Sleep disorders are common and often undiagnosed. According to the National Institute of Neurological Disorders and Stroke, approximately 40 million people in the U.S. suffer from long-term sleep disorders, and an additional 20 million people suffer from occasional sleeping problems. The fatigue from these disorders is not only a safety concern within the workplace, but also could become a huge financial burden for employers if working conditions or schedules are found to be a contributing factor to someone’s inability to sleep normally.
What are sleep disorders?
Sleep disorders can be described as a lack of sleep caused by something other than binging Netflix, staying out late at night, or consciously choosing another activity instead of sleeping. Sleep disorders are serious conditions that can cause impairment during the day. There are various types of sleep disorders with different effects on a person’s mental, physical, and emotional well-being.
The most common type of sleep disorder is Insomnia. Insomnia can make it difficult to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. Short-term (acute) insomnia lasts for days or weeks, while long-term (chronic) insomnia lasts for a month or more. Insomnia can sometimes be associated with other medical conditions or medications.
Obstructive Sleep Apnea is a sleep disorder that causes a person to stop breathing repeatedly during the night. Many with sleep apnea suffer from other health problems that are exacerbated by their sleep disorder.
Restless Legs Syndrome is a condition that causes an overwhelming urge to move the legs, usually because of an uncontrollable sensation. This condition can often disrupt sleep as it typically happens in the evening or nighttime hours while sitting or lying down. This condition can begin at any age and generally worsens as you age.
Shift Work Disorder, also known as circadian rhythm sleep disorder, largely affects people who work during the night, in the early morning, or rotating shifts. This sleep disorder is characterized by insomnia, excessive sleepiness, or both, and affects people whose work schedules overlap with the typical sleep period.
Sleep is crucial to our overall health. Adults need an average of seven to nine hours of sleep each night, but 30% report averaging less than six hours. Chronic sleep-deprivation can cause depression, obesity, cardiovascular disease, and other illnesses, and is estimated to cost employers $136 billion per year in health-related lost productivity.
Common risk factors for sleep disorders include working second or third shift, obtaining less than seven hours of sleep per night, commuting longer than 30 minutes one-way to work, and having less than 12 hours off between shifts. Because of this, jobs like factory workers, nurses, police officers, firefighters, doctors, medical students, airplane pilots and air traffic controllers, truck drivers, senior management, and network administrators are all at high-risk for sleep disorders.
While an injured worker can pursue a claim for a work injury that results in a sleep disorder, there are limitations as to whether one can claim permanent disability as a result of a sleep disorder. In California, the current law indicates that there shall be no increases in impairment ratings for sleep dysfunction arising out of a compensable physical injury. However, if the sleep disorder is the direct result of an incident that occurs at work, such as a stressful or traumatic event, the employee may be eligible for permanent disability.
These specific laws vary from state to state, but getting treatment for sleep disorders through a workers’ compensation claim is possible as long as the employee can reasonably prove that the sleep disorder was either caused by or worsened by work, which is standard for any work compensable injury.
The determination of whether or not the sleep disorder was caused by or worsened by work is left up to the QME or AME. The medical evaluation will determine the diagnosis and medical causation. Determination of liability of sleep disorders lies solely on the medical evaluation. However, helpful tools such as a medical facility canvass can help the employer or insured determine if there was previous treatment for the sleep disorder, which may be helpful in mitigating claims.
Not only can sleeping disorders become workers’ compensation claims themselves, but they can often lead to other work-related injuries. Research suggests that around 13% of all work injuries could be due to sleep problems. Sleeping disorders can cause difficulties concentrating, decreased hand-eye coordination, slowed thinking/reaction time, reduced attention span, worsened memory, poor/risky decision making, lack of energy, and mood changes, all of which can easily turn into a dangerous situation in the workplace. Highly fatigued workers are 70% more likely to be involved in accidents. In one recent case, a ferry captain suffering from fatigue failed to prevent his ferry from striking a ferry terminal, causing $10.6 million in damages to the boat and piling. Investigators determined that the captain had become briefly incapacitated during a microsleep episode, which caused him to lose control of the vessel.
Regardless of who is held liable for the sleep disorder, it is clearly important that employers and insurers are actively helping to educate and prevent disordered sleeping amongst employees. This will, in turn, help to decrease other work-related injuries altogether.
When possible, employers should avoid rotating shifts, offer ample time off between shifts, ensure a work-life balance is prioritized, and provide flexibility for employees who may be struggling with lack of sleep. Workplace environments can also be modified to increase alertness with lighting, temperature, and noise, and can incorporate dedicated break rooms or even nap rooms. Making these changes may result in higher levels of productivity while lowering safety risks and the potential for workers’ compensation claims down the line.
Providing employees with the information and tools to understand and improve their sleep is a great place to start. Encourage employees to establish a regular bedtime routine, avoid caffeinated drinks such as soda, tea, and coffee before bed, minimize stress, and exercise regularly to ensure a good night’s rest.
Know the signs and symptoms of when someone should seek treatment for a sleep disorder, and where they can go for help. For more information, visit the CDC’s website below: