sleep better to live better: why sleep matters bob mitchell, lpc may 29, 2008

Sleep Better to Live Better:Why Sleep Matters

Bob Mitchell, LPCMay 29, 2008

Bob Mitchell, LPCMay 29, 2008

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Objectives

To understand:• importance and

meaning of good sleep

• systems that control sleep

• mechanics of sleep• factors that affect

“good sleep”• sleep debt

• consequences of sleep debt

• resolving sleep debt and maintaining sleep

• sleep and the workplace

• healthy sleep hygiene

• role of EAP

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Importance of Sleep

Vital to:

• health and well-being

• our careers

• our marriages

• all aspects of our life

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Importance of Sleep

• rejuvenates

• re-energizes

• restores

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Meaning of Good Sleep

Quantity of sleep• varies across

populations• base sleep need• sleep debt• adults need 7-8 hours

per night• teens need 8.5 to 9.25

hours

Quality of sleep• continuous and

uninterrupted

• lifestyle factors

• work schedules• stress levels

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Systems That Control Sleep and Wakefulness

Homeostasis• blood pressure

• body temperature

• how much we sleep

• adenosine

Circadian rhythms• brain’s biological clock over

24-hour period

• regulates sleep/wake

periods during day

• triggered by light

exposure

• jet lag

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Mechanics or Stages of Sleep

NREM

• 4 stages of NREM

• little or no eye movement

• little or no dreaming

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Mechanics or Stages of Sleep

Stage 1 NREM• eyes closed

• easily aroused

• hypnic jerks

• brain wave changes

Stage 2 NREM• light sleep

• no eye movement/dreaming

• BW fluctuations

• HR and body temps decreases

• prep for deep sleep

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Stages of Sleep

Stages 3 and 4

• slow wave or delta wave sleep

• deep sleep

• disorientation

• sleep inertia

• body repairs and regenerates

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Stages of Sleep

REM

• 20-25% of total sleep

• 90-120 minutes

• 4 or 5 periods

• dreaming

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Factors that affect

“good sleep”

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Factors That Affect “Good

Sleep”

Medical

• integral to healing

• pain awareness/more

drugs

• increased confusion

• chronic diseases

Alcohol

• disrupts delta

• creates REM rebound

• aggravates sleep apnea

• up to 6 hours before bed

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Factors That Affect “Good Sleep” (cont.)

Caffeine• moderate dose: 250 mg.

• blocks adenosine

• adrenaline

• long half life

Illicit and over-the-counter• nicotine

• weight loss medications

• HBO

• antihistamines

• anticonvulsants

• bronchodilators

• estrogen

• MAO inhibitors

• SSRIs (such as Prozac)

• thyroid hormone

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Factors That Affect “Good Sleep” (cont.)

Mental health• insomnia contributes to the development of mental

health issues • insomnia routinely targeted for treatment

– 2-10x risk of developing major depression– anxiety and SA disorders

• substance abuse disorders• mood disorders• anxiety disorders• psychotic disorders

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Sleep Debt

• not enough “good” sleep

• cumulative sleep debt reduces:

– sustained attention

– cognitive speed and accuracy

– reaction time

• lack of awareness of deficits

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Consequences of Sleep Debt

• monetary cost

– $30 billion

• human cost

– 100,000 crashes

– 71,000 injuries

– 1,500 fatalities

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Resolving Sleep Debt

• 2 hours weekend sleep for 1 hour missed

• nap

• earlier bedtime

• medications

• follow healthy sleep hygiene regimen

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Sleep and the Workplace

“Good sleep”• restores

• rejuvenates

• refreshed

• alert

• keeps relationships positive

• timely projects

• punctual

Sleep Debt• fatigued

• enervated

• less punctual

• project tardiness

• “grouchy”

• problems with co-workers

• problems with supervisor

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Sleep and Unique Workplace Issues

Extended shifts

ruled out:

• accident frequency high

• high physical workloads

• overtime expected

• expectation to work days off

Extended shifts

considered:• evaluate schedules before

and after• long-term monitoring • hybrid schedules used

effectively• consider cross training

and job sharing

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Sleep and Unique Workplace Issues (cont.)

Early/late shift start times

• changing from 6 am to 7 am

• 7 am to 9 am on one shift system

• 24 operations: 7:00 am +/-

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Night Shift: What a Company Can Do

Night shift

• avoid use of overtime

• frequent rest breaks

• “hard” tasks left to evening or day

• variety of hot and healthy foods

• lunch break at consistent time

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Night Shift: What a Company Can Do

Make your workplace safer• educate• install bright lights in the work areas • schedule shifts to allow sufficient breaks and

days off • develop a napping policy • be concerned about employee safety going to

and from work

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Night Shift: What an Individual Can

Do

Shift worker tips

• minimize exposure to sun

• keep consistent sleep schedule

• get friends involved

• postpone house work or repairs

• do not disturb sign on door

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Bedtime Rituals: Shift Worker

Bedtime rituals

• warm bath

• lower room temperature

• avoid stressful activities

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Light

• darken bedroom/bath

• light blocking/sound absorbing curtains/shades

• eye shades

Sound• ear plugs

• white noise machine

• carpets

• disconnect phone

Bedtime Rituals: Shift Worker (cont.)

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Healthy Sleep Hygiene

• regular sleep and wake patterns

• appropriate amount of time in bed

• avoid napping

• avoid stimulants

• exercise

• avoid food before sleep

• get adequate exposure to natural light

• bedtime routine

• sleep environment pleasant and relaxing

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“I haven’t slept since October.”

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“Me either!”

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Sometimes we get good sleep when

things are going our way.

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The Role of the EAP

Evaluate• Ok to profile

• avoid assumptions

• ask for specifics

• sleep schedules

• substance interference

• lifestyle related

Educate• EAP affiliates

• supervisors

• employees• Sleep Better to live

Better CD • Handouts and Tools

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