Mike was interviewed for thefollowing article, published on the Business Insurance website in 2017.Author: Louise Esola
How
much sleep are employees getting at night? Workplace safety experts are calling
this one of the most frequently overlooked but critical questions to answer in
employer safety programs due to rising fatigue risks.
The
Park Ridge, Illinois-based American Society of Safety Engineers is funding an
ongoing study on fatigue through the University at Buffalo in Buffalo, New
York. The study, which began in August 2015, is surveying what workers think
about fatigue and whether they can recognize the signs in their everyday work
life, according to researcher Lora Cavuoto, an assistant professor in the
university’s Department of Industrial and System Engineering.
Fatigue
is often overlooked in safety programs because “it’s hard to pinpoint the
instant it happens,” Ms. Cavuoto said.
“If
we think about fall risk, a dominating injury, you can see those points; you
can see you have a worker at height and know the mechanism for solving that.
It’s fall protection,” she said. “Fatigue is a little more subtle and in the
background. Workers might not be aware they are feeling the consequences (of
fatigue).”
Michael
Trufant, an Asheville, North Carolina-based fatigue awareness program manager
for Aeroflow Healthcare Inc., which sells sleep apnea tests, called fatigue an
“epidemic.” “You can wear your eye protection, but (fatigue) is where it is,”
he said.
“A person who sleeps only four to five hours a day is the same as a (person with a) 0.08 blood alcohol level,” said Mr. Trufant, touting research that’s been echoed over the years by many safety organizations — from the U.S. Occupational Safety and Health Administration to the American College of Occupational and Environmental Medicine.
The
Itasca, Illinois-based National Safety Council put the issue on the forefront
of its agenda recently. In 2016, the nonprofit tackling workplace safety issues
launched a fatigue initiative, providing statistics on how prevalent the issue
is becoming in a report issued in July. And this fall, it is launching a
fatigue calculator for employers to gauge how tired their employees are and
what risks are created as a result of fatigue.
“The
tired employees are increasing safety risk,” said Emily Whitcomb, an
Itasca-based senior program manager with the fatigue initiative. “Employers are
becoming more interested in this issue (because) of the major consequences it
leads to.”
The
statistics are alarming, she said, listing some of what she called the most
eye-opening in the council’s national survey of 2,000 employees across several
industries: 43% of those surveyed reported not getting enough sleep every day;
16% reported falling asleep while driving; and 27% reported falling asleep on
the job in the past month.
“That’s scary if you are doing a safety-critical job,” she added. The council also narrowed down a list of nine risk factors that contribute to the likelihood of an accident occurring at work — a list that includes long shifts, demanding jobs and long commutes. “Nearly everyone (at 97%) reported at least one risk factor, and 80% reported at least two. With that, your risk factor increases,” Ms. Whitcomb said.
Experts
have long pointed to such high-profile incidences as the Chernobyl nuclear
disaster in Russia, the Three Mile Island nuclear accident in Pennsylvania, the
Exxon Valdez oil spill off Alaska and even the most recent string of collisions
at sea involving U.S. naval vessels.
“When
we look at the largest incidents in the world, all of them are fatigue-related,”
said Mike Harnett, Calgary, Alberta-based vice president of human factors for
Six Safety Systems Inc., which delivers solutions in the United States and
Canada to reduce worker fit-for-duty risks associated with drugs, alcohol and
fatigue in the workplace.
“We
constantly blamed the operator, but it’s the flaws in the system we have to
look for,” said Ms. Harnett. “That’s not human error; they fell asleep because
they were not getting enough sleep.”
The
council’s research found that 16% of workers surveyed reported at least one
near miss or safety incident because of fatigue.
Ms.
Whitcomb said much of the problem exists in current employment culture, which
is shifting slowly.
“The
hard thing with fatigue is we always see that pushing ourselves, putting sleep
to the side, is seen as a badge of honor,” she said. “If you lose sleep and put
in your overtime, people think it will pay off in the end.”
Ms.
Harnett said corporate policymakers and executives are often behind the curve,
as many have “gone through” fatigue to find success. “The harder and the longer
they worked, the better it was for promotions,” she said. “We have to convince
management they have a problem.”
