Promote Better Sleep and Rest through Occupational Health

It’s recommended that adults get at least seven hours of sleep each night, but more than one-third of American adults report sleeping less than that during each 24 hour period. A lack of adequate sleep is associated with impaired cognitive performance and an increase in vehicle, industrial, and medical accidents. Poor sleep affects the individual as well as their follow employees, customers or patients, and the business or community.

Occupational health departments can play a role in promoting better sleep habits of their employees, which can in turn improve their productivity, mental health, and professional outcomes. In fact, the United States has declared insufficient sleep a public health problem because it affects so many people on such a large scale. An occupational health department that supports the healthy sleep habits of its workforce will see better outcomes and more satisfied—and well-rested—employees.

Insufficient Sleep Problems in Your Workforce

Insufficient sleep is estimated to have an economic impact of $411 billion each year in the United States. It is a contributing factor in more than 6,000 car crashes each year and studies estimate that mistakes made due to being tired cost companies $31.1 billion annually. In some industries, such as healthcare, these errors can be fatal. In a 2020 study, 55% of nurses reported experiencing insomnia.  

In addition to monitoring employees for signs of fatigue, occupational health teams can assess employees sleep habits through surveys and provide additional support and education about better sleep habits.

Some suggested methods or questionnaires for assessing sleep quantity and quality include:

• Polysomnography
• Pittsburgh Sleep Quality Index
• Multiple sleep latency tests
• Daytime maintenance of wakefulness test
• Activity monitors or wearable technology
• Insomnia severity index
• Ovideo Sleep Questionnaire
• Sleep diaries
• Functional Outcomes of Sleep Questionnaire
• Daily Cognitive Communication and Sleep Profile
• Occupational Balance Questionnaire

Besides self-reporting a lack of sleep, occupational health will need to carefully watch employees for signs of fatigue or possible negative outcomes as a result of poor sleep habits. Some of these can include:

• Memory lapses
• Poor recall
• Lower self-regulation
• Cognitive errors for tasks they normally perform
• Minor injuries
• Lower motivation
• Absenteeism
• Deterioration in interpersonal relationships
• Decrease in productivity

The Impacts of Shift Work on Sleep Habits

An additional risk factor for poor sleep hygiene is shift work. Shift work is any regular work schedule outside a standard 7am-6pm range. It can include split shifts, night shift, or rotating work shifts. This impacts about 16% of the US workforce with workers concentrated in fields such as medicine, manufacturing, utilities, and transportation.

Studies have shown significantly higher rates of insomnia, poor sleep quality, and daytime drowsiness in shift workers. They also score higher on the Occupational Impact of Sleep Disorder questionnaire. This creates additional negative outcomes such as traffic accidents, dissatisfaction with their occupations, mortality rates, and lower productivity.

Occupational health departments can be a great source of information and support for shift workers, particularly those who are new to this schedule. Some of the best methods to improve sleep quality for shift workers include:

• Maintaining a sleep schedule even on days off.
• Block light and sounds as much as possible while sleeping during the day. This can include black-out shades, sleep masks, and earplugs.
• Find activities that help your body relax and more easily enter a sleep state such as meditation.
• Avoid alcohol.
• Eliminate nicotine.

Healthy practices should also be established to maintain wakefulness while they are at work, even if it is during traditional sleep periods. Some tips for shift workers are:

• To use caffeine, but sparingly.
• Work out before work or during a break. It may also help to move regularly during the shift for an energy boost.
• Eat on a regular schedule.
• Stay hydrated.
• Turn on the lights to simulate sunshine when you need to be alert.

Coach Employees to Promote Better Sleep Habits

Occupational health departments are an invaluable resource for interrupting unhealthy sleep patterns and giving employees the tools that promote better sleep habits. Education is a vital part of improving sleep hygiene. All employers, but particularly those who have shift workers, should regularly make educational materials and consulting available to those who need support for developing better sleep habits. Make written and video materials easy to find. Include modules on sleep in onboarding and regular safety training. Know the medical professionals in the area that specialize in treating sleep disorders in shift workers so you can refer employees for more specialized assessments and treatment. Ensure that employees can recognize signs of fatigue in themselves and their coworkers.

