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Sleep Problems: Lackluster Slumber

Jack (not his real name) is an airport baggage screener who works a midnight-to-8 a.m. shift so he can take care of family matters during the day. He loves the flexibility of being able to take care of his son when he's off, but admits his energy and alertness have suffered as a result.

"I'm always a cup of coffee away from joining the rest of society," says Jack. Off-duty, that has meant feeling constantly sluggish and sometimes nodding off at the wheel.

At work, although he puts in his best effort, he tends to feels more irritable, looks forward to his break more often, and tries to get passengers through the line at a faster rate. "I guess the quantity of work that a person can do during those hours is less."

Jack is not alone. According to the 2000 National Sleep Foundation (NSF) Poll, one-half of American employees report that sleepiness on the job interferes with the amount of work they get done.

The NSF estimates the direct costs of sleepiness and lost productivity in the workplace at about $18 billion.

Not only that, Jack is part of a growing group of shift workers who labor while most people are asleep and try to snooze while everyone else is awake.

The NSF puts the number of people who fit this description at 22 million Americans, and that figure is reportedly increasing by 3% each year. That's because there are more occupations that require around-the-clock attention, besides the trades of law enforcement, health care, energy, and manufacturing, which traditionally have had rotating schedules.

"Our whole society has moved toward a 24/7 kind of economy," says Mark Rosekind, PhD, president and chief scientist of Alertness Solutions, a scientific consulting firm that deals with sleep issues. He says people are now working all the time in retail, banking, information technology, and the media.

Plus, Rosekind says shift workers also could include business travelers who often cross time zones and people who get up very early in the morning to make a one-hour-plus commute to work.

Experts say shift workers are often hardest hit by sleep problems. Their biological clocks are confused, and when they try to get shuteye while the rest of the world is active, they can get disturbed by neighborhood noises, phone calls, kids at home, or a ringing doorbell.

Meir Kryger, MD, professor of medicine at the University of Manitoba in Winnipeg, Canada, says people who don't sleep well can exhibit the following symptoms:

• Frequent sleepiness
• Nodding off at meetings or while driving
• Difficulty with concentration
• Lapses in memory
• Poor performance, worse than usual
• Mood changes, such as being more snappy and irritable

These symptoms, when manifested at work, can have mild to grave consequences, depending on the job. "If you're sitting around and you're at a computer, it's not a big deal, but if you're operating a motor vehicle, it is a big deal," says Kryger.

For people who think they might have a sleep problem, here are some suggested first steps of action from Kryger and Rosekind:

• Get evaluated by your primary health care provider to see if you have a treatable medical condition.
• Educate yourself about sleep issues, and take advantage of sleep diaries and other resources available at the web sites of respectable organizations, such as the American Academy of Sleep Medicine (AASM) and the National Sleep Foundation (NSF).
• To find a board-certified sleep specialist or center, turn to the AASM web site, or ask your doctor for a referral.
• Evaluate out your priorities. How important is doing shift work for you?
• Explore your own workplace options. Try talking with your supervisor or your union representatives about other jobs that could be done during the daytime.

Shift work is only one of the problems related to slumber that concerns employees and their employers. The AASM reports at least 84 sleep disorders. For more information about other shuteye problems, including insomnia, sleep apnea, and restless leg syndrome, tap into our Sleep Disorders Health Center.

Originally published March 12, 2004.

Medically updated March 9, 2006.

SOURCES: World Health Organization. American Psychiatric Association. John Weaver, PsyD, owner of Pscyhology for Business, a workplace consulting firm. National Sleep Foundation. Meir Kryger, MD, professor of medicine, University of Manitoba, Winnipeg. Mark Rosekind, PhD, president and chief scientist, Alertness Solutions. Anxiety Disorders Association of America. Jeffrey P. Kahn, MD, clinical psychiatrist, author, Mental Health and Productivity in the Workplace. Rudy Nydegger, PhD, professor of psychology, Union College, Schenectady, N.Y. Lawrence S. Brown, Jr. MD, MPH, president, American Society of Addiction Medicine. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. WebMD Feature: "Internet to Sex: Defining Addiction." Angie Moore, licensed counselor in the treatment of alcohol, drug, and gambling addiction; spokeswoman, Illinois Institute for Addiction Recovery. Russell Barkley, PhD, professor of psychiatry for the Medical University of South Carolina.Children and Adults With Attention-Deficit/Hyperactivity Disorder. WebMD Feature: "Adult ADHD: More Controversy, Treatments."