The
latest interventions can be as simple as a questionnaire for workers on sleep
habits, both before or after an incident, Ms. Harnett said. Another solution is
to train employees on the importance of sleep and to limit longer shifts, she
added.
Experts
say a burgeoning area is in research and testing for sleep apnea and other
conditions that can cause a person to be tired during a workday.
“What we are trying to do is get employers to push sleep health programs and sleep screening,” said Ms. Whitcomb. “We found that 90% of sleep disorders are untreated.”
I have the pleasure of speaking at various conferences and industry events on the subject of workplace fatigue. Regardless of the direction of my speech, there is inevitably a number of individuals waiting patiently to ask me questions about their own personal struggle with sleep.
It’s not surprising. Sleep was a mystery to us for centuries. It’s only been the last few years that science is beginning to unravel what is truly going on when we sleep, and why it’s not simply a waste of 8 hours in bed. Here are some frequently asked questions concerning why we don’t get the sleep we need.
1. Is it true we need less sleep as we get older?
For the most part, this is a myth. All adults require somewhere between 7-9 hours of sleep. As we age, we have a shift in how much time we spend in the different stages of sleep, with older workers getting less deep sleep (meaning less human growth hormone production) as well as REM sleep, reducing the overall length in the process. We also see a shift in our chronotype, meaning that as we get older, we tend to become more “morning larks”, getting up earlier in the day, often at the expense of not sleeping as long. It’s not uncommon for older adults to make up for their shorter night sleep by having a nap during the day, getting them closer to that minimum requirement of 7 hours.
2. It seems like every night I have to get up and go to the bathroom, and then I have difficulty falling asleep. What can I do?
There are medical and non-medical reasons why you’re waking up to pee in the middle of your sleep period. Urination at night (known as nocturia) can range from 1 or 2 episodes to as many as 5-6 times per night. The more frequent, the more we need to be concerned.
Try to get most of your hydration during the daytime hours and cut back at night, with no liquids a couple of hours before you go to bed. Alcohol, coffee and tea are all diuretics and will increase the need to wake up and visit the bathroom.
Keep in mind that as we get older, our bladders lose their “holding capacity”. We also have less of an anti-diuretic hormone that allows us to retain more fluid before we need to run to the bathroom! Older adults are at higher risk for certain medical disorders, or may be on medications that directly affect the bladder. Urinary tract infections, diabetes, and liver conditions could be culprits. Nocturia is also a warning sign for the development of something more sinister such as cancer of the bladder or prostate. Frequent urination isn’t always due to a full bladder.
Finally, shift workers may experience a body clock disorder that makes the body think it’s daytime when it’s nighttime and vice versa, and upset the natural timing of when we’re supposed to urinate.
If you can’t attribute your nocturia to consuming liquids too close to bedtime or some other cause, then please consult with your physician. Keep a daily drinking diary to help them determine what is going on.
3. I never dream. Is there something wrong with me?
Whether you know it or not, you are in fact drifting in and out of dreaming throughout your sleep, but if you don’t wake up while it’s happening, chances are that you won’t recognize it. For example, most of our vivid dreaming occurs during REM sleep, but if you wake up during a different stage of sleep, you may not notice the dragon chasing you through the woods. If you wake up and remember your dream, it often reflects a more gentle form of waking up, as opposed to an alarm clock blasting you awake or your kids jumping on top of you.
A sudden awakening typically causes a spike in noradrenalin being released, which quickly washes away your ability to recall the dream.
There are many theories as to why we dream, but academics are leaning towards the memory consolidation process, meaning that it reflects the brain trying to figure out what information is important to keep, and what can be removed. Think of it like a file cabinet where you have to weed out the old information to make space for the new.
4. I have very vivid dreams. Most don’t make any sense. Should I be worried?
One of the things that happens when we enter into our dream state is a heightening of emotions, creativity, and imaginings. This is due to a quieting of the frontal lobe of our brain, which is responsible for things like logic, problem solving, reasoning and self-control, and an increase in activity in our amygdala, which is responsible for our “fight or flight” hormones. As a result, our dreams are often incredulous, or make no sense at all. Don’t worry. You’re normal.
