Tired husband narrowly avoids car accident, need tips for prevention
May 2, 2022 12:20 PM   Subscribe

My husband almost rear-ended a car early this morning on his way to work. I would love your tips for preventing this in future.

My husband has a job where he has to be at his desk around two in the morning. It's not a new schedule--he's been doing this for fifteen years. He gets anxious on work nights and is afraid of oversleeping--though he sets alarms. He turns in around six in the evening, and that should give him about six hours of sleep, but he doesn't sleep very well. Gets up a lot to pee, or just tosses and turns for an hour or two. By ten o'clock he's finally in a deep sleep--the cat jumping on the bed won't wake him at that point. But then he has to get up at midnight, and he's always very tired.

On the weekend he's able to catch up somewhat--he'll sleep for ten or twelve hours, say, on Saturday.

On weeknights I go to sleep around the same time with him, but I sometimes stay awake and stare at my iPad. I wonder if I need to knock that off so the light doesn't bother him. I keep the room as dark as possible--we have heavy dark drapes. We have friends in a similar situation, where the husband works overnights. They use separate bedrooms during the week, I think mostly so he doesn't wake her up when he's going to work. I've suggested it to my husband, in case my presence in the bed is somehow keeping him wakeful, but he doesn't like the idea of sleeping separately. Still, it's something I will insist on if he keeps having close calls on the road.

Anyway, having something like our portable AC unit going often helps--I guess it's the white noise. Otherwise, we listen to sounds on an app for relaxing, or some other kind of audio. But Hubby is still tired when he gets up between midnight and twelve-thirty. He doesn't complain because he doesn't want to worry me, so I never really know how tired he is on a scale from, say, one to ten. I wonder if I should start quizzing him on this? The problem is, he has to go to work no matter how he feels. He was working at home during the first part of the pandemic, but something has changed with the connection, and the IT department is having trouble fixing it. My husband is tired of dealing with it, so he's been going in.

So this morning about half an hour into his freeway commute--it's about fifty minutes long--my husband realized there was a car directly in front of him. He was going about 55 MPH. He said he didn't freak out, just started breaking and veered quickly into the left lane, which was empty, thank goodness! There's not much traffic at one-thirty in the morning on this stretch. He passed the car and it was fine. So he handled it well. But this is exactly the kind of thing that worries me, since it's ALWAYS oh-dark-thirty when he commutes to work, and it was raining, which makes accidents more likely. And he's tired on top of this. Just frightening.

He was sneezing yesterday, and he took some Nyquil around four in the afternoon, about eight hours before he got up for work. I've heard about microsleeps, where you can fall asleep for a few seconds while driving and not even realize it. I'm wondering if Hubby had a Nyquil hangover.

He doesn't like coffee, so I'm going to pack him a thermos with tea to take tomorrow morning. Are there teas with higher caffeine? He won't be taking Nyquil in the afternoons on work nights anymore. Are there drugs that are safe to take on a regular basis? I would appreciate any suggestions.

Oh, since I mentioned her: our cat
posted by cartoonella to Health & Fitness (37 answers total) 3 users marked this as a favorite
 
Unfortunately nothing about messing with one’s circadian rhythm long-term is safe. Humans are built to sleep at night, and shifting things in this way is notoriously risky for one’s health and cognition and safety. If there is any chance to change this, it’s the only genuinely safe option.
posted by asimplemouse at 12:28 PM on May 2, 2022 [27 favorites]


Modafinil can be prescribed for shift workers.
posted by blue suede stockings at 12:33 PM on May 2, 2022 [6 favorites]


Hello from a (former) shift worker!

One day many years ago I drove through a red light, because I was waiting to turn left and when I LOOKED left, the light was green, so like, in my sleep-addled brain it made sense for me to go. Thankfully I didn’t crash into anyone, but it gave me the scare I needed to talk to my doctor.

Turns out I had mild sleep apnea and it ALSO turns out that CPAPs these days are about 1000x quieter than they used to be. So that helps a lot because it turns out breathing while sleeping is important. As a sensitive sleeper I found I was able to sleep with the CPAP easily, and the quality of sleep got a lot better. So maybe look into that, but that’s a whole process and the machines can be $$ if you don’t have health insurance.

