As Canadians, we sit back with beer in hand, (*insert team name here) hockey jersey on, orange-fingered and covered with the dust of cheezies (look it up), bemused as we channel surf during commercial breaks to catch glimpses of the chaos that is the American Presidential Election unfolding to the south of us.
I realize that we as outsiders should hold our opinions to ourselves. But come on… this is no ordinary election! Still, I will refrain from trashing/endorsing either candidate and instead, attempt to rationalize their behavior based on science. Ok, just Trump. I can’t explain Hillary.
As someone who specializes in fatigue management, perhaps I can shed some (blue) light on Trump’s communication style. Let’s look at the facts.
Fact #1. Last November, Trump eloquently bragged about his lack of need for sleep. “You know, I’m not a big sleeper,” he said. “I like three hours, four hours, I toss, I turn, I beep-de-beep, I want to find out what’s going on.”
Now we all like a good beep-de-beep now and again, but this lack of sleep has been an ongoing habit of his for over a decade. In 2004 in his bestselling book, Think Like a Billionaire, he wrote,
“Don’t sleep any more than you have to. I usually sleep about four hours per night.” There’s also been mention of him getting as little 90 minutes! Keep in mind that many groups use sleep deprivation as a form of mental torture.
There are two issues of concern with Trump’s slumber habits. First, he is not getting the essential amount of sleep for the brain and body to fully repair itself. The short term consequences will show up
in real time, such as impaired judgement (“I could stand in the middle of 5th Avenue and shoot somebody and I wouldn’t lose voters,“), trouble with complex decision making (“Rarely is the question asked: Is our children learning?”), reduced tolerances to stress and increased aggressiveness (“I’d like to punch him in the face”), and lack of memory consolidation (“I never said that”).
The long term consequences are even more devastating, with science now proving the link between restricted sleep and mood disorders, brain inflammation, and several dementias including the onset of Alzheimer’s.
And although research has yet to prove it, I’m sure there’s a connection to his hair.
Fact #2. Second, and by his own admission, he’s a twitter addict and famous for using technology in the middle of the night. All of our backlit devices (smartphones, tablets, laptops, e-readers) use blue LED. While any light exposure at night is bad, blue wave length is especially damaging as it prevents the production of melatonin, our body’s natural sleep hormone. It’s what helps us fall asleep and stay asleep. So even if he wanted to get more sleep, it could be possible that he can’t, and now he just believes (erroneously, as most people do) that his body doesn’t actually need more sleep than what it’s allowing him.
Now I can’t say for sure whether or not this is the case with Donald, nor am I suggesting he’s using these devices every night. He may have blue-blocking apps that reduce the blue light effect, or maybe he wears sexy orange tinted glasses to bed while tweeting out his latest gems, but even those controls won’t eliminate the problem completely.
I suppose that we have to acknowledge that he could be one of the approximately 1% that carries a mutation of the DEC2 gene which plays an important role in regulating daily total sleep time requirements. These individuals have been known to function at the same level of most people but with needing only half the sleep to fully recuperate instead of 8 like the rest of us, but only for the short term. The science is quick to point out that there will still likely be long term consequences related to health impacts if this pattern continues over time.
Ok, so maybe he’s a mutant. Again, not saying there’s anything wrong with that unless you’re taller than a skyscraper and eating Manhattanites for breakfast. Just making a point.
In summary, I have attempted to explain why Donald Trump may be exhibiting extreme temperaments, poor memory, and unclear thoughts at times. As for Hilary, a wikileaks document from 2011 reveals that she is regarded by her staff as a “champion napper” and big on caffeine to boost her alertness. If so, the drug test that Trump is insisting on may reveal nothing more than overdose of Starbucks (think Tim Horton’s with twice the flavour but four times the cost). Rumor has it, she can afford it.
This is not a judgement on either one’s political skills or presidential aspirations. Who am I to judge someone else’s country? Remember, I’m Canadian.
I had the pleasure of presenting fatigue management concepts to the Occupational Safety and Health Cooperative Committee at the Kennedy Space Center in Orlando. And yes, that’s my foot in the photo, proving I was there!