5. I’m a new parent. I am chronically sleep deprived. Please help!
A recent 2019 study examining new parents and sleep found that sleep deprivation lasted for the first 4-6 years after the birth of the first child. The first three months were the worst, with mothers receiving about 60 minutes less sleep, but improved to 40 minutes less sleep for the rest of the first year. The effect on fathers was less pronounced at only 13 minutes less sleep even during the first three months.
What’s worse is that not only are you getting less sleep, but you have more interruptions throughout the sleep period, with one survey indicating new moms getting only 1-3 hours of undisturbed sleep at a time. This interrupts our sleep cycle and you may miss out on critical stages of sleep.
The act of breastfeeding is a known sleep enhancer, making it easier for mom to fall asleep while feeding as opposed to bottle-feeding which causes the baby to move about more and disrupt the quietness of the situation. More controversial but often promoted is the notion of breastfeeding and sleeping in bed with the infant to minimize awakenings to both mom and the baby. If it means less sleep disturbances, it might be in your best interest.
Napping is a tired parent’s best friend. It can supplement the sleep you’re not getting. To effectively nap during daytime hours, be sure you have blackout drapery with no TV or lights on around you. Use a white noise device to block out daytime sounds from outside. And most importantly, lie flat. We fall asleep quickly when we’re lying down, but not so when simply reclining on the couch or in a chair. Try to always nap in the same location. Our bodies thrive on routine and as soon as you enter into your sleep space, it will help you to fall asleep quicker.
Still, every once in a while, you need a good solid night of sleep. Have your mother-in-law, siblings, or someone else who owes you a favour, take care of the kids for a night every couple of weeks so you can escape into deep, undisturbed sleep.
Finally, give yourself a break. The housekeeping police won’t be coming by to see if you made the bed, dusted the shelves, and vacuumed the carpet. Time is your most important commodity. Make sure your older children keep up with the chore list. If cost isn’t a huge factor, hire somebody to mow the lawn, clean the house, or pick up your groceries. And with all the options now available, ordering in food has became a lot more nutritious (and less clean up required)!
In December of 2016, I was thrilled to be invited to the National Safety Council’s (NSC) first Blue Ribbon Panel on Fatigue held in Chicago. It was an excellent opportunity to meet and collaborate with icons in the fields of fatigue and sleep research as we broke into workshops to discuss the status of fatigue and how it is being managed (or not managed) at the worksite.
Rubbing shoulders with the likes of Dr. David Lombardi, Dr. Charles Czeisler, Dr. Mary Caskadon, Dr. Mark Rosekind, Dr. Steven Higgins, Dr. Imelda Wong, and so many more reaffirmed the need for tackling the issue of fatigue from a position of science and evidenced-based research.
2016 Blue Ribbon Panel on Fatigue (Can you spot me?)
This inaugural event led to the development of tools and guidance documents issued by the NSC and which are readily available to both the public and private industry sectors. Many of these resources were introduced to us at the NSC’s 2019 Workplace Fatigue Conference in Seattle, an outcome of the efforts in Chicago. This event once again drew world-class researchers but more importantly, it drew industry leaders who came to learn and share.
One of the many resources introduced at the event is the NSC’s Fatigue Cost Calculator. Led by Dr. Charles Czeilser and The Brigham and Women’s Hospital Sleep Matters Initiative, this tool helps organizations build a business case around the development of fatigue management initiatives. After inputting workforce size, industry and location, this information is used to predict the prevalence of sleep deficiency and common sleep disorders among employees in geographical regions. Most importantly, the algorithms are based on the findings of 55 peer-reviewed studies.
It must be noted that this is a US based tool on American figures of sleep deficiency and sleep disorders. It does not directly equate to Canadian sleep or cost factors (perhaps it’s time to develop our own?).
There are numerous resources available on the NSC website including videos and an excellent white paper that looks at the causes and effects of fatigue entitled Tired at Work: How Fatigue Affects our Bodies.
As fatigue hits the radar of more and more companies, it’s important to make informed decisions using the latest science available. A big shout out to Emily Whitcomb and the rest of the fatigue management team at the NSC for continuing to drive this important conversation forward!
