Sleeo Recovery

Sleep and recovery:
a toolkit for employers

Click here to
read the toolkit
In association with Sponsored by

Introduction 1/ Key issues to consider 2/ Understanding sleep deprivation 3/ Taking action to support good sleep Appendices Resources Case studies
Contents
Introduction 2/ Understanding sleep deprivation 19 Appendices 33
Core statistics 3 Signs of sleep deprivation 20 Glossary of terms 34
Checklist of actions 4 Causes of sleep deprivation 21 A guide to sleep 35
Positive partnership 5 –W
ork-related causes 21 Clinical sleep conditions 36
SMEs 5 –C
hanges in health and wellbeing 22 Cognitive behavioural therapy 37
Toolkit development 5 –P
ersonal and lifestyle factors 23
Resources for employers 38
Increasing awareness of sleep deprivation 6 –S
leep disorders 24
Taking a proactive approach 7 tress
–S 25 Case studies 41
Foreword from Peter Simpson 8 Mental health and work life balance 26
Acknowledgements 51
Foreword from Dr Justin Varney and Sleep hygiene 27
Louise Aston 9 Impact of blue light 28
The business case for good sleep 10
Your legal responsibility as an employer 12 3/ Taking action to support good sleep 29
Prevention: creating the right
1/ Key issues to consider 13 culture and providing support 30
The importance of good job design 14 Early intervention: recognising
Shift work 15 and addressing sleep deprivation 31
Travel and working across time zones 16 Recovery: helping employees
Driving and road safety 17 to recuperate 32
Introduction Contents 3
Sleep in numbers Health risks:

Adults who sleep fewer
We naturally feel <6 than 6 hours a night have
tired at two different
annual cost a 13% higher mortality
around of lost sleep

times of the day: 13% risk than adults who sleep
at least 7 hrs1
£
30bn to the UK1
2pm 2am <7
Adults who sleep less
than 7 hours a day are
30% more likely to be
200,000 working days lost 30% obese than those who
sleep for 9 hours or more4
in UK every year to
insufficient sleep1
Working night shifts Adults need
has about a 25-30% between
1 in every 3 higher risk of injury 7 & 9
people in the UK are than working day shifts 7
affected by insomnia3 hours of

sleep a night2
3.2 night workers
million in the UK5
Better sleep We spend about
1/3
is the biggest 1/3 of our
single contributor 1 in 9 workers
And 1 9
who work night shifts5
lives sleeping
to living better 6
Sources: 1 RAND Europe • 2 NHS Livewell • 3 NHS Choices • 4 One You • 5 TUC • 6 Sainsbury’s Living Well Index • 7 IOSH
Checklist of actions
Be prepared: Encourage sleep and recovery: Provide knowledge and training:
Understand the importance of Ask employees what will help them Include training, information and
sleep quality and recovery to and encourage them to take the lead guidance on sleep and recovery
your employees on implementing change for managers and employees in
your health and wellbeing strategy
Inform employees that you recognise Identify the threats to good sleep
the impact of sleep deprivation in the workplace and the problems Ensure that training, information
your employees face and guidance is evidence-based
Consult employees about their sleep
and any problems they experience Conduct a workplace assessment Ensure that training and guidance
with getting the right amount and for good lighting and ventilation is implemented
quality of sleep
Signpost managers and employees Collect feedback to ensure training,
Understand your legal duty of to information about better sleep information and guidance meets
care to employees and to the circumstances and recovery employees’ needs
wider community
Know how to access occupational
health services
Identify external resources you can

use to support sleep and recovery
among your employees
For more detail on practical actions:
Read the ‘Taking action to support
good sleep’ chapter in this toolkit
Toolkit development
SMEs
Positive partnership This toolkit has advice that is
This toolkit has been informed by an evidence
review produced by the Public Health
Your approach to supporting specifically aimed at small and England Library Team and the evidence was
sleep and recovery will reap medium sized enterprises (SMEs). considered by a steering group made-up
SMEs can be disproportionately of practitioners, professionals and business
greater benefits if it has the affected by the loss of key staff for experts. It also draws on the experience of
support of employees. any period of time because of illness, employers who have taken steps to support
or when they are unable to perform sleep and recovery and signposts external
Engage with employees from the outset, ask to the best of their ability because organisations that offer advice and support
them what will help them and encourage of fatigue. So, helping employees to to employers and employees.
them to take the lead on implementing change maintain healthy sleep patterns and
to recover fully after a period of sleep The case studies in this toolkit have been
Your employees might be aware of existing deprivation, is of vital importance. sourced and written following consultation
support that can be improved or expanded
with experts working in the sleep sector
to have greater reach and impact This toolkit provides practical and through the contribution of employers
information for all employers (small, who are taking this topic seriously. They
Appoint workplace champions who can help
medium and large) on how you demonstrate a combination of employers
spread the word
can create an environment where sharing real-world examples of the initiatives
Report back regularly, test what is working employees understand the importance they have trialled to support employees and
and what requires further development of sleep and recovery and are able personal stories from individuals who have
to make healthier choices at work experienced situations which have impacted
Create channels of communication that reach and at home.
as widely as possible on their sleep and work performance.
Encourage employees to share their learning Many of the points are simple to
“I haven’t seen a specific resource for
across the organisation so everybody can implement, supported by resources
sleep and recovery like this before and
benefit that are free or inexpensive. The
I think it is brilliant. It’s really clear and
crucial element is a commitment to
Agree goals and the best way to measure accessible and I’m sure employers will
support the health and wellbeing of
achievements find it very valuable.”
the organisation by fostering an open
and inclusive culture. Janet Cummings
Marketing and Health Coordinator, Amacus
We spend about a third of our lives Increasing awareness of sleep deprivation

