfamiliar, and/or intrinsically time-limited, one should expect sudden, severe and even catastrophic failure to occur.
One Important Hour
Next, let’s look at the effect sleep deprivation has on the 4-hour group. By the end of the study, the performance of the 4-hour group dwindled to a miserable 14.8% of their starting capability. They were not only unproductive but were a danger to themselves and anyone around them.
Let’s make an important observation from the preceding data/graph. Examine the ending results of day-20 for the 6-hour group compared to where they started. It is critical to see with only one hour of sleep less than the recommended 7 to 9 hours for adults, there was almost a 50% drop in performance. That’s just one hour. According to the National Sleep Foundation, 23% of people with chronic pain rarely get a good night’s sleep of 7—9 hours compared to 6% of the general population without chronic pain.
If you live in chronic pain there is a likelihood you are or have been sleep deprived. If you are not getting 7 to 9 hour of sleep per day, you are most likely sleep deprived. Complex tasks that are dynamic and ever-changing, such as driving should be avoided. While the operation of a vehicle is relatively simple, all the other aspects of driving however require focused attention and the ability to make quick decisions.
Consider all the things you do while driving:
- Maintaining a safe following distance from the car in front of you while also compensating for the guy tailgating you
- Continually maintaining awareness of the rest of the traffic around you
- Maintaining appropriate positioning in traffic in case you need to make a tactical lane change to avoid collision
- Watching your speed
- Scanning your mirrors and the traffic in front of you
- Managing navigation and negotiating safe lane changes required to get you to your final destination
- Continually looking for the unexpected
Operating a 3000 to 4000-pound steel vehicle at driving speed when sleep deprived is a recipe for disaster. Don’t do it. There is a reason cross-country trucker have federally mandated limits defined for safe operation on our roads. Tests show driving when sleep deprived is dangerous.
If you’ve ever gotten behind the wheel feeling drowsy, you’re not alone. Sixty percent of adults in the U.S. have done it and around 33% have fallen asleep at the wheel. Though driving while exhausted may seem relatively harmless, it has serious consequences. You could crash possibly harming yourself or someone else.
Drowsy vs. Drunk
Drowsy driving is dangerous because sleep deprivation can have similar effects on your body as drinking alcohol. Being awake for 18 hours straight makes you drive as though you have a blood alcohol level of 0.05%. For reference, one common standard being drunk is having a blood alcohol 0.08%. Some states are moving that standard down to only 0.05%. Often chronic pain sufferers are awake for a full 24 hours or more. After a night where you just couldn’t fall asleep, you will function as though you have a blood alcohol level of 0.10%, well above current standards.
Both drowsy driving and drunk driving make it hard to pay attention to the road, and negatively impact how well you can make fast decisions. But as similar as they are, drowsy driving and drunk driving don’t always look the same on the road. A drunk driver can often drive slowly and try to react, but a drowsy driver can nod off while still going fast. So, drowsy drivers don’t always brake or swerve if something appears in front of them.
How to Establish Healthy Sleep Hygiene
The next 14 recommendations come from www.sleepeducation.org
- Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
- Set a bedtime that is early enough for you to get at least 7 hours of sleep.
- Don’t go to bed unless you are sleepy.
- If you don’t fall asleep after 20 minutes, get out of bed.
- Establish a relaxing bedtime routine.
- Use your bed only for sleep and sex.
- Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
- Limit exposure to bright light in the evenings.
- Turn off electronic devices at least 30 minutes before bedtime.
- Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
- Exercise regularly and maintain a healthy diet.
- Avoid consuming caffeine in the late afternoon or evening.
- Avoid consuming alcohol before bedtime.
- Reduce your fluid intake before bedtime.
The most important thing to remember is that sleep hygiene is as much about brain health and tissue repair as it is about chronic pain. This is true whether or not you live with chronic pain.
[1] Belenky G, Penetar D, Thorne D, Popp K, et. al., The Effects of Sleep Deprivation of Performance During Continuous Combat Operations, National Academy Press, Washington, DC, 1994