The holidays are a joyous time, but let’s face it, all that travel and celebrating can be exhausting! We’ve compiled some tips to help you stay rested and keep you singing fa-la-la-la-la instead of fa-fa-fa-fatigue.
Travel Tips
There’s nothing like sleeping in your own bed, but during the holidays, chances are your squatting on someone else’s turf. Here are a few tips to get the best sleep you can while sleeping in unfamiliar surroundings.
If you’re staying in a hotel, ask for a room
far away from the elevator and all the noisy traffic it brings.
Bring an eye mask in case the curtains don’t darken
the room enough. Or, use clothespins or hairclips to hold the curtains closed.
Don’t forget the earplugs to block out the
celebrations in the room next door (wink wink J)!
Use your new Christmas socks or scarf to cover
up any light sources in the bedroom. All light is bad light when trying to
sleep.
If you’re staying at someone else’s home, let
your hosts know what time you would prefer to get up so that they know not to muzzle
the kids and not bother you before you’re ready.
If your hosts have pets (or young children),
keep the bedroom door closed to discourage them from entering and disturbing
your sweet slumber.
Bring your own pillow (especially if you have
allergies) to optimize your sleep and prevent a kink in your neck.
Travel with anti-histamines. They produce a
drowsy effect that can help you fall asleep when the house is noisy, and they
don’t have the addictive or narcotic effect of sleep medications.
If you use a C-Pap device, make sure you bring
it with you. There are travel versions available for easier packing.
Stick to a Schedule
Our bodies’ circadian rhythms crave routine, including a set sleeping schedule. However, if you find yourself invested in an all-night Christmas move marathon, or catching up with family and friends over one too many libations, a mid-day nap may be just what you need, but make sure you stick to the rules!
Limit your nap to 20-40 minutes to avoid
falling into a deep sleep or, commit to at least two hours so you can complete
a full sleep cycle and wake up back in the lighter stages.
No nap is too short. Sometimes a five-minute
nap is all you need to kick start the festivities all over again.
If you’re traveling
between time zones, there are more rules to follow.
If it’s a short trip (2-3 days) to see Aunt
Bertha and Uncle Herbert, or if you’re only travelling across one or two time
zones, stick to your home schedule. For example, if you normally go to bed at
11PM EST, make sure you still go to bed at 11PM EST even if it’s 9PM MST.
If it’s a longer trip (3+ days) or across
multiple time zones (hello jetlag!), slowly adapt your routine towards the time
at the new location that you’re headed to.
A few days prep can make all the difference!
Watch the Indulgence
The holidays are a time for indulgence and who are we kidding, most diets go out the window until the new year. However; what we eat and drink can have a big impact on our sleep.
Avoid late-night meals and snacking when our digestion is shut down.
Over-indulgence of alcohol especially 2-3 hours before you go to bed not only increase drowsiness, but significantly disrupt sleep patterns and the ability to get into deep recuperative sleep. It also wipes out your memory.
Alcohol also increases snoring by causing the throat muscles to relax.
Salty snacks can cause dehydration, which makes you feel tired.
Eat breakfast to help stay alert throughout the day.
Sugary snacks and beverage give a quick energy boost, but after 30 minutes, can makes us crash and burn.
Don’t Blame the Turkey!
We all know the turkey drug… Tryptophan! Yes, it makes you drowsy and has a calming effect, but only when the tryptophan is activated. So what activates tryptophan? Carbohydrates such as stuffing, mashed potatoes, cranberries, and all the lesser regarded dishes at the holiday feast that we overdose on. If you just ate turkey and nothing else, you would be alert enough to do the dishes after dinner instead of crashing in front of the TV within 5 minutes of “It’s a Wonderful Life”. So stop blaming the turkey.
Exercise
During the flurry of activities, set aside time to get out for some fresh air and exercise. Not only will it help keep the holiday pounds off, but it also does wonders to relieve stress and stabilize your body’s circadian rhythms for a better night’s sleep.
Finally, make sure you schedule in some quiet time for
yourself; catch up on a book or take a relaxing bath!
Before you know it,
the holidays will be over and you’ll need a vacation!
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