Welcome to Focus on Fatigue!
Here at Focus on Fatigue we spend a lot of time talking about the benefits of getting enough sleep and how everyone, shift workers and non-shift workers alike, should make sleep a priority. But what about those times when you have the opportunity to sleep but the sandman fails to show up? This can result in frustration and worry, especially as the minutes continue to tick by. In this issue of Focus on Fatigue we’ll be looking at insomnia: what it is and what shift workers can do to prevent it from becoming a problem.
The FRMS Team
InterDynamics Pty Ltd
320 Adelaide Street Brisbane Qld 4000
Tel +61 2 8404 0400 Ext 23
Views expressed in articles and links provided are those of the individual authors, and do not necessarily represent the views of InterDynamics (except where directly attributed).
Insomnia and Shift Work
We’ve all experienced nights when we can’t get to sleep, no matter how long we lie in bed wishing it would happen. Other times we’ve woken up hours before dawn and not been able to go back to sleep. For some people, however, these sorts of sleeping difficulties are a nightly struggle and this is when the term ‘insomnia’ comes into play. Around 6% of the adult population meet the diagnostic criteria for insomnia. For shift workers, however, estimates rise as high as 20%. Insomnia is also a major component of shift work disorder.
Consequences of insomnia
The consequences of insomnia are varied, including psychosocial, occupational, health and economic repercussions. While those who suffer from insomnia are faced with the same symptoms as anyone experiencing sleep deprivation, such as daytime sleepiness and irritability, the long-term nature of insomnia introduces more far-reaching problems. Insomniacs tend to take more frequent sick leave and use health care resources more often. There is an increased risk of accident and, over time, an increase in the risk of developing depression, anxiety, and substance-related problems. In recent research, the sleep deprivation experienced in sleep disorders such as insomnia has also been linked to an increased risk of Alzheimer’s disease later in life.
How much sleep are insomniacs really getting?
One surprising finding of insomnia research is that most (but not all) people who suffer from insomnia have a surprisingly limited ability to accurately estimate the amount of sleep they’re getting. They will often overestimate their sleep onset latency (how long it takes them to fall asleep) and underestimate their total sleep time (compared to objective measures of sleep such as a polysomnograph). In contrast, normal sleepers are usually able to perceive their sleep more accurately. A review of the research surrounding this issue concluded that such misperceptions are likely caused by misinterpreting sleep as wakefulness, worry causing a distortion in perceived time, and an increase in brief awakenings in the initial onset of sleep. These misperceptions regarding sleep do not, however, decrease the distress caused by the disorder; nor does it relieve the adverse outcomes associated with it.
Preventing insomnia in shift workers
A recent review of non-pharmacological preventions for fatigue and insomnia in shift workers included the following interventions:
- Napping – A 20-minute nap during a shift can improve alertness, vigilance, reaction times, and performance and decrease the risk of accidents. Although, sleep inertia should be taken into consideration upon waking.
- Nutrition – The use of caffeine at the start of a shift can be helpful, as well as high-protein meals and maintaining a wholefood diet. Regular normal day and night eating patterns should be maintained wherever possible.
- Light – Planned exposure to bright light can assist shift workers in making adjustments to their internal clock to reduce sleepiness during work shifts.
- Lifestyle training – Holistic training programs can help give shift workers tools to cope with the challenges of shift work, including good nutrition, managing fatigue, and sleep hygiene.
- Cognitive and behavioural interventions – A variety of behaviours, such as exercise, can help to prevent insomnia. Shift workers can also use interventions such as timing their work breaks, social interaction during breaks, and sensory stimulation.
- Vallieres, A., Azaiex, A., Moreau, V., LeBlanc, M., and Morin, C. (2014) Insomnia in shift work. Sleep Medicine, 15(12), 1440-1448.
- Belcher R, Gumenyuk V, Roth T. (2015) Insomnia in shift work disorder relates to occupational and neurophysiological impairment. Journal of Clinical Sleep Medicine, 11(4), 457–465.
- Harvey, A. and Tang, N. (2012) (Mis)Perception of sleep in insomnia: A puzzle and a resolution. Psychological Bulletin, 138(1), 77-101.
- Richter, K., Acker, J., Adam, S., and Niklewski, G. (2016) Prevention of fatigue and insomnia in shift workers—a review of non-pharmacological measures. The EMPA Journal, 7(16).
In the News
Provided below are a selection of articles from around the web on the issues associated with fatigue. We hope you find them useful and interesting.
J. P. Lawrence (24 June 2017) San Antonia Express News
A new study on sleep suggests the best way to cure insomnia is to get out of bed. Often those with insomnia spend long hours in bed, but few actually spent sleeping. Spending more time tossing and turning can actually make insomnia worse, because over time, people begin to associate bedtime with frustration and anxiety, the researcher said.
PictureFit (26 January 2017) YouTube
Learn about insomnia and how you can fix it today. Insomnia is a huge problem for many people around the world. Roughly 95% of all Americans deal with insomnia in one point of their lives. It’s time to fix it and get a good night’s rest!