So, you think how your staff sleep is none of your business? It’s about time we woke up to the importance of having a well-rested workforce. The view that ‘sleep is for wimps’ is a nonsense, and potentially dangerous.
British workers put in more hours than any other European nation, but still have low levels of productivity, and the reason for this may be staring us in the face. We are exhausted. We work long hours, and arrive home late. We don’t give ourselves time to unwind, perpetuating the cycle of poor sleep. British workers not only work longer than their European counterparts – they also have the highest rates of insomnia.
Poorly designed shift patterns, and long working hours that fail to balance work time with rest and recovery, can lead to fatigue, accidents, injuries and ill health. Shortage of sleep affects not just safety and the risk of accidents, health (physical and mental), but also productivity and creativity.
Fatigue is generally defined as a decline in mental and/or physical performance caused by prolonged exertion, sleep loss and/or disruption to the body’s internal clock. It is also linked to workload: workers are more prone to fatigue if their work is machine-paced, complex or monotonous.
Fatigue slows reactions, and reduces the brain’s information processing ability. It causes memory lapses, absent-mindedness, lower awareness and a fall in attention span. Importantly in a work environment, it also leads to risks being underestimated, reduced co-ordination and poor judgment calls. The result can be errors and accidents, ill health and injury. Another victim is productivity. Crucially, fatigue is often a root cause of major accidents, with examples including the sinking of the passenger ship the Herald of Free Enterprise, the Chernobyl nuclear disaster, and the Exxon Valdez environmental catastrophe. The Three Mile Island meltdown in 1979 and the aborted launching of the Challenger space shuttle were also both attributed to tired staff. In statistical terms, fatigue is implicated in 20% of major road accidents; it is calculated to cost the UK between £115 million and £240 million annually in work accidents alone.
What complicates sleep issues is that they can be interlinked with so many other conditions, all of which can affect our performance at work. If we don’t get enough rest, we build up a harmful ‘sleep debt’.
Obstructive sleep apnoea, which disrupts the breathing of sufferers whilst sleeping, is the most common cause of daytime sleepiness, and is directly linked to being obese. Currently, just over one-third of Britons are overweight, but this problem is predicted to get more severe as workers become increasingly sedentary. Not only is the immediate result of such disturbed sleep tiredness and irritability, it is also associated with heart disease and depression.
There are more than 80 known sleep disorders, from not being able to get to sleep to the inability to stay awake, yet staff can be labelled as being lazy or leading inappropriate lifestyles. All of these conditions can be suitably controlled, given the right treatment.
Other contributing factors include smoking and excessive alcohol, and failing to exercise is all part of the mix. Poor sleep places you at high risk of many other major illnesses. It affects energy, relationships and overall wellbeing.
In a study of more than five million people, a shortage of sleep was linked to diabetes, high blood pressure, cardiovascular and coronary heart disease, plus obesity. Even depriving people of sleep for a few consistent nights damages the body’s ability to control blood glucose levels. Vaccines are less effective; immune systems are more open to infection. One study concluded that fewer than seven hours of sleep increased the chances of catching a cold by a factor of three.
Studies around the world into the occurrence of diseases come to much the same conclusion. Short sleepers and long sleepers are more likely to suffer from a range of ailments, and have shorter lives. Too little sleep at the wrong time of day is linked to diabetes and obesity. NHS statistics show that shift workers are more likely to have “fair to bad” general health, and “limiting longstanding illness” with the Office for National Statistics figures showing them taking significantly more time off sick. Lack of sleep seems to have a greater effect on non-manual workers in sedentary jobs. Whether a loss of sleep is the symptom of less healthy lifestyle is hard to judge.
There are many reasons why people are unable to sleep, or can’t get the hours of sleep they need. The causes are often outside the workplace, but the effects are felt at work and may impair an employee’s ability to carry out their duties. Work can also cause excessive stress, which may lead to sleep deprivation or poor sleep. In some sectors, this can present a risk to the safety of colleagues or members of the public.
The received wisdom is still that eight hours’ sleep a night is about right. In general, people who sleep for fewer than six hours a night are termed short sleepers; those getting on for 9 or 10 hours are long sleepers. Poor sleep and poor health feed off each other. Less fit people tend to exercise less and sleep poorly, becoming exhausted and less inclined to exercise in a vicious circle. Chronic sleep deprivation, defined as under-sleeping by an hour or two every night over a consistent period, has been linked to poor health outcomes.
Employers have a legal duty to manage risks from fatigue and sleep deprivation, irrespective of any of their workers’ willingness to work extra hours, or preference for certain shift patterns. Employers have a duty of care to protect not just the health, safety and welfare of their workers, but any other people who might be affected by their business. The following general principles apply.
- Health and safety law requires employers to consult with their employees on all matters of health, safety and welfare. They can do this either directly or, if there are health and safety representatives, through them. Employees may prefer certain shift patterns that are unhealthy and likely to cause fatigue. The HSE are keen on consultation, but their preferences shouldn’t be granted automatically if they are unhealthy or cause fatigue. A wiser approach is to have limits on working hours, overtime, shift-swapping and on-call working. This must be monitored and enforced, perhaps with a robust hours recording system.
