Fatigue Management: Cheaper than Therapy Fatigue Management Cheaper - - PDF document

Fatigue Management: Cheaper than Therapy

www.solarisfm.com 1

Fatigue Management

Cheaper than Therapy

Mike Har ke Harnett ett

Pres esident ident Solar laris F Fatigue tigue Management Management

Ty Types o

• f Fa

Fatigue

• 1. T
• 1. Task

sk Relat lated d (Ex (Exertion) ion)

• Depleting our body’s resources

either physically, or mentally

• The more exertion, the more

rest and recovery required throughout and after shift

• 2. Sleep R
• 2. Sleep Related

lated

• Inadequate restorative sleep, resulting in ongoing

decrements in physical and mental capabilities

Dr Drowsiness/S siness/Sleepiness eepiness

• Fluctuates; can be temporarily

masked

• More fatigue, more drowsy

episodes

• Real time effect on

performance

Sleep W Sleep Wars rs

• A typical day:

– sleep – work – family / recreation

• From over 9 hrs to less

than 7 hrs today

NSF 2010

Fatigue Management: Cheaper than Therapy

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How How much is enough? much is enough?

NSF 2010; AASM 2010; Work-Life Balance of Shift Workers, Stats Can 2008

Irregular/erratic schedules reduces TST by an average of 2 hours (chronic sleep deprivation)

2016 C 2016 Canadian nadian Sleep R Sleep Review view

26% 38% 28% 8%

0% 5% 10% 15% 20% 25% 30% 35% 40%

7 hours or more 6‐7 hours 5‐6 hours Less than 5 hours

Amount of Sleep

Rachel Morehouse, Dalhousie University, 2016

• NO! You cannot train

yourself to need less sleep

• Accelerates aging of

every cell at DNA level

Doesn esn’t m t my body k body know bett better? er?

The S e Scienc ience of Sleep e of Sleep

Sleep/W Sleep/Wake C ake Cycle cle

Circadian drive Homeostasis sleep drive Peripheral Clocks External zeitgebers

• Light timing
• Mealtimes
• Bedtimes
• Social Cues
• Physical Activity

Fatigue Management: Cheaper than Therapy

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• Can never “fully” adapt to night shift (<3%)
• Any night shift adaptation gained doesn’t last

The Reality of our Species

Ligh Light and t and Melat Melatonin nin

• Natural sleep hormone synthesized

and secreted at night

• Light at inappropriate times can

depress production

• Age reduces melatonin production
• Powerful anti-oxidant
• Melatonin synthesized from

Serotonin

• Known as the “happiness” hormone
• Significantly reduced serotonin

levels in rotating shift workers

Se Serotonin From F

• m Food
• od to Mood
• od

L- Tryptophan Serotonin Melatonin

Meat, dairy, fish, nuts, whole grains, quinoa Sunlight promotes synthesis of serotonin from tryptophan Melatonin synthesized from serotonin

Stages of Stages of Sleep Sleep

Awake Stage 1 Stage 2 Stage 3 REM

(Beta/Alpha) (Theta) (Delta) (Beta/Alpha/Theta)

NREM

(Spindles)

• Stages 1 & 2 NREM

– brain waves slow – snoring is initiated – motor skill consolidation – easier to arouse from

Light Stages Light Stages of

• f Sleep

Sleep

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Deep Sleep eep Sleep

• Stage 3 NREM

– brain is quiet (long, slow Delta brain waves) – HGH released – long term memory consolidation – recharged immune system – hard to wake up from

• Body is “paralyzed” while

brain kicks into high gear

• Important for

– psychological well-being – primary cognitive repair – Short term memory consolidation

REM Sleep REM Sleep

Stage Stage 1 Stage Stage 2 Stage Stage 3 Stage Stage 2 Stage Stage 1 REM REM 1 C 1 Cycle cle = = 90 M 90 Minutes nutes

REM REM REM REM REM

Health Healthy A y Adult Sleep P ult Sleep Patt ttern ern

Hours After Going to Bed

Older A Older Adults ults (45+) (45+) Health I Health Impac pacts

Physical Health

• Stroke and cardiovascular

disorders

• Digestive disorders
• Kidney disease and scarring
• Rheumatoid arthritis
• Fertility problems
• Various cancers
• Obesity
• Hypertension and diabetes

Emotional and Mental Health

• Aggressive and intolerant
• Impulsive
• Mood swings
• Irrational
• Decreased motivation
• Depression
• PTSD
• Dementias
• Alzheimer's Disease

Fatigue Management: Cheaper than Therapy

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Loss of Loss of Situational Situational Awar arenes eness Mo More T Time

• n T
• n Task

sk Under- Under- esti estimati mation

• n
• f R
• f Risk

sk Fl Flawed Log Logic Hinder ndered ed Vi Visual Pe Perception Poor

• or

Pr Problem So Solving Slo Slowed ed In Information Proce

• cessi

ssing ng Reduc Reduced d Re Reac acti tion

• n

Ti Time Decr Decreas eased d Learning arning Ab Ability ility

The wheel i e wheel is t turni rning bu but th the h hams mster is d dead ad…

Cognitiv itive e Im Impairment

Fatigue and tigue and Monot notonous nous Tasks sks

• Commuting is high risk when sleep deprived

Hours of Sleep <4 4‐4.9 5‐5.9 6‐6.9 Risk Level for MVC 11.5 5.4 1.9 1.3

AAA Foundation for Traffic Safety, 2016

Fatigue is tigue is Danger Dangerous

• us

0.05% 0.08% 0.10%

15 17 19 21 23 25

Hou Hours A s Awake BA BAC Equiv C Equivalenc lency

Impair paired is I ed is Impair paired ed

~40% drop in alertness

Lamond & Dawson, 1997

Subjec Subjectiv tiveness ≠ ness ≠ Accur curacy

Van Dongen, et al. Sleep. 2003; 26:117

Manage Y nage Your ur Sleep Sleep

• Aim for 8-9 hours (rejoice if you get 7!)
• Stick to a routine
• Get daily exposure to sunlight
• Keep your room pitch black
• Use white noise to mask pets, snorers, etc.
• Reduce blue light exposure at night

Fatigue Management: Cheaper than Therapy

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• Naps can supplement sleep, not

replace it

• Short naps reduce sleep inertia
• Most effective on first night of a

sequence of shifts

• Lie down (50% faster)

The The Rules of Napping Rules of Napping

Zhao, et al. Biol Psychol. 2010; Dr. Neil Kline, American Sleep Association, 2017

Consumer Sleep S nsumer Sleep Study (20,000) udy (20,000)

50% of Americans regularly use a mix

• f two or more

sleep aids per night

ResMed Tech, 2017

Sleep meds treat the SY SYMPT MPTOMS MS not the problem!

Non- Non- Prescr escription Sleep Aids iption Sleep Aids

• Melatonin NOT for those with depression;

try L-tryptophan instead

• OTC and Antihistamines = dementia?
• Cannabidiol – anti-inflammatory, not a sleep aid
• THC –higher rates of chronic insomnia for daily users

Turn off rn off your br ur brain! ain! Thank you! Thank you!

Mike H Mike Harnett, ett, Pres esident ident Solar laris F Fatigue tigue Management Management mharne nett@sol solari risfm sfm.com www.sol .solarisfm fm.c .com

• m

604-379-912 604-379-9124

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