Fatigue and the Transport Industry

Here is an interview from ABC Radio National in 2011 that is really great.

We recommend that you listen to the full interview if you can.

Why?

Because according to sleep expert Professor Drew Dawson, Australians have the greatest percentage of workers working over 55 hours a week in the developed world.

Additionally, Australians have the second highest average working hours anywhere in the world.

This excellent discussion covers a few of the burning questions that many people are not aware of, or denying, when fatigue is discussed. Such as:

1. Why the fatigue rulings are ignoring how people ARRIVE at work. All the concentration is on how many hours workers have been working etc – nothing about what condition they arrive at work in the first place.

2. How is fatigue defined as the cause of an accident – e.g. road accident. Very interesting to know that it isn’t called fatigue unless it is a single vehicle accident, which makes it very unlikely to occur within 100 kilometres of a post office. It is not called fatigue if the driver is killed, etc. It is the definition of fatigue that varies within states that makes the figures vary significantly – e.g. from 5 percent to 30 percent for fatigue related accidents. And it’s not counted as fatigue if an accident happens at 10 am. Hmmm, they are just some of the examples.

3. How the introduction of cruise control brought on driver disengagement – and resulted in accidents going up. The trucking companies that had previously installed cruise control were then very busy taking it out of trucks.

4. Recognition by Simon Smith, researcher at the Queensland University of Technology, that the work starting time can make a measurable difference to accidents and performance at work. e.g. getting up at 5 am or 6 am (I can personally relate to the 5 am wake up problems, not my circadian rhythm preference!).

It is hard to believe in 2013-4 I’m continually being asked by fatigue “experts” and trainers “What has fatigue got to do with sleep?”, and “what has sleep got to do with work”?

If it wasn’t killing people daily, these questions might seem like jokes.

Finally the comment made by Drew Dawson that about half the time people are fatigued at work its due to factors OUTSIDE OF WORK.

For people with a clue this statement seems very obvious. Duh! But with my experience when talking to organizations, businesses, schools etc I’m so glad that the statement was made!

Of course part of that “outside of work” activities must include quality sleep for every person.

Here’s the link to the full interview:

http://www.abc.net.au/radionational/programs/backgroundbriefing/fatigue-factor/2948418

Cognitive Behavioural Therapy for Anxiety and other Psychological Problems

I’m putting together my new training product working in conjunction with medical doctors in Australia at the moment.

In the process of talking about the solutions to psychological problems such as anxiety and depression I have found that the excellent SBS Insight Television program that was dedicated to anxiety was on YouTube.

So I have included it here, so that you can watch it.

Anxiety – “the most treatable of all the mental disorders” – Professor Gavin Andrews.

The whole show is excellent, but it you just want to get straight to the bit where Prof. Andrews talks about his online clinic move to minute 34 to save time.

Sleep Paralysis

Recently I have spoken to a number of people who suffer from sleep paralysis, which is when you are conscious, but your body is paralysed at the time. This occurs for some people when they “wake up” from sleep, but find they can’t move.

The reason behind the problem is not totally understood. What it does appear to relate to is some dysfunction between the awake state, and the paralysis that normally occurs while we are asleep (such as during REM sleep so that we don’t act out our dreams while we sleep). So, for example, a difficulty coming out of REM into the awake state.

It has the same characteristics as narcolepsy, with some experts distinguishing the two only by whether it occurs while you fall asleep (sleep onset)or when you are waking up. Wikipedia states that 30% – 50% of people who have been diagnosed with narcolepsy have experienced sleep paralysis.

I’ve also heard some evidence that it might relate to a previous trauma, though my questioning of people has not shown that explanation to be always the case, only in some cases.

The length of the paralysis varies. Luckily it often only lasts for a minute or two. But the paralysis can last longer.

It is generally extremely stressful for the person, as they feel trapped within their bodies and can’t communicate it to their partners to help them (by gently waking them up, for example) – if they have a partner there at the time.

A kind woman Wendy Buckingham shared with me that she has managed to make a noise, at the back of her throat, to communicate to her husband, so that he can gently help her to wake up.

She has contributed the following article to help readers of this blog with the problem.

This was a wonderful gesture, thank you Wendy.