Occupational health nurses are great advocates for employees. Some of the structural and policy changes they can request on behalf of workers that will promote better sleep habits include:

• Natural light in working areas or regular access to the outdoors.
• Nap rooms for employees working non-traditional shifts.
• Limit the overtime each person works. Consider the length of each shift, how many hours they work within a 24-hour period, and the hours they are required to be alert during the week.
• Provide regular breaks for employees to relax, nap, eat, or exercise.
• Encourage flexibility in work schedules and environments for those who are struggling with sleep problems.

Allow Employees to Take Advantage of Opportunities to Nap

For shift workers or those who work for long shifts, creating the opportunity for naps can foster an environment where sleep is respected and valued. For example, nurses or doctors who are on call or working for long periods of time will benefit from short naps during their shifts. Napping for just 15-20 minutes can improve alertness, activity levels, and focus, all of which is essential for health care providers. A short nap is also helpful for transportation workers before a long drive.

Most naps should be less than 30 minutes to avoid sleep inertia. At that point, sleepers may be groggier and have a harder time getting back to work effectively. To nap in order to make up for existing sleep debt, naps would need to be at least 90 minutes.

Encourage Employees to Truly Take Time Off

Whether for a single day off during the week or as a longer vacation, encourage your employees to truly take time away from work. For health care workers, pilots, transportation workers, construction crews, and other shift workers, time on the job can be very stressful. Time to relax and recuperate is necessary for optimal functioning at all times. It can be difficult for people to disconnect but setting the expectations that their time off will be respected is an important first step.

Other tips occupational health workers can share with employees that will make their time off more rejuvenating include:

• Not answering emails, voice mails, or other communication on their days off.
• Decline meetings that interfere with self-care or vacation time.
• Work only within paid working hours.
• Discuss any trouble completing work tasks during set working hours with a manager to prioritize or reassign tasks.
• Have hobbies or activities to do for pleasure.

Create an Official Fatigue Risk Management Program

If you have identified poor sleep hygiene and fatigue as a potential risk factor at your place of employment, a Fatigue Risk Management Program (FRMP) may benefit the company. Occupational health can take responsibility for this program and include all employees in the risk assessment and education. This approach will enable health care professionals to identify those who are not getting enough sleep and intervene before it causes injury or loss of employment.

If your occupational health department wants to start a Fatigue Risk Management Program, follow these steps.

1. Evaluate your current safety management program to determine how an FRMP fits.
2. Involve all relevant stakeholders that are impacted or can make decisions about policies, including employees from a variety of departments, management, and occupational health professionals.
3. Evaluate staffing levels, protocols for when employees call off, and how workloads are assigned.
4. Track who works non-traditional shifts, rotating shifts, or long shifts, and how that shift affects their performance. Evaluate if there are alternatives to any of these shifts that would allow employees to better regulate their sleep.
5. Determine which fatigue assessment tools will be most useful for your situation. You’ll need to decide how frequently to evaluate employees, what standards you’ll use to determine risk factors, and what to do with the results when someone is not practicing healthy sleep hygiene.
6. Establish a referral program to ensure employees with sleep disorders, or simply chronic sleep deprivation, can be treated by a specialist.
7. Evaluate the physical environment to determine if there are changes that can be made such as lighting or establishing nap rooms that will promote better sleep.
8. Teach employees to recognize the symptoms of fatigue in themselves and their coworkers, and what they can do in response to these symptoms immediately and in the longer-term.
9. Recommend fatigue monitoring devices. These are often found in transportation technologies as they monitor speed, lane tracking, and other indicators of wakefulness. When they notice signs of drifting attention or slow reactions, they alert the operator that they need to take a break and get some rest.

Every employee should be aware of the standards of the FRMP and understand how to intervene to prevent an accident or mistake. Putting protocols in writing establishes a precedent that sleep is critical and that your occupational health department prioritizes sleep habits.

Once this program is part of the standard safety training, every employee is responsible for their own sleep habits. An FRMP sets the expectation that workers manage their sleep in order to protect themselves, their fellow workers, and their clients or customers. They should have the education they need to develop healthy habits, seek support for sleep problems, and intervene if the fatigue of another person is creating a dangerous situation.

Occupational Health Can Help You Promote Better Sleep for Your Employees

Sleep deprivation is a frequent problem in the United States, across a number of industries and types of roles. Not only can it cause inferior work, it can also cause a loss of income and open organizations up to potential injuries on the job. Ensuring better sleep for employees is critical to maintaining a positive working environment and a healthy financial outlook.

There are many methods organizations can choose to promote better sleep within their staff, but regardless of which method they choose, it should be continually re-evaluated to make sure it continues to help employees over time.