Anyone with a small child knows what it’s like to go to work on a few hours’ interrupted sleep, and nobody would argue that they are at their best when they are sleep deprived. For most of us, a few nights’ interrupted sleep may cause a few typos or maybe, at worst, a missed deadline. For others, though, the consequences of sleep deprivation are much greater.

Investigators looking at the nuclear accident at Three Mile Island in 1979, as well as the nuclear meltdown at Chernobyl in 1986 concluded that sleep deprivation was a major contributing factor to both of these disasters. That’s not all, investigations into the Exxon Valdez grounding and the explosion of the space shuttle Challenger concluded that the people who were making the critical decisions for the vessels were operating under severe sleep deprivation and that the sleep deprivation played a role in both these tragedies as well. If you’re thinking “Scary stuff, but the last of these disasters was in 1986, I’m sure there’s been huge progress made on preventing accidents caused by sleep deprivation”, then I’ve got some frightening news for you. In 1999, American Airlines flight 1420 crashed when the sleep deprived pilot overshot a runway. That accident killed 11 including the Captain. More recently, the 2013 derailment of a Metro-North Railway train in New York City that killed 4 people and injured 70 more was attributed to the engineer falling into a at the controls due to a undiagnosed sleep disorder and sleep deprivation from a drastic change in his work hours. Among the National Transportation Safety Board recommendations that came out of the 2013 accident were to screen engineers for sleep disorders such as sleep apnea and to avoid sudden shifts in work hours for engineers. In November 2016, regulators in New Jersey decided not only to implement screening but to prevent engineers with sleep apnea from operating trains until their condition was under control. It took another widely covered accident, in September 2016, which resulted in 1 death and over 100 injuries before the issue of sleep apnea in train operators was addressed. There is still no national screening process or national regulation for sleep apnea with regards to train engineers the way there is with airline pilots.

In 2014, comedian Tracy Morgan was seriously injured in an accident that is in part attributable to drowsy driving. Morgan and the others in his limousine were injured when a truck driver, who had allegedly been awake for 24 hours, failed to notice traffic slowing ahead and crashed into them. There is currently no law that says how much sleep a driver needs to have in a 24 hour period, only that they cannot be operating their truck for more than 11 hours in a day and have to have 10 hours off duty. Whether they sleep during some of those 10 hours or do other things is basically up to the driver. Sleeping conditions for long haul truckers are generally cramped and not conducive to getting restful sleep, but most cannot afford to spend nights in motels either. The American Automobile Association released a study in 2014 that stated that an average of 328,000 crashes annually involved drivers who were drowsy behind the wheel. That’s a lot of sleep-deprived people operating huge, heavy vehicles. We have laws against using substances that impair our judgement and then getting behind the wheel, but nothing to prevent people whose judgement is impaired by lack of sleep from driving. This needs to change — driving while drowsy is just as dangerous as driving while impaired by alcohol or drugs, yet there are currently no laws to help prevent accidents caused by drivers who are impaired by lack of sleep. There is, however, an initiative from the American Academy of Sleep Medicine that is helping to bring awareness to the issue of drowsy driving. They’ve even started a twitter account named Awake at the Wheel with facts and tips to help people recognize signs of drowsy driving and prevent accidents from occurring.

Sleep deprivation at work doesn’t always cause a catastrophic accident with multiple casualties. There are thousands of deaths and injuries attributed to medical errors every year and some of those errors are made by interns, residents, physicians, or nurses operating on dangerously low amounts of sleep. In the United States, it wasn’t until 2011 that regulations came in that limited first year residents to 16 hour shifts with an 8 hour break. Before that, 30 hour shifts were the norm, not the exception. Second and third year residents can still work up to 28 hours but are prohibited from taking on any new patients in the last 4 hours of a shift. It’s an improvement, but doctors of all people should know how important sleep is to cognitive functioning. If physicians don’t honour their own sleep needs, how can they expect the rest of the population to prioritize sleep? Physicians, heal thyselves.

Another frightening consequence of sleep deprivation recently came into the public eye when the entertainer Kanye West was hospitalized, on November 21st 2016, reportedly suffering from “psychosis due to sleep deprivation and dehydration”. The rapper had been acting increasingly erratically in the days before his hospitalization, which lasted over a week. A 2007 study by Harvard Medical School, showed sleep deprivation renders the brain almost incapable of putting emotional events into perspective and prevents subjects from reacting in a controlled, suitable manner. With hectic tour and recording schedules, it seems that Kanye West has been burning the candle at both ends to the direct detriment of his health.

Given that sleep deprivation impairs concentration, working memory, mathematical capacity, and logical reasoning, it follows that one of the easiest measures that can be taken to help prevent these kind of accidents is to ensure that workers have a full night’s sleep before operating heavy machinery, be it a plane, a train, an automobile, or a scalpel. Getting enough restful sleep is important for everyone, no matter what their job, but when a job impacts the safety of others, it is critical.

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