Driver rest: Topping off the tank

July 5, 2016
Fleets need to understand the science, operational impacts of sleep

When it comes to truck driver fatigue, fleet executives continue to try to keep up with the complicated science, with the resulting regulations and, at the end of the day, with the best practices to maximize operational efficiency and move freight given these human limitations and government requirements.

But inadequate rest isn’t just a problem for trucking. Americans are working more and are trying to cope with the resulting daytime sleepiness, according to a Sleep in America poll released by the National Sleep Foundation in 2008. (The survey is the most recent data focused on sleep and work; other research literature suggests American sleep habits have not improved.)

In fact, 63% state they are very likely to just accept their sleepiness and keep going, while 32% are very likely to use caffeine when they are sleepy during the day, and more than half (54%) are at least somewhat likely to use their weekends to try to catch up on sleep.

The poll finds the following:

◗ 29% fell asleep or became very sleepy at work in the past month;

◗ 36% have nodded off or fallen asleep while driving, with 32% reporting that they drive drowsy at least one to two times per month and 26% drive drowsy during the workday;

◗ 14% have missed family events, work functions, and leisure activities in the past month due to sleepiness;

◗ 2% were late to work in the past month because of sleepiness.

And that’s costing U.S. employers tens of billions of dollars a year in lost productivity, to say nothing of the highway accident toll. The AAA Foundation for Traffic Safety found sleepiness to be associated with 21% of all motor vehicle crashes in which a person was killed, causing 328,000 police-reported crashes, 109,000 injuries, and 6,400 deaths in the United States annually.

And then there are the high-profile, fatigue-related catastrophes such as the Chernobyl nuclear disaster, the Challenger explosion, and the Exxon Valdez oil spill, as Dr. Jeffrey Durmer, a physician specializing in sleep problems, points out.

Durmer, co-founder and chief medical officer of FusionHealth, calculates that each sleep-deprived employee typically costs the company an average of 7.8 days in lost productivity compared to well-rested employees.

Of course, truck drivers aren’t data entry clerks—their output can’t be measured in typing speed or error rates, minute by minute throughout the workday. But they are normal human beings, and the causes and effects are still present in measures of safety and efficiency, Durmer explained to Fleet Owner.

He works with several trucking companies, and notes that while some operations may have more regular schedules than others (such as LTL compared to over-the-road drivers), sleep disorders create the same problems “no matter what your sleep timing is like.”

One signal trucking companies can use to identify drivers with a sleep problem is preventable accidents, especially routine bumps and scrapes such as backing accidents or parking lot collisions.

“One of the things we know from the research is that if folks are sleep deprived, they may function just fine for a while, but if you go longer in the work day you really start to see accumulated sleep debt affect the ability of an individual to maintain accurate behaviors,” Durmer says. “Reaction time goes down, the ability to judge goes down, so making proper decisions is impacted.”

Specifically, executive functions—those processed in the brain’s frontal lobe—are impaired after several hours on task in people with sleep deprivation.

“You’ll see a lot of start-and-stops, where people get out of the truck to walk around, or to get more coffee—those behaviors will start to accumulate,” he says. “You can also look at speed. Situational awareness is impaired when people are sleep deprived, and speed is one of the first signs of a problem—either driving too fast or too slow.”

Indeed, Durmer likens awareness of the importance of sleep and monitoring to the way sabermetrics, or baseball data analytics, changed the way ball players are assessed—specifically by identifying the measures of a player’s true effectiveness beyond batting averages and home run totals.

“That’s what we’re looking at now—a measure of the human factor that’s behind the wheel of a truck,” he says. “What are those measures of human behavior that are important to determining whether a load is going to get there on time and safely?”

And the measurement of wake–fulness needs to be respected in the same way the fuel gauge is: If the tank is low, the truck had better pull over and refuel. So should the driver.

“Some companies treat the drivers like a piece of machinery—and that’s a problem, because they’re not,” Durmer says. “We’re trying to get companies to understand that they listen to the mechanic about the truck, to know if it’s roadworthy.  And companies shouldn’t put people on the road with problems, either.”

In people with sleep deprivation, executive functions—processed in the brain’s frontal lobe—are impaired after several hours on task. (Thinkstock)

Mandating sleep

While the federal hours-of-service limits are at the heart of the government’s program to make sure truck drivers get the rest they need, compliant doesn’t necessarily mean safe.

And though behavioral changes might be in order for some, such as a trucker with a non-driving second job, or one with a long commute to the terminal (as came to light in the 2014 Walmart Transportation driver’s crash involving comedian Tracy Morgan), many drivers suffer from health-related sleep disorders.

