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

Fatigue Management: Cheaper than Therapy Fatigue Management Cheaper than Therapy Types o Ty of Fa Fatigue Mike Har ke Harnett ett Pres esident ident Solar laris F Fatigue tigue Management Management 1. T 1. Task sk Relat lated d (Ex (Exertion) ion) 2. Sleep R 2. Sleep Related lated • Depleting our body’s resources • Inadequate restorative sleep, resulting in ongoing either physically, or mentally decrements in physical and mental capabilities • The more exertion, the more rest and recovery required throughout and after shift Drowsiness/S Dr siness/Sleepiness eepiness Sleep W Sleep Wars rs • A typical day: • Fluctuates; can be temporarily – sleep masked – work • More fatigue, more drowsy – family / recreation episodes • From over 9 hrs to less • Real time effect on than 7 hrs today performance NSF 2010 www.solarisfm.com 1

Fatigue Management: Cheaper than Therapy 2016 C 2016 Canadian nadian Sleep R Sleep Review view How How much is enough? much is enough? Amount of Sleep 40% 38% 35% 30% 28% 25% 26% 20% 15% 10% 8% 5% Irregular/erratic schedules reduces TST by an average of 2 0% hours (chronic sleep deprivation) 7 hours or more 6‐7 hours 5‐6 hours Less than 5 hours NSF 2010; AASM 2010; Work-Life Balance of Shift Workers, Stats Can 2008 Rachel Morehouse, Dalhousie University, 2016 Doesn esn’t m t my body k body know bett better? er? • NO! You cannot train yourself to need less The S e Scienc ience of Sleep e of Sleep sleep • Accelerates aging of every cell at DNA level Sleep/W Sleep/Wake C ake Cycle cle Homeostasis sleep drive Circadian drive External zeitgebers Peripheral Clocks • Light timing • Mealtimes • Bedtimes • Social Cues • Physical Activity www.solarisfm.com 2

Fatigue Management: Cheaper than Therapy 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 • Can never “fully” adapt to night shift (<3%) • Any night shift adaptation gained doesn’t last Se Serotonin From F om Food ood to Mood ood Meat, dairy, fish, nuts, whole grains, quinoa • Melatonin synthesized from Serotonin Sunlight promotes L- synthesis of serotonin Tryptophan • Known as the “happiness” hormone from tryptophan • Significantly reduced serotonin Serotonin levels in rotating shift workers Melatonin synthesized from serotonin Melatonin Stages of Stages of Sleep Sleep Light Stages Light Stages of of Sleep Sleep • Stages 1 & 2 NREM Awake (Beta/Alpha) – brain waves slow – snoring is initiated Stage 1 (Theta) – motor skill consolidation NREM Stage 2 (Spindles) – easier to arouse from Stage 3 (Delta) (Beta/Alpha/Theta) REM www.solarisfm.com 3

Fatigue Management: Cheaper than Therapy Deep Sleep eep Sleep REM Sleep REM Sleep • Stage 3 NREM • Body is “paralyzed” while – brain is quiet (long, slow Delta brain kicks into high gear brain waves) • Important for – HGH released – psychological well-being – long term memory consolidation – primary cognitive repair – recharged immune system – Short term memory – hard to wake up from consolidation Health Healthy A y Adult Sleep P ult Sleep Patt ttern ern Stage Stage 1 Stage Stage REM REM 2 REM REM REM REM REM 1 C 1 Cycle cle = = 90 M 90 Minutes nutes Stage Stage Stage Stage 1 3 Stage Stage 2 Hours After Going to Bed Older A Older Adults ults (45+) (45+) Health I Health Impac pacts Physical Health Emotional and Mental Health • Stroke and cardiovascular • Aggressive and intolerant disorders • Impulsive • Digestive disorders • Mood swings • Kidney disease and scarring • Irrational • Rheumatoid arthritis • Decreased motivation • Fertility problems • Depression • Various cancers • PTSD • Obesity • Dementias • Hypertension and diabetes • Alzheimer's Disease www.solarisfm.com 4

Fatigue Management: Cheaper than Therapy Loss of Loss of Cognitiv itive e Fatigue and tigue and Monot notonous nous Tasks sks Situational Situational Impairment Im Awar arenes eness Decreas Decr eased d Mo More T Time Learning arning • Commuting is high risk when sleep deprived on T on Task sk Ability Ab ility Hours of Sleep <4 4‐4.9 5‐5.9 6‐6.9 Reduc Reduced d Under- Under- Reac Re acti tion on estimati esti mation on Risk Level for MVC 11.5 5.4 1.9 1.3 Time Ti of R of Risk sk Slowed Slo ed The wheel i e wheel is t turni rning bu but Fl Flawed Information In th the h hams mster is d dead ad… Log Logic Proce ocessi ssing ng Poor oor Hinder ndered ed Pr Problem Visual Vi So Solving Pe Perception AAA Foundation for Traffic Safety, 2016 Fatigue is tigue is Danger Dangerous ous Impair paired is I ed is Impair paired ed BA BAC Equiv C Equivalenc lency 0.10% 0.08% 0.05% ~40% drop in alertness 15 17 19 21 23 25 Hou Hours A s Awake Lamond & Dawson, 1997 Subjectiv Subjec tiveness ≠ ness ≠ Accur curacy 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 Van Dongen, et al. Sleep. 2003; 26:117 www.solarisfm.com 5

Fatigue Management: Cheaper than Therapy The Rules of Napping The Rules of Napping Consumer Sleep S nsumer Sleep Study (20,000) udy (20,000) • Naps can supplement sleep, not replace it 50% of Americans regularly use a mix • Short naps reduce sleep inertia of two or more • Most effective on first night of a sleep aids per night sequence of shifts • Lie down (50% faster) Sleep meds treat the SY SYMPT MPTOMS MS not the problem! ResMed Tech, 2017 Zhao, et al. Biol Psychol. 2010; Dr. Neil Kline, American Sleep Association, 2017 Non- Non- Prescr escription Sleep Aids iption Sleep Aids Turn off rn off your br ur brain! ain! • 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 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 om 604-379-912 604-379-9124 Visit me on LinkedIn Follow me on Twitter @mike_the_girl www.solarisfm.com 6