asleep and the multiple risks of sleep Sleep has a number of critical Certain occupations are particularly
deprivation are well documented. functions. It is essential for good at risk of impacted sleep (e.g. hospital
This toolkit aims to provide health and wellbeing. It is also night workers, emergency services,
essential for maintaining levels of police, 24/7 call centres). But it doesn’t
information, resources and practical cognitive skills such as speech, just affect shift workers; stress at work
actions that employers can take to memory and innovative and flexible is a significant cause of poor sleep,
maximise employee energy through thinking. Lack of sleep has a profound so employees in any organisation,
impact on our brain’s ability to function. whatever their working patterns, can
effective sleep and recovery. The cumulative impact of successive experience sleep deprivation. All of
nights of poor sleep is significant. these are reasons for employers to
There is a strong relationship between understand the causes, possible
sleep and physical and mental health. effects and solutions to poor sleep.
This is why taking steps to prevent
sleep deprivation or poor sleep is
so important. “This toolkit is a great resource for
employers, providing comprehensive
Organisations are becoming and easy to navigate information on
increasingly aware of the impact the importance of sleep and recovery.
of sleep deprivation on the health As someone who provides advice
and wellbeing of employees and and support to staff on areas such
the implications for creativity, good as stress, sickness absence and
decision making, safety, productivity case management – all of which can
and competitiveness. Sleep deprivation tie into sleep issues – I found this
is often associated with shift work, toolkit really helpful in providing clear,
or work that takes place during practical steps to take to help benefit
antisocial hours. our workforce.”
Debs Ireland
Occupational Health Adviser,
Teesside University
Taking a proactive approach This toolkit is designed to support “This toolkit has helped us with
employers and line managers to some really practical actions to
Working in partnership with create a workplace culture in which support our employees with sleep
employees, employers can take the employer and the employee can and recovery. For us, the information
a positive, proactive approach to openly and fairly discuss the need for on shift working, overseas travel and
sleep and recovery and employees sleep assessment are all especially
support sleep and recovery in the are able to get the sleep they need pertinent to our employees and we’ll
workplace, with a strong emphasis to perform to the best of their ability. be embedding these elements into
This includes the importance of good our health and wellbeing programme.”
on the prevention of problems. job design and the need to remove Susan Wynn
barriers in the workplace to good Occupational Health Manager,
sleep and recovery. Sunderland University
It sets out steps that are easy to follow
and helps you choose the best free “This thorough toolkit will be a very
resources for you and your team. Peer- useful resource for employers. I like
reviewed evidence about what works that it encourages people to consider
best to support sleep and recovery is how a lack of sleep could be to do
still limited, so the toolkit also reflects with a range of issues and the links
the experience of employers who are to further resources where employers
beginning to respond to this emerging can find out more details about
issue at work. particular areas are really helpful.
I certainly feel better equipped to
Taking action on sleep and deal with sleep and recovery in the
recovery can make a real difference workplace having read the toolkit.”
to your workforce and doesn’t have
Ashley Lowe
to involve a significant investment
Health & Wellbeing Project Coordinator,
of time or resources. Using this
Newcastle United Foundation
toolkit as guidance, you can
develop an approach that suits
your organisation, whatever its
size or sector.
Foreword from Peter Simpson Chief Executive Officer, Anglian Water

