Not Enough Sleep: Managing Fatigue

How many times have you come to work tired?

Fatigue management and managing worker fatigue as a result of outside forces is a constant challenge for employers. Especially when the work that tired employees perform is high risk. Insufficient or disrupted sleep results in numerous workplace and driving accidents as well as adverse mental and physical health outcomes.

For this article, we review a recently published paper that investigates fatigue management strategies to ensure employees obtain adequate sleep. Sleep schedules, work breaks, modelling and monitoring tools, fatigue detection technologies, and pharmacological countermeasures can be implemented at home and/or in the workplace to reduce performance and safety hazards.

Inadequate Sleep Leads to Fatigued Workers

Sleep experts recommend 7–9 hours of sleep per night but many adults fail to achieve these regular sleep hours.

High workplace demands, long work hours, lengthy commutes, disrupted circadian rhythms, social and societal demands, and insufficient sleep lead to tired workers.

Sleep is especially a problem for workers in production, health care, protective services, transportation, and food services mostly because of the high levels of shift work in these occupations.

Sleep quality, sleep quantity, sleep timing, the amount of wake time since the last sleep period, and recovery from long stints of duty are critical determinants of waking performance and associated safety.

Failure to obtain adequate sleep per day and remaining awake for longer than 16 continuous hours, significantly reduces both alertness and performance.

Reduced sleep leads to adverse effects on cognitive performance including reduced vigilance, increased lapses of attention, short term memory degradation, and deficits in frontal lobe functions. Remaining awake on any single occasion for more than 24 hours reduces reaction time, attention, memory, and decision making.

Importantly, employees who experience 5 nights of severe sleep restriction will not fully recover after a single night of 10 hours of sleep.

Inadequate Sleep Affects Worker’s Mental Health

Inadequate sleep has a direct effect on our mental health.

When we’re tired we fail to express our emotions effectively, in that we fail to recognise others’ emotions and we have an increase in our own emotional response in that we can either overreact or underreact to situations.

Sleep deprivation leads to increased irritability, anger, and hostility. Lack of sleep creates overreactions to problematic events and reduced friendliness, happiness and empathy. Sleep-deprived individuals are less able to appreciate humour and are worse at resolving interpersonal conflicts.

Lack of sleep has been associated with an increase in mood disorders, including depression and post-traumatic stress disorder. People who suffer from insomnia are at elevated risk for depression, anxiety disorders, alcoholism, substance misuse, and nicotine dependence.

Read our article, Does Mental Fatigue Impact Worker’s Hazard Detection?

Inadequate Sleep Threatens Productivity and Safety

Inadequate sleep can have a negative impact on workplace safety.

Lack of sleep leads to reduced attention, memory, decision-making, vigilance, reaction time, mood, arousal, and emotional/affective regulation.

Insufficient sleep negatively impacts blood pressure, work capacity and productivity, and physical performance reaction time.

Several studies of night shift work suggest errors are more likely to be related to time-of-day than to time-on-task, with the greatest risk occurring in the early morning hours, coinciding with the circadian period of peak sleepiness.

Strategies to Manage Fatigue

There are a number of strategies that can be used to manage workplace fatigue and encourage good sleep habits for employees.

1. Educate – It is critical that employees learn about the dangers of fatigue and the importance of obtaining adequate sleep. They need to understand that full recovery from fatigue may take longer than anticipated and that good sleep habits are essential for ensuring optimal sleep quality.
2. Optimise sleep opportunities – It is important to keep consistent bedtimes, to use the bedroom only for sleep-compatible activities, to resolve worry issues to minimise sleep-disrupting thoughts (e.g., write a list with actions before bedtime), to exercise regularly, but not too close to bedtime, to create a dark, quiet, cool and comfortable sleep environment, to manage caffeine and alcohol intake, and to avoid smoking just before bed.
3. Avoid watching the clock – If sleep does not occur in 20 minutes get up, go into another room, and engage in something boring (or at least something that is not stimulating) until you begin feeling sleepy, at which time return to the bedroom and try to fall asleep in bed once again.
4. Napping – A nap during long periods of continuous wakefulness can significantly improve alertness and performance. Taking a nap during the day before an all-night work shift will improve performance over the night compared to not napping. However, sleep inertia occurs immediately after waking from a nap where feelings of grogginess and reduced cognitive and motor performance can occur. When napping is proposed as a fatigue countermeasure and skilled performance is required immediately following the nap, allow 30 minutes for sleep inertia to dissipate.
5. Short rest breaks – Encourage employees to stand up and move about every 45 mins-1 hour to change their posture and provide a mental break from the task.
6. Adequate lighting – Blue light appears to be especially effective at enhancing alertness. However, blue light is detrimental when trying to sleep. Blue light-blocking glasses can be worn or blue-blocking apps can be used at night when using electronic devices.
7. Behavioural strategies – Stimulus-control therapy creates positive associations with bedtime and strengthens the association between sleep and the bedroom. Progressive muscle relaxation reduces physical tension whereas imagery training focuses on reducing intrusive thoughts and mental tension. Mindfulness meditation can reduce sleep-related arousal, or anxiety, by increasing positive mental and physical states.
8. Medications – When sleep is difficult, prescription sleep aids may be the only way to get a good night’s sleep. Generally, sleep aids are intended for short-term use when other options are not adequate. There are numerous prescription options available, along with herbal remedies and acupuncture treatments to enhance sleep.

Read our article, Strategies to Manage Workplace Fatigue.

Fatigue Monitoring Technologies

Implementing a formal fatigue management programme demonstrates that the risks resulting from sleepy employees are recognised.

Key procedures to reduce fatigue should be integrated into an overall programme that ensures: that employees are getting sufficient sleep; are monitored for fatigue-related issues including sleep disorders; controls are in place to minimise the impact of fatigue-related errors that occur, and these procedures are periodically assessed to ensure their effectiveness.

Organisations whose employees spend time a lot of time driving, often turn to technology to monitor fatigue and an example is a vehicle-mounted fatigue management system.  However, despite almost three decades of research on technological strategies for monitoring driver fatigue in near real-time, the usefulness of such approaches is questionable because there is limited evidence of the success of their operational implementation.

An alternate technology for evaluating basic sleep parameters is wrist-worn sleep/activity monitoring via smart devices. Wrist-worn activity monitoring records the frequency and time-course of body movements and processes this information to provide measures of sleep quantity, sleep quality, and sleep/wake timing.

Other methods, such as bio-mathematical models are increasingly being used in fatigue management programmes. These models use a set of integrated equations to predict fatigue levels based on factors including recent sleep quantity, sleep quality, sleep/wake timing, the current time of day (during work shifts), and sometimes they include workload.

Read our article, Does Mental Fatigue Impact Worker’s Hazard Detection?

How Can We Effectively Train About Fatigue?

TIS has interactive safety training courses that include detailed education on fatigue across a number of high-risk industry scenarios. These safety training courses can be completed in 15 minutes and can easily be added to your existing induction, onboarding and refresher training courses via a simple URL integration.

See our dedicated fatigue-related courses, Fitness For Work, Heavy Vehicle Solo Driver Fatigue Management, Workload and Burnout and Fatigue Management.

We can even customise the courses to suit your specific needs. Contact us today to learn more.