CDC WHRC: Make Wellness Your Business: Sleep Strategies for the Workforce

CDC WHRC: Make Wellness Your Business: Sleep Strategies for the Workforce



hello to all of you and welcome to the CDC workplace health Resource Center's webinar series make wellness your business sleep strategies for the workforce is today's topic my name is dr. L Casey chose wood and I will serve as today's moderator the purpose of today's call is to discuss how sleep affects you and your workers personal and professional well-being we will discuss the benefits of sleep the current challenges around getting enough sleep and we'll share some existing sleep strategies and show you how the CDC workplace health Resource Center which will also refer to today as the W HRC is contributing to this critical topic especially when it comes to the safety health and well-being of you and your workers and now I'd like to introduce today's speakers as I mentioned before I'm dr. Casey chose Witt and I will serve as your moderator I am the director of the office for total worker health at the National Institute for Occupational Safety and Health and we're part of the Centers for Disease Control and Prevention our office leads the total worker health program at NIOSH and total worker health is defined as the programs practices and policies that improve the safety and the quality of work for workers while advancing their overall safety health and well-being we're very concerned about safe work about healthier work design certainly things like sleep and stress and aging and work and chronic diseases related to work are critical focus areas for us before this role I served as the director of the Health & Safety for CDC's own work force and I was the medical director for CDC's three occupational health clinics our presenters today are two of the nation's top experts when it comes to the subject of sleep and its impact on our work and our well-being first I'd like to introduce dr. Claire Caruso a colleague of mine at the National Institute for Occupational Safety and Health she's a subject matter expert on shift work long work hours and related workplace sleeping fatigue issues her PhD from the University of Michigan focused on the health and safety risks associated with shift work and long work hours and the underlying sleep and circadian rhythm research that provides evidence for this topic Clare's also a registered nurse which gives her additional personal insights into this issue today regulatory agencies labor and industries cite her publications in their recommendations and in their position statements on working hours she entertained have developed a number of online online training programs for managers and workers and these programs offer the latest evidence-based recommendations to both present and better manage the demands of long work hours and shift work our next presenter will be dr. Michael – Airy Michael is the director of the National Center on Sleep Disorders research at the National Institutes of Health he has led sleep and respiratory neurobiology research programs at the NIH s National Heart Lung and Blood Institute since 1966 and he became the director of the sleep center there in 2006 dr. toire serves as a point of contact for the coordination of federally funded sleep activities and a wide array of scientific research he also administers the sleep disorders research advisory board which is an important federal advisory committee representing both sleep disorders patients their healthcare providers and biomedical researchers on needs and opportunities around sleep research improving our understanding of how sleep disorders and insufficient sleep pose a national burden to our physical and mental health this has certainly been a prime direction of particular interest to dr. Tori he chairs the sleep health working group in a focus area within the nation's healthy people 2020 initiative that establish national objectives for specifically improving sleep health well our agenda today is as follows will first cover sleep and the workplace in our agenda and within this portion our presenters will discuss the benefits of sleep the challenges around inadequate sleep and then provide some great resources and strategies that employers can put in place to address these challenges will then hear more about CDC's workplace health Resource Center and I'm appreciative to them for inviting me here today to lead the webinar after that we'll learn some next steps you can take to learn more and intervene in this important answer and then we'll move on to your questions and answers now here's a warning yet your pen and paper ready or your keyboard and take some great notes today because you're going to hear lots of pearls and ideas strategies that are not necessarily on the slides so be ready to write down the great information and recommendations you're going to hear now I'd like to turn the presentation over to dr. toir who will cover an overview on the benefits of sleep dr. Tori welcome to the webinar Thank You Casey most every metric of workplace performance no matter how we look at it and ultimately business success is vulnerable to various effects of sleep deficiency our productivity based on time on task is limited by our ability to stay awake creativity intelligence motivation effort efficiency our effectiveness when working in groups our emotional stability and sociability are all diminished by insufficient sleep duration your regular sleep schedules or poor quality sleep optimal sleep health requires seven to eight hours in bed for adults it requires a regular sleep schedule timing is important and good quality sleep but health surveillance data worldwide is now indicating that a large proportion of adults and adolescents frequently do not get enough sleep arrest in the image that you see on the screen right now is a US map of insufficient sleep and it reveals