Long before the term ‘24/7 economy’ delivered. These days, poor sleep has workplace, with demonstrably positive
entered our language, utilities like an impact across society, affecting outcomes.
Anglian Water were working around millions of people. Stress at work,
the clock to ensure that our customers or poor job design, can cause sleep Sleep and recovery is a new topic, so
enjoyed uninterrupted essential services deprivation or affect the quality of sleep. our understanding of what works best
like water. Occasionally, incidents And because people spend so much to support employees is still evolving.
happen that require our teams to make time at work, the workplace is an ideal Our health and wellbeing programme
emergency deployments that can take place to begin to offer the support they is focussing on the impact of sleep
several days to resolve. I have first-hand need to address these issues. deprivation across the organisation and
experience of working 12-hour days for how we can support all employees to
Click the links two weeks or so, under intense pressure At Anglian Water, we understand that understand the importance of good sleep
below to view and I understand the toll it takes on body employees are the lifeblood of our and effective recovery after periods of
Anglian Water’s and mind if you are unable to make the organisation. Their health and wellbeing intense work. We are adopting a holistic
videos on sleep time to rest and recover. are central to the sustainability of the approach, recognising that where sleep
and recovery: business. As many employers now has become a problem it cannot be
Working in those conditions has recognise, we have a responsibility solved in isolation. As an organisation,
The importance consequences for the individual, but as business leaders and managers we need to understand the root causes,
of sleep health also for the organisation. The cumulative to provide the support our employees provide support and information and
in the workplace effect has an inevitable impact on need to stay fit and well for as long make the necessary adjustments in the
the quality of decisions. But when as possible. It is the right thing to do, workplace. It is also about encouraging
Legal a community is depending on you, but it also makes good business senior managers to lead by example
responsibilities it can be difficult for somebody who sense, for a healthy workforce will be and creating high performing teams
of the employers is focussed on getting the job done, more engaged and make a positive that harness individual resilience.
as quickly as possible, to admit that contribution to sustainable growth.
How to sleep better fatigue is affecting their ability to work. We are committed to sharing our
and sleep hygiene We have deep experience of working learning across our supply chain
The impact of sleep deprivation is with our employees to embed practices to ensure that as many people as
not only felt by teams on emergency that support physical and mental health possible benefit. Workplace health
deployment, or even by the men and across the organisation. Our “Fit for the and wellbeing are of vital importance
women who work during the night Future” programme has transformed the for the whole community.
to make sure that vital services are way that we think about wellbeing in the
Foreword from Dr Justin Varney, National Lead for Adult Health and Wellbeing, Public
Health England and Louise Aston, Wellbeing Director, Business in the Community
Sleep is essential to a healthy life. is estimated to cost the UK economy no sleep as something to be admired
Deprivation of it increases the risk over £30 billion a year, equivalent to need to be challenged. Sleep deprivation
of premature death, mental health almost 2% of GDP. is a huge organisational risk that can
problems, disease and disability. result in poor decision making, affecting
Nobody can perform at their best if All employers have a responsibility the lives of thousands of people and
they do not have good quality sleep. to support the health and wellbeing even potentially causing fatalities.
of their staff as part of their health and
The World Health Organisation safety duties and, at a national level, We hope that businesses can use this
estimates that two thirds of adults in we want to see more people leading toolkit in conjunction with the suite of
developed countries globally do not healthy, productive lives. Public Health England and Business
get the recommended seven to nine in the Community toolkits to safeguard
hours of sleep each night. The 24/7 Responsible employers are beginning their employees and ensure that they
digital economy has brought us to consider the implications of sleep are getting the right wellbeing support
many good things, creating jobs and deprivation and how it can be addressed. they need to remain in good health and
prosperity. But the downside is that Their challenge is to understand and fulfil their potential.
we are on the go, all the time. The respond to the underlying reasons why
dividing line between our work and employees may be suffering from poor
our life outside work has blurred. In sleep. Their reflections must extend
a connected society, we are always beyond shift workers. In a global
switched on. Modern lifestyles leave economy, employees increasingly
less time for sleep and when we do work across international time zones,
sleep, it is often interrupted or cut short. or remain connected to work during
hours supposedly set aside for home
Evidence shows that sleep matters life or rest. We need to raise awareness
to individuals but it also matters to and encourage wider discussions about
business. Poor sleep leads to poor sleep deprivation and its impact at
interpersonal interactions and dynamics, work and across society. Conversations
poor customer service, mistakes and about sleep need reframing and cultures
accidents. As a result, sleep deprivation which hold that getting by with little or
The business case for good sleep The number of hours the average There are many reasons why people are
person sleeps has been in decline for unable to sleep, or to get the hours of
As a society, we sleep less than we the past few decades, but its impact on sleep they need, which are discussed in
used to and less than we should. economic performance has received this toolkit. The causes are often outside
Although the optimum amount varies little attention. Yet we know that sleep the workplace but the effects are felt at
quality has an important influence on our work and may impair an employee’s
from person to person, most of us cognitive functions. Not getting enough ability to carry out their duties. Work can
need between seven and nine hours sleep is likely to affect our performance also cause excessive stress, which may
a night. Around four in 10 people at work. lead to sleep deprivation or poor sleep.
In some sectors, this can present a risk
do not get enough sleep. One in One of the most comprehensive studies to the safety of colleagues or members
five suffer poor sleep most nights, on the economic impact of sleep was of the public.
carried out by Rand Europe, a not-for-
representing the second most profit research organisation. It used
common health complaint after pain. data from 62,000 people in five major “We know from our wellbeing
economies (the United Kingdom, the work with our staff and the work
United States, Canada, Japan and that we do as a charity, that the
Germany). The study concluded that the most important thing is to start the
economic cost of tired employees being conversation – making people feel
less productive or absent from work comfortable to start talking about
altogether amounted to almost two per sleep issues they are having which
cent of GDP. In the United Kingdom, are either caused by or impacting on
this equates to around a £30 billion a work. This toolkit is a great resource
year loss, attributed to lower productivity for employers to help people start
levels and higher mortality rates. talking about this issue.”
Separately, a study published by the Kate Upshall Davis
London School of Economics Centre Wellbeing and Mental Health
for Economic Performance in 2017 Manager, Crisis
found that a one-hour reduction in sleep
duration adversely affects the number
of hours worked and household income.
Sleep deprivation takes a toll over a The challenge for employers and line “Our health and wellbeing app Bupa Boost shows
long period of time, which means that managers is to understand the cause that sleep is among the top three issues of concern
employees are often unable to judge of sleeplessness to be able to consider to employees. In fact, among users of the app who
for themselves how they are affected. what the best response is. The good set personal wellbeing goals, sleep is consistently
That’s why line managers play an news is that small changes to sleep number one. Wellbeing is individual and what is
important role. They must understand duration and quality can have a positive important for one person may not work for another.
the importance of good sleep and impact and there are simple steps that Our sleep habits are particularly personal and
be able to spot the symptoms of employers can take to achieve this. it can be difficult to have a conversation about
sleep deprivation. Employers should sleep in a workplace setting. But it is critical for
also consider this when designing organisations to understand the impact of sleep
their health and wellbeing strategy. and recovery for the health and wellbeing of
employees and the implications for productivity.
Sleep deprivation is often where “That is why this toolkit is so important. We know
physical and mental health intersect. there is an unmet need for advice and support and
Sleep deprivation itself can be a as employers we have a responsibility to ensure
symptom of mental health problems that employees have access to the information they
and can increase the risk of developing need to make healthier choices and to understand
mental health problems. There is also what steps they can take to improve the quality of
a growing understanding of the link their sleep. We also can ensure that the workplace
between lack of sleep and hypertension, does not become a barrier to a good night’s sleep
heart disease and diabetes. After and we can support employees to recover to
just a short period of reduced sleep, reduce the risk of fatigue.”
people are more vulnerable to infection.
Brain function deteriorates, drastically Patrick Watt
increasing the risk of accident and Corporate Director, Bupa UK
injury. Longer periods of sleep loss
can significantly impair learning and
cognitive processing, particularly in
older people. Those sleeping fewer than
six hours a night have a 13 per cent
higher mortality risk than those getting
seven to nine hours.
Your legal responsibility as an employer

Employers have a legal duty to manage risks from workers health assessments – although they don’t have to
fatigue and sleep deprivation, irrespective of any of their accept. If a decision involving work equipment, processes or
workers’ willingness to work extra hours or preference for organisation could potentially affect the health and safety of
certain shift patterns. Under the law, employers have a duty employees, such as any proposed changes to shift working
of care to protect not just the health, safety and welfare of arrangements, the employer must give the employees
their workers but any other people who might be affected (or their representatives) information about the proposals
by their business. The following general principles apply. and time to consider it. The employer must also give the
employees (or their representatives) the chance to express
Health and safety law requires employers to consult with their views on the proposed changes. Then the employer
their employees on all matters of health, safety and welfare. must take account of these views before reaching a decision.
They can do this either directly or, if there are health and
safety representatives, through them. Employees also have a duty to take reasonable care of their
own health and safety and that of others at work who may be
The Working Time Regulations 1998 (as amended) affected by their activities. Employers should take positive
(“WTR”) lay down the minimum legal requirements on how steps to help staff understand potential causes and
to organise working time. Employers are required not just to risks of fatigue at work. They should make staff aware
satisfy the provisions of the WTR, but to proactively consider of relevant safety rules, policies and procedures.
fatigue a risk factor in their business like any other health and
safety risk. Whether the business involves major hazards or
not, employers are required to set up appropriate systems
to control potential causes of fatigue, such as shift patterns
and excessive overtime. Some sectors (such as aviation) For further information, see the following resource links
have specific regulations to guard against fatigue. below from the Health and Safety Executive website:
Note that some employees may prefer certain shift patterns Managing shiftwork
that are unhealthy and likely to cause fatigue. Develop a
policy that specifically addresses and sets limits on Fatigue
working hours, overtime and shift-swapping to guard
against fatigue. The WTR require employers to offer night Health assessments for night working hours
Contents 13
1/ Key issues to consider

