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This chapter is from the book

We Are Drowning in Change

Demands swirl. They collide against the constraints of time and energy—yours and others'. The list of "to do's" can grow forever as realities change, intermingle, and change again. Sylvia Hewlett and Carolyn Luce discuss the "dangerous allure of the 70-hour workweek." They describe the rise of so-called "extreme jobs" with unpredictable workflows, 24/7 client access, heavy responsibility, and travel. Their survey found that 69 percent of 25-to 34-year-olds in these jobs felt they would have better health if they worked less, and 65 percent said they would turn down a promotion if it involved more work.1

Many of us are sleep deprived. We operate at the edge of exhaustion. Doctors recommend that adults get 7 to 8 hours of sleep per night. Are you getting that much? The National Sleep Foundation found that less than a third of us are getting 8 or more hours of sleep on weeknights (as shown in Table 2.1). A study of lunchtime in America found that 55 percent of employees took lunch breaks for less than 15 minutes, 63 percent skip lunch at least once a week, and 39 percent took no true break at all. The fact that the researchers even considered a span of under 15 minutes as a "break" is telling in and of itself. This is no way to run a river, a railroad, an army, or anything for very long—much less our own lives.

Table 2.1. Weekday Sleep Hours

Fewer than 6


6-6.9 hours


7-7.9 hours


8 or more


National Sleep Foundation's 2002 Sleep in America poll

Those Starbucks cafes on every corner with high-octane beverages provide just one of many signs of the ways this business environment is taking its toll. Caffeine is now the second largest commodity by dollar volume after oil. America really does run on Dunkin'. (And we worry about our dependence on foreign oil! Perhaps we should be less concerned about OPEC and more concerned about Juan Valdez.) We push for higher and higher levels of caffeine to get the jolt that we need to keep up the relentless pace we think we need (see Table 2.2).

Table 2.2. Caffeinated Competition (16 oz.)

Common Joe

100 mg


148 mg

Dunkin' Donuts

211 mg

La Colombe

241 mg


251 mg


265 mg


322 mg

*Philadelphia Enquirer, p. F3, 12/2/04

Caffeine is not the only drug we use to prop open our tired eyes and fill the gaps in our physical and emotional resources. We have taken to using more serious drugs such as amphetamines to keep going. All this works for a while, but at the end of this crazy road is burnout. Between 2004 and 2005, the percentage of people who arrived in ERs with symptoms such as confusion and convulsions from nonmedical use of stimulants rose by more than 33 percent.

For years now, we have asked participants in executive education programs how many have experienced at least one of the following four events in the last year:

  • Same staff but at least 10 percent more work without any increase in compensation
  • At least 10 percent less staff and no diminution in workload without any increase in compensation
  • Responsibility for an additional geographic area without any increase in compensation
  • Responsibility for an additional functional area without any increase in compensation

Regardless of industry, 50 to 75 percent of the hands go up. When asked who has experienced two or more of these events, more than 33 percent raise their hands, and there are nearly always at least a few people who have experienced three or four. Ask yourself the same questions. How has the pace of your own company and industry increased over recent years? Do you have any reason to believe that the pace will not continue to quicken? Have you adjusted your own pace in response?

The Impact of Exhaustion

A few extra hours with your head off the pillow may seem like a small price to pay for increased success. The price is higher than we think...and the price may, over the long run, actually hinder securing whatever we prize. We suffer and our organizations suffer from fatigue. Fatigue significantly impairs performance. Wakefulness for more than 24 hours impairs performance as much as a blood alcohol level of 0.1 percent. After a day of reduced sleep, we become slightly impaired (as shown in Figure 2.1). By the sixth day, we suffer from noticeable reduced alertness and head toward being dangerously drowsy.

Figure 2.1

Figure 2.1 The cumulative effects of sleep deprivation

Sleep deficits can prove cataclysmic. The total cost of lost sleep to the U.S. economy runs at $45 billion per year, including lost productivity, health care expenses, and motor-vehicle accidents.2 There are, very likely, much higher indirect costs. The National Highway Traffic Safety Administration attributes more than 100,000 crashes, 71,000 injuries, 1,500 fatalities, and $12.5 billion per year to driver fatigue alone.3

Many high-profile disasters have fatigue and sleep deprivation at their center; so do many less visible corporate meltdowns. In The Twenty-Four-Hour Society, Martin Moore-Ede attributes the Three Mile Island, Bhopal, Chernobyl, Exxon Valdez, and Challenger disasters at least in part to human fatigue and "a fundamental conflict between the demands of our man-made civilization and the very design of the human brain and body." Concisely stated, we "were designed to hunt by day, sleep at night, and never travel more than a few dozen miles from sunrise to sunset."4 Automation has increased productivity so that the same work requires fewer human hours, but we struggle mightily to keep ourselves up to the tasks before us, indeed, to honor our biological limits as well as our organizational responsibilities and technological possibilities.5

Individuals and organizations alike make choices about how to handle sleep deprivation. Take the example of the sleepy physician. A physician in a Boston area hospital fell asleep while driving home from an extended shift. Her car struck a pole. She was relatively unscathed, but the hospital decided it needed a new policy to prevent such accidents by weary doctors. So, they came up with a fix—not a solution, just a fix: Instead of ensuring that their physicians had more sleep, the hospital decided to offer tired medical staff vouchers for taxi rides home! This solution amounts to the perfect Band-Aid (pun intended). It addresses the symptom of sleepy drivers, but does nothing to address the underlying cause. Patients, of course, might be more concerned about the impact of weariness on medical practice than on driving. How long before falling asleep at the wheel (or in the back of a cab) might a physician have prescribed potentially lethal medications, determined a course of treatment for an acutely ill patient, or had his or her hands inside a patient's chest cavity?

In fact, physicians who worked one to four marathon sessions (longer than 24 hours) in a given month were 3.5 times more likely to make fatigue-related errors. Those who work five or more marathon sessions are 7.5 times more likely to make fatigue-related errors and three times more likely to make fatal errors than when they did not work marathon shifts.6

Others besides patients suffer ill effects from sleep deprivation. The situation is unhealthy for the person missing the rest and rejuvenation. Lack of sleep contributes to diseases and obesity. Death from all causes is significantly lower for adults sleeping 7 to 8 hours per night. A study reported in Harvard Men's Health Watch concluded that: "Over nine years, men who took vacations were 29 percent less likely to be diagnosed with heart disease and 17 percent less likely to die than those who did not take regular vacations."7 Exhaustion can kill.

The cycle grows vicious. You fall further behind; you skip vacations and work through weekends. You consume more caffeine. You multitask, dropping another 25 to 50 percent in performance.8 You are less efficient and make more mistakes, so you work even longer hours, sleeping still less. Your key relationships at work and at home strain under the grind of the sand of unaddressed issues and unresolved struggles. Your pile of work deepens every day. You are drowning in it. Literally, drowning in it.

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