It also turns out that the best drug (IMO, IANAD) in the world exists for just such situations, and I also got a prescrption for that and it has made all the difference. The drug is Modafinil, and it just makes you feel “not-tired”. It doesn’t make you feel jittery or give you a huge amount of energy, it’s very difficult to describe because it simply takes away the feeling of being tired, and makes you feel like you effectively had an extra 6-8 hours of sleep. It’s approved for a condition called “shift work sleep disorder” which is pretty much defined as “I’m tired because of when I have to get to work”.

I had read this article: Experts back brain boosters for all and asked my doctor to give it a try, and I do not regret it one bit. If you have any kind of drug plan it could well be free, but even if not it’s pretty cheap and a month’s supply is like $20USD.
posted by BlueSock at 12:36 PM on May 2, 2022 [17 favorites]


I also came here to mention Modafinil. If your husband is interested, he should talk with his doctor about it.

Modafinil for Excessive Sleepiness Associated with Shift-Work Sleep Disorder

Reviews of Modafinil for Shift Work

Waking up to modafinil in shift work sleep disorder
posted by Winnie the Proust at 12:38 PM on May 2, 2022 [4 favorites]


Shift work like this is terrible, inhumane, health-damaging, and should be illegal or at least come with mandatory hazard pay. If your husband's job doesn't already pay like a slot machine jackpot (and maybe even if it does) the solution should be to encourage him find a new one with a better schedule.
posted by pullayup at 12:41 PM on May 2, 2022 [15 favorites]


I'd consider a light-based alarm clock. When I've used one for waking up early, like pre dawn flights, it doesn't feel as bad.
posted by sebastienbailard at 12:45 PM on May 2, 2022 [2 favorites]


Is he willing to put his foot down about having IT fix the remote work issues? If he’s been there for 15 years, they should be willing to treat him pretty well, or he should be willing to give it a go elsewhere. He’s got expert-level time in and apparently works a job that can be remote. He could probably bounce if he wanted.
posted by hollyholly at 12:49 PM on May 2, 2022 [15 favorites]


Is he really only getting 2 hours of sleep a night? That's just not sustainable and he can't caffeinate or medicate his way out of that. You're right to be concerned. Best thing to do in my opinion is figure out the issue with remote working & make that work.
posted by bleep at 12:51 PM on May 2, 2022 [12 favorites]


> He turns in around six in the evening, and that should give him about six hours of sleep, but he doesn't sleep very well.

He should aim for 7+ hours, especially if he's building up sleep debt through the week and sleeping long hours when he can.
posted by sebastienbailard at 12:55 PM on May 2, 2022 [12 favorites]


I can’t speak to most aspects of this, but if I am reading this correctly your husband has—in the best case scenario—only been getting six hours of sleep most nights for fifteen years. I would be seriously concerned not just about car crashes but all kinds of other health problems from being chronically underslept.

I think there are many good strategies out there for improving sleep quality, but I feel like the number of hours available to sleep in is equally critical. Can he start going to bed at three or four, in order to approach a more typically healthy amount of sleep?

(Oh, and fwiw I also think that driving 8 hours after taking NyQuil may also have been too soon. Personally, I don’t feel cognitively normal until the 12-hour mark, even if I am able to be awake and puttering around before then.)
posted by CtrlAltDelete at 12:55 PM on May 2, 2022 [12 favorites]


Gosh, I think hubby needs more sleep. What does he do when he gets home after work? Does he take a nap? It seems like he either needs to get to bed earlier -- likely in a dark room, and without you there -- or sleep after work. My layperson's understanding is that it's not necessarily bad to sleep in two different shifts (so a nap after work and then more sleep later in the day), but that would be a good question for a doctor up to date on all this.

Also it seems like he needs to try to keep as much as possible to this sleep schedule, even on weekends.

But yeah, he needs to take some responsibility here for figuring out how to get more sleep, work at home, or find a new job.
posted by bluedaisy at 12:56 PM on May 2, 2022 [5 favorites]


Does he ever take naps after he gets home from work? If he doesn't want to go to bed earlier than 6 PM or doesn't think he could fall asleep if he did, then I would highly encourage a daily nap. As sleep deprived as he is, there must be some point during the day when he feels like he could fall asleep. If he's already napping, see if he can make his naps longer.

