The science of sleep and fatigue in the workplace

The science of sleep and fatigue in the workplace

Presented by: Dr Nicholas Mabbott

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Spencer Howsen: Nick, first of all, welcome to the podcast.

Dr Nicholas Mabbott: Thank you very much.

Spencer Howsen: Sleep has to be one of the most, if not the most important thing to nail in our lives. Am I right?

Dr Nicholas Mabbott: It certainly is, and it is one of the least thought of for most people. In fact, I had a show of hands in there. There was about 400 people, and probably half the people have said that they have some sort of sleep condition such as insomnia or sleep maintenance insomnia, and about 95 per cent had admitted to having a micro sleep on the road at some point. So it's very common and people just don't see the real relevance of sleep until someone like me stands in front of them and says, "Well this is really how it works and if you don't get it while you're in bed, you'll do it on the road or in the office or wherever."

Spencer Howsen: Wow. Okay. We'll get to what employers and organisations can do, but let's just stay with the very personal and the every person. How much sleep do we need?

Dr Nicholas Mabbott: We need about seven and a half to eight hours every night. That is best to be average though because sometimes you'll find yourself getting six hours. That doesn't mean that seven and a half hours the next night is good. What you need the following night is about nine hours because sleep comes basically in 90 minute waves or cycles. We do five of these cycles every night. And if you only get six hours one night, you only get four cycles, which means the next night, you need to get six cycles to pay back that one that you are short.

Dr Nicholas Mabbott: If you don't pay that back, then the following day, you'll still be drowsy while you're at work. You are less productive. You are less safe. Your mental health takes a bit of a hit as does things like type two diabetes.

Spencer Howsen: Can you bank it up or rather bank, take, go into credit for a few days and then catch up on the weekend for example, or does it not work like that?

Dr Nicholas Mabbott: Yes, it sort of does work like that. You can't literally bank it, but what you can do is if you can average seven and a half to eight hours every night for say three or four nights in a row, then one short sleep or two short sleeps even won't make much difference because you build up a resilience to it.

Dr Nicholas Mabbott: And I use this sometimes with athletes that are going from Australia to different countries to compete. Basically I teach them the golden rules of sleep around the seven and a half, eight hours. And if they can do that for the whole week preceding their flight, they can normally perform for up to two days before they start falling apart from lack of sleep in the new country they're in.

Dr Nicholas Mabbott: So that's probably the best example that we see from that. And myself, when I'm flying around, if I get a six hour sleep, I don't really feel it much the next day. Although, I do notice a little chink in my armour regarding mental health. I won't be as resilient to other people's mistakes on roads and so on. But I can catch up the next night and then it's all gone away and I'm as good as gold.

Spencer Howsen: What are some of the things that impact on sleep?

Dr Nicholas Mabbott: Well, how long is a piece of string? One of the first questions I ask when I'm training is who's coming to work for a rest because I've got a little baby at home? So for the FIFOs, for example, that can be really good for them, just getting away from the situation at home where they're tending to babies and so on.

Dr Nicholas Mabbott: But also, when we're talking about shift work, people trying to sleep during the day, there are numerous things that stop us or disturb us from sleeping. And often, we find on shift work, we get to about four and a half hours of sleep. And because we then do mainly light sleep, we're woken really easily. And this is why a lot of people only get about four to five hours sleep on night shift.

Dr Nicholas Mabbott: So, I do spend a lot of time with people helping to educate them on how to get more sleep. So we're seeing good results, people getting up to seven hours sleep on night shift now, which improves every aspect of their life basically. But also things like pain, heat and the session I walked out on just now was all about heat and how that can impact sleep as well. That has a circular effect because if you go to work fatigued and you're in a hot, dry location, you often forget to rehydrate. So then you suffer from heat stress as well as fatigue. So there are numerous factors there.

Dr Nicholas Mabbott: Also, anxiety and depression can really suppress your sleep. It can put your sleep back. It can wake you several times. The flip side of that is if you're not sleeping well, you can become depressed or take on anxiety as well. So there's a whole lot of things there as well.

Spencer Howsen: So, most of those, you mentioned young babies, but apart from that, most of the other things that you said, they were very much workplace-related and there'd be other things at home like alcohol, I suppose, TV, distractions from phones, et cetera.