The most common sleep disorder among truckers is easily obstructive sleep apnea (OSA), as manifested by excessive sleepiness during work hours. OSA is a chronic disease that afflicts at least 25 million adults in the U.S., including more than 20% of commercial truck drivers, according to the American Academy of Sleep Medicine.

Then there are the health issues that OSA contributes to over time: heart disease and hypertension, diabetes, and obesity resulting from the nightly erosion of a body’s metabolism.

The size and scope of the potential problem means that OSA “presents a critical safety issue” for all modes and operations in the transportation industry, the Dept. of Transportation says. It has taken the first step to address OSA in truck drivers and rail operators with the publication this spring of an advance notice of proposed rulemaking (ANPRM) by the Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA). The agencies are calling for public input on the impact of screening for and treating OSA.

The National Transportation Safety Board has recommended that DOT take action to address OSA for transportation workers, placing “require medical fitness for duty” on its Most Wanted List of transportation safety improvements for 2016.

In a series of public listening sessions in May, FMCSA gathered the opinions of dozens of drivers, sleep specialists, and medical examiners.

“We want drivers to engage in the process and understand this isn’t just a regulatory activity to put new burdens and responsibilities on them,” FMCSA Associate Administrator for Policy Larry Minor said in concluding the final session. “But we’re interested in their health and well-being, especially when they’re in a safety-sensitive capacity.”

Truckers who spoke expressed concern about the risk factors, the qualifications of the medical professionals making the determination, and the cost. They also cautioned FMCSA against setting hard and fast standards for a required sleep study, such as a Body Mass Index (BMI) threshold or neck size measurement.

About those costs: Not only are drivers typically required to take time off and to pay for the sleep study that must be done once an at-risk determination has been made, they also must cover any treatment expense.

A recent sleep apnea whitepaper issued by the American Transportation Research Institute (ATRI) and based on a survey of over 800 truck drivers echoes those listening session concerns. The ATRI survey finds that the out-of-pocket expenses for treatment average $1,220 or some 1.5 weeks of median drive pay.

Managing sleep

Dr. Durmer recommends a number of specific measures companies can take to help their employees. These include the following:

◗ Cut down on the time on task for employees during the workday by implementing rest breaks, and limit the total length of shifts for employees to reduce preventable accidents and errors.

◗ Assign workers to the shift hours that better align with their natural circadian rhythms.

◗ Discourage extended work hours and all-nighters by limiting access to work facilities and equipment when possible.

◗ Institute blackout hours for work email by configuring corporate email servers to not update during certain periods of the night.

But how do these translate for trucking?

“The well-established concept of time on task definitely applies to driving, or the time you spend doing something monotonous,” Durmer says. “And OTR trucking, in particular, can be quite monotonous. When you’re sleep deprived, that actually increases the likelihood of error. You’re lulled into a state where your situational awareness is reduced.”

So truckers need to be aware of “body signals,” he continues. Yawning and eye rubbing are just such signals that the body needs a break.

“Taking those signals for real, and not trying to mask them with caffeine or other stimulants, is a really good idea,” Durmer says. “It’s a matter of safety and a matter of getting the load there. But there’s a human behind the wheel. That human has variables that need to be attended to, even more so than maintaining the truck. There’s no gauge in the truck for awareness.”

Getting out of the cab for some fresh air and to get the blood pumping can be a good idea, but it’s a short-term remedy. If mid-shift drowsiness is a daily occurrence, then it’s time to work on getting more sleep, more regularly.

Durmer also instructs his clients on the proper use of caffeine.

“Using caffeine to fight off sleepiness on a regular basis is something we see in truck drivers in particular,” he says. “If you use caffeine all the time, indiscriminately, it won’t work. Your adenosine system in the brain will uncouple. If you use it appropriately, it can be a helpful therapy for people with some sleepiness, but if you have a sleep disorder and you’re not treating it, no amount of caffeine is going to help you.”

Returning to the man/machine metaphor, he notes that if a driver can’t fill up the tank every night when he sleeps, “then there’s a problem.”

“If they’re filling it up, but not fully, that’s a quantity issue that can be addressed,” Durmer says. “If they’re having problems because of disturbances or irregular shifts, there are strategies to help.”
Specifically, Durmer suggests napping, along with more routine scheduling, and activities to stimulate wakefulness—including reducing task time, or taking more, shorter breaks.

To promote better overnight sleep, people often need to change behaviors such as turning off televisions and laptops, and skipping late caffeine.

“Light is the worst because it is so ubiquitous: Everybody uses light-based things at night when they should be sleeping,” Durmer says. “If you can get that turned around, then we’re only dealing with tobacco. If tobacco was the only problem with driver sleep, I’d be happy.”