So, here is Wendy’s story:

Sleep Paralysis Case Study

Sleep paralysis.

It’s mysterious; it’s exhausting and it’s scary. My first experience of it was when I was meditating and I must have dozed off. I became aware of everything around me but couldn’t come out of it into full body consciousness. I wished the phone would ring or someone would come in. Eventually of course, I did come out of it – I always do – but it left me wary of meditation for years.

Sleep paralysis has become more common for me over the years. Sometimes it happens often or even several times a night and then there might be a gap for months. Sometimes it can be prompted by a stuffy nose, other times by the way I am lying and a lot of the time none of those – it just happens.

The process takes two different scenarios.

The first is where I am dreaming and suddenly become aware that I am asleep and need to wake up. I can’t move and struggle. I have the thought of just relaxing into it again but that is terrifying. There then follow what feels like a life and death struggle to regain consciousness and when I do finally wake up my heart is pounding and I’m exhausted. And sometimes I seem to slip back into the paralysis so easily that the only solution is to get up and walk around for a bit.

The second scenario happens just as I am falling asleep. I become aware I am sinking into sleep and then again the panic and need to wake up again sets and I fight to stay conscious.

Over the years, I have learned to alert my husband as to when sleep paralysis is happening so he can gently wake me up.

He says I sometimes tremble, which could be the effort of trying to move. But mainly I have learned to make a moaning noise at the back of my throat to alert him. It’s a bit like a hum but from the back of the throat rather than the front.

Try it. Hum or moan from the back of your throat. When my husband hears this he gently shakes me saying my name. Sometimes it seems to take ages before I wake up even though I can hear him calling my name and I want him to shake me.

But I always do wake up, whether or not there is my husband to help me. Yet there is always the fear that I won’t and sink into something terrible which, I guess, is death and it is a fear of survival.

Can You Contribute?

If you are reading this and you have experience with sleep paralysis we would love to hear from you. Please enter your comments below.

Rising Unemployment and Longer Working Hours Highlight Fatigue Policy Flaws

Media Release.  September 13, 2013.

This month the Health Services Union negotiates with the State Ambulance Service over rosters for regional paramedics, with fatigue as a major issue.  Earlier in the year the Industrial Relations Commission ratified an agreement to remove rosters that the union said required paramedics to be on call for 16 hours at a time, 7 days a week.  This month also marked the announcement by Canada’s energy industry of a set of guiding principles around rising workplace fatigue.

“With Australians now working more hours because of job security concerns, fatigue management at work is becoming a more important issue” says fatigue and sleep expert Elizabeth Shannon, “it translates to the bottom line in a myriad of ways such as errors, bad decisions, frayed tempers, memory lapses and increased absenteeism”.  There are 1.4 million shift-workers in Australia, with research showing that 56 percent of them are falling asleep on the job at least once a week.  The US National Highways Traffic Safety Administration calculated the average motor vehicle crash costs an employer $ 16,500.  When a worker has an on-the-job crash that results in an injury the cost to their employer is $ 74,000, and can exceed $ 500,000 when a fatality is involved.

Productivity and brain function problems fall into two broad areas, which can overlap:  fatigue (slowing down of performance which includes errors and accidents), and sleepiness (which relates to the individual’s daily natural sleep-wake circadian rhythm and the amount of sleep they are getting).

Psychological fatigue is caused when relentlessly doing the same task (such as driving a vehicle or placing trade transactions) eventually fatigues the neural networks and causes impairments such as crashing a car, or making an error in the transaction amount.  Fatigue is complicated by emotional stress such as anxiety, exhausted adrenals, trauma, urgency, negative thoughts, over-stimulating and challenging environments, even extreme temperatures and noise.

The sleepiness issue is compounded by anything that prevents people from sleeping properly at night such as inappropriate nutrition, lack of exercise, medical problems, age, and some medications.  If you get really sleepy the body can suddenly and involuntarily just put you to sleep.  The workers most at risk of falling asleep are shift-workers, frequent flyers crossing time zones and all workers that work in hours of darkness.  According to Dr Charles Czeisler of Harvard Medical School, 70 percent of people say they frequently don’t get enough sleep, with 30 percent saying they don’t get enough sleep every single night.

