AAOHN: How Are You Dealing with Sleep in the Workplace?

As an occupational health nurse, should you be concerned about the kind of sleep your workers are getting?

Mary O'Sullivan, MS, and Kathy Ohlmann, RN, MSN, COHN-S, both of Quanta Dynamics Inc., suggest that OHNs should at the very least be aware of the possibility that sleep or lack thereof could be a factor when workers suffer chronic illnesses, injuries and other problems on the job. O'Sullivan and Ohlmann discussed the importance of sleep in relation to worker safety, health and productivity during a May 9 presentation ("Sleepiness in the Workplace: How Are you Dealing With it?") at the American Association of Occupational Health Nurses' 2006 Conference and Expo in Albuquerque, N.M.

As for the sleep-work connection, the duo pointed to one study that concludes that getting fewer than 7 1/2 hours of sleep per night increases the risk of workplace injury by 61 percent. Another study found that one out of two Americans say that sleepiness affects their job performance.

O'Sullivan and Ohlmann also pointed out that sleep problems now are thought to have played a role in causing the Challenger, Exxon Valdez and Cherynobl disasters, among others.

Sleep Revitalizes Us

Why is a good night's rest believed to play such a key role in maintaining a safe and healthy workplace? O'Sullivan noted and common sense only confirms this that sleep revitalizes us physically, mentally and emotionally.

"A lot goes on when we put our heads down on the pillow," she said, adding that deep sleep is a "miracle process."

Human beings experience two sleep states, both of which serve different restorative purposes:

  • REM (rapid eye movement) sleep, which is active, dreaming sleep. During REM sleep, the brain processes all the information and feelings taken in that day and organizes them, renewing our sense of emotional well-being and enhancing our learning and memory.
  • Non-REM sleep, which is quiet, slow-wave sleep. During non-REM sleep, our bodies are physically repaired and our immune systems are bolstered.

The normal, healthy sleep process includes periods of deep sleep, light sleep, REM sleep and non-REM sleep. However, the stresses and pressures of the modern world tend to infringe upon a decent night's sleep, cutting many of us off from the benefits of sleep.

The major factors that inhibit sleep include stress; medical problems; poor sleep habits; medications that disturb sleep; lifestyle factors (alcohol and caffeine both can have detrimental affects on healthy sleep); altered sleep/wake schedules (shiftwork and travel); and sleep disorders such as insomnia, sleep apnea and restless leg syndrome.

The National Sleep Foundation estimates that fatigue and chronic sleep loss cost the United States $80 billion a year. Statistics such as that one, Ohlmann said, make it obvious that sleep is an issue that OHNs need to begin looking at.

Such assertions are reinforced by the growing body of evidence that suggests that being awake for prolonged periods of time can reduce a worker's performance level to that of an intoxicated person: For example, being awake for 17 hours straight deteriorates alertness levels to those found in a person with a .05 percent blood alcohol level, studies show.

Staying awake for 24 hours straight reduces a person's functioning and alertness levels to those expected from a person with a .10 percent blood alcohol level. (In most states, .08 percent is considered legally intoxicated, Ohlmann pointed out.)

Much like having a few too many beers, chronic sleep deprivation, according to Ohlmann and O'Sullivan, results in impaired judgment, an inability to handle complex tasks, an inability to comprehend rapidly changing situations and a tendency to think more rigidly.

That's because the brain, like a computer, needs to be "defragged" each night in order to make the repairs necessary for the body to perform as it should, Ohlmann said.

Education is the First Step

The presenters noted that their goal was to make OHNs aware of the impact that sleep problems can have on the safety, health and productivity of their work force. As OHNs begin to look more closely at sleep, the first step they should take is simply to educate themselves and their employees on the importance of sufficient sleep, Ohlmann said.

They offered these tips and "sleep words of wisdom" for OHNs to pass along to workers and to apply in their own lives:

  • Maintain a regular sleep schedule. It is important to have a consistent wakeup time, even on weekends. After normal sleep, you should awaken on time without an alarm.
  • Take time to relax at the end of the day before going to bed. Practice a regular sleep routine to cue your brain for sleep.
  • Create a relaxed, calming sleep environment. Your room should be cool and your mattresses and pillow should prove good support.
  • Use your bedroom only for sleep and sex. Remove work materials, computers and TVs from the bedroom to reduce sleep distractions.
  • Exercise for deeper, quality sleep, but allow 3 hours after workouts before going to be, since exercise raises metabolism.
  • Eat well-balanced meals throughout the day to maintain energy levels. Don't eat a heavy, late-evening meal before bedtime since it affects sleep quality.
  • Watch stimulant intake, especially late in the evening. Caffeine remains in the body 6 hours or longer. Limit nicotine and alcohol use, since later in the night they also act as stimulants and disrupt sleep.
  • Leave the bedroom if you cannot sleep. Tossing and turning in bed can create a negative sleep pattern. Do some quiet activity and keep the lights down low. Return to bed when you are sleepy.
  • Examine any medications you take to see if they contain caffeine. Many common medications such as aspirin, antihistamines and antidepressants can interfere with sleep.

For more information, some valuable resources include the National Sleep Foundation, the American Academy of Sleep Medicine, the American Insomnia Association and the American Sleep Apnea Association.

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