As for driver schedules, trucking does face special challenges. But one of the keys is for a driver’s working hours to be as regular as possible, e.g., not switching back and forth between daytime and overnight driving, creating the equivalent of jet lag.

“We can’t put jet-lagged people behind the wheel of trucks,” he says. “It’s not good for the driver, for the trucking company, or for the shipper.”

Additionally, everyone has a “sleep imperative,” but not everyone’s natural time for sleep is the same.

“We all have circadian rhythms,” Durmer says. “Some of us are morning larks; some of us are night owls. If you put a night owl on a morning lark shift, or vice versa, you’re destined for failure. If we can get to understand their natural habits—all of the sleep components that make a human more effective—then, no matter the industry, we can apply it to the work force and find ways to maximize the benefits and increase the chances of success.”

As for making sure drivers aren’t disturbed in their bunks, Durmer explains there are substantial cultural differ­ences between companies. Some take outside stresses and driver well-being into consideration, and recognize that time off is necessary for drivers to show up ready to work the next day. But many other companies do not—and industry turnover is high because of it.

“The common ground is to have mutual respect, to have the company and drivers understand that they’re on the same team. We can’t push people into a lean and mean process because a machine can do it,” Durmer concludes. “For safe and efficient operation to be repeated on a daily basis, we need to take in the human factors of rest and recovery. For fleets, that means they should examine their protocols, the standards they are holding their drivers to—and make sure these meet those needs. The policies shouldn’t reflect some standard from the FMCSA, necessarily. That’s the minimum standard. What you should be looking for is the optimal standard for your fleet. One shoe does not fit all.”

“Some companies treat drivers like machinery—and that’s a problem, because they’re not.”

- Dr. Jeffrey Durmer, chief medical officer, FusionHealth

Managing drivers

In terms of fleet operations, Paul Transportation Inc. COO Kevin Andrew focuses on a pair of key areas for monitoring and managing driver fatigue: compliance, including driver health, and equipment.

For driver health compliance, the 250-truck, Tulsa-based flatbed fleet uses a third-party provider to manage medical certifications and screen for OSA and other factors.

And, at least for his company drivers, those who have been diagnosed and who are using CPAP devices have found the treatment beneficial. Similarly, Paul Transportation and the industry overall have benefitted from improved awareness of driver health and wellness issues.

Indeed, Paul Transportation is developing a wellness program and setting aside space in the new headquarters for a fitness facility.

“It’s something that’s been around, but it’s really caught fire the last five or six years,” Andrew says. “The education and knowledge that carriers are providing has really helped people understand the importance of keeping your weight down, that if you have a big neck you’re more prone to sleep apnea, and to understand all the other symptoms like blood pressure and diabetes. A lot of what DOT has put in place has helped diagnose health problems and enhance driver health.”

But there’s more to managing driver fatigue than clinical treatment and exercise. Driver comfort has become a key element in fleet purchasing decisions. Paul Transportation has begun buying Kenworths because of the additional cab and sleeper space in the T660 and the mid-roof T680, and because of details such as adjustable, well-contoured seats.

“We’re doing everything we can to make life in the truck more comfortable,” Andrew says. “I was a truck driver for a million miles, and sometimes those flat mattresses on a plywood board could get kind of hard. But the ride has improved so much. When I go out and drive these trucks today, it’s almost like driving my Ford F-250.  The ride is so much more comfortable than just 10 years ago. That really helps with driver fatigue.”

Paul Transportation is also transitioning to automated transmissions and has set a fleet speed limit of 65 mph.

“Driving is a lot less stressful and drivers can focus more on their surroundings and safety. Over the course of a day, it really helps you relax,” Andrew says. “It’s when we get in a hurry and aren’t paying attention that we have problems.”

And the company is in the process of converting to electronic logs. Andrew reports that the feedback from company drivers has been positive. 

“It’s not because you have to, it’s because it’s a good thing,” Andrew says.

Dispatchers now use the e-log reports to know when drivers are stopped and resting, and to know not to disturb them, he notes. And the company can pinpoint the time drivers spend at shipping docks.

“We’re going to start charging for detention time, and the driver gets part of it,” he says. “If they know they’re going to get paid for waiting to load or unload, that’s got to be a positive thing for how they feel at the end of the day.”

And, at the end of the day for a trucking company, a driver who is happy with his job is a driver who’s not thinking about jumping to another carrier—or of leaving the industry altogether. 

About the Author

Kevin Jones 1 | Editor

Kevin Jones has an odd fascination with the supply chain. As editor of American Trucker, he focuses on the critical role owner-ops and small fleets play in the economy, locally and globally. And he likes big trucks.

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