Shannon offers four cost-effective fatigue guidelines to introduce to your workplace:

  1. Capitalize on the light entering windows by placing desks nearby.  The American Academy of Sleep Medicine showed that workers who accessed an extra 173 minutes of light slept on average another 46 minutes at night.
  2. No member of staff should operate equipment and/or dangerous machinery, or drive a vehicle if they have been awake for 14 hours straight.
  3. Napping for periods of up to 20 minutes is allowed at work, and should be encouraged for shift-workers and all staff members who are working after midnight.
  4. No member of staff should catch a red-eye flight and then drive a car, under any circumstances.

Elizabeth Shannon can be contacted by phone + 61 458 41 4441 or email elizabeth@sleeplessnomore.com.  To download the complimentary Executive Function Report outlining the business and personal costs of fatigue visit http://www.sleeplessnomore.com/executive-function/

 

The Relationship between Better Sleep and Sunlight

We hear a fair bit about light and it’s relationship to melatonin – the sleep inducing hormone), but we hear a lot less about how sunlight can help you sleep.

Yes, HELP you sleep.

For people following this blog, you’ve probably heard me encouraging you to walk in the morning in the sunlight (in preference to other times) to send a strong message to your circadian rhythm that it is time to wake up, and that this is ‘morning time’.  And we’ve spoken about how sunlight can help your mood as well – especially for those of you who have combination sleeping problems and mental health challenges such as anxiety and depression.  They often go together.  And finally we’ve talked about getting some good Vitamin D.

Here is new research that is putting some specific numbers to this concept.

The American Academy of Sleep medicine has released the results of a study that show that workers with windows in the office received 173 more minutes of white light exposure during work hours, and slept for an average additional 46 minutes at night.

To read more, click in the link below.

http://www.aasmnet.org/articles.aspx?id=3943

So, keep up the good work with more light during the daytime.  It has also been shown to elevate mood and attitude.

Seems like those “office with a view” aspirations at work aren’t so silly after all.  Even without a view, just for the light and preferably some sun…

Best wishes for your health and happiness

Elizabeth

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Dr Charles Czeisler on Sleep Deprivation, Children Sleeping and Recreational Media

I have found a quality video on YouTube with Dr. Charles Czeisler of Harvard, called Sleep Deficit:  The Performance Killer.

So take 13 minutes out of your life to hear a bit of common sense from a man with some serious “creds” around sleep disorders.

In this video he states that:

  • 70 percent of people say they frequently don’t get enough sleep and 30 percent say they don’t get enough sleep every single night,
  • some children are so sleep deprived that they are distractible,  showing symptoms of ADHD but may not have ADHD,
  • fatigue makes it difficult to pay attention, impairs judgement and learning – and people have difficulty consolidating memories (which actually happens while we sleep),
  • 8,000 people die each year in fatigue related car accidents,
  • 1 in 5 motor vehicle accidents is caused by fatigue,
  • having a regular, set bedtime for children is highly recommended for them to have a good night’s sleep,
  • 70 percent of people have a television in their bedroom,
  • lights inhibit the production of melatonin, which is the hormone that helps trigger sleep onset,
  • children need 9 – 10 hours sleep a night, and they are presently spending far too much time on electronic entertainment,
  • coffee is addictive, and has a half life of 6-9 hours,
  • energy drinks are a $ 9 billion dollar industry (containing caffeine).

And the good news: Well rested individuals have

  • enhanced immunity to disease,
  • less tendency to put on weight,
  • reduced risk of diabetes,
  • live longer,
  • reduced risk of cancer,
  • faster reflexes,
  • enhanced performance.

Finally.  Napping is good.

Our Food Labeling Laws Need to Change

Here is Jamie Oliver’s TED speech on nutrition, diet and food.

Food labeling laws, obesity, food additives and diet are the ingredients of sleep disorders.

This guy is one of my heroes… I hope you “enjoy” it.

Performance Training and Corporate Services

Today I’m announcing Performance Training and Corporate Services in my sleep and fatigue services.

It was the recent release of a report, which will remain nameless, that made me realize just how trivial the sleep discussion still is in Australia – probably overseas too, but lets start here!

