abstract: 'Most adults spend a significant number of their waking hours at work.

  The work relatedness of employees'' sleep is not always obvious to

  employers, as sleep is usually a private behavior. Yet there is much

  about how work is organized that influences the opportunity to sleep,

  the quality of sleep that is achieved, and the risk for sleep disorders.

  Circadian rhythm disruptions influence sleep when work schedules include

  very early start times, night shift work, or shift rotation. Reduced

  sleep opportunity from long working hours, shift overruns and overtime,

  long commutes, and being called in during time off may cause sleep

  deprivation. The physical surroundings of the job (light, noise) can

  increase or inhibit alertness, and over time can alter circadian

  rhythms. When work is physically or psychologically stressful, it can

  inhibit sleep by increasing sympathetic nervous system activity that is

  incompatible with restful sleep. Certain occupational groups (health

  care, transportation, public safety, food service, mining, construction,

  executive travel) are at particular risk for impaired sleep because of

  work stress and the scheduling of work hours. Because nurses care for

  workers throughout the life span in all health care settings, the

  nursing curriculum must teach the basics of sleep to entry-level nurses,

  nurse practitioners, and occupational health nurses (OHNs). (See Chapter

  24, Future Directions in Sleep Promotion: Nursing Practice, Research,

  and Education.) This chapter discusses the work-related impediments to

  sleep and interventions to improve sleep, with implications for health

  promotion and occupational health programs in the workplace.

  The consequences of acute and chronic sleep deprivation for workers are

  well documented. Workplace injuries and accidents are more frequent,

  causing pain and suffering, as well as lost productivity for the worker

  who is sleep deprived. Frequent or high cost claims can lead to higher

  costs to the employer for health benefits. Chronic sleep deprivation

  increases the risk for cardiovascular diseases such as hypertension,

  stroke, and heart disease, as well as metabolic disorders such as

  obesity and diabetes. These work-related health hazards can be addressed

  with active health promotion and occupational health programs and

  practices that minimize serious adverse outcomes.

  Sleep promotion is ideally a shared responsibility of workers, their

  employers, and health care providers. Workers themselves must consider

  the priority they place on sleep when competing demands threaten to

  derail a healthy lifestyle and performance at work. They must also be

  aware when their sleep is abnormal, seek treatment, and adhere to

  treatment recommendations if a sleep disorder is detected. Employers who

  are trying to create a healthy work environment must have a systematic

  plan at all levels of the organization to recognize sleep-related

  aspects of the physical work environment, the intensity of workplace

  stressors, and how work is organized to advantage workers'' sleep. They

  must provide health insurance coverage to ensure that workers receive

  specialty treatment for their sleep disorder-related symptoms and

  provide accommodations if chronic sleep disorders continue to impair

  functioning.

  The employee health unit is the best place to coordinate the health

  promotion activities at work as well as screening, clinical care,

  referrals, and accommodation. The personnel in the employee health

  and/or safety departments should conduct exposure assessments of

  scheduling practices and monitor trends in injuries to inform healthy

  scheduling practices. When the exposure assessment identifies possible

  risk factors for sleep deprivation or sleep disorders, the occupational

  health nurse clinicians must incorporate thorough sleep and occupational

  exposure histories, provide health education regarding sleep and work,

  and tailor interventions to improve sleep quantity and quality. The

  health care providers in the employee health department can also

  recognize sentinel occupational health events, such as sleep complaints,

  drowsiness at work, and accidents and injuries which might indicate

  additional workers at risk for occupational sleep disorders (Figure

  22.1). In the ideal situation, all are motivated to create a healthy

  workplace where workers can be safe and productive and then go home,

  sleep restfully and long enough, and enjoy a high quality of life.

  Combined, these concerns clearly have implications for workplace policy

  development to ensure worker safety and productivity.'
affiliation: 'Geiger-Brown, J (Corresponding Author), Univ Maryland, Sch Nursing,
  Work \& Hlth Res Ctr, Dept Family \& Community Hlth, Baltimore, MD 21201 USA.

  Geiger-Brown, Jeanne, Univ Maryland, Sch Nursing, Work \& Hlth Res Ctr, Dept Family
  \& Community Hlth, Baltimore, MD 21201 USA.'
author: Geiger-Brown, Jeanne and McPhaul, Kathleen M.
author_list:
- family: Geiger-Brown
  given: Jeanne
- family: McPhaul
  given: Kathleen M.
booktitle: SLEEP DISORDERS AND SLEEP PROMOTION IN NURSING PRACTICE
da: '2023-09-28'
editor: Redeker, NS and McEnany, GP
files: []
isbn: 978-0-8261-0658-2
keywords-plus: 'BRIGHT-LIGHT EXPOSURE; NIGHT-SHIFT WORK; CIRCADIAN-RHYTHMS; IMPROVE

  SLEEP; ALERTNESS; PERMANENT; FATIGUE; ADAPTATION; MELATONIN; DISORDER'
language: English
number-of-cited-references: '64'
orcid-numbers: 'McPhaul, Kathleen/0000-0002-7008-142X

  Redeker, Nancy S/0000-0001-7817-2708'
pages: 355-369
papis_id: 6b084e246a7d4f5a43116a36e8d5edd4
ref: Geigerbrown2011sleeppromotion
researcherid-numbers: 'McPhaul, Kathleen/AAC-3205-2021

  Redeker, Nancy S/Q-8252-2016'
times-cited: '2'
title: Sleep Promotion in Occupational Health Settings
type: article
unique-id: WOS:000291326200023
usage-count-last-180-days: '1'
usage-count-since-2013: '22'
web-of-science-categories: Primary Health Care; Clinical Neurology; Nursing
year: '2011'