that sleep deficiency is affecting twenty to forty percent of adults in every state the legend of the map shows that states that with the lightest color the white shading are in the that 20% to 30% range and then the progressive darker colors a green show are associated with higher rates of insufficient sleep among US adults however this map of sleepiness is only showing you the invisible threat this issue of being awake what it is not showing is the impact of chronic sleep deficiency on our health and this is where scientists and researchers have made amazing breakthroughs in just the last decade scientists have started to identify the nuts and bolts of how sleep and circadian biology are regulating gene expression and cell function in L most every single organ whether it be the brain the heart or the immune system all of these systems are closely coupled to our sleep health sleep deficiency undermines these functions they run inefficiently and ultimately overtime contributes to the risk of many conditions whether it be the risk of catching a common cold obesity diabetes heart disease and even cancer bottom line sleep the employees are often unproductive employees and because sleep deficiency undermines their health it undermines their health and many work-related behaviors so the continuous lack of sleep affects everyone it affects health safety and performance and in the workplace sleep deficiency is predicting a lower work rate slower completion of even basic tasks insufficient sleep is both physically and mentally harmful so one starting point to improve sleep health might be to take a look at your workplace and consider is sleep deficiency sleep deprivation a characteristic that is commonly tolerated or perhaps even reward or encouraged in your workplace is this a a systemic problem or practice a second idea is 10 materials that you can obtain from CDC and other sources be used to educate employees about sleep health the average individual may not understand how what the effects are and how to recognize when sleep deficiency is affecting them affecting their their contribution in workplace teams and their interaction with customers all of which are important to sleep in the workplace the are individuals aware that their performance is fluctuating widely from day to day in some cases these ups and downs might reflect changes in the amount of sleep this individuals obtaining invite employees to keep sleep Diaries might help individuals recognize these problems and also these sleep Diaries can be a useful starting point if the individual seeks consultation or wants to discuss their sleep problems with a physician the diarrhea is very very useful our human biology is organized around sleep and the bottom line from the scientific and is there is no immunity or vaccination to prevent this the effects of these deficiencies so one difference between sleep and many other workplace performance factors is that the impact of sleep deficiency is occurring in the workplace but also every place between the workplace and home in fact driving to and from work a very prevalent and common problem for in many settings is drowsy driving individuals who are at risk of drys are driving it can take them out of their workforce at least temporarily and can interfere with their own success but sleep occurs at home it's not occurring in the workplace sleep disorder whether it be insomnia sleep apnea they're all contributing to the problem of sleep deficiency but the effects of if left untreated can impact employee productivity and performance in work encouraging employees to to being air enabling employees to recognize these problems and to seek the assistance of their physician discuss these symptoms with their physician can help minimize the effects of sleep disorders there's also another dimension which is a bit less tangible in some ways and that's the societal outcomes because sleep affects every dimension of our activities our interpersonal relationships it affects how we can our relationships with families whose spouses children well how we behave how adults the parents behave and also impact the outcomes in the family and also affect their risk balancing this is another example we're balancing professional and personal responsibilities is very very important it's important in the workplace it's important in the family and these two successes in these two venues will only contribute to the workplace environment it's important with respect to interacting with peers we all have a greater depth of behavioral regulation and reserve when we're well-rested and awake and of course it affects our overall mood and happiness now I'd like to turn the presentation over to Claire who will discuss emerging technologies that employers can consider implementing Claire thank you Michael appreciate this opportunity to just give you just a few of the many strategies that managers and workers can use to promote alertness on-the-job sleep health and all of the health benefits the first thing I'll talk about is naps these are really an important countermeasure to help relieve sleepiness just falling asleep for a few minutes has a learning affect our brains benefit from this brief period of sleep not just a quiet time to recover from sleepiness and to restore alertness one problem we have though is the cultural barriers in the United States to using naps at work some workplaces have policies that reprimand people for sleeping on the job and workers have been fired however as managers began begin to understand the strong science behind the usefulness of naps this will probably change there is a lot of good science about the usefulness of naps it's a healthy method to restore alertness when somebody's feeling very sleepy and it's very useful so some enlightened employers are making use of naps during work breaks how so there's a couple things I'll cover you