Dr Nicholas Mabbott: Sleep nonchalance, we call that. People not really caring. There's too many other important things to do like just watching that one episode of Netflix, which runs right up till midnight, and then you find you get five or six hours sleep. So the general public in Australia are very nonchalant about their sleep until I tell them about some of the consequences of their lack of sleep and then they go, "Oh, I might try and change that."

Spencer Howsen: And that's, what, the micro sleeping while driving, you mentioned, but what are the others?

Dr Nicholas Mabbott: There are several health factors. For example, one research project in 2004 by Dr. Evan Quarter, University of Chicago, they found that if you take a bunch of young, fit healthy guys, about 22 years old and subject them to four hours sleep a night for six nights, they go from point, sorry... five millimoles of glucose per litre of blood, so not diabetic, in six nights to what we call pre-diabetic or six millimoles of glucose per litre of blood.

Dr Nicholas Mabbott: So basically, they're going from a 22-year-old to a 50-year-old in six nights with only four hours of sleep each night. The good thing about that research, they could reverse that and catch up on sleep the next week and they all went back to perfectly healthy again.

Dr Nicholas Mabbott: When we're talking about mothers of newborns. Three nights in a separate experiment, three nights with no deep sleep, and you can imagine with a newborn, you get a lot of nights without deep sleep. It only took three nights to go pre-diabetic from perfectly healthy. So, you can see not only with things like type two diabetes, but also things like postnatal depression and different forms of anxiety. These are all things that can come about from a lack of sleep or just sleep restriction or impaired sleep through many of the disorders that we have. We have more than 80 disorders. So there's a whole raft of things that can cause sleep restriction. And the outcome of that sleep restriction is not only safety impacts, but it's health and wellness and a lot of people don't really know that.

Dr Nicholas Mabbott: And in fact, one of the things I've changed when I deliver training now is, I'll say where a group of workers, "I'm not here to talk to you about safety. I want to talk to you about your health and wellness and going home in a really good condition," and that's something that they've really switched onto. They're hungry to hear that stuff because it's not just beating on them on safety and they take the message home.

Spencer Howsen: Whatever the cause of people not sleeping then, whether it be anxiety at work, choosing to watch another episode of Netflix, et cetera, et cetera, what can employers and organisations do with all of those causes to actually make a difference?

Dr Nicholas Mabbott: Well, there are a number of things. Firstly, I think it's always a good idea to just stop everything and do a fatigue risk workshop. To do that, you need to get a hold of a good set of guidance notes on fatigue. And one of the best ones I've seen in this country is the Q Gen 16 developed in Queensland and released in 2014. It's really good at identifying fatigue risk within an organisation and it also supplies controls put in place.

Dr Nicholas Mabbott: To do the fatigue risk assessment workshop, you need the right people on board, so everyone from upper management right through to shop floor, supervisors and in management. You need to develop fatigue management plans, usually arising from that workshop so that you can put these plans in place, but you also need to monitor to make sure that these plans are working and reducing the fatigue risk.

Dr Nicholas Mabbott: Some of the other things we can do is we can look at selecting people for the task, which has always been the case for most industries. But when it comes to fatigue, you need to be a little bit more careful about who's going to drive your haul trucks, or who's going to deliver goods on the highways and things like that. Are they good sleepers? Are they well educated? Research shows that truck drivers without fatigue education, roughly six to seven times risk of a crash. Also, truck drivers with depression are seven times at risk of a crash and so on. So that's just some of the stats that you can throw around there.

Dr Nicholas Mabbott: I think one of the biggest outcomes we've got from in any industry, and some of my clients have told me this, is that if you deliver good fatigue management education, people take this awareness home, which is where good fatigue management starts. They educate themselves, they educate their families and take their families on a ride of "Let's improve our sleep. Let's improve our whole family dynamics. Let's all become more energised, safer, happier," and they're getting really good results.

Dr Nicholas Mabbott: And some of the research that I've seen recently from my own training has improved the sleep of not only day shifters but also night shifters. And when I go back to that workplace, the supervisors were saying, "Well, we didn't just get a few impacts on safety and productivity. What we got was a more mentally stable workforce and the guys are coming to work really happy and they're going home happy."

