Health Services Center Organizations 3333

1
Sleep Interventions for Corporate Occupational
Health Dr. Larry Clevenger, Director Sandia
National Laboratories Health, Benefits and
Employee Services
2
Outline

• Sleepy Nation
• Types and prevalence of sleep disturbances
• Problems related to sleep disorders
• Sandias Sleep Solutions Program
• How to manage the risk

3
A Nation of Sleepy People

• One in five adults report getting insufficient
  sleep
• Problems falling asleep or daytime sleepiness
  affect 35 to 40 percent of
• the population

More than 50 million Americans suffer from a
chronic sleep disorder
4
Common Sleep Disorders

• Sleep Deprivation
• Insomnia
• Sleep Apnea
• Restless Leg Syndrome (RLS)

5
Nature of Sleep Disturbance

• Sleep disturbance is a complex process which
  often involves both psychological and physical
  components
• Additionally, the tendency for sleep deprivation
  and disturbances is often a result of our culture
  and environment

6
Physical Components

• Oxygen Levels
• Nasal Airflow
• Allergies
• Co-morbidities
• Neurological conditions

7
Psychological Components

• Learned Behaviors
• Beliefs and Attitudes
• Emotional Distress
• General Stress
• Personality Styles
• Psychological Disorders

8
Environmental/Cultural Factors

• Sleeping is a waste of time
• Too much to do and not enough time
• Sleep is overrated
• Ill get plenty of sleep when Im dead
• I get more work done because I have more awake
  time

9
How much sleep do we need?
10
Impairment of alcohol vs. sleep loss
In New Mexico it is illegal to drive with the
breath alcohol concentration of .08
11
Consequences of Sleep Deprivation

• Accidents\near misses
• Depression
• High blood pressure
• Cardiovascular risk
• Diabetes
• Weight management
• Quality of life
• Lost Productivity

12
Accidents related to sleep deprivation
Chernobyl Three-mile island
Comair Flight 5191 Exxon Valdez
13
Accidents related to sleep deprivation

• Driver sleepiness is related to one in five
  serious car crash injuries

14
Sleep Solutions Program

• Annual guest speaker
• Directorate buy-in/promos
• Four-week insomnia class
• Individual consultations and sleep assessments
• Organizational presentations on sleep
  disturbances
• Limited case management

15
Insomnia Class

• Provides information on
• Common sleep disturbances
• Sleep hygiene
• Stimulus control therapy
• Relaxation techniques
• Cognitive behavior therapy
• Medications, diagnosis and treatment for sleep
  disturbances

16
Most helpful behavior changes

• Survey says
• Not watching the clock
• Get up at the same time everyday
• Dont lose sleep over losing sleep

17
Quality of sleep

• Improvement from 4.9 to 3.8
• p
• N 50

• Ranked 1- 8
• Extremely Good
• Very Good
• Good
• Adequate
• Fair
• Poor
• Very Poor
• Extremely Poor

18
Insomnia Sleep Index

• Describes proclivity toward insomnia
• Improvement from 12.95 to 8.75
• N 44
• where
• p

Bastien CH, Vallieres A, Morin CM.Validation of
the Insomnia Severity Index as an outcome measure
for insomnia research. Sleep Med. 2001
2297-307.
19
Epworth

• self-administered questionnaire provides a
  measurement of the subject's general level of
  daytime sleepiness
• Improvement from 11.4 to 9.2
• N44
• Where 10 is excessive daytime sleepiness
• p

Johns, Murray W. (1991)"A new method for
measuring daytime sleepiness the Epworth
Sleepiness Scale" Sleep 1991 (14) 540-5.
20
What should we do?

• Regular screening
• Encourage work/rest guidelines
• Teach management about the danger signs
• Recognize sleep disturbances as a treatable
  disorder
• Make it easy to access resources
• Socialize impact with other health and safety
  professionals
• Screen in the case of select near miss and
  occupational events