might think well how long should this nap be well you could use both short naps with fifteen to thirty minutes or longer naps and it depends upon the situation for instance if you're working in the daytime schedule a brief nap like less than twenty minutes which could be useful you can set the alarm for fifteen to thirty minutes to wake up and this brief nap will increase alertness for several hours and the other benefits is you'll wake up with less grogginess than if you slept for a longer period and the other benefit is that it doesn't disrupt your sleep that night because you won't go your brain won't go into the deeper stages of sleep and reduce the build-up of sleep pressure longer naps now and a half or more can be useful during emergencies when workers have to work long hours for example during snowstorms when the next group of workers can't come in or there's a whole range of emergencies that can happen and these happen in a wide range of work settings from police fire to healthcare but also to a variety of service operations such as heating and air conditioning technicians so you might think when one's a good time to make take a nap well what if someone is feeling very strong sense of sleepiness when they're at the job or when they have to drive or whatever a nap at that point could be useful and there are times during the day when we can predict that what people may feel sleepiness and this is during the night you know when we normally are sleeping and for those people that are working night shift they may feel strong periods of sleepiness particularly between 2:00 a.m. and 5:00 to 6:00 a.m. the other time that we tend to feel sleepy is in the middle of the afternoon from about 2:00 to 4:00 so during those times it can nap can be useful the other tip I can give you is people can combine the benefits of both caffeine and a short nap so how that would work is you would drink some caffeine and then you would lay down and take a short nap the caffeine takes about 30 minutes to take effect and so when you wake up from them that nap in about 30 minutes you'll get the alerting benefits from both then you might think what kind of an environment is good for this for taking a nap or you want a safe place a safe room close to the workplace that's conducive that's quiet dark comfortable and cool and it doesn't expose the workers to slamming doors and other noises and if you're using the short naps less than 30 minutes you can have provide a reclining upholstered chair with elevated leg rests but for longer naps it's best to have a horizontal surface of bed because it allows the brain to go into the deeper stages of sleep and reduce the sleep pressure and promote better recuperation a couple cautions beware on awakening people can feel a period of grogginess and they can have declines in a performance and mood during this time so you want that to pass before you carry out critical critical tasks this it depends upon the situation how long this will last if someone is sleep-deprived it may last a while if we're a very short nap it probably just lasts a few minutes 10 minutes it could last 30 to 60 minutes depending it will this period of grogginess will pass more quickly by taking some caffeine being in a brightly lit area let's say outside or washing one's face face the other thing I want to point out is these naps are a temporary aid for improving alertness and it's not a replacement for getting a regular long period of sleep at night next I'll talk about indoor lighting and there's been a lot of study on lighting it has a big impact on our sleep our circadian rhythms our alertness and our sleepiness and in recent years they've found that the different colors of light have differing impacts blue light which is part of white light shifts arcadian rhythms the warmer light like red yellow orange have much less effect on the circadian rhythms so some workplaces can use this kind of information to design lighting to help people maintain alertness let's say if they're working night shift and help their bodies get adjusted to those work times some places for night shift have got set up brightly lit areas where the workers can go in intermittently pretty much this is recommended for the first half of the shift and then for those the towards the end of the shift you move towards the lesser lit areas so then when they go home they can fall asleep there are other strategies being used by companies we've heard through the news outlets of one company that offered their employees money for sleeping so if for the people who were sleeping seven or more hours a night they for twenty days they offered a maximum up up to five hundred dollars a year now that company really understands the importance of sleep health for their their their operation exercise improve sleep so some employers are said have sexercise rooms with exercise equipment and exercise classes one of the major problems that the workplace can help with is reducing this widespread lack of information about sleep people don't get this information in their schools their training programs their healthcare visits for the most part and they really need this basic information to move them to better practices at home and at work so this Resource Center provides a lot of links for some great sources that managers and workers can use to get this critical information about sleep the National Institute for Occupational Safety and Health has several online training programs that are tailored specifically for several types of workers and managers and we're developing more as time goes on there are also resources available from the National Safety Council Yero research Transamerica Center for Health Studies and the Massachusetts Department of Public Health so besides educating and promoting that managers can do a lot of other things you can promote a workplace culture that respects the need for