A huge shout out to Darcy Miller and Brian Gloade of NASA for inviting me to address such an important group of leaders, and for the once-in-a-lifetime behind the scenes tour. We’ve all witnessed that defining moment when, on the day of a launch, the astronauts exit through that infamous doorway littered with past mission stickers, smiling, waving, before being whisked away and strapped onto massive rockets that go where few, or no one, has gone before them.
To walk the path of the astronauts as they made their way onto a Mercury, Apollo or Space Shuttle flight was humbling. To view the remnants of the Apollo 1 disaster site, and the debris collected from Challenger and Columbia… words simply cannot describe their courage, or the bravery of those who marched forward from the footsteps left behind.
Such legacies continue to drive space exploration forward and human factors is front and center in ensuring the safety of these noble missions. Their Human Systems Integration Division is world leading in the areas of human performance, human computer interaction, and technology design for both in-flight and ground operations. But its the people, the spirit, the camaraderie that is their heart and soul, proudly displayed through such ways as the signature wall of every worker who has helped to launch a space shuttle.
In other news, the Canadian Space Agency is recruiting potential astronauts for two spots in its program. To date, they have received over 3300 applications. If only I was 30 years younger!
Very proud to have this report released! Thank you to all who contributed to our efforts, and a huge thank you to the CSA Group for tackling this issue. We are one step closer to providing all Canadian workplaces, both large and small, with a national standard on how to address fatigue. – Mike
With unprecedented levels of workplace fatigue attributed to modern day work, a national standard could help address the issue and improve workplaces in Canada
(Toronto, November 20, 2019) – Professional burnout is affecting a wide range of jobs, workplaces and industries, and there is no standard definition or management practice in place to address this issue. That’s the key finding from CSA Group’s latest research report Workplace Fatigue: Current Landscape and Future Considerations which was released today and finds that a common definition of workplace fatigue is currently lacking in Canada.
In 2019, for the first time, the World Health Organization recognized burnout as a medical diagnosis. However, without a standard definition of what workplace fatigue means in Canada, it’s difficult to say how pervasive the problem is.
CSA Group’s research finds that while a number of industries in Canada, including aviation, rail, marine, nuclear, oil and gas, healthcare and defense do recognize fatigue as an issue for workers, there is no comprehensive definition of workplace fatigue, what causes it or how it may affect performance.
“Our research has identified that there is certainly an opportunity for standards that address workplace fatigue to make a real and positive difference to workers in this country,” said Mary Cianchetti, President of Standards, CSA Group. “What we’ve found is there is a need to support the management of workplace fatigue in Canada for the health and safety of Canadian workers. CSA Group could help to address this gap with a national standard.”
In some workplaces, the potential consequences of fatigue can be a matter of life and death. Workers in paramedic services face unique health and safety issues on a daily basis such as shift work and extended work days, as well as periods of intense psychological stress or trauma. That’s why the Paramedic Association of Canada is currently working with CSA Group to develop a national standard on fatigue risk management for first responders, in parallel with this new research.
“Paramedics do a job that can be grueling both physically and emotionally, and workplace fatigue is an issue we cannot ignore. We know that the impact of fatigue on first responders can affect neurocognitive performance, which in turn can endanger not only their own personal health and safety, but also the health and safety of their fellow responders and the public they serve,” said Pierre Poirier, Executive Director, Paramedic Association of Canada. “This research identifies that a gap does exist in Canada when it comes to how fatigue is being addressed in the workplace. We are pleased to already be working with CSA Group to develop a standard for fatigue risk management for first responders aimed at reducing exposure to fatigue-related hazards and protecting both paramedics and the people they help every day.”
In 2018, CSA Group introduced a psychological health and safety standard to address the specific needs of paramedic service organizations. The creation of a standard for workplace fatigue could address gaps in the existing legislation to protect the health and livelihood of all Canadian workers, regardless of where they work.
For more information on the Workplace Fatigue: Current Landscape and Future Considerations research report, click here.
One of your top workers is rubbing his eyes, yawning and moving slowly. You know that “John” still has four more hours on shift in a safety-sensitive job. You ask him how he is and he responds: “I’m fine, just a little tired.” What do you do? Do you get him a cup of coffee? Make him take a break? Or do you tell John to just be safe out there? What actual written procedures do you have in place for your supervisors to follow?