1/ Key issues to consider Contents 14
The importance of good job design A job that is well designed also health and performance levels and
enables an employee to accomplish thereby reduce ill health. Periodic
Good job design helps to reduce what is required in a safe and healthy assessment of the job or tasks is
the risk of physical and emotional manner and thereby reduce physical preferable as it should be able to
stress. Good work for employees and psychological strain. Further, it identify if changes or adjustments
helps with the organisation of work are needed to the way in which
incorporates elements which make (identifying issues such as work employees carry out their duties.
that job worthwhile to the individual, overload, repetitiveness and limited
such as job security, the ability to control over work) and supports
occupational safety and health within Click on the useful resources below
use and develop skills and clear organisations. A well designed job which help explain the importance
responsibilities. results in more engaged, healthy of good work and job design:
and productive employees and these
outcomes benefit both employees Taylor Review of Modern
and organisations. Working Practices
European Agency for
The work environment is changing,
Health and Safety at Work
due to a move to a stronger service
economy, the increasing number of
women in the workforce and the large “Sleep is a basic human need and
number of older workers who remain equally important to health as good
in employment. Good work design diet and exercise. Health and wellbeing
must also evolve to retain productive, policies should promote good sleep
safe and healthy employees. hygiene. There may also be health
and safety issues arising from shift
Work and job design should occur working, particularly at night and
within organisations when a new job sleep apnoea, which may make the
is created or when the work and jobs employee unfit to drive. Employers
no longer fit the worker or exceed the need the support of good occupational
capacity of an individual employee. health advice.”
Effective organisations should have
monitoring procedures in place to Professor Diana Kloss
continuously assess workers’ safety, Chair, Council for Work and Health
Shift work
Millions of people work in HSE guidance on shift work includes:
shifts, at night or on split,
rotating or varying schedules.
Plan an appropriate and
Consider the needs of vulnerable
varied workload workers, such as young or ageing
workers and new and expectant
Shift work can take a toll on employees’ minds
Offer a choice of permanent mothers
and bodies. Shift workers are at increased risk or rotating shifts and try to
of chronic illnesses such as heart disease and avoid permanent night shifts
Limit consecutive work days to a
gastrointestinal diseases. Although the link maximum of five to seven days and
between disrupted sleep patterns and the
Either rotate shifts every two to restrict long shifts, night shifts and
increased risk of disease has not been proven, three days or every three to four early morning shifts to two to three
employers should recognise the duty of care weeks – otherwise adopt forward consecutive shifts
they owe to shift workers. rotating shifts

Allow two nights of full sleep when
Shift workers are also at increased risk of fatigue,
Avoid early morning starts and switching from day to night shifts
which in turn elevates the possibility of errors, try to fit shift times in with the and vice versa
accidents and injuries. The risk is found to be availability of public transport
higher on night shifts and rises with increasing
Build regular free weekends into
shift lengths over eight hours, across successive
Limit shifts to 12 hours including the shift schedule
shifts and when there are not enough breaks. overtime, or to eight hours if they
are night shifts and/or the work
Consider increasing supervision
The Health and Safety Executive (HSE) has is demanding, monotonous, during periods of low alertness
developed good practice guidelines on shift dangerous and/or safety-critical
design, as well as general guidance on shift
Control overtime, shift swapping
work and fatigue. Encourage workers to take regular and on-call duties and discourage
breaks and allow some choice as workers from taking second jobs
to when they are taken
Click here to read HSE’s good
practice guide on shift design Remember that some employees who are not officially night workers will be
affected by ‘night shift’ patterns (e.g. those who get up at 4 a.m. for a 6 a.m. shift).
Travel and working across time zones

The globalised nature of today’s Minimising the effects of jet lag
business world means that employees Encourage employees to do the following:
are increasingly likely to work across
time zones.
Select a flight that allows early
Upon arrival at a destination,
evening arrival and stay up until avoid heavy meals
10 pm local time
International travel is an integral part of many
Bring earplugs and blindfolds
occupations, while many other employees
If the employee must sleep to help dampen noise and block
work outside normal office hours to support during the day, take a short nap out unwanted light while sleeping
colleagues or customers in other parts of the in the early afternoon, but no
world. In such cases, the demands of work longer than two hours, setting an
Try to get outside in the sunlight
can disrupt healthy sleep and become a alarm to be sure not to oversleep whenever possible because
barrier to recovery. daylight is a powerful stimulant

Anticipate the time change for for regulating the biological clock,
Jet lag is one of the most common issues trips by getting up and going while staying indoors worsens
impacting sleep. Typical consequences of to bed earlier several days prior jet lag
jet lag include disturbed sleep, decreased to an eastward trip and later
alertness, general malaise and impaired for a westward trip
Although it is always important to
daytime function. In addition, gastrointestinal eat healthily, the type of foods we
distress is common and occurs when travellers
Upon boarding the plane, eat have no effect on minimising
eat at irregular hours. change your watch to the jet lag
destination time zone

If you are only ‘in country’ for a
When it is necessary for employees to travel
Avoid alcohol or caffeine at short time, it might be easier on
across time zones, there are some simple least three to four hours before your body to avoid adjusting to
behavioural adjustments that can be made bedtime, because both act as the new time zone
before, during and after arrival to help stimulants and prevent sleep
minimise some of the side effects of jet lag.
Driving and road safety Driving while fatigued is an offence road drivers as they are more likely to
under road traffic law and may result drive in fatiguing situations, undertaking
Managing the risk of fatigue and in prosecution leading to imprisonment long journeys, under time pressure
sleep deprivation for employees who and other penalties. Every week around and after long working hours. In the
drive can save lives. Driver fatigue 150 British road deaths and serious rail industry, work-related road traffic
injuries involve someone using the road accidents and incidents and CIRAS
is a serious problem that results in for work purposes. The Royal Society staff reports show that many workers
thousands of serious injuries and for the Prevention of Accidents names are exposed to similar crash risk factors.
deaths on Britain’s roads every year. driving as the most dangerous work
activity that most people do. Around Increasingly, drivers are self-employed
It is estimated that fatigue may be 40 per cent of sleep-related accidents and may hide sleep problems through
a factor in up to 20 per cent of all involve drivers of commercial vehicles. a fear of losing work. Responsible
organisations should work closely with
road accidents and up to a quarter Employers should consider not only the contractors to prioritise safe driving.
of fatal and serious accidents. risk to those whose primary occupation
is driving, but also those who routinely
drive long distances for work and those Click here to see following
who commute to and from work by road. page for tips on reducing risk
Long working hours, irregular shifts,

work schedules and night driving are
factors that increase crash risk.
Business drivers with high work-related
mileage have over 50 per cent more
injury accidents than non-business
“Fatigue is known to contribute to

one in five UK road deaths, more than
Safe driving 80% of inflight procedural errors and to
increase the risk of accidents four-fold.
Measures for reducing risk in this regard include: It is linked to longer-term health risks
such as obesity, diabetes, depression,

