Sarasota, FL (WorkersCompensation.com) – The Challenger explosion; the Exxon Valdez oil spill; the Three Mile Island nuclear accident. All three disasters had one thing in common: lack of sleep. Root cause investigations showed that in each case workers behind the scenes were hustling to get things done and suffered from sleep deprivation, which contributed to the incidents.
“These are three massive catastrophes,” said Scott Cherry, DO, chief Medical Officer for Axiom Medical. “What’s more insidious is actually the small things that are near mistakes or small errors that really don’t go noticed until a bunch of them are compiled together and make one big catastrophe.”
The importance of sleep on work performance has reached a level of awareness such that many organizations are trying to reverse the thinking of sleep deprivation as something to be rewarded. During a recent webinar, speakers discussed the problems with lack of sleep on work and how employers can encourage their employees to focus more on getting enough rest.
Sleep is one of the pillars of health – along with diet and exercise, according to experts. The true value of adequate sleep is demonstrated by the lack of it.
“There are lots of studies that show, for instance, if someone is awake for 19 hours their behavior is similar to someone with a blood-alcohol level of .05 percent, which actually can be considered intoxicated in some states.,” Cherry said. “So, really, your cognitive and your executive functions, like concentration, judgment, decision-making are really negatively impacted.
Someone who is awake for 28 hours behaves as someone whose blood alcohol level is .1 percent, considered very high. But the culture in many work environments has been to reward those who work endlessly and tirelessly. It’s seen as a warrior mentality where working through sleep deprivation is embraced.
“It’s almost become a badge of honor to say that you’re tired,” said Les Kertay, SVP of Behavioral Health for Axiom. “I’ve noticed that in corporate environments [the sentiment is] ‘you must be working really hard if you’re tired all the time.’ Difficulties happen when you are tired all the time.
Sleep professionals recommend adults get 7 to 9 hours of sleep per night. However, studies show about half of Americans get less than 7 or even less than 6 hours.
Research has shown that sleep deprivation leads to overall slow information processing. Even in the absence of being sleepy, brain activity is impacted.
In one recent test, researchers tasked working memory, then measured brain activity. They found it was overall slow.
“That means we can take in less information, and because we take in less information there are attention lapses. We have trouble processing that information and that delays our reactions,” Kertay said. “There are also mood changes that tend to happen when sleep deprivation becomes chronic. Feelings of depression, anxiety, irritability will increase the longer we are deprived from sleep. That creates an issue. But of course, that has safety implications if we’re not processing information well and our reaction times are slowed.”
The safety implications were evident in the root cause analyses of the three disasters mentioned above. The presidential commission tasked with investigating the Challenger accident found that some of the most prominent managers involved in the space shuttle launch had slept only two hours before reporting to work at 1:00 AM. It prompted the commission to publicly state: “The willingness of NASA employees in general to work excessive hours, while admirable, raises serious questions when it jeopardizes job performance, particularly when critical management decisions are at stake.”
“Having NASA actually admit that in some ways it’s part of the culture to get things done through sleep deprivation, it’s probably not as sustainable and it directly adds to the risk of the mission,” Cherry said. “So now we’ve seen large corporations focus on fatigue risk management inherently, at least to a degree.”
Changing the Sleep Culture
The safety and health risks associated with workplace mistakes should be a wakeup call for organizations. Rather than rewarding employees for soldiering on despite lack of sleep, employers should instruct and encourage workers on the benefits of sleep – for themselves and the company.
Employers themselves can make small changes in shift work, for example, to ensure workers have enough time to get adequate sleep. They can also educate workers on how to get the best sleep.
Sleep hygiene, for example, means going to bed at the same time every day and trying to sleep in a darkened area with low noise. Looking at cell phones or other electronic devices confuses the brain and sends a message that it should be daytime.
Self-monitoring of sleep helps the employee see how much sleep they are actually getting. There are electronic ways to track sleep.
“The key thing is to monitor yourself and make sure you are waking up refreshed,” Kertay said. “You can do things to minimize interference with light and sound.”
Asking employees what they are experiencing in terms of sleep and fatigue can be invaluable. Communicating back to them in terms of what employees have said and putting it in context in what that can mean for safety in the workplace setting helps. In healthcare, for example, medical mistakes can be highlighted.
“I’ve never been in a workplace where there weren’t simple mistakes that kept popping up, that everybody knows about. Those are likely to be worse with sleep deprivation,” Kertay said. “Using those examples is probably a good intervention.”
Providing wearables for workers to track their sleep is also advised, where possible. Even if the devices are not completely accurate, just wearing it makes people pay attention to what improves their sleep patterns.
“That’s where I would start,” Kertay said. “Ask, [provide] feedback, shape interventions in such a way that people begin to pay attention to their degree of restfulness.”
Kertay’s other strong piece of advice: encourage and enable cat naps.
“There’s a lot of discussion about cat naps [and] the benefit of 15-minute naps, which interesting enough has a better impact on performance than a 50-minute nap because there’s a lot of inertia coming out of sleep if you sleep longer,” he said. “Cat naps – and providing space for that, if appropriate – can be a really effective intervention revitalizing people throughout the course of the day, especially people who have to work longer shifts.”