Fatigue is not simply a state of feeling tired. Fatigue can be a hazard in and of itself, but what is often overlooked is how fatigue can elevate the risk of other hazards you’ve already identified. To prevent errors and incidents from happening, it takes more than just having a worker show up with eyes open.
While there are a number of personal reasons why a worker may be struggling with fatigue, at some point we have to start looking at the flaws in the system — not just the flaws in the worker.
The science is clear: workplaces need to understand their role in the promotion and mitigation of fatigue. The most important factor in their control comes down to the design of work schedules. There are two components to consider in a schedule design — the time of day that the work is being done (circadian factor) and the length of hours on and off duty (homeostasis factor).
Humans are not nocturnal
Based on our circadian rhythms, humans are a diurnal (day-oriented) species. This means we will always perform better and be more alert and safe when working during daylight hours, and get our best sleep during dark nighttime hours. We are at our worst between midnight and 6 a.m. when we are programmed for sleep, and suffer poor sleep when trying to sleep during daytime hours. There is also a dip in our rhythms in the early afternoon (the siesta period), which can also affect alertness and performance. Most importantly, research has demonstrated that less than three per cent of night workers show any physiological adaptation to night shifts. In other words, we have yet to figure out how to turn our species into nocturnal animals. So, while you may think you’ve adapted, the truth is, you’ve adapted to being in a state of impairment — it’s your new normal.
Night-shift risks
Recognizing that shift workers are at higher risk for fatigue and performance impairment, consider the following:
Do one or more shifts exceed 12 hours in a 24-hour period?
Do any shifts start or finish between the hours of midnight and 6 a.m.?
Do changes to a roster, or posting of shift assignments occur with less than two weeks’ notice?
Are complex or critical tasks scheduled during the high-risk zones?
The longer you’ve been awake, the more sleep pressure builds in the brain due to a depressant called adenosine. The result is that after being awake for 14 hours, sleepiness starts to set in. At 17 hours, you are the equivalent of .05 blood alcohol impairment (BAC). At 18 hours, you will be struggling to stay awake. At 20 hours, you are equivalent to .08 BAC, and your cognitive abilities drop by up to 40 per cent. Back to John. If he works a 12-hour shift, considerations would need to include when he woke up, length of his commute and any other factors that might influence how long he’s been awake, in addition to circadian factors.
If John’s on a night shift, that means a minimum of 12 hours off duty before his next shift. Ask yourself:
Do some extended hour shifts exceed 12 hours?
Are more than three consecutive 12-hour night shifts worked?
Is there less than 12 hours undisturbed rest after a 12-hour night shift?
Do employees work more than 60 hours in a seven-day period?
Are there irregular and unplanned schedules as a result of call-outs?
Is overtime unmonitored?
If you have identified flaws in the scheduling system, that doesn’t mean you have to throw it out. It does mean that you need to put a plan in place to mitigate the risk attached to those flaws.
In my previous blog, we reviewed frequently asked questions I get at conferences, such as why we get up to pee in the middle of the night, what my dreams really mean, and how to reclaim sleep after bringing a baby into the mix. In Part 2, we delve into the impact of technology, sleep disorders, prescription meds and of course, non-prescription sleep aids.
1. I’ve heard looking at my smart phone can be bad for my sleep. How come?
All of our smart technology is driven by blue-enriched LED light. Within the full spectrum of light, there is a particular blue stream that has a direct effect on our ability to sleep by suppressing the production of Melatonin and affecting our circadian drive. Melatonin is our natural sleep hormone. It’s what helps us fall asleep and stay asleep.
During daytime hours, blue light exposure (including sunlight) is excellent. It can enhance our moods, improve focus and concentration, and actually help us sleep better at night. However, it’s all about timing and any night time exposure (after the sun has gone down) is strongly discouraged. Since the impact of light is affected by distance, small handheld devices like smart phones, e-readers, IPads, tablets and laptops are more damaging due to their proximity to your eyes than a big screen TV across the room.
While many devices have dimming features to ease eye strain, that is not the same as a blue light filter and will do nothing to prevent the suppression of melatonin. Most of our newer devices have built in blue-light filters to reduce this damaging effect. Check if your device has one. Go into settings, display, and then look for either “night shift” or “blue light filter” to activate it.