I also wonder if he could arrange things so he could sleep a bit later. If his commute is 50 minutes and he has to be at his desk around 2:00, he must leave around 1:00. He probably doesn't need to get up an hour before that. Maybe he doesn't even need to get up half an hour before that if he sets things up so he doesn't need to do more than put on his clothes and get in the car. He could shower and lay out his clothes and everything he takes with him the night before and take food to eat in the car (which would also help keep him awake.)

A coffee alternative that works for me is Trader Joe's Dark Chocolate Coffee Buzz Bars. They do taste like coffee but they also taste like chocolate, so he might not dislike them as much as a cup of coffee. But Modafinil sounds like it might be an even better thing to try.
posted by Redstart at 12:57 PM on May 2, 2022 [3 favorites]


Modafinil sounds like a good option. If that's something he's open to, and since he'd need to talk to his doctor anyway to get a prescription, a thought: if his doctor ends up having any concerns about your husband's ability to safely drive at night, perhaps that doctor would be willing to write a letter asking his workplace for a medical accommodation to work from home.

You mentioned issues with the internet connection. I agree with hollyholly that it's worth revisiting (and I assume he really tried to make it work, so maybe this is impossible) whether the IT folks can help him resolve whatever connection issues he was having. Perhaps framing it as a medical accommodation might create some leverage to actually get the issue solved.
posted by katieinshoes at 12:58 PM on May 2, 2022 [6 favorites]


He turns in around six in the evening, and that should give him about six hours of sleep, but he doesn't sleep very well. Gets up a lot to pee, or just tosses and turns for an hour or two. By ten o'clock he's finally in a deep sleep--the cat jumping on the bed won't wake him at that point. But then he has to get up at midnight, and he's always very tired.

That's a completely insane arrangement, and it will make him insane if it doesn't kill him on the road first.

If he needs to wake at midnight, he needs to be asleep - not just in bed, but asleep - by 4pm. If the rest of his life is not compatible with being able to do that consistently, he needs to move jobs because this one will kill him.

Modafinil vs other driving wakefulness solutions is old shoe or glass bottle territory.
posted by flabdablet at 12:58 PM on May 2, 2022 [41 favorites]


Is a newer car an option? There are some incredible safety features available these days. My 2018 Subaru beeps so loudly (and will eventually brake for me) if I'm going to hit something straight on. They call it pre-collision braking.
posted by mcgsa at 1:11 PM on May 2, 2022 [5 favorites]


How much has he played around with different sleep patterns? He might sleep better/more easily (not just *longer*) if he goes to bed earlier (or sleeps in the morning after work) because he'll be less afraid of oversleeping.

Nthing that this is not something to allow to continue on like this or fix with drugs that create a feeling of wakefulness.

Also, I know an older woman who told me that sharing a bedroom and the attendant sleep issues contributed to the decline of a previous relationship. "My current partner and I have separate bedrooms," she said. "I used to think sleeping in the same bedroom was more romantic, but you know what? Getting enough sleep is romantic!" Wise words, IMO.
posted by needs more cowbell at 1:13 PM on May 2, 2022 [4 favorites]


I was not in this situation but my sleepy driving terrified me enough that I now try to only drive very safe. However, I will share the tools I used:

for sleeping, I invest energy into making the bedroom perfect for sleep - not just "good enough." I listen to sleep podcasts and have a white noise generator.

For driving, I routinely found podcasts that were fascinating enough that they kept my brain from dozing off for microsleeps (a real thing and really terrifying once you start noticing them while driving). I also found that SUNFLOWER SEEDS in shell got my mouth working enough that it was very hard to drift off. And finally, everyone's favorite - coffee.
posted by rebent at 1:28 PM on May 2, 2022 [2 favorites]


He absolutely needs more sleep. Maybe that’s going to bed earlier or separately or doing most of his sleep right *after* work or what, but throwing caffeine at this isn’t good enough. Catching up on weekends isn’t enough for chronic sleep deprivation.

