Most people blame it on Margaret Thatcher. Others point the finger at Thomas Edison. Whoever the culprit, the gravity of the crime is indisputable: Sleeping habits in the industrialised world are in a dire and dangerous state. Though the Iron Lady enjoyed lording her four hours of sleep over the nation - single-handedly turning contempt for sleep into a capitalist aspiration - it’s doubtful that even her forceful example affected sleeping patterns much. But since Edison invented the lightbulb in 1879, the total amount of time industrialised humans sleep has dropped by 25%.And accidents have risen. Chernobyl, Bhopal, Exxon Valdez and the Challenger disasters all had a fatigue component. “People blamed Chernobyl on rubbish Soviet technology,” says Neil Stanley, director of the Sleep Laboratory at Guildford University. “But the problem was the workers were tired - they saw something was wrong, but their reaction was too impaired to fix it.”
This is no surprise to sleep experts, who supply alarming figures with alarming ease: People who work on night-shifts sleep two hours less per day than dayworkers, and are 40 times more likely to have an accident while driving home. A British Sleep Foundation survey found that 20% of male drivers admitted to falling asleep at the wheel. When Gary Hart drove onto Selby’s railway line, it was seen as an extreme case of lack of sleep. In truth, only serendipity and road barriers prevent it happening more often.
“Simple societies respect nature’s diktats,” says Stanley. They work when it’s light, sleep when it’s dark.” But the lightbulb changed everything. Our 24/7 society now provides all-night shopping, entertainment, work. There is medicine, policing and banking at 3am. Companies who operate night-shifts can compete better with the cheaper labour costs of the developing world. Its benefits are undeniable. Except to the people who keep it running.
The human body is governed by powerful circadian rhythms, which run roughly in 24 hour cycles, and govern everything from temperature to alertness. According to the bodyclock, unchanged over millions of years, humans aren’t designed to work at night, and neither Thomas Edison nor Tesco can change that. Between 2-4am, the circadian rhythms start screaming for sleep, even in nightworkers who have slept during the day. (The critical errors of Chernobyl, Bhopal and Three Mile Island all occurred at around 3am.) All areas of human performance - reaction, manual dexterity, cognitive thinking - slow down at night and only pick up again at dawn.
The immune system uses night-time sleep to repair itself. Because nightshift workers miss out, they show higher incidences of heart disease, stress and infection. One study from Seattle’s Fred Hutchinson Research Center concluded that working in bright light overnight increased the risk of breast cancer by up to 60 per cent. Human growth hormone is one benefit only produced at night; immune regulator interleukin-1 is another. Expecting humans to work at night, says chronopsychologist Simon Folkard, is as ridiculous as expecting them to be aquatic. The result is unequivocal: Shiftwork can shorten your life.
Yet sleep research is a neglected field, and nightshifts have been off most people’s radar, being the province of the economically disadvantaged and desperate. The British Sleep Federation, a professional association of sleep researchers, was only formed in 1989, and it wasn’t until the publication of Dr. Martin Moore-Ede’s book “24 hour society” that public perception was pricked.
Moore-Ede now heads Circadian Technologies, a company that works with companies to adjust their shift rotas to match human physiology. Work has been up since September 11, he says. “Before, health and safety wasn’t too much of a concern, because insurance was cheap.” The figures - $100 billion a year lost to absenteeism and accidents because of tired workers - are finally hitting the accountancy departments. Circadian Technologies now works with 230 of the Fortune 500 companies. After sustained lobbying, the figures also hit the politicians: Recently, the US Transport Secretary said fatigue was the number one cause of motorway accidents.
Despite installing “Tiredness kills” signs on motorways, there is little sign of such political wisdom in Britain. Mr Justice Mackay, sentencing Gary Hart to five years, even said - spectacularly - that drinking while sleepy was morally equivalent to drink-driving. But the message was lost in the tabloid furore, which focussed on Hart’s “crime” of talking all night to a woman not his wife. “If Gary Hart had been a junior doctor, or a mother kept awake all night by her children, or a shiftworker,” says Stanley, “the debate would have been very different. There are a hell of a lot of sleepy drivers on our roads.” Drowsy drivers have bad reaction times. They don’t slow down so well on a motorway, or at traffic lights, causing classic “shunting” accidents. Driver drowsiness causes 1 in 5 accidents on motorways, and 10% of all car accidents in general. 3,500 people were probably killed last year because someone was too tired to drive.
The problem is, we don’t read the danger signs. After only one night without sleep, the average human will start making mistakes by 5am. Nightshift workers sleep two hours less than dayworkers, on a good day. Driving while impaired from alcohol is an offence: There is no breathalyser to catch the sleepy driver. Truck tachographs regulate the hours driven by the truck, not the hours slept by the human at the wheel. “The human machinery is the liability, not the truck,” says Neil Stanley. The Federal Aviation Association says most air crashes are now due to human error. Human ingenuity in technology has outpaced humans. So we turn to technology to solve it.
Japanese car firms are working on gadgets to read driver drowsiness level based on the movement of the steering wheel, or on drooping eyelids. There are infra-red eyeball trackers, servotrackers, all manner of measuring devices. The actigraph, developed three decades ago by the US military, can read wrist movements to establish alertness - our movements while asleep are recognisably different to when we are awake. There have been experiments with feeding aromas into a workspace, or installing 1000 lux lights, which raise wakefulness.
There are chemical weapons: Service station fridges are now laden with pro-caffeine-plus-redbulls. There are drugs that can tweak sleep patterns: Modafinil, used for narcoleptics, stimulates like amphetamine without the side-effects. Melatonin can cause sleepiness, though not on everybody.
Perhaps science can soothe the clash between sleep and society. The body-clock’s suprachiasmatic nucleus (SCN) emits chemicals which regulate waking and sleeping. If the right chemical can be isolated, the theory goes, scientists will have a magic on-off switch that will enable us to fit ourselves better to the society we have created. It will put jet-laggers in sync, keep pilots awake, help astronauts hibernate at will. Stanley calls this the search for the Holy Grail. At least every month, says Dr. Stampi, there is new research that has isolated some chemical or other in animals. Late last year, a Harvard team discovered that hamsters, whose natural inclination is to run on their wheels at night, stopped all activity when they were given transforming growth factor alpha (TGF). But it’s unlikely that a single chemical holds the key to waking or sleeping. “It’s a jigsaw, not a switch.” says Stanley. “And we’re a very long way from solving it.”
Our best weapon to conquer the night is knowledge. Stampi specialises in the sleeping habits of solo sailors, because they can apply to anyone - politicians in a crisis, emergency workers - who need to work around the clock for limited amounts of time. Working with clients like Ellen Macarthur, he developed a strategy of polyphasic sleep, or multiple napping. Adult humans have monophasic, or unbroken sleep, which makes them relatively unique in nature, as any cat-owner will notice. “Animals divide their sleep into episodes throughout the day,” says Stampi. “But humans do that too - even a 3 1/2 year old sleeps 2 1/2 hours in the daytime.” He’s not sure exactly why napping works better, but it might be because one of the initial stages of sleep - slow-wave, or “obligatory sleep,” as one sleep expert calls it - lets the brain recharge more than other stages, such as REM (rapid eye movement) sleep.
Military scientists use the same technique. Pilots on long-range missions - the B2 stealth bomber can require 40 hour missions - are trained to take power naps. “Solo sailors have to become mini-experts on their sleeping patterns,” says Stampi. So does everyone: The usual tendency for managers to devise shifts into 8 hour blocks, apparently randomly, suits no-one. Software such as Leeds University’s Shiftcheck programme now matches workers to shift rotas that suit them best, taking account of the person’s natural tendencies - larks (early risers) and owls (late night people) are genetically stuck in their ways and should be accounted for accordingly. Latenighters are actually worse at nightshifts, because their bodyclocks are less rigid, and they suffer more damage. Knowing this can save companies a fortune.
When Merseyside Police installed Shiftcheck, they saved £2 million in absenteeism and inefficiency costs. In Canada, Moore-Ede has matched train driving shifts to the least tired drivers, rather than simply picking the next driver on the rota. Some companies have started to encourage napping on night-shift break times, which has increased alertness, and some - such as consultants Deloitte - show even more respect for circadian rhythms by allowing daytime napping after lunch: It’s more productive to let workers sleep during the post-lunch dip, than have them wasting energy struggling to stay awake. The maxim is simple: Respecting sleep makes economic sense.
But the prognosis isn’t good. Humans have a history of stretching themselves to adapt, says Claudio Stampi. Until the sleep on-off switch is found, they will stretch themselves too far. “Before, 24 hour work affected only bluecollar workers. But now in a globalised world, information is constantly on tap, and the burden is shifting to whitecollar workers, like stockbrokers. My fear is that the burden is moving to people who have even greater responsibilities than before.” Neil Stanley isn’t optimistic, either. “In daily situations, it’s hardly likely that someone coming off a shift will ever feel able to say to an employer, “You have made me an accident risk, I’m unfit to drive.” I think the only way things will change is if someone has an accident on the way home from work, and sues their company.”
For now, the nation will continue with its groggy habits. Sleepy drivers on the roads, fatigued workers at powerful controls. There will always be another Chernobyl or Selby around the corner. It’s enough to keep you awake at night.
Published in the Independent Saturday magazine