Dr Nicholas Mabbott: So, one of the biggest things is good fatigue education. And I can tell you now, you get what you pay for with that. If you want just one hour of education, don't expect any changes. You need at least two to three hours or more. In fact, one of my clients who's right onto this says, "Nick, I want you to do four hours no less" because he's seen the impacts that it's had on some of his work crews.

Dr Nicholas Mabbott: So that's really important. The other important thing is training up supervisors. So supervisors need to do what the employees do to start off with, but they also need additional training on how to recognise in their people who's a little bit off today and to put controls in place before things go pear-shaped. That is a really crucial part of it. So, there's a lot that an organisation can do.

Spencer Howsen: And what about management modelling behaviour? For example, not coming in and gloating about how they were up till 11 pm working on reports, sending emails on the weekends. It's got to be top down, isn't it?

Dr Nicholas Mabbott: It has to be. And that's part of the supervisor training is walking the talk. Just give you a little case study recently because I'm in a position where I need to be doing the same. Obviously I'm sort of on the stage as the fatigue guy. Recently, I had to fly home. I woke up in Mackay, I did a session in Mackay. I flew down to Brisbane. I had to fly from Brisbane back to Perth that night. I was originally arriving at 11:30 pm and having to drive one hour, which is probably double the risk of a crash, and I knew that, so I take precautions along the way.

Dr Nicholas Mabbott: As misfortune would have it, the flight wasn't flying till later. In their ultimate wisdom, they decided to land in Melbourne first, refuel, and then fly to Perth. The captain announced on the way into Melbourne that we would arrive at about 4:30 in the morning. I said to the cabin crew, "I need to talk about disembarking at Melbourne." She said, "Why? Don't you want to go home?" And I said, "Well now I've just done the maths. By the time I get home at 4:30, I would have been awake 25 hours, and then I have a one hour drive. And the stats that I know at 24 hours awake, you are equivalent performance as 0.1 BAC, alcohol. So I'm getting off at Melbourne." Cost me 260 for a room for the night and 88,000 frequent flyer points to get another flight the next day. That's walking the talk.

Spencer Howsen: Wow. I do want to finally just tap into the fact you do travel a lot, and there'd be some of our senior managers listening to this who also can relate to using that many frequent flyer points to do something. Others are like, "What? How do you ever get that many frequent flyer points?" What are you tips for getting good sleep if you're someone who has to travel a lot for work?

Dr Nicholas Mabbott: Yes. Look, it's all about very careful planning around the trips themselves. What do I do for every client is I'll say, "Here are my preferred flights." And I understand it might take me 15 to 30 minutes to work out what flights suit me better as far as sleep and performance is concerned and I'll give them the flights and say, "This is what I'd like to do." Because if you don't, a client will have you on a 6:00 flight from Perth, which means for me personally, I have to get up 3 am, which means I have to have been in bed by 7:30 that night to get seven and a half hours, which is never going to happen. You can't do that and you arrive in big trouble. You're tired. You go to sleep debt, and kind of hard walking the talk.

Dr Nicholas Mabbott: So, what I always do is I plan my flights very carefully. I have to educate my clients sometimes that you need to be looking out for you know consultants and contractors are often forgotten about, especially for a one or two-day job. Coming onto site, I recently had a case where I had to educate the client that me starting at 8:00 in the morning, finishing at 4 pm in the afternoon was okay, but then to do two sessions at night and go from 7 till 11 pm six nights in a row was not going to happen.

Dr Nicholas Mabbott: So, I said, "Here are my boundaries. I'd be finishing at 9:00 at night, but only if I don't start until at least 8:00 in the morning." So, sometimes it's about educating yourself, but other people as well.

Dr Nicholas Mabbott: I guess probably the most important thing is you need seven and a half hours on average every night and you need to try and keep the same wake up time and that gives you a bedtime every night, which is the same time. You can build routines around this. You can get to sleep. I generally get to sleep within five minutes. And I've got a theory of sleep timing that I will be producing in a book soon. I won't give too much of it away, but I can tell you basically if whatever time you wake up, you need to be in bed at a certain time to get to sleep within five minutes. I'll give you a tip there. If you wake up at 6, you need to be in bed at about five past 10 and you'll be asleep by 10:15. So there's a bit of a tip.

Spencer Howsen: Fantastic. I could listen to you all day. Nick, thanks so much for being on the podcast.

Dr Nicholas Mabbott: You're most welcome. I love it.

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