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feeling tired?
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Shiftwork and Fatigue
Once, a pilot crashed after 16 hours on duty
because he read an altimeter incorrectly.
He had been flying safely for 15 hours, and
suddenly he couldn't read an altimeter?
This is hard to believe. That's fatigue.
Fatigue is a loss of alertness which
eventually ends in sleep
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Fatigue is a serious issue
Fatigued operators can cause accidents, (egThree Mile Island, Bhopal, Space ShuttleChallenger, Exxon Valdez and Chernobyl)
USAcost of sleep-related accidents estimatedto be between $43 - $56 billion
UKannual cost of work accidents caused bysleepiness estimated to be 115240 million
25% of fatal truck crashes are due to fatigue
7% of motor vehicle accidents may be attributed
to fatigue, a figure that rises to 15% for motorwayaccidents
pilot fatigue is implicated in upwards of 20% ofnear-accidents in aviation
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The Sleep Quiz
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Im safe at work so it doesnt
matter if Im sleepy?
Falsebeing sleepy can cause:
slower reaction time
impaired judgements and decision making
decline in attention
decreased alertness
increased moodiness and aggressive behaviour
difficulty in remembering things
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I can tell when Im going to fall
asleepFalse.
People do not know how sleepy they
are The more tired you become, the less
able you are to make a good judgement
about your ability to remain awake Being awake for 18 hours is as great arisk as driving drunk
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Signs of tiredness
The signs include:
not feeling refreshed after sleep
difficulty keeping your eyes open and
focussed greater tendency to fall asleep while at work
more frequent naps during leisure hours
lots of yawning
extended sleep during days off increased errors and loss of concentration at
work
feeling irritable, restless and impatient
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Lack of sleep is the only cause
of fatigue...False but it is the only cure
Causes of fatigue include:
Workload
Social factors
Individual factorse.g., age, diet,fitness etc
Shift work
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The older you get, the fewer
hours of sleep you needFalse
Sleep needs remain unchanged throughout
adulthood Older people wake more frequently through
the night
Shift work becomes harder with age (4050yrs)
Ability to cope with early starts may improve
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Most people need 8 hours of
sleep to function at their bestTrue
78 hours is recognised as an average and normalneed
Less than this and you build up a sleep debt
Sleep comprises several stages which must follow acertain pattern if you are to feel fully rested and alert Stage 1 and 2: transitional phase between waking and
sleeping
Stage 3 and 4: deep sleep
Rapid Eye Movement (REM) sleep
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If I sleep a lot now, I wont
need to sleep much laterFalse
Sleep is not like moneyyou cant save
it up and you cant borrow it
While napping is an effective means ofmanaging alertness it is not a substitute
for regular sleep
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Everyone has a biological
clockTrue
We have evolved own internal body clock /
circadian rhythm It controls a number of internal rhythms, eg,
sleep/wake cycle, body temperature
It is this body clock that makes us feelsleepier and less alert when we try and workat times normally reserved for sleep
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The human body can adjust to
nightshift workFalse
Our body clock programmes us to feel mostsleepy when it is dark
Eating meals at times normally reserved forsleep means they are less well digested
On night shifts you tend to get less sleep and
it is of a poorer quality (e.g., after one week ofnight shifts, workers had lost the equivalent ofone nights sleep)
Successive night shifts, eg, 4, result in an
increase in accident risk
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Features of shiftwork
that lead to fatigue Timing of shifts (earlies, lates and
nights)
Duration of shifts
Rotation of shifts
Rest and recovery periods
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Early Starts
Associated with a reduction in duration ofsleep
Sleep periods prior to early start are on
average 3 hours shorter Difficult to compensate with earlier bedtime:
Social pressures
Forbidden zone
Fear of not waking up early Successive early startscumulative sleep
deficit
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Snoring is not harmful as long
as it does not disturb sleepFalse
Chronic snoring may indicate sleep
apnoea, a sleep disorder
Other common sleep disorders are:
Insomnia
Restless leg syndrome
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Drinking coffee cures
drowsinessFalse
Caffeine has a short term effect
Caffeine should be used carefully as it willdisrupt sleep
Other measures such as opening windowsand putting on the radio are not effective
The only cure for drowsiness is to get somesleep
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Conclusions
Being tired impact on our performanceand increases the risks of an accident
The amount and quality of sleep areimportant factors in ensuring you wakeup feeling fully rested
Shift work makes us more prone tofatigue because it makes us workagainst out natural circadian rhythms
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Coping with Shiftwork
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Sleep Strategies Managing your work time Use naps to improve alertness
Create a good sleep environment
Establish a regular pre-sleep routine Establish a regular bedtime and wake-up
schedule
Manage your caffeine intake
Other advice: Avoid alcohol
Take regular exercise
Manage your diet
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Managing Your Work Time
There are different tips for managing fatiguedepending on your shift pattern and the type
of shift you have just finished. Example: managing night shifts
Go to bed as soon as you get home
Have an afternoon nap
Avoid exposure to daylight
Eat 3 regular meal with lunch during your night
shift
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Creating a good sleep
environment Quiet
Dark
Warm/cool
Comfortable bed that you associate withsleep
Fresh air
Free from interruptions
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Pre-sleep routine
You can learn that it is time to relax andgo to sleep
Establish a pre-sleep routine to providespecific cues: Reading
Listening to music
Getting dressed for bed
Only get into bed when your tired
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NappingNot to be used
whilst at work Limit naps to about 3045 minutes including
the time it takes to fall asleep
Naps of 1520 mins are most restorative Give yourself time to get over sleep inertia
There is no minimum time period for effectivenapping
Improved alertness may last for several hours
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Caffeine
It is a stimulant so it can keep youawake but it can also disrupt sleep
Use caffeine in moderation and when itis most needed
Avoid it for several hours before sleep
Dont quit cold turkey, cut backgradually
How much caffeine is okay?
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