If you’re a day worker, use the automated “sunrise to sunset” feature. If you’re a shift worker, you may want to select specific times for it to activate. Your screen will turn a pink or orange-ish hue and greatly improve the chances of you getting a restful sleep. If your device doesn’t have a blue light filter, there are plenty of free blue light filter apps available online.
2. I’ve heard you can buy Melatonin. Do you recommend it?
Here’s what we know. It has been heavily marketed in recent years as a safe way to help get sleep, but synthetic melatonin is not the same as what your body produces, and does not take you through the sleep cycle like natural melatonin. Many side effects have been noted, including excessive grogginess the next day after you use it, upset stomach, and very vivid, horrific nightmares. It is also not recommended for people who have a history of depression, as it can enhance these feelings, or a history of seizures.
Recent scientific literature is advising that you restrict the use of Melatonin on a temporary basis, such as when you’re travelling across time zones, to help offset jetlag, but not to use it on a regular basis as a sleep aid. Not everybody produces, or requires, the same amount of melatonin, and the timing of taking it is just as important as the amount. For example, some need it earlier in the day than others. As for parents giving it to children, there simply isn’t enough long term research on the effects of children, but given what we know about the effects on adults, why take the risk of giving them nightmares or affecting the quality of their sleep.
If you suspect your lacking melatonin, a safer and gentler alternative is the natural supplement called L-Tryphtophan. It is the precursor needed for the body to produce serotonin in the gut, which ultimately is synthesized into our own natural version of melatonin.
3. How do I know if I have a sleep disorder?
Very simply, if you wake up unrefreshed and struggle to stay alert throughout the day, you could have a sleep disorder. If it takes you longer than 30 minutes to fall asleep, and you wake up several times during the night and can’t fall back asleep, you could have a sleep disorder. Most importantly, if someone tells you that you snore loudly, or has heard you gasp or choke during the night, you could have a sleep disorder. In this case, you may be suffering from Obstructive Sleep Apnea (OSA).
OSA is becoming more and more prevalent and is probably the most dangerous. It’s the result of something blocking our airway while we sleep. We literally stop breathing. When it repeatedly lasts for more than 10 seconds, you officially have OSA. This means we starve both the heart and the brain of oxygen, and this leads to all kinds of other significant health issues including cardiovascular disease and stroke. It also means we don’t get through all of the sleep stages that we need to because every time we gasp for air, it wakes us up and kicks us out of the sleep cycle, thus preventing us from getting the recuperative sleep we need. You’ll be constantly exhausted, unable to focus, and emotionally drained.
While obesity is a prime contributor to the onset of OSA (a size 17 neck for men and 16 for women is a primary risk factor), that doesn’t mean other people can’t have airway obstructions. Adults and kids alike can have enlarged tonsils or adenoids that block the airway. A narrow palette with a wide tongue could collapse back into the throat during sleep. Sleeping on your back is also a known cause. Heavy smokers, drinkers and those using sedatives are at high risk, as they all cause the muscles of the throat and tongue to relax and collapse on themselves.
It has been reported that 1 in 4 Canadian adults have symptoms of OSA. If you think this may be you, book an appointment at a sleep clinic to get checked out. Depending on the severity, you may be outfitted with either a dental appliance (minor OSA) or a CPAP machine (severe OSA). A CPAP machine is one that provides continuous positive air pressure to ensure the airway stays open while you sleep and is the most effective method for combatting OSA. Check if your benefit plan covers the cost of these devices.
4. What sleep medication would you recommend?
In short? None. And not only because I’m not a Doctor. Both prescription and non-prescriptions medications (including melatonin) disrupt your natural sleep cycle so they don’t replicate normal sleep patterns. Alcohol needs to be included here, as many people turn to is as a sleep aid.
Prescriptive medications (benzodiazepenes) are highly addictive and their use should be limited to being a last resort and only under the strict guidance of your doctor. However, even over-the-counter meds can create high tolerances and come with other side-effects. More importantly, taking medication only treats the symptoms, not the problem. Stress is a common cause of sleep disturbance, in addition to those previously mentioned. You need to address the heart of the matter for the best results!
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