He should see his doctor ASAP to rule out medical issues and talk about whether a sleep aid might help him. Meanwhile he should give a fair try to an alternate sleep arrangement, and get on I’s case about this connection issue. I believe in cultivating an excellent work relationship with IT and cutting them a lot of slack, but ‘save me from driving an hour commute at 2 a.m. while semiconscious’ is the sort of issue I’d be willing to burn a little goodwill on. If there is anyone he can escalate to to get the connection fixed so he can work from home, he should do that immediately.
posted by Stacey at 1:38 PM on May 2, 2022 [5 favorites]


I’m adding on to the needs more sleep chorus. Sometimes questions have easy answers. The answer to “why is he tired?” is “because he’s not sleeping”. Don’t overthink it.
posted by kevinbelt at 1:40 PM on May 2, 2022 [10 favorites]


15 years is a *long* time to be sleeping and working like this. The fact that it’s getting harder and not easier is a red flag.

As many others have said, I would be very concerned about significant health impacts of chronic sleep deprivation. Humans are really not evolved to sleep and work on schedules like this.

Your husband is not sleeping enough, full stop. That’s why he’s tired. The health risks are very real, and no amount of modafinil or coffee is going to change that.

New hours or new job is the only real sustainable solution. How long does he intend on continuing to work like this?
posted by gnutron at 1:46 PM on May 2, 2022 [11 favorites]


...he doesn't like the idea of sleeping separately. Still, it's something I will insist on if he keeps having close calls on the road.

You should insist on this now. Long-term, this isn't sustainable, but in the short term, create a sleep chamber.
posted by holgate at 1:51 PM on May 2, 2022 [13 favorites]


Yes to so much of this, more sleep, have IT actually fix it, etc.

If he's against separate bedrooms, a nice comfy eye mask will help block light, and combined with a melatonin an hour before he needs to be a sleep might be a small step he'd be willing to take, if the others seemed like too much.
posted by advicepig at 1:58 PM on May 2, 2022 [3 favorites]


To those saying he needs to get more sleep: humans cannot just decide to fall sleep at 4pm or 6pm or anything like that, unless they naturally fit that sleep profile. This is part of the reason why shift work destroys people’s health. Circadian rhythm is serious, intractable business and forcing it to work differently WILL lead to serious consequences in one way or another. And forcing pharmaceutical solutions after 15 years of this kind of self-destructive sleep pattern is not a solution for someone you care about. A new job or new hours is the only answer here.
posted by asimplemouse at 2:10 PM on May 2, 2022 [13 favorites]


Seconding (BlueSock) checking for sleep apnea and getting a CPAP. While I agree that Mondifinil is very helpful, it treats the effect, not the cause. I would focus first on the cause.

I generally sleep in two shifts. A 1.5 hour nap when I get home and then 5 hours from 2:00am to 7:00am It helps, but the CPAP I use helps even more. The difference in my alertness when I use it and when I don't is night and day.
posted by JohnnyGunn at 2:14 PM on May 2, 2022 [2 favorites]


I'll put it bluntly (which isn't answering the question, so apologies) IT's inability to fix the connection (I assume the VPN?) is putting your husband's life in danger at this point. He's enabling this by just going in - IT doesn't need to fix it now, because he's going into the office. This is 2022, not 2000. Seriously, what happens if he just doesn't go in and the connection flakes out? No job is worth your life or health like this.
posted by cgg at 2:14 PM on May 2, 2022 [28 favorites]


Sounds like the important stuff is pretty well covered, so:

Black tea has about the same amount of caffeine as matcha or mate, all of which have more caffeine than green tea, which has more caffeine than oolong tea, which has more caffeine than white tea, which has more caffeine than decaf tea, which, although it has only a very small amount of caffeine, still has more than herbal or rooibos teas, which don't have any at all.
posted by box at 2:25 PM on May 2, 2022 [1 favorite]


Response by poster: Oh wow! Thanks for all these wonderful suggestions, guys! I should have asked y'all for help earlier!

I will look at each of these solutions carefully. I agree that it would be best to treat the underlying issue and not just the symptoms. But I'm going to put as many of these suggestions into effect as possible, while we wait to see his doctor.

I agree about my husband's work situation. It's dangerous, and his company bears some responsibility. They just got bought by another firm, so it's new management and they're a bit underwhelming so far. He'll need to find a way to break through their inertia and resistance.

Thanks for being in my corner about this.
posted by cartoonella at 2:40 PM on May 2, 2022 [2 favorites]


Seconding the suggestion for a newer car, these are the 2022 models with self-driving features (you probably want adaptive cruise control and hands-on lane centering). I find these features significantly reduce fatigue when driving, and the near-miss you described would have been a non-event if the cruise control were in use. Newer Volvos can even detect a moose about to cross the road!

It's not a substitute for good sleep and a reasonable work schedule, but it might remove a little bit of the danger and dread of the commute while you figure it out.
posted by credulous at 4:49 PM on May 2, 2022 [3 favorites]


A doctor's note and medical requirement for work accommodation could be very helpful in having the company's IT either fix this issue or hire someone who can. The company should be loathe to go against medical advice as well as have the potential liability in case a horrible accident does happen. Seeing a doctor ASAP (tell them it's urgent) would be great if it's at all possible.
posted by quince at 4:55 PM on May 2, 2022 [4 favorites]


Sleeping separately says nothing about the relationship outside of what TV tells you it does.

My parents have slept separately for years because they sleep so differently that sharing a bed is stressful. My spouse and I sleep separately because one of us cosleeps with our toddler and deals with the accompanying night wakeups while the other can get a full night’s rest.

I would highly suggest creating a cozy, dark room for your husband where he can try getting better sleep by himself during the week. You sharing a bed for a handful of hours before his shift is not helping your relationship at all.
posted by redlines at 7:58 PM on May 2, 2022 [11 favorites]


It was mentioned upthread that you really can’t make up a sleep deficit by sleeping in on the weekends. A friend of mine was a consultant specializing in shift workers and the unfortunate solution is to keep to the same awake/sleep schedule on weekends.
posted by TWinbrook8 at 8:43 PM on May 2, 2022 [9 favorites]


combined with a melatonin an hour before he needs to be a sleep

Came in to recommend melatonin to make the most of his available sleep time. Though it usually knocks me out in under 15 minutes and if i fight it it can be ineffective so experiment a bit with timing. Also it takes a good four hours to clear my system and I'm a complete zombie until then so it is best to take it no later then five hours before wakup time in my case.
posted by Mitheral at 6:33 AM on May 3, 2022


Oh, and maybe while y'all are sorting all this out, get the doctor to write him a note for medical leave for a couple weeks. Two hours of sleep a night for weeks on end, even with 12 hour(!) catchup sleep on the weekends is a medical emergency in my book.
posted by hollyholly at 7:31 AM on May 3, 2022 [11 favorites]


I used to frequently fall asleep while driving, I was prescribed Modafinil and it worked wonderfully. I went from 6-7 incidents a week to maybe one or two a quarter. YMMV.
posted by schyler523 at 8:13 AM on May 4, 2022


Yesterday I listened to an interview with Diane Macedo on the Ten Percent Happier podcast, where she spoke about her own sleep problems, which led her to research all things sleep and ultimately she found a solution to her problems. She worked shift work as an "overnight news anchor" and her work hours sound similar to your husband's.

She has a new book The Sleep Fix: Practical, Proven, and Surprising Solutions for Insomnia, Snoring, Shift Work, and More about her research and her own personal story and how she solved her sleep problems.
posted by daikon at 7:26 PM on May 4, 2022


Sunlight, room lights, and screen light inhibit melatonin production, preventing him from getting sleepy at midday.

So keep this in mind in the lead-up to getting in bed. Along with trawling for books, checklists, and advice/doctor's note from his GP.

I'm sure this is laid out in the book just mentioned.

Or in The Promise of Sleep by William C. Dement. From memory, I think Demet mentions the hazards and biological fallout of shftwork, the ways chronic sleep debt kills people, along with healthy sleeping habits.

Healthiest thing for him to do is switch to a daytime schedule.
posted by sebastienbailard at 3:55 AM on May 6, 2022


As a former shift worker, one more bandaid suggestion I haven't seen above; I found ice water really helpful for temporary wakefulness (ie if I just had to stay awake long enough to get home on the bus for example). Getting him a straw cup full of ice water to sip during his drive isn't going to fix any of the big HUGE problem his shifts are causing, but it could be a helpful stopgap thing to try *today* to see if it helps.
posted by Sweetchrysanthemum at 7:14 AM on May 6, 2022


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