Working practices, journey schedules, appointments and routes should enable drivers
suicide, heart disease and cancer.
to stay within the law
“As managers, we should be striving

Employers are legally required to consult with employees on health and safety issues to get the best from our people and
that means avoiding fatigue. Sleep is

Work patterns should allow for a minimum of between seven and eight consecutive
the only cure for fatigue and should
hours of sleep in each 24-hour period
be considered a weapon to be utilised

Foster a culture that encourages drivers to acknowledge when they are fatigued and against its degradation.
should not drive “It makes good business sense to
protect our people from fatigue and,

Provide training on the importance of sleep and recovery to employees who drive
in return, we will be rewarded with
at work for significant periods of time
a sharper-thinking, healthier, more

Signpost all employees to information about sleep and recovery effective and more efficient workforce.”
Wing Commander John Rollo

Understand driver fatigue risk factors (both at-work and non-work)
RAF Centre of Aviation Medicine

Make sure there are enough drivers to cover work schedules while maintaining required
safety standards

Ensure vehicles are well maintained, which reduces risk of breakdowns and delays

Maintenance should include the environment within the driver’s area and cabin

Be aware of drivers who swap shifts among themselves and the impact this can have Information summarised from:
on working hours
Click here to read ‘Driving for
Work: Managing Fatigue Risks’
Contents 19
2/ Understanding
sleep deprivation
2/ Understanding sleep deprivation Contents 20
Understanding sleep deprivation Signs of sleep deprivation

The challenge for line managers
is to be able to recognise the
symptoms of sleep deprivation
or poor sleep, particularly when it
might be a health and safety issue
that puts colleagues or members Decreased Performance Poor concentration/
of the public at risk. Knowing what communication deterioration easy distraction
to look for is important.
Poor cognitive Poor mood/

Greater risk-taking
assimilation inappropriate
behaviour
and memory behaviour
Inability to make Increased intake

Increased sickness/
necessary of caffeine/
sickness absence
adjustments energy drinks
Causes of sleep deprivation Work-related causes

There are many reasons
why people do not sleep Shift patterns: Shift work can create response, regardless of time of day
issues because it involves working or night. Encourage employees to
enough or suffer from a against the body’s natural rhythm. We disconnect work emails, calls and
broken night’s sleep, which look at this in more detail on page 15. texts between agreed hours and/or
causes them to suffer at weekends. Sharing out-of-hours
Time zone work: Globalisation calls across teams can also help.
tiredness the following day. means more people work across
international time zones, either Stress: Work-related stress can have
There may be more than one reason, travelling in person or engaging with an adverse impact on sleep. The risk
and these may not be related to work, customers and suppliers outside is greatest at times of change, or when
although the impact will be felt in the normal working hours, by phone or there is uncertainty at work. Some
workplace. Line managers should try email. Allowance must be made for stress can be positive, but stress that
to understand what is causing sleep extended working hours and the time is persistent over longer periods is
deprivation to be able to take steps it takes to recover from jet lag and detrimental. It can make it difficult to
to address the problem, including international time differences. Air rest and sleep and cause fatigue.
recognising when changes to work travel within the same (or similar) time See page 25 for further detail.
can help remove some causes of sleep zone can also be disruptive to sleep.
deprivation. When health and safety See page 16 for more info. Work relationships: Work is
is a concern, such as handling heavy central to many people’s lives, and
machinery, an employer may request Working day/week: The 24/7 relationships with colleagues have
that an employee consult with their economy requires many of us to work a significant bearing on wellbeing.
GP before resuming duties. longer hours than a generation ago. A difficult relationship with a line
Even when our formal working hours manager or bullying by colleagues can
An employee might not even be aware have not changed substantially, we cause stress, which carries over into
that he or she is not sleeping enough and find it harder to disconnect from a person’s home life, disrupting sleep.
may not be able to pinpoint the reasons. work because of our mobile devices
This might be the first time an employee and expectations of an immediate
has considered the significance of sleep.
Changes in health and wellbeing

Temporary/treatable illnesses Pregnancy
A short-term illness or injury can affect the quality of sleep Sleep can be difficult at any stage of a pregnancy and
or cause sleep deprivation. Small adjustments to working adjustments must be made in the workplace if an employee
arrangements, including working from home and flexibility chooses to disclose their pregnancy. Pregnant workers can
around working hours, may aid recovery. review NHS Choices for advice about sleep during pregnancy.
Onset of a lifelong condition/disability Click here to visit NHS Choices for advice
Employees diagnosed with serious illness or those who
experience a life-changing disability are more likely to suffer Age-related
from sleep deprivation in addition to other problems linked 60 It is a myth that older people need less sleep, but we are
to their diagnosis. A side effect of medication or treatment less able to sleep in a single block as we age. When we are
such as chemotherapy can be sleep disturbance. Cancer older we are more prone to being affected by a poor sleep
Research UK provides support for chemotherapy and insomnia. environment or entrenched lifestyle factors. An older worker
may need more time to recover from a late/night shift than in
Click here to visit Cancer Research UK their younger years. Information for aiding sleep in later life
can be found at Age UK and could be used sensitively and,
Mental health where appropriate, to start a conversation with employees.
There is a close relationship between sleep and mental health.
Living with a mental health problem can affect how well you Read Age UK’s aid to sleep in later life here
sleep and poor sleep can have a negative impact on mental
health. Business in the Community and Public Health England’s Menopause
Mental Health Toolkit for Employers provides straightforward The menopause transition can disrupt sleep for a prolonged
advice and actions for employers. The mental health charity Mind period. Employers are encouraged to make adjustments
has useful information on sleep, including tips from mental health at work, such as providing desk fans, cold water fountains,
advocate, Jonny Benjamin. Likewise, the charity Mental Health access to natural light, quiet workplace rest areas and
Foundation has a guide to sleep. Workers can also review the non-synthetic clothing or uniforms.
Good Thinking website and One You content on sleep and stress. Click here for more information about
Read Mind’s ‘How to cope with sleep problems’ menopause transition and the workplace
Read ‘How to sleep better’ from MHF