people to be off work to get good quality sleep and recover from work it's critical that managers send these messages to their workers because there are some conflicting messages out in our society about being productive and advancing in one's career and so forth that are actually counter to a good sleep health for instance so one of my bosses several layers up a few years ago posted a blog and she was a great promoter of sleep health and then if she said when it comes to our health sleep happens can be just as important as diet and exercise but a third of us aren't getting enough sleep and this is enormous ly expensive to our healthcare system and our nation's productivity managers can relay how they improve their sleep practice and how much better they feel and how they've seen their ability to cope with the challenges at work that these have improved there's lots of other opportunities across the year to give these messages during the flu shot season managers can tell remind the workers to make sure they get sleep after their shot for several days there's there's evidence that when people slept better after they got the shot their levels of antibody were higher the other times are during the spring you know we have that time change a couple weeks ago and in the fall we have another time change will that one hour change in the time we have to get to work and get up and go to sleep impacts some people for up to a week and so this is another time when we can remind people about how to better adjust to these time changes as well as if that if I'm doing fine I have to remember that the other people around me being half maybe having trouble another issue is on-call work it's very difficult to be on call 24 hours a day and obtain good sleep health so the workplace has to recognize this and it's useful to set up the expectation that when people leave the job they do not need to be responding to emails phone calls and so forth managers can tell their employees this that during the meetings and they can model the pay behavior they want seeing like they they themselves will not respond to emails and so forth after their shift ends now we understand this is real challenge for global global operations when your customers and co-workers across the globe are on a different time zone but I think as managers understand the difficulties that this will cause for workers to try to respond 24 hours a day seven days a week or whatever and the people are smart I think that they will create better ways of handling that job stress leads to insomnia and other sleep problems so that's another issue that managers can work towards reducing and by that would be by creating a good psychological work environment for instance people are treated with dignity and respect they're given resources to do their job they're recognized for a job well done and so forth you can look at your policies and these some of these may be very relevant to sleep health for instance your shift links you can set up as consider setting limits on the length of the shift and overtime and hours per week you can look at see if any policies encourage excessive overtime and if there are some you can modify them you can explore flexible scheduling options shorter shifts and telework telework can be very helpful it saves time that they don't have to commute and groom themselves to get ready for work next thing that could be looked at is the work schedules themselves the design of the work schedules it helps to give workers input into their schedule because they'll likely consider their own personal responsibilities and capabilities as they provide their input be cautious about using long hours per day you have to remember that these extended hours for long exposures to the workplace hazards such as noise heat and so forth and by that extended hours that may be exceeding the established permissible exposure limits also think about the work that's being done is it feasible to do that normal on shift I mean if work is very it has very heavy physical demands emotional demands cognitive demands and the pace of the work is fast that could be pretty difficult next I'll talk a little bit about 24-hour operations just have a couple tips a lot more information is available on our resource with the Resource Center think about if you have 24-hour operation is that nightshift the tasks that you're trying to accomplish that is it really necessary to be done at night I keep in mind that night shift is associated with increased risk for errors injuries and development of chronic illnesses now we understand that there are certain types at work that we just cannot do without during the night some manufacturing processes for instance healthcare police fire and so forth but if if if some of the tasks are optional consider moving those to the daytime hours for your permanent or for your night shift operations use the permanent night shift with caution some people really just do it well and they like it but most people have difficulty be sure to give people how to put time off each day at least 10 hours between shifts if not 11 or more is much better next I'll move on to some good sleep practices for both employers and managers these are have been our and there's a lot of support for that they used to help improve sleep and it's important to try it for people to use these to help themselves so number one create a very good sleep environment you want to have a comfortable mattress and pillows if you haven't replaced these in a number of years consider doing that because they do get lumpy wear out and you'll wake up with aches and pains the other thing is have it comfortably cool very very dark and quietly it helps to go to sleep and get up about the same times every day including your days off these consistent sleep times help the brain understand when to be awake and when to be sleep get some exercise every