1. Healthy People 2020 Objective: Sleep Health Kathleen Maloney, RN Jenna Patterson, RN

2. Sleep Health 2020 Objectives Goal #1: Increase the proportion of persons with symptoms of obstructive sleep apnea (OSA) who seek medical evaluation. Goal #2: Reduce the rate of car crashes per 100 million miles traveled that are due to drowsy driving. Goal #3: Increase the proportion of students in grades 9-12 who get sufficient sleep. Goal #4: Increase the proportion of adults who get sufficient sleep (Healthy People 2020).

3. Overview Poor sleep health is a common problem with 25% of adults in the United States; reporting insufficient sleep or rest 15 out of every 30 days. Low awareness of poor sleep health among the general population requires a well managed tactic to improve sleep health (Healthy People 2020). What is the “magic number” for sleep duration nightly?

4. Why is Sleep Health Important? Sleep plays an important part in allowing a person to relax, restore, and revitalize the body, mind, and emotions every day. Repairs the physical body to improve & maintain general health, consolidate learning and memory, and revitalize the mind to maintain emotional balance and well-being. Inadequate sleep, does not allow humans to function at an optimal level. We become accident prone, are less productive, and experience increased fatigue and health problems (Keller, 2009).

5. Target Population: Shift Workers

6. Defining Shift Work Shift work involves working outside the hours of 7am-6pm; the time period in which many people work a 8 hour day. Shift work is a major feature of work life across a broad range of industries including health care, restaurant workers, police officers, firemen, factory workers, construction, or any business that operates 24 hours a day. These shifts can include night, evening or rotating shifts (National Institute of Occupational Safety (NIOS).

7. Numbers of Shift Workers Bureau of Labor Statistics reports that about 5% of American adults work in the evening, another 4 % make up night workers and irregular scheduled workers. All together that accounts for 15.5 million shift workers in the United States. The need for 24 hour business practice increases the demand for shift workers (NIOS).

8. People Who Work Shifts Men work more night and rotating shifts, while women work more evening and do more part time work. However, women are starting to take on more full time jobs so their numbers are not far behind. Younger people aged 20-30 > older people. African Americans > Caucasian-Americans. Single people > married people. Single mothers > married mothers (NIOS).

9. Immediate Effects of Shift Work Soon after starting shift work, people notice changes in their quality of sleep and amount of sleep. Night workers usually get the least amount of sleep, evening workers get the MOST amount and day workers get a medium amount (NIOS). Sleep loss makes it much easier to fall asleep at inappropriate times, affecting a worker’s ability to perform safely and efficiently.

10. Sleep Deprivation & Health Risks  Cardiovascular diseases  Weight gain  Type II Diabetes  Poor Memory  Depression  Digestive Problems  Cancer (Ohlmann & O’Sullivan, 2009)

11. Public Health Programs 1.NYS Partnership Against Drowsy Driving 2.National Sleep Foundation’s Drowsy Driving Prevention Week 3.Wake Up And Get Some Sleep 4.Sleep Apnea Awareness Week

12. NYS Partnership Against Drowsy Driving (NYPDD) Created in 2004, joint effort to educate the public and high risk groups about the dangers of drowsy driving & promote the adoption of preventative strategies. Members include NYS Governor’s Traffic Safety Committee (GTSC), NYS Thruway Authority, NYS Police Department, DMV, NYS Motor Truck Association.

13. Rumble Strips Each year NYS approximately 2,800 people are involved in police reported crashes where “fatigue or fell asleep” was designated in the report (SafeNY.gov). Estimated 40-60% of “run off road” (ROR) crashes are due to driver fatigue, drowsiness or inattention (SafeNY.gov). NYS initiated rumble strips in 1978, made a common feature on highways in 1995 (SafeNY.gov).