Here are some of the problems:

  • Most companies in Australia have inadequate Fatigue/Sleep Policies.  The leaders in fatigue policy are the companies and organizations that have correctly recognised the significant effect that fatigue can have on the operation of heavy machinery, truck driving, railway and transport workers etc.  However, the margin for improvement in companies that seek ‘top performers’ and ‘top performance’ is wide.
  • The Fatigue Management Legislation is way behind the game.  Too afraid to deal with the politically incorrect issues of medications, drugged, drunk and hungover employees and a myriad of other issues (yes, some definitely related to sleep and fatigue) – most companies would prefer to ignore the issue completely.
  • Fatigue and its associated physical and mental health conditions are costing companies, families, children and Australia a fortune.  Some of this is very well documented – tens of billions every year.  But still we continue to talk about it, and do very little to remedy the situation.
  • The Medical System in Australia is after-the-fact oriented.  5 per cent of the health budget is spent on preventative health solutions in Australia.  Sleep is a huge issue and related to many other physical and mental health conditions.  Where are the preventative trainings, or anything else, that relate to sleep and fatigue management and prevention?  The figures from the medical profession themselves, shift workers and ambulance workers in the hospitals etc are some of the most alarming available.  Are internship hours in hospitals where lives are at risk, for example, anywhere near “best practice”?  How is this allowed to continue?
  • Fatigue Management is dealt with in the Wrong Way at the moment.  In spite of the fact that the insomnia and sleep disorders are symptoms of an underlying issue, 95.2 per cent of people who visit their doctor with a sleep related issue are prescribed a medication by their doctor.  This, by the way, is against the recommendations of the National Prescribing Service.  But, well, what the heck!  Many of these medications are addictive, cover up the underlying problem, and cause the problem to get worse over time (not my words, by the way – see the NPS website itself).
  • Just about no-one is talking about the real solutions.  Which include exercise, nutrition, a positive lifestyle, etc.  Am I being cynical when I think that maybe there’s no money in hearing the truth?
  • Everyone wants a quick fix.  Hmmm – behind most of the problem, perhaps?  “Can’t sleep, pop a pill”.  People buy this story every day.  Even when they know it isn’t working.  You tell me?
  • No-one wants to hear the truth.  So you can’t sleep because you are totally stressed at work and you hate your job, your boss, your life?  So you can’t sleep because you are drug dependent and don’t know how to deal with that?  You can’t sleep properly and you might even have sleep apnea but you don’t want to lose weight, and ask for proper help to do that.  You can’t sleep because you are eating and drinking the greatest lot of rubbish that is arguably not even food every day?  You can’t sleep because you won’t even exercise every day for 40 minutes or so?  Etc etc.   But nope, the truth is far too hard to deal with – lets continue and ignore the problem till we screw up something else – relationships, health, secondary illness problems (there is a long list, see other posts), etc.
  • Legislation Denial.  Who cares that caffeine, sugar and colour-additive loaded drinks are being marketed and sold to our kids?  Who cares that there is MSG in foods but it is not shown on the labels, or it might be, but no-one knows that “that wording” actually means MSG.  And that’s just MSG, what about the other 30+ food additives that have been associated with sleep disorders?  Food labeling laws need an overhaul.  And what about sensitivities to other chemicals, such as VOCs and airborne chemicals, even flavourings in toothpaste that can effect sleep for those intolerant to them.
  • Psychological Problems.  Inadequately funded and managed.  A considerable factor in fatigue and sleep related issues.  And a whole lot more, of course.

Rant, rant, rant.

Ahem, glad I’ve got some of that off my chest.

So, if you would like to know more – if you think your company would benefit from having your key personnel productive, alert, and happy at work and driving home from work, then email Elizabeth at elizabeth@sleeplessnomore.com to see how she can help change the situation and increase productivity and profitability for your company or organization.

Even if you would like us to walk you through some of the bottom line costs (I promise this is not a ‘soft’ management issue) we’d be happy to help.  Everything from the proven loss of executive function, the 56% of shift workers that fall asleep on the job at least once a week, the most accident prone times of the day (when maybe you should have your staff do something else), the percentage of your staff members taking medications for sleep, (anxiety and depression – also sleep-related), etc etc.  Do you have shifts at your workplace that are equivalent to having your employees working at a concentration level the equivalent of being legally drunk.  These statistics are now available, ignorance is no longer an excuse.