day people who report the best sleep and exercise vigorously but even walking for 15 minutes or so can be helpful look at your caffeine intake stop that well before bed lunch time at least 5 hours beforehand and think about your own sensitivity you may have to stop it well before that I set a time to relax before bedtime about an hour or more and use this time to do only relaxing things so don't use that time to plan your next exciting vacation or you know look at an action-packed film or whatever use this time for relaxing things lower the light levels stop using the devices with the backlit screens like our computers and our tablets and our phones those acts of brushing one's teeth getting dressed for bed it signals to the brain that we're winding down now and we're getting ready to fall asleep also take care of the variety of things that can disturb sleep if you've got a chronic illness like that involves pain or respiratory symptoms like from asthma or nose irritation deal with that so you don't have those symptoms during the sleep unfortunately the way our body works is the pain and respiratory system symptoms are more bothersome at night also dealing with noise from traffic barking dogs and so forth you may have to use some sort soft earplugs and these are available in the pharmacies all these measures do improve sleep if if someone has consistent problems with sleeping or feeling sleepy during work they should see their health care provider or sleep disorder specialist there's a lot of good options available to improve people's sleep and quality of life as I said this short presentation can only give you a few of the many strategies that are available for workers and managers on the South sleep health topic be sure to check the resources to get more information now I'll turn the session back over to Casey Casey thank you so much Claire and Michael as well I found your comments today very rich and practical and very very actionable so I certainly learned something new from you guys every time I hear you speak now to talk a little bit about the CDC workplace health Resource Center as you may know the CDC has been involved in raising awareness of a number of critical public health issues including that around sleep health and its connection to work and worker safety health and well-being and really with the goal of improving the overall quality of the health of Americans we want you to take a look if you haven't had a chance yet at the website for the CDC workplace health Resource Center and for many it can be your first stop online to help you launch or expand a work health place program in your own environment certainly the site is filled with evidence-based and credible resources and it can really help employers tailor workplace health promotion goals to meet their organization's needs a number of tools exist on the website and here you can see that there are a variety of things available currently the website has more than 300 resources and that list is growing every single day I'll just reiterate that the website is completely free and it includes a number of interesting case studies what I might consider is very important real life examples from organizations much like your own including organizations of different sizes with an emphasis on solutions that work in small and medium-sized businesses there's a section on emerging issues such as the focus of today's webinar improving sleep quality to address the health and safety of workers and there are a number of workplace help strategies available there that can play really a significant role in keeping healthcare more affordable for your organization and for your workers the W HRC includes resources to help small businesses as I mentioned design workplace health programs that are at accessible for employers as few as 12 or 25 workers they're also on the site evidence-based summaries and issue briefs for example there's a new issue brief just out now on total worker health and I would invite you to take a look at at the integrated approach to health and safety that the total worker health program espouses you'll also find on the site a suite of webinars and videos to help organizations like your own who are really looking to start or improve a workplace health promotion program on this next slide you will see a snapshot of the website where visitors can search for these credible resources just by entering a few keywords in the search box on the upper right-hand corner in this example you see the search results after entering the key word sleep now if you find a resource that you think will be useful for you simply select the resource and you'll be directed to its source the website is continually being updated so I invite you to check back regularly it's also interesting that you can help us rate the quality of these resources and we give you a 5-star rating system to do that to give feedback that not only helps others but it will give us some feedback too about the quality and how people are perceiving the quality of the products that are offered through the Resource Center here you see a new sleep brief that helps employees and employers address this often very thorny issue that we've been hearing about today now to summarize what we've been talking about today I just want to leave you with a few things in the sleep summary here clearly sleep plays a critical role in our safety or health and our overall well-being while sleep is highly individualized it is very closely tied to so many aspects of worker well-being our energy level our attitudes our working relationships our personal relationships with friends and family and co-workers our creativity our spark if you will our happiness even our immune system that we heard from dr. Tory is strongly associated gated with a healthy sleep hygiene and in my view it's much too important to isolate this issue that's