Time for bed sleepyhead

FOUR years ago this month, three children were left fatherless, because a lorry driver fell asleep at the wheel of his truck and crashed headlong into oncoming traffic. Two motorists were killed, one of whom was a 35-year-old father-of-three from Preston, Lancashire.

That accident should be remembered by every driver on Monday morning as they stagger out of bed when the alarm goes off, because Monday is a day when we are all at special risk. The dangers increase even more this weekend: tomorrow night the clocks go forward and research from the US shows that in the days following the change to summer time, road accidents increase by six per cent. The connection between these two sets of risk? Sleep - or more accurately, a lack of it.

According to sleep expert Stanley Coren, a neuro-psychologist from the University of British Columbia, Canada, who carried out the research, the reason is that most of us are already chronically sleep-deprived, because of our macho work culture and 24-hour society. Monday mornings are bad, when we have to rise early after two days of lie-ins. The loss of an extra hour because of the start of British summer time - with everyone getting up an hour earlier from Sunday onwards - is enough to tip the scales to disaster.

Our whole attitude to sleep is wrong, according to Coren. "Sleep is simply not dispensable, regardless of the attempts in today's society to treat it as if it were unproductive 'downtime'. The desire to get more sleep is not a sign of laziness, nor does it represent a lack of ambition. The need for sleep is real, he says.

Unfortunately, people think it is praiseworthy to manage on little sleep - one only has to think of the admiring tones in which people talked of Mrs Thatcher's ability to by on four hours sleep a night to realise the truth in that - and the way that society is now organised, we can work, shop and go clubbing for 24 hours a day. Once you could not do much research at 2am, because the library was shut, but today nothing is ever closed, be it the Internet, the banking system or the supermarket.

According to Coren's book Sleep Thieves (The Free Press, pounds 9.99), we would all perform our roles better if we got more sleep. He claims that we should we sleeping about nine hours a night, instead of the seven-and-a-half hours average that we now have. Although we can catch up a little with a couple of extra hours on some nights, it is far healthier to have the same healthy amount every night than suffer sleep deprivation five days out of seven.

A medical experiment on US Army recruits showed that they performed their physical and intellectual tasks considerably better when they were given nine hours of sleep a night. The experiment was stopped, however, when senior officers discovered that their men were being "mollycoddled" and they were put back on the US standard issue of seven-and-a-half hours' sleep.

"There are parallels between sleep deprivation and drinking or smoking," says Coren. "Today, the person who runs on little sleep is seen as being mentally tough, ambitious and admirable. Perhaps, as society recognises the harm that building up a sleep debt does to the sleep-deprived person, and to those around him or her, this situation will change.

"It may even come to pass that, someday, the person who drives or goes to work while sleepy will be viewed as being as reprehensible, dangerous or even criminally negligent as the person who drives or goes to work while drunk. If so, perhaps the rest of us can sleep a little bit more soundly," he says.

Sleep experts in Britain are so concerned about the dangers of sleepy drivers and the toll on society of sleep disorders that they are now planning to establish a national sleep foundation, a non-profit making charity, similar to the American one of the same name, to raise awareness of the problem.

Following a conference in Dublin last October, a committee has been set up under the chairmanship of Professor Neil Douglas, professor of respiratory and sleep medicine at Edinburgh University, to raise funds and organise the foundation's constitution and programme. In its first year, it plans to concentrate on the twin problems of sleep apnoea, the cessation of breathing for a few seconds or a minute or two, and narcolepsy, in which people suddenly drop off to sleep several times a day.

"About 90 to 95 per cent of daytime sleepiness is the result of people suffering from treatable disorders. People often do not realise that they have a disorder or do not know that there is effective treatment available," says Professor Douglas. He is particularly concerned about sleep apnoea, which he says affects about two per cent of the middle-aged population.

"Sufferers wake hundreds of times a night, because their airways become blocked. There is now an excellent treatment for it called Continuous Positive Airway Pressure (CPAP), in which patients wear a mask during the night and receive a gentle stream of air through the nose to keep the airways open. It has good results but some people do not know that they have the condition and others do not realise that it is treatable."

The committee is appealing for funds to drug companies, manufacturers of breathing machinery and other multi-national companies interested in sleep disorders. As well as carrying out research, it plans to work with a public relations company to educate GPs, politicians and the public about the disorders.

The importance of tackling the problem is illustrated by recent research quantifying the proportion of road deaths result from drowsiness at the wheel. Professor Jim Hom and Dr Louise Reyner, from the University of Loughborough, found that sleepiness accounted for 15 to 20 per cent of serious accidents on monotonous roads in the UK, especially on motorways. Typically, these accidents involve running off the road or into the back of another vehicle, and are worsened by the high-speed impact, due to lack of braking beforehand.

The problem worries not just sleep experts but accident organisations, too. Dominic Connell, spokesman for the AA, says: "We know that fatigue is a monumental factor in accidents. We would advise our members that it might take time to adjust [after the clocks change]."

The Royal Society for the Prevention of Accidents (RoSPA) has launched a new code of practice for organisations with company cars. A recent RoSPA survey shows that a third of company car and van drivers said that their company did not worry about the long hours they spent behind the wheel "as long as the job got done". The organisation is also running a series of day-long courses around the country for fleet and transport managers and health and safety advisers on "managing risk on the road".

With added awareness, changing to summer time should become less dangerous in future. Perhaps Monday morning won't be so hazardous after all. Certainly the research provides an excellent justification for going to bed exactly when one feels like it, without any fear of being labelled a wimp.