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March 25, 2004

Sleep and safety make sound partners

A lack of shut-eye can lead to jobsite accidents

By RALPH PASCUALY
Swedish Medical Center

Photo courtesy of Swedish Medical Center

A technician fits a Continuous Positive Air Pressure device, which is often prescribed to sleep apnea patients to ensure they do not stop breathing during sleep.

Why should any company worry about how well its construction and transport crews sleep? For many more reasons than you might think. As a recent BusinessWeek article pointed out: “Lack of sleep makes people clumsy, unhappy, stupid and dead.”

Sound sleep is vital to good health and to peak performance in any line of work. Yet, according to the National Sleep Foundation, most Americans don't get the optimal eight hours of shuteye each day. In fact, 40 percent of people surveyed recently say they experience disruptive on-the-job sleepiness at least a few days every month.

Anyone who's ever worked construction knows it's often both physically and mentally demanding. Lifting heavy tools and materials, the constant motion of equipment, fatigue from noise and stress, elevated temperatures and other factors can all lead to weary workers. Add to that insufficient sleep — and maybe an undiagnosed sleep disorder — and you have the recipe for a possible workplace disaster.

Sleepiness breeds inattentiveness and that can lead directly to costly construction mistakes and, worse yet, to industrial accidents. Also, employee time loss can be increased because insufficient sleep often aggravates pre-existing conditions such as lower-back injury and pain.

Here are a few common concerns about sleep and construction work.

Snoring and sleep apnea. Most people think insomnia is the only sleep-related problem. But among adult males, especially those who are at or nearing middle age and have gained weight, the most frequent and severe sleep disorders are snoring and sleep apnea.

Often undiagnosed, apnea is a potentially life-threatening breathing condition affecting up to 20 million Americans. In addition to disrupting sleep, it is clearly associated with an increased rate of heart attack and stroke. Typical apnea symptoms include falling asleep while working or driving, early morning headaches, learning and memory difficulties, depression and irritability — all of which impair performance.

How to get a good sleep

Most people only need to make a few simple changes in their lifestyles to improve sleep-related health.

Get up about the same time every day.
Go to bed only when sleepy.
Establish relaxing pre-sleep rituals such as a warm bath, a light snack, or 10 minutes of reading.
Exercise regularly. If you exercise vigorously, do this at least six hours before bedtime. Mild exercise, such as simple stretching or walking, should not be done closer than four hours to bedtime.
Try to maintain a steady schedule. Regular times for meals, taking medications, doing chores, and other activities help keep the “inner clock” running smoothly.
Don’t eat or drink anything containing caffeine within six hours of bedtime.
Don’t drink alcohol within several hours of bedtime, or when sleepy. Tiredness can intensify the effects of alcohol.
Avoid smoking close to bedtime.
Avoid sleeping pills, or use them conservatively. Most doctors avoid prescribing sleeping pills for a period of longer than three weeks. And never drink alcohol with sleeping pills.

Heavy equipment and vehicles. If employees operate heavy equipment or drive vehicles on the job, supervisors must pay careful attention to signs of sleepiness or fatigue. Ignoring signals such as yawning, frequent blinking, general malaise or a failure to make routine safety checks can put one person (and potentially many others) at genuine risk.

If a worker is obviously drowsy, encourage him or her to stop work as soon as safely possible. Crew leads should quickly grant requests for a break or brief nap, and make caffeinated beverages available to help increase alertness. Caffeine, of course, is no long-term substitute for adequate sleep.

Shift work. In large-scale commercial and industrial construction, work schedules can be brutal — particularly in areas where there are no neighborhood noise restrictions. Every hour of every day must be put to productive use. Often that translates into extended, nontraditional shifts and less sleep for workers.

Many smaller-scale residential contractors have it even worse. Their days start very early on the jobsite and end with the late-night paperwork, purchasing, sales, payroll and billing. During the height of the building season, it's not uncommon for homebuilders to work dawn to dusk, six days a week.

If you or employees regularly pull more than one shift, don't try to sustain that for very long. And, if you rotate crew shifts frequently, make sure they progress forward from day to swing to night — or you risk upsetting the body's Circadian rhythm. Also, encourage swing- and night-shift workers to keep the same wake/sleep cycle on their days off.

Offsite liability. It's important to recognize that employers who have created production schedules that result in sleep loss can be liable for injuries away from the worksite.

In one recent high-profile case, a young construction supervisor's employer had huge financial pressures to get a manufacturing plant retrofitted and back online. After working 20 hours straight for several days in a row, the supervisor fell asleep on the way home and drove off the road. He suffered a serious head injury in the crash and was permanently disabled. In the civil litigation that followed, the young man's wife provided compelling testimony that her husband felt he simply couldn't say no to his employer.

For free copies of workplace posters and flyers on sleep health, contact the Swedish Sleep Medicine Institute at (206) 215-3899.

Dr. Ralph Pascualy is medical director of the Sleep Medicine Institute at Swedish Medical Center in Seattle.

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