There are a myriad of simple, proven ideas that are easy to implement.  Education is a big factor in people being able to help themselves with these issues.

One less accident at your workplace per year, or a few less absentee or presentee days, will pay for the cost of changing your systems and educating your staff.

Help your top performers do that,

Elizabeth

elizabeth@sleeplessnomore.com

 

Researching Sleep Over the Decade

Hi Everyone

Some of you might have noticed how this site has evolved over the years – since it’s beginnings in 2002.

Back then I was focused on the Compatibility Blanket, the blanket we invented to help partners who argued about the amount of bed-coverings they had on the bed – because one partner is often hotter than the other in bed.  You know how it happens, if you’re the cooler partner you are continually sleeping under whatever ‘junk’ bedclothes your partner has pushed over to your side.  Or if you are the hotter one, you’re hanging your leg out the side of the bed to get cool, or finding it very hard to sleep properly.

Overheating in bed reduces the quality of your sleep.

After finding this information, and experimented with it myself, I began the journey to find out what else we didn’t know about better sleep.

The next phases included a mail order catalogue selling items that might help people sleep better naturally (remedies, oils etc), while continuing to research sleep.

I have been interested in alternative health as well as main stream health for many years – but it was difficult (and still is, often) to find empirical evidence and clinical trials to support some of the processes and systems that either don’t work, people “believe” work, or they simply do work.

Some solutions appear to work without any supporting evidence.

My research appeared to be getting more and more obscure, trying to find the latest information from a neurological perspective, evidence that certain non-drug solutions actually worked, etc.

Here’s where it gets interesting.

Whatever the science and technologies, natural, drugs, and otherwise – what I’ve found just talking to people is a lot of the underlying real, human, life issues are not being addressed when people have sleeping problems.

People just want to pop a pill, or have an instant fix, without actually getting to the underlying cause of the sleep problem.  It’s never going to work that way, sorry.  I know no-one wants to hear that, but …

I’ve spoken to many people over the year who can’t sleep because of relationship problems, bad diet, little or no exercise, a job they hate, they’re really overweight, they have a ridiculously stimulated lifestyle, no play time, etc.

So, it’s like I’ve come full circle on it all.  Yes, some of the issues can be as basic as overheating in bed (I still have people who improve their sleep when they dump their heavy doonas/duvets).

The trouble is – lack of sleep becomes a vicious cycle.

We’re tired, then we get grumpy, then we start having relationship problems, and get depressed.  Or we’re tired and we eat chocolate and drink too much coffee to keep us awake – then we start putting on weight, don’t feel so motivated to play sport of any kind, then we start snoring, maybe develop breathing problems, even sleep apnea.  Not good.

Sound familiar?

So before you take any medications, natural or otherwise, have a little sit down and list a few things in your life that are getting you down, making you fat, hurting your feelings, or stopping you from relaxing and make a strategy to solve those things.

Each week address one.  Maybe diarize it for Wednesday’s each week.

Next Wednesday I’m going to book for a weight reducing program.  The week after that I’m going to start a fun sport with some friends. After that I’m going to have that “deep and meaningful” conversation with my partner about what improvements I’d like in our relationship.  The week after that I’ll get a cleaner in for one hour to help me with the extra work since my new baby arrived.  Etc, etc.

Small change by small change – whatever yours might be.

It’s often the simple things that are keeping us anxious, feeling bad, and stopping us from getting enough sleep.  When we are happy and relaxed we often sleep just fine.

One last word, if you have trouble falling asleep, and I know a lot of you do, don’t convince yourself that you have a ‘problem’.   It commonly takes people a little while to fall asleep – especially if they’ve just been doing something proactive, watching scary/violent stuff on television, working on the computer etc.

Turn the lights down early and put some soothing music on instead.

Here’s where you’ll find more information about the Compatibility Blanket.  For those of you who haven’t been around that long.

Sweet dreams

Elizabeth

P.S.   Does any of this make sense for you?  Put your comments below: