For Employers

The slumbering threat to health, safety and “the bottom line”.

“Forty million Americans are chronically ill with various sleep disorders; an additional 20-30 million experience intermittent sleep-related problems. Sleep apnea alone is the cause of excessive daytime sleepiness experienced by almost 20 millions Americans. Millions more are severely sleep-deprived as a result of demanding work schedules and various other life-style factors. One estimate of the cost of sleep related workplace productivity is $150 BILLION.”

Report of the National Commission on Sleep Disorders Research submitted to the U.S. Congress and Department of Health and Human Services, April 1993.

  • Sleep apnea has been found in up to 24% of men over age 40. A workplace survey reported in 1995 found that in a sample of 1,658 Franklin County, Ohio businesses, only 5% of employees tested positive for drug abuse. Hence. a much higher percentage of workers may suffer from a sleep disorder that causes dangerous workplace impairment very similar to that of substance abuse–but which is much more readily and rapidly treatable.
  • Sleepiness among workers was cited as a primary factor in causation of the disasters at Chernobyl, Three Mile Island and Bhopal.
  • The Nuclear Regulatory Commission closed Philadelphia Electric Company’s Peach Bottom nuclear plant because night shift workers were found to be sleeping repeatedly on the job. The Davis-Besse nuclear reactor in Oak Harbor, Ohio, went into shutdown at 1:35 a.m. An operator then responded by pushing two wrong buttons: thereby disabling its safety backup provisions. Nightshift worker errors were cited as factors in the automatic tripping at California’s Rancho Seco nuclear reactor and subsequent failure to regain prompt control of the plant.
  • Marked increases in human job-related errors during the second half of night shift have been documented in studies of gas works employees, drivers, pilots and train engineers.
  • Eighty percent of policemen admitted to falling asleep at least once a week on night shift. An estimated 50% of night shift workers fall asleep on the job at least weekly, and 75% fight sleepiness each night shift. An estimated 20% of workers on any given night shift fall asleep.
  • A U.S. Bureau of Mines investigation found that shift workers have more frequent and severe individual accidents.
  • Night shift workers obtain 1.5-4 hours less sleep per 24-hour period than day shift workers, and their sleep is more fragmented and more physiologically abnormal: even if noise and other interruptions are eliminated.
  • Numerous studies have demonstrated a strong association between worker sleepiness and both lower productivity and increased healthcare costs.

All corporations of significant size are virtually certain to employ workers with serious but untreated sleep disorders.

  • SLEEP APNEA has now been documented in up to a startling 24% of adult men – for example, in unselected electrical technicians and in a general practice study. It has been noted in 27 to 47.8% of people with high blood pressure. Nearly 80% of distance truckers in one study showed repeated drops in oxygen levels during sleep, consistent with sleep apnea.

Sleep apnea – repeated cessation of breathing in sleep, often with loud snoring and gasping – occurs with greatest frequency in overweight individuals. Thus, one could reasonably anticipate that its prevalence will increase progressively as a result of the rapidly escalating prevalence of obesity in the U.S. While identified most often in men over age 40, sleep apnea also afflicts younger workers and women–particularly if obese or post menopausal. It is more likely in people with short, thick necks, nasal congestion and “sinus trouble”, and it can be aggravated by alcohol and sleeping pills.

Sleep apnea has been associated with an up to 23-fold increased risk of heart attack, an up to nine-fold increased risk of motor vehicle accidents, and a 2.7 fold increased risk of vascular deaths. Sleep apnea was also found in 73.8% of male stroke victims.

Sleep apnea also has been implicated in heart failure, sleep related convulsions and cardiac arrests, as well as irritability, mood swings, and difficulty with memory.

-One study found impaired concentration, memory and problem solving ability in 89% of untreated sleep apneics.

Yet, sleep apnea is extraordinarily treatable.

  • NARCOLEPSY, another treatable cause of excessive sleepiness is at least as prevalent as multiple sclerosis. It usually begins earlier in life than sleep apnea, most frequently before age 30. Industrial injuries were reported in 18.9% of untreated or inadequately treated narcoleptics.
  • INSOMNIA, which afflicts over one-third of Americans, can impair alertness and functioning. Insomnia has been reported to cause a 2.5-fold increased risk of motor vehicle accidents: a risk that may be compounded by inappropriate self-treatment with alcohol or sleeping pills.
  • NIGHT & ROTATING SHIFT WORK SCHEDULES have been associated with a wide range of problems that increase employer health expenditures.