- The Working Time Regulations 1998 (“WTR”) lay down the minimum legal requirements on how to organise working time. Employers are required not just to satisfy the provisions of the WTR, but to proactively consider fatigue a risk factor in their business like any other health and safety risk. Whether the business involves major hazards or not, employers are required to set up appropriate systems to control potential causes of fatigue, such as shift patterns and excessive overtime. Some sectors (such as aviation or HGV driving) have specific regulations to guard against fatigue.
- The legal duty is on employers to manage risks from fatigue, irrespective of any individual’s willingness to work extra hours, or preference for certain shift patterns for social reasons. Employers have a legal duty to manage fatigue risks, even when employees are keen to work overtime, drive for long hours creating a long working day in preference to booking into a hotel or B&B over night, or request specific shift patterns for social reasons.
- Employers who ignore the importance of encouraging staff to get sufficient sleep could land themselves in hot water, under the Corporate Manslaughter and Homicide Act.
Key Principles in fatigue
- Fatigue needs to be managed, like any other hazard.
- It is important not to underestimate the risks of fatigue. For example, the incidence of accidents and injuries has been found to be higher on night shifts, after a succession of shifts, when working hours are long and when there are inadequate breaks.
- Changes to working hours need to be risk assessed. Consider HSE guidance, such as the Fatigue and Risk Index Tool, a risk assessment method for use with rotating shift patterns.
- There are many different shift work-schedules, and each schedule has different features. This sheer diversity of work and workplaces means that there is no single optimal shift system that suits everyone. However, a planned and systematic approach to assessing and managing the risks of shift work can improve the health and safety of workers.
- There are a number of key risk factors in shift schedule design, which must be considered when assessing and managing the risks of shift work. These are the workload, the work activity, shift timing and duration, direction of rotation and the number and length of breaks during and between shifts.
- The WTR require employers to offer night workers health assessments – although they don’t have to accept.
- Consider people with underlying health conditions that may seriously affect their sleep patterns, including women undergoing a difficult menopause.
What can Management do to improve workers’ sleep?
Organisations should protect employees against the worst effects of exhaustion, especially in sectors where staff are required to drive, operate machinery, or expected to deal with considerable amounts of constant pressure.
- Understand the importance of sleep quality and recovery to your employees. Inform employees that you recognise the impact of sleep deprivation.
- Improve working styles – a long-hours culture leads to poorer sleep.
- Be aware that constant tiredness can be a symptom of serious illness.
- Consult employees about their sleep, and discuss any problems they experience, with a view to getting the right amount and quality of sleep.
- Suggest good sleep hygiene practices – see below.
- Ask employees what will help them, and encourage them to take the lead on implementing change.
- Identify the threats to good sleep in the workplace, and the problems your employees face.
- Develop a robust system of recording working hours, overtime, shift-swapping and on-call working.
- Conduct a workplace assessment for good lighting and ventilation.
- Where possible, maximise access to natural light. Research tells us that employees whose offices receive more sunlight sleep better and have higher levels of wellbeing
Employees also have a duty to take reasonable care of their own health and safety, and that of others at work that may be affected by their activities. Explain to them that while work is important, it isn’t everything, and taking time to relax, recharge and taking breaks are crucial.
There is also a difference between sleep and rest, people need to know that their lifestyle is important, and they need balance and enough sleep. Many employees have hectic social lives, and enjoy late nights. Sleeping too little during the week and trying to close the gap at weekends is another cause of feeling sleep deprived. The advent of laptops and mobile phones is making it harder for young people in particular to drift off. Blue light from electronic devices makes us feel less sleepy. Digital socialising also winds the brain up at a time when we should be winding down for a peaceful night’s sleep. The top tip from ‘Why We Sleep’, the bestseller by Prof. Matthew Walker, is to stick to a sleep schedule that involves getting up the same time each day regardless of what time you went to bed.
There have always been early-risers and night-owls; the advent of artificial light makes night-owls even more inclined to stay up comfortably, and alert into the early hours. Some 30% of us are morning people; another 30% are evening people. The remaining 40% are in between. We have limited control of our body clocks. Night-owls and late-risers can try to alter their habits by cutting their exposure to light in the evenings, while increasing their light exposure during the day.
Positive Measures – Provide knowledge
Include information and guidance on sleep and recovery for Managers and employees as part of a health and wellbeing strategy. Monitor how well it is working. Consider fatigue as part of the risk assessment process, particularly for hazardous activities such as driving. Advise drivers not to wait until it’s too late. Head nodding and eyes closing are not early warnings; they are signs they are falling asleep. Encourage everyone to take proper rest breaks.
Signpost Managers and employees to information about better sleep circumstances and recovery. We have drawn heavily on work by Business in the Community and Public Health England Sleep Recovery Toolkit published in February 2018. The HSE document – Good Practice Guidelines and their guidance about shift working is also a good reference guide. To quote Matthew Walker – “Sound sleep is sound business”.
Our Consultants would be pleased to advise you on any element of the issues arising from this newsletter.