something that's only managed in the personal domain or only viewed as a personal responsibility because the workers all report to a workplace with an employer who can have a tremendous role in improving sleep opportunity for for their workers and I would say have a responsibility when they have such a strong voice in the schedules that people maintain for their work so for employers we encourage you to integrate sleep into your health and well-being strategy into your safety programs into your training and orientation programs and also introduce it into your risk assessments when you're talking about risks and exposures that workers face factor in schedules and shifts as an important influence on many many health safety and well-being outcomes Taylor Street sleep strategies by using the resources that are available from some of the high quality places you've been hearing about today you know we also believe that employers can assist and educate workers around the topic of sleep make sure you pay close attention to work demands schedules and deadlines make sure they're realistic and there's adequate staffing for employees we want each and every one of you to create a manageable sleep routine and do all you can to stick with it overall we'd like to leave you with this message what happens at work can strongly influence our opportunities for high quality sleep so developing sleep centric and worker centered programs around managing and improving the quality of sleep are of critical importance if we want to improve the safety health and well-being of all our workers alright so let's move on to a few next steps on how you can stay connected and continue to learn more about this topic and others within the workplace health Resource Center we invite you to stay connected with us on social media you can see LinkedIn so book and Twitter options here certainly check back to the website of a wh RC to learn about new product updates upcoming events including a discussion on mental health best practices that will be offered very soon upcoming soon also is a train-the-trainer webinar designed to help navigate the center's many resources and the website you can follow us as I mentioned on social media finally if you would like to partner with us on an upcoming event or you have follow-up questions about this webinar other upcoming activities or the center please email workplace helps at CDC gov workplace health at CDC gov and someone from the center will follow up with you here on this next slide you can see a number of promotional opportunities that are out there using materials that have been developed and can be shared via your own social media channels if you would like to access promotional materials you can visit the website or again email the center at workplace health at CDC gov to move on to our question and answer portion of the meeting and I'll invite Michael and Claire to join me back on the line again to thank both of you for your wonderful presentation I'll remind folks that you can enter your own questions at this point still if you would like to do so and I will start off by really just asking Claire a question that we that we know has come up and that is you know managers oftentimes ask what are some of the ways that people will behave or will appear when they're not getting enough good quality sleep so you have some guidance for supervisors or manager home really ways I could help out if they notice people are struggling this is Claire and they can be looking for symptoms and some of the obvious ones would be that the person is yawning a bit has droopy eyelids maybe they're even involuntarily falling asleep and you can see them doing that at work they may have a slow reaction time that could have slurred speech in fact there has been studies that have compared people in the lab when they were sleep-deprived and they compared them when they had alcohol and they did write some similarities people can have a blank stare that's caused by short episodes of sleep just a few seconds long they could have mental signs such as difficulty concentrating difficulty remembering emotional signs that could be more quiet or withdrawn than usual lack of energy motivation don't care attitude they can have inappropriate emotions like they might giggle and laugh in serious situations they can have problem with their thinking you know they may fixate on a solution even though it's you it's obviously some other better alternatives are easily available they may have more risk-taking behavior they and they and their risk assessment may be poor and they must may misinterpret written or oral communication so you can see there's a whole range of behaviors that somebody may show when they haven't gotten haven't been getting enough sleep great thank you for that clear um we've got a question that's come in and it's addressed to Michael but I will start with Michael then see if Claire wants to add anything as well but the question Michael is is there any rule about snacking before going to bed does that seem to have any impact on sleeping pattern and so in general the consumption of food close to or near the bed time period so so I think there's several dimensions to that question one of the reasons we snack in general is is part of how we achieve some restore our emotional regulatory balance we eat we we sleep these are all mechanisms of restoring that mental function now in terms of rules there's we have science and the science says that consuming heavy carbohydrate loads and fats at the circadian inappropriate time of day is is is a problem because our if we're if our bodies are preparing for sleep the chemistry the metabolism of our body is not prepared to metabolize metabolize those incoming calories so eating pizza eating pizza at night or chocolate cake or or even it may be healthier snacks fruits have many carbohydrates and so the bottom line is