Personal and lifestyle factors Bereavement

The loss of a loved one can precipitate an extended period
Poor housing of sleep deprivation. Fatigue, anxiety and mood swings are
Living conditions that are noisy, cramped, damp, or poorly common during bereavement. Knowing that their employer
heated and ventilated can contribute to fatigue and sleep supports them can help to minimise the employee’s stress
deprivation. While most employers have limited scope for levels and reduce or avoid periods of sick leave, as well as
influencing where and how people live, it is important to aiding sleep and recovery. It can help employees to have
understand the pressures that employees and their families access to counselling sessions, which may be provided
must cope with in order to provide appropriate support in through HR or an employee assistance programme. ACAS has
the workplace. developed an employers’ guide, Managing Bereavement in the
Workplace, in partnership with the bereavement charity Cruse.
Employers who have influence over living arrangements –
for example, those employing seasonal or migrant workers Click here to read the ACAS guide
and those who provide temporary or overnight accommodation
for staff, shift workers, people on call for duty (including Click here to visit the bereavement charity Cruse
emergency workers), or staff working offshore – have
opportunities to create the conditions for employees to sleep New parents
and recover after extended and intense periods of work. One inevitable consequence for new parents is sleep
deprivation. Families have the option of shared parental leave
Financial but employers also should consider making other reasonable
Money problems can cause anxiety, which leads to sleep adjustments, particularly in the first few months. NHS Choices
deprivation. Employers can signpost financial advice, including provides advice and support for new parents.
credit unions, which offer lower rates of interest on loans.
Click here to visit NHS Choices for advice and support
Citizens Advice is a source of online information about debt
management. GamCare and Gamblers Anonymous give advice
about gambling addiction and financial problems caused Personal life
by gambling. Click on the below links for more information: Significant changes at home can also affect sleep patterns
for prolonged periods, with a detrimental impact at work.
Citizens Advice Divorce and separation should be considered as risk factors,
as should disputes over child custody. The charity Relate
GamCare provides support and information for families.
Gamblers Anonymous Click here to visit the charity Relate
“The serious impact of those “It’s important to take employee welfare

Sleep disorders health conditions which cause seriously and that includes supporting sleep
sleep-disrupting pain must be and recovery. Sleep is often underrated,
Sleep deprivation or poor sleep may recognised by employers. If yet we need it to feel healthy and happy.
be the consequence of a clinical sleep someone has a painful condition
disorder, or this may be a contributory that affects their sleep, it then has “Poor sleep and fatigue are common
factor. Line managers should encourage a far greater impact on that person’s problems, affecting millions of people
employees to seek advice from their GP health and their ability to perform world-wide. Chronic sleep debt can have
for symptoms of a possible sleep disorder. in day to day life, including at work. a seriously damaging effect on our mental
These include insomnia and breathing- and physical health and research shows
related disorders such as obstructive sleep “Therefore if someone has sleep- that lack of sleep erodes concentration
apnoea. They can have a significant impact disturbing pain they need to target and problem-solving ability. Each hour
on health and wellbeing, but they can be it by using analgesics or other of sleep lost per night is associated with
treated. NHS Choices has information approaches so their sleep is less a temporary loss of one IQ point.
about these and other conditions. disturbed. This is why shoulder pain,
neck pain and other MSK conditions “This toolkit provides an invaluable insight
Click here to visit NHS Choices can have a greater impact than for employers to know what steps they
individuals and employers might can take to support sleep and recovery
expect, because they are conditions by improving staff environment, looking
Line managers should consider health for sleep deprivation signs and providing
and safety implications when an employee which wake people from sleep.”
advice on how they can address the issue
has been diagnosed with a clinical Professor Anthony D Woolf with their employees.
sleep disorder. Does it put the safety of Bone and Joint Research Group,
colleagues, or members of the public at Royal Cornwall Hospital “Early detection is key if someone is
risk? Should an employee be temporarily suffering with lack of sleep. It is much
reassigned to other duties? easier to help and solve the problem
if it’s addressed quickly. Once a sleep
Workplace adjustments may be required issue becomes a sleep disorder, such
to support employees who have a clinically as insomnia, it becomes much harder to
diagnosed sleep disorder, including change the learned behaviour and habits.”
extended leave or working from home,
Lisa Artis
temporary help with work responsibilities,
The Sleep Council
or reassignment to another role.
Stress All employers have a legal responsibility The Health and Safety Executive has
under the Health and Safety at Work designed the Management Standards
Stress is one of the main causes Act 1974 and Management of Health Approach to help employers manage
of sleep deprivation or poor sleep and Safety at Work Regulations 1999 the causes of work-related stress.
quality. In many cases, the cause to ensure the health, safety and welfare It is based on the familiar ‘Five steps
at work of their employees. This includes to risk assessment’ model, requiring
of stress is outside the workplace, minimising the risk of stress-related management and staff to work together.
but in around a third of cases, it is illness or injury to employees.
related to work. Click here for more info about
Click here to read more about HSE’s Management Standards
your legal responsibility
People sometimes get confused about

Line managers
the difference between pressure and
stress. Everyone experiences pressure Line managers play a vital role in
regularly – it can motivate people to identifying and managing stress
perform at their best. It is when people within the organisation. They are
experience too much pressure and feel likely to see the problems that cause
unable to cope that stress can result. stress first hand and will often be
the first point of contact when an
Many organisations have reported individual is feeling stressed. It is
improvements in productivity, retention essential that they have the skills and
of staff and a reduction in sickness behaviours to be able to manage
absence after tackling work-related these situations.
stress. As an employer, you are also
required by law to assess the risk of
stress-related ill health arising from
work activities and take action to
control that risk.
Mental health and

HSE Management Standards work life balance
The Standards refer to six areas of work that can lead to stress if not properly managed: Good mental health
and work life balance
are important for sleep
and recovery.
Workplace initiatives to encourage
sleep and recovery can be part of
a holistic approach to health and
Demands Control Support wellbeing, with a focus on mental health
Workload, work How much say a Includes the encouragement, as well as physical and social wellbeing.
patterns and the person has in the way sponsorship and resources
work environment they do their work provided by the organisation, The mental health toolkit for employers,
line managers and colleagues created by Business in the Community
and Public Health England, is an ideal
starting point.
Good Thinking is an online service

that helps people to manage and
maintain their wellbeing. One You also
provides information about good sleep
and recovery.
Role Change Relationships
Whether people understand How organisational change Promoting positive working
their role in the organisation (large or small) is managed relationships to avoid
and whether the organisation and communicated in conflict and dealing with
ensures they do not have the organisation unacceptable behaviour
conflicting roles
Sleep hygiene: the right conditions for a good night’s sleep