These include ulcers, gastritis and other gastrointestinal problems, respiratory problems and increased respiratory infections, low back pain, headaches, heart disease, emotional/marital difficulties, susceptibility to stress, increased smoking and alcohol use, memory lapses and an overall decline in health.

A study of over 121,000 female nurses reported that those working irregular shifts for over six years were up to 70% more likely to suffer heart attacks. This finding was similar to a 1986 study that showed an 80% increased risk of cardiovascular disease in male paper mill workers on shift work when compared to those on day shifts.

The impact of sleep disorders in the transportation industry.

  • The U.S. Department of Transportation has estimated that up to 200,000 motor vehicle accidents per year may be sleep-related.
  • One of every five drivers admits to having fallen asleep at least once behind the wheel, and 69% of motorists report drowsiness while driving.
  • The U.S. National Transportation Safety Board found that nearly one-third of all fatal-to-driver traffic accidents had sleepiness as their probable cause. The NTSB investigated 107 single-vehicle accidents in which the driver survived and discovered that 58% were related to fatigue–with 18% of the drivers admitting they had fallen completely asleep. The drivers in this sample had obtained only 5.5 hours of sleep during their preceding sleep periods: 2.5 hours less than the average reported by truckers with non-fatigue related accidents.
  • One British study found that 16-20% of all police-reported MVAs were sleep-related.
  • Sleep-related highway crashes caused 1.55 deaths/wreck in another British study, versus none in accidents caused by heart attacks or convulsions while driving. Such was attributed to these being high-velocity crashes, typically occurring on freeways, without driver awareness of impairment or impending sleep.
  • Sleep apnea, an extremely prevalent but treatable disorder, has been associated with an up to nine-fold increased incidence of motor vehicle accidents. In a Swedish study, after correcting for miles driven, individuals with full sleep apnea symptoms had twelve times as many accidents as controls. A British study showed that 93% of sleep apneics were at fault in one or more accidents. The significance of these figures is increased by indications of a markedly greater prevalence of sleep apnea among distance truck drivers: who recently were reported as having the highest on-the-job mortality rate of any profession for the third straight year!
  • Shift workers are reported to have twice as many auto accidents.
  • The NTSB cited pilot fatigue as a cause or contributing factor in 69 plane accidents, with 67 deaths between 1983-1986 alone.
  • Night shift flight simulator performance has been found to be impaired to a degree comparable to that produced by a blood alcohol level of 0.05%.
  • Operator fatigue was a major factor in the near-disastrous attempted launch of the space shuttle Columbia in 1986. Accidental drainage of 18,000 lbs of liquid oxygen escaped detection until only 31 seconds before liftoff. Just three weeks later, the space shuttle Challenger exploded with loss of lives. Key managers of that launch had been seriously sleep-deprived. A Presidential Commission cited ground crew fatigue as a significant factor in causation of that disaster.
  • The skipper of the World Prodigy, which dumped 300,000 barrels of oil into Narragansett Bay, admitted to not having slept for 36 hours. The NTSB ultimately determined that a primary cause of the Exxon Valdez disaster was sleepiness on the part of its third mate.
  • Sleep attacks on the job have been documented via EEG monitoring of night shift workers: including locomotive engineers.

What factors could place your organization at risk of preventable losses due to sleepy workers?

Ask if your workplace includes:

  • Males over age 40
  • Shift workers
  • Equipment operators
  • Drivers
  • Overweight employees
  • Overtime requirements
  • Factors that create hazard of injury or damages in event of employee inattention or error

“Sleepy workers are dangerous, less productive, and a major source of increased health care costs and corporate liability. Studies of the workplace and transportation industries reveal that human error causes up to 90% of accidents, with inadequate sleep representing a major factor in human error.”

-Time magazine cover story, “Drowsy America”, 12/17/90.

In summary: sleepy employees experience potentially dangerous degrees of impairment–essentially comparable to that of substance abusers.

Their impairment can jeopardize your bottom line–in a virtually identical manner.
And you probably employ even more of them.