research is showing that this appears this late night snacking or eating at the wrong time of day is does contribute to the risk of weight gain and there are studies underway right now to look at to develop dietary recommendations about you know eating the correct when to eat during the day great thanks Michael clear anything you'd want to share I guess the other point is that if somebody is hungry that may make it difficult for them to fall asleep or stay asleep so a very very light snack is sometimes recommended like a combination of a little protein and low carbohydrate no this wouldn't be a big snack it would be a small one and also if people are feeling hungry close to bedtime maybe they should consider when they are eating maybe they need to adjust the times when they are eating their dinner and so forth great thank you both for that we actually had a couple of questions that came in around the issue of eating and sleep so I think you did a great job of addressing the other questions on this topic as well we oftentimes here too in the medical profession about people who eat too late or too much near the bedtime will get GE GI symptoms or gastroesophageal reflux often times it can certainly impair the duration and quality of sleep um we've had a question come in about the resource center itself first of all is the Resource Center free it absolutely is there are no costs associated with use of the Resource Center so really regardless of the size of your budget the center is suited for your business or your organization's opportunities to build or expand a healthy workplace culture and also folks ask about some of the criteria for information to be included in the site well there are a few standards obviously that CDC follows before posting this to assure its quality and credibility first of all the information that a featured has to be published within the last ten years so that it's up to date it has to be available and accessible to the public free of cost without a registration required to reach those resources that we link to the resource has to be US based currently and it also has to be relevant to workplace health and factually accurate with appropriate citations and an evidence base and all of the sites are vetted before becoming part of the resource center by a peer panel of experts in the field so gives you some information about how items are chosen for inclusion as a resource in the workplace Center well let's get back to a question about sleep and this one specifically Claire is about policy language around naps and there may be some examples out there is there a source you're aware of where a policy language around naps exists if not it might be something that we could follow up with more information on the website later yeah NIOSH training for nurses on shift work and long work hours it's a online training program that we developed and released a couple years ago it has a whole module on naps now and at it it doesn't give you a specific language but it does tell you what things to consider when you're developing you want to use naps in the workplace so you might want to for instance consider how you're going to time the naps how you're going to schedule people for the naps now you're you know you're going to have enough staffing to recover the workload when people are napping you're going to have someone wake them up you have them using alarm and if they don't didn't return to the worksite in appropriate time have someone to check on them so the I'd like to refer you to that NIOSH training for nurses that module seven on naps an important countermeasure fatigue great thank you for that there is another question here that I will pose to you first Michael and then we'll see if Claire has anything to add and that really is about this connection between blood circulation and sleep patterns and getting good quality sleep certainly we know that a number of chronic conditions can impact sleep and the lack of high-quality and good sleep can predispose to certain chronic conditions so if I could just ask for a few thoughts about this connection between sleep and chronic disease and we'll start with you Michael okay so so when we don't have a regular sleep schedule either sleep insufficient sleep duration irregular timing asleep or poor quality sleep all of these conditions are associated with abnormalities in our autonomic nervous system this is the part of our nervous system that is that is coupled to mediating how we how we deal with stress stress hormones are secreted hormones are secreted at the wrong time and this type of response over if sustained if this is a chronic condition a chronic exposure it appears to contribute to cardiovascular disease risk great thank you for that yes stress is oftentimes this sort of central mediator for so many of the poor health outcomes associated with you know challenging work schedules and and heavy work demands Claire anything you want to add to this connection between sleep and work chronic disease yeah there is a lot that could be said about it I guess one thing I'd like to do is again refer people to the NIOSH training for nurses on ship work on long work hours module 3 covers the risks when people work these schedules but also those risks also relate to people who don't have adequate sleep because with the theory is that these work schedules to forkin long work hours impact health and safety by disturbing sleeps arcadian rhythms and family and social life so it's a it's like the common thread would be the disruption to sleep and circadian rhythms but you can also brief thing that I could add is that when we're laying sleeping it gives a heart arrest are to some extent our blood pressure goes down heart rate goes down and all of that you know you can you can think would be beneficial but then again I'd like to refer people to module 3 of the nurse training because it is it can go into more depth on on the various chronic health problems that can result from not getting adequate sleep great thank you for that Claire you know having seen that training module it's just really very very rich with a lot of actionable recommendations and the other thing even though it's developed for nurses it really is applicable to a wide number of workplace settings so I echo that encouragement for folks to check out we had a question come in around this issue of sleep and belly fat or obesity and certainly there's strong evidence base for the lack of good quality sleep and obesity for shift work that's so common in so many industries and occupations today and its association with obesity I'll ask you Michael any thoughts about this sort of connection between poor quality sleep or poor duration of sleep and obesity right so get connected to abnormalities uh in our appetite control abnormalities in our anabolic hormones there is a there is a science has now established a a mechanistic a causal pathway between sleep deficiency irregular sleep schedules or poor quality sleep and weight gain but I want to be careful about label the label of belly fat because there are genetic and other factors that can influence where fat is deposited in some places may be associated with particular health risk compared to other sites so the fact that it is exterior to the the belly fat that we often see hanging over hanging outside the body versus fat that is clinging to organs and then there's fat that may be intercalated into the muscle structure that can weaken muscle neurotransmission these are all have different medical significance and so someone who's concerned about this they have you know they have a regular pattern of of they feel they're chronically that sleep deprivation or insufficient sleep is a daily burden i'd encourage them to you know seek the advice how does this information how does these symptoms how are they important for them as an individual great thank you for that doctor to airy um certainly we know that shift work long associated with a high risk for certain chronic diseases including obesity diabetes even severity of stroke and shift workers has been shown so where there clearly seems to be some connection between a number of chronic disease receptors and their association with sleep disruption and poor duration and quality of sleep we have a question here really asking about how a company specifically their what their wellness program leader can go about getting advice on implementing a high quality sleep health program in their setting and thank you for that it's an opportunity for us to refer you back to some resources that are available both at NIH and the National Institute for Occupational Safety and Health and I that are our speakers both represent those organizations I'll also refer you to the workplace health resource center is a very credible place for additional information as well I mentioned some of the resources that are industry and organization specific on the NIOSH website really apply broadly to all workers more generally um we have fun just perhaps time for a couple more questions and Michael one that has come in before really is it's fairly general and it's talking about how employers can sort of approach this issue of sleep hygiene or helping employees manage sleep habits when they are off the clock or not at work and and this it really gets to the last question as well so what advice would you have for employers who are wanting to help their employees manage sleep habits Casey I think that there's a an immense opportunity to fill the you know the basically a knowledge vacuum out there there's a lot of things that people can see you know one-off observations and reports and in the media but but the reality is is that the average person is not yet aware are familiar with the you know how sleep deficiency is affecting them so there's there's a lot of materials on the CDC website there's material on the NIH website to help close this information gap this is a this is a very low level just just providing information connecting that information with perhaps with the discussion of the the barriers and challenges to you know that the company observes in the workplace problems that in terms of whether it be performance and production or whether it be customer service or the teamwork you know is sleep a you know in spring the question up is a formal education and providing leadership in these areas it's one place to get started it's very low hanging fruit and and we would certainly encourage anyone who feels that insufficient sleep is a regular daily problem for them please and you know can they be in you know have the option the encouragement to you know obtain that medical consultation if they have a sleep disorder it can be treated great thanks and in many ways that was a wonderful summary for us to end our day together today Claire I'll give you one more opportunity if there's any final remarks you'd like to make to our panel and our attendees today yeah I think one thing about the sleep topic is if people haven't been getting enough sleep once they do they I don't believe they'll want to go back to their previous life it makes such a big difference in the quality of your life how you feel how your health is it's really a journey that is well worth it and there's a lot of great resources to help people start that journey thank you great again my thanks to all of you and the people at the workplace health Resource Center for inviting me to be your moderator today this is all the time we have for thanks again to dr. Michael Terry and dr. Claire Caruso and on behalf of the CDC workplace health resource center and the NIOSH office for total worker health i'm dr. casey chose wood stay safe and well and hey guys get some sleep good day

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