I was recently asked to talk to employees of one of Hawaii’s largest companies on how to manage fatigue in the workplace.
No question, fatigue impairs productivity, erodes safety, increases risk and affects company morale. Fatigue is the final common denominator for a human system that is off-form and out of balance.
What, most commonly, keeps us from thriving?
Nonrestorative sleep: Under normal circumstances we spend roughly one-third of our lives sleeping in order to process the day gone by and rejuvenate body and mind. There are three main causes of nonrestorative sleep:
» Insomnia from poor sleep hygiene. Many people complain about having a hard time getting to sleep.
Insomnia often arises simply from too much caffeine too late in the day. Another culprit is late-night screen time. The light of a display from a smartphone, notebook, laptop or desktop computer makes the body think it is daytime. Switching off moments before going to bed might not give the body enough time to get ready for sleep.
Another troublesome habit is "television napping" before bedtime. After a long, hard day, it’s home for dinner and then to the couch for a well-earned episode of whatever. Snooze out in front of the screen, wake up 20 minutes later and realize it’s time for bed. Good luck.
» Shift work: Nighttime shift work tends to shake up our natural circadian rhythms. The reason it’s tough to work all night and get solid sleep after the sun comes up is because even if we are tired, the sun tells the pineal gland in the brain to send the body chemical signals to wake up. The worst case is, say, three nights on and then, after the weekend, a day shift again.
» Sleep apnea: Even more common than not being able to get to sleep is being "out" for six to eight hours, perhaps with a sleep aid, and waking up feeling unrested.
Sleep quality is more important than quantity. Sleep apnea is defined as repeated episodes of halted breathing resulting in lowered oxygen levels. It’s like someone is choking you but quickly runs away just as you wake up. It is not unusual for sufferers of sleep apnea to think they awaken because of stress on the job or chronic anxiety. More often than not, successful treatment of sleep apnea resolves those anxious feelings.
Risk factors for sleep apnea include daytime fatigue, snoring, being overweight, diabetes and heart disease. Since opening Manakai o Malama’s sleep lab in January 2013, more than 90 percent of those screened for sleep apnea were positive.
Effective the first of this month, people holding commercial driver’s licenses must also be screened for sleep apnea. All facilities that offer exams for CDLs must send their providers for additional training to meet these requirements.
Poor diet: The wrong foods also affect stamina and drive, resulting in fatigue.
» Sugary foods: Drink a sugary soda and glucose levels fly up within three to five minutes, stay up for 30 to 60 minutes, then plummet.
Low blood sugar causes fatigue, poor concentration and irritability. Foods that cause spikes in blood sugar are also the primary cause of diabetes.
» Excess weight: High-glucose foods together with those high in fats, especially in the absence of regular exercise, also lead to weight gain. Put 20 pounds in a daypack as soon as you get out of bed one morning and don’t take it off until bedtime. Tired? You bet.
» Inflammation: Sugary foods and excess weight result in a more acidic biochemistry, which causes inflammation that leads to heart disease, chronic pain and accelerates aging. It also causes fatigue.
Sedentary lifestyle: Humans don’t hibernate through the winter like bears, but being sedentary does release biochemical signals that tell the body to slow down and bulk up (fat, not muscle). Simply working up a sweat three to five times per week can keep that at bay. Sweating also helps rid the body of toxins and does wonders to shake fatigue.
Depression: Fatigue can also be a presenting symptom for depression. Low mood, poor concentration, appetite changes and poor sleep, especially when occurring together, might indicate that it’s time to seek assistance.
Chronic fatigue is usually a sign that life is out of balance and tends to develop slowly — so slowly we might miss it. The first step in finding a solution to fatigue is noticing that it’s there and realizing attention is needed. Sometimes a family member, co-worker or supervisor recognizes it before we do. The chances are that if you are too tired to enjoy life, people at home and work are taking notice. Make the necessary changes to get back on your game. Life is for thriving.
Ira Zunin, M.D., M.P.H., M.B.A., is a practicing physician. He is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.