14. National Sleep Foundation’s (NSF) Drowsy Driving Prevention Week “Almost all say that drowsy driving is unacceptable, but a third of us do it” (National Sleep Foundation). Awareness program providing tips to decrease drowsy driving and warning signs when you are too sleepy to drive. Studies showing that being awake for more than 20 hours results in a BAC equal to the legal limit of 0.08% (National Sleep Foundation). It is possible to fall asleep for 3-4 seconds without even realizing it!

15. Driving Drowsy; Just as Dangerous as Driving Drunk http://www.youtube.com/watch?v=c2GLHyCY ifk http://www.youtube.com/watch?v=c2GLHyCY ifk

16. Drowsy Driving Warning Signs & Prevention Strategies Warning Signs!!! Frequent blinking Trouble keeping your head up Drifting from your lane, swerving, tail gating, hitting rumble strips Inability to clearly remember the last few miles driven Repeated yawning Feeling restless, irritable or aggressive. Prevention Get a good night’s sleep before hitting the road. Don’t feel rushed to your destination Take a nap before a long drive Avoid driving at times when you normally would be asleep. Consume caffeine if necessary

17. Wake Up And Get Some Sleep

18. Education program developed by the National Traffic Safety Administration (NHTSA) in collaboration with the National Center on Sleep Disorders Research (NCSDR) Comprehensive program specifically designed for businesses and organizations that employ workers beyond the typical “9-5” workday

20. Sleep Apnea Awareness Week

21. Sponsored by the American Sleep Association October 1 st -October 7 th Primary objective of this campaign is to improve the nation’s knowledge about the symptoms, complications, diagnosis, and treatments of sleep apnea (American Sleep Association). News stations and Sleep Laboratories around the country will be providing life-saving information every day during Sleep Apnea Awareness Week.

22. Sleep Apnea Symptoms of Sleep Apnea Snoring Daytime sleepiness Nighttime gasping, choking sensation Morning headaches Morning sore throat Behavioral problems in children Complications of Sleep Apnea Increased risk of motor vehicle accidents Increased risk of heart attack Increased risk of stroke Decreased physical performance Decreased mental performance Increased risk of deadly heart rhythms Increased difficulty managing diabetes Increased difficulty managing blood pressure

23. Summary: Can Sleep Health Be Achieved?

24. References Admi,H., Tzischinsky, O., Epstein, R., Herer, P., Lavie, P. (2008). Shift work in nursing: Is it really a risk factor for nurses’ health and patients’ safety? Nursing Economics. 26(4), 250-256. American Sleep Association. (2007). Sleep apnea. Retrieved from http://www.sleepassociation.org/index.php?p=sleepapneapublic. http://www.sleepassociation.org/index.php?p=sleepapneapublic Keller, S. (2009). Effects of extended work shifts and shift work on patient safety, productivity, and employee health. American Association of Occupational Health Nursing. 57(12), 497-502. National Institute for Occupational Safety (2000) Plain language about shift work. Cinncinati, OH: Rosa, R. & Colligan, M. National Sleep Foundation. (2011). Drowsy driving prevention week provides tips to prevent one in six traffic fatalities. Retrieved from http://www.sleepfoundation.org/article/press- release/national-sleep-foundation%E2%80%99s-drowsy-driving-prevention-week%C2%AE- provides-tips-prev.http://www.sleepfoundation.org/article/press- release/national-sleep-foundation%E2%80%99s-drowsy-driving-prevention-week%C2%AE- provides-tips-prev Ohlmann, K. & O’Sullivan, M. (2009). The costs of short sleep. American Association Occupational Health Nurses. 57(9), 381-385. SafeNY. (2010). Drowsy driving and fatigue. Retrieved from http://www.safeny.ny.gov/drow- ndx.htm.http://www.safeny.ny.gov/drow- ndx.htm Stanhope, M. & Lancaster, J. (2012). Public Health Nursing: Population-centered health care in the community. (8th ed.) Maryland Heights, MO: Elsevier Mosby.

25. Questions????