Sleep hygiene is simply a description of the ideal conditions for a good night’s
sleep. Each person has individual preferences but ‘good’ sleep hygiene includes:
Fixed times for going to Regular physical activity Maintaining a comfortable

bed and waking up can positively impact sleeping environment Avoiding caffeine, nicotine
sleep. Also keep to a that’s not too hot, cold, and alcohol late at night
relaxing bedtime routine noisy or bright
Avoiding the use of a

smartphone as an alarm
Avoiding watching television, Turning off all devices at clock and charging the phone
Avoiding eating a heavy
making phone calls, eating least one hour before bedtime away from the bedroom at a
meal late at night
or working while in bed and keeping technology central charging point for
out of the bedroom everyone in the household
Impact of blue light on sleep Computer screens, tablets, “It is not only the physiological
smartphones, flat-screen televisions impact of the blue light on our
Although any type of light can and LED lighting all emit large amounts ability to produce melatonin. If you
stop people feeling sleepy, of blue light. Encourage employees check your work email, Facebook
research has shown that light to limit their exposure to blue light in or BBC News before you turn in
the few hours before they go to bed. for the night and read something
towards the ‘blue’ end of the Some organisations choose to close that causes a negative emotion,
spectrum is particularly likely to down email servers after a certain for example, this could impact
point in the evening, to encourage your ability to fall asleep or disturb
keep people awake because it staff to switch off from work. If using your sleep throughout the night.
suppresses the production of the a smartphone, tablet or computer
“By the same account, if you keep
sleep-inducing hormone melatonin. is necessary late in the evening, it’s
your phone in your bedroom and
important to turn down the brightness
and keep the device at least 12 inches wake up in the middle of the night to
from the eyes. There are a number see it flashing with notifications then
of apps available to dim lighting on the temptation to check it is there. We
phones and tablets. recommend that people get an alarm
clock, turn off their phones and other
technology and charge them in the
kitchen or living room away from the
sanctuary of their bedroom.
“Also, by leaving your phone off
while you get up, dressed and eat
breakfast makes for a better start
to the day. You are setting your
own agenda as opposed to allowing
whatever you read to set it for you.”
Laura Willis
Shine Offline
Contents 29
3/ Taking action to support

good sleep
3/ Taking action to support good sleep Contents 30
Actions for employers

We suggest you include 1. Prevention: creating the right culture and providing support
sleep matters in your

Embed sleep and recovery into your
Create quiet spaces for rest and relaxation,
organisation’s approach organisation’s health and wellbeing strategy where employees can switch off completely
to health and wellbeing. from work for a period

Consult employees about the support
These simple steps will also support they need and put it into practice with
Work with employees to create shift
and reinforce actions you are already their collaboration patterns which allow for recovery, making
taking to support other issues, adjustments for those who work out of the
including mental health, physical
Conduct a sleep audit in the workplace, office, particularly those who spend time
activity and musculoskeletal health. or encourage employees to self-assess on the road and will sometimes be long
They will help you recruit and retain distances from home when their regular

Support line managers, particularly through working day ends
valued employees and help them training, helping them to recognise symptoms
to stay well at work for longer. of sleep deprivation
Incorporate flexitime for employees who
Starting the conversation about sleep work or travel across international time zones

Use the HSE stress management standards
with employees can be challenging; to reduce work-related causes of stress
Don’t count travel time as down time, even
sleep is very personal and can be if employees have not been connected to
difficult to discuss. As a first step,
Make sure staff have access to natural the office
encourage employees to use the light and consider the use of daylight
NHS Choices self-assessment tool simulator lamps, which emit a bright
Make allowance for additional time employees
to review the quality of their sleep. flicker-free light close to natural sunlight, have spent away from their families
particularly during the winter

Let staff unplug; encourage employees to
Click here to do the NHS
Temperature, ventilation and humidity switch off by reducing/halting out-of-work
Choices self-assessment all contribute to comfort at work. They emails and protecting disconnected time
help employees work efficiently during during non-work hours
the day and rest/sleep at night, so ensure
air conditioning is well maintained and
Bear in mind that some employees will find
provide additional ventilation such as it stressful to be ‘out of the loop’ and work
fans when necessary with them to decide what’s best for them
2. Early intervention: recognising and addressing

sleep deprivation

Empower line managers to intervene
Lighten their load: Consider the possibility
when necessary and to approach the that some employees are working long
subject in a caring and concerned way hours because they are not coping well
with their workload

Open
a dialogue with employees to
talk and recognise if sleep deprivation
Explore ways to ease their burden:
is a problem sometimes job redesign may be
necessary

Remember that many will not consider
that sleep and recovery is an issue that
Where appropriate, refer to Occupational
can and should be addressed at work Health or an Employee Assistance
Programme (EAP); Most EAPs have a

Signpost
to information that will help confidential helpline or advice service
employees make lifestyle changes that for employees
will address some of the problems they
experience with sleep and recovery
When symptoms persist, encourage
employees to seek professional help

Self-care
is an important first step,
so promote good sleep routines
A pharmacist may be appropriate in
the first instance and NHS Choices

Encourage use of self-care tools provides a lot of advice
like sleep diaries or apps to help get
a better understanding of triggers Click here to visit NHS Choices
and issues
“There are a number of determinants of

insufficient sleep which will affect many
3. Recovery: helping employees to recuperate employees, including heavy commutes,
not getting enough physical activity,

Help employees to understand the
Break-out spaces, sofa areas and smoking and alcohol. Employers can
impact of excessive screen time relaxation pods are used by some provide practical support relating to
on their mental wellbeing, work/life employers to promote rest and recovery all of these situations, which needn’t
balance and sleep be complex or intrusive. Support can

Ensure staff take their full holiday range from allowing flexitime and home-

Encourage them to have screen breaks, entitlement. Time off work is not ‘nice working to help with long commutes,
including a break from social media to have’ but an essential element of to incentivising employees to be more
and news channels throughout the day work/life balance active (such as offering additional
holiday time to employees who cycle to

Hydration aids recovery, so make work or meetings). This toolkit provides
drinking water available throughout a good, comprehensive resource for
the workplace employers to consult when considering
employee support around sleep.”

Encourage exposure to natural light,
as sunshine helps the body recover Marco Hafner
natural rhythms disrupted by poor Senior Economist, RAND Europe
sleep or lack of sleep

Walking meetings, outside lunches and
breaks from work that involve stepping
out of the workplace can all be promoted

Ensure staff have a quiet space away
from their desks to eat lunch and
consider providing spaces for staff to
relax during the working day or night
Contents 33
Appendices
Appendices Contents 34
Glossary of terms
Good sleep
This will vary from person to person, but evidence suggests the healthy daily sleep range is between seven and nine hours every 24 hours.
Sleep quality
The key determinants of sleep quality are the time spent sleeping in bed, the time taken to fall asleep and the amount of times sleep is disrupted.
Sleep deprivation
Where good sleep (between seven and nine hours every 24 hours) is denied over a prolonged period of time. Chronic sleep deprivation involves
sleeping less than six hours a night over a prolonged period of time.
Fatigue
Generally considered to be a decline in mental and/or physical performance that results from prolonged exertion, sleep loss and/or disruption
of the internal clock. It also refers to the issues that arise from excessive working time or poorly designed shift patterns.
Mental health
A person’s condition with regard to their psychological and emotional well-being.
Sleeplessness
Inability to sleep, or to achieve good sleep.
Sleep disorders
A group of conditions which affect the ability to sleep well on a regular basis.
Recovery
The process that enables a person to return to a normal state of health, mind or strength after a prolonged period of sleep deprivation.
A guide to sleep Non-REM sleep REM sleep

We all have a ‘sleep-wake cycle’,
Stage 1: Light Sleep The first REM period usually begins
known as a Circadian rhythm, During the first stage of sleep, we’re about 70 to 90 minutes after we fall
the daily pattern of alternating half awake and half asleep. Our muscle asleep. We have around three to five
wakefulness and sleep. This activity slows down and slight twitching REM episodes a night. Although we
may occur. This is a period of light sleep, are not conscious, the brain is very
rhythm is a biological programme meaning we can be awakened easily at active – often more so than when we
tied to time, like an internal clock. this stage. are awake. This is the period when
This clock tells us when it is time Stage 2: True Sleep
most dreams occur. Our eyes dart
around and our breathing rate and
to go to bed and when it is time Within ten minutes of light sleep, we enter blood pressure rise. However, our
to wake up. Our sleep-wake cycle stage two, which lasts around 20 minutes. bodies are effectively paralysed,
The breathing pattern and heart rate start said to be nature’s way of preventing
occurs about once every 24 hours. to slow down. This period accounts for us from acting out our dreams.
the largest part of human sleep.
Our Circadian rhythm is also influenced by cues After REM sleep, the whole cycle
Stages 3 and 4: Deep Sleep begins again.
from the external world. Most of us go to bed not During stage three, the brain begins to
only when we are tired, but also when the outside produce delta waves, a type of wave that
world says it is time. Similarly, we tend to wake up is large (high amplitude) and slow (low
when the room becomes bright with morning light, frequency). Breathing and heart rate are
or when the alarm clock goes off. These cues from Click here to read about
at their lowest levels. the science of sleep
the outside world are important in determining
both the quality of sleep and how long we sleep. Stage four is characterised by rhythmic
breathing and limited muscle activity.
Sleep occurs in a recurring cycle of 90 to 110 If we are awakened during deep sleep,
minutes and is divided into two categories: we do not adjust immediately and often
non-rapid eye movement (non-REM), which feel groggy and disoriented for several
is further split into four stages and rapid eye minutes after waking up.
movement (REM) sleep.
Clinical sleep conditions
Obstructive sleep apnoea (OSA) • Using a continuous positive airway Occasional episodes of insomnia may come
pressure (CPAP) device, which prevents and go without causing any serious problems,
OSA is a condition where the walls of airways closing during sleep by delivering but for some people it can last for months or
the throat relax and narrow during sleep, a continuous supply of compressed air even years at a time. Persistent insomnia can
interrupting normal breathing. This may through a mask have a significant impact on quality of life. It
lead to regularly interrupted sleep, which can limit what can be achieved during the day,
can have a big impact on quality of life and • Wearing a mandibular advancement device affect mood and lead to relationship problems.
can increase the risk of developing certain (MAD), which are gumshield-like devices
conditions. OSA is a treatable condition, fitting around the teeth, holding the jaw and It is not always clear what triggers insomnia,
and there are a variety of treatment options tongue forward to increase the space at the but it is often associated with:
that can reduce the symptoms. back of the throat during sleep
• Stress and feeling anxious
• Surgery may also be an option if sleep
Sleep apnoea can have adverse effects on
apnoea is thought to be the result of a • Poor sleeping environment, such as an
workplace safety, but is frequently undiagnosed.
physical problem that can be corrected uncomfortable bed, or a bedroom that is
Employers may wish to consider screening for
surgically, such as an unusual inner too light, noisy, hot or cold
sleep apnoea in the workplace, or encouraging
neck structure
employees to undertake a self-assessment, • Lifestyle factors, such as jet lag, shift work
using a tool like The Epworth Sleepiness Scale. or drinking alcohol or caffeine before going
Click here to visit NHS Choices for to bed
further information on sleep apnoea • Mental health conditions, including
Click here to use the
Epworth Sleepiness tool depression and schizophrenia
Insomnia • Physical health conditions, including heart
Although sleep apnoea can present risks
problems and chronic pain
to workplace safety, there are a number People with insomnia find it difficult to sleep or
of treatment options available, including: to stay asleep for long enough to feel refreshed. • Certain medicines, including antidepressants
It affects about one in three people and is and steroids
• Lifestyle changes, such as losing weight, common in older people.
cutting down on alcohol and sleeping on
the side of the body
continued overleaf
Clinical sleep conditions continued Cognitive Behavioural Therapy

We can all benefit from improving the quality
Treatment: insomnia will often improve There is a link between RLS and pregnancy
of our sleep. For many of us, it may simply
by making changes to bedtime habits, – about one in five pregnant women will
be a case of making small lifestyle or attitude
and using sleep hygiene methods. experience symptoms in the last trimester.
adjustments in order to help us sleep better.
If these don’t help, GPs may recommend
For those with insomnia, it is usually necessary
other treatments. If insomnia lasts for more
to seek more specialist treatment. Sleep
than four weeks, cognitive and behavioural Click here to visit NHS Choices
medication is commonly used, but may have
treatments or a short course of prescription for further information on RLS
negative side effects and is not recommended
sleeping tablets as a temporary measure
Click here to visit the charity for the long-term.
may be recommended. If it is possible to
Restless Legs Syndrome UK
identify an underlying cause of sleeping
Psychological approaches are useful for
difficulties, treating this could be enough
people with long-term insomnia, because they
to return sleep to normal. Narcolepsy can encourage us to establish good sleep
This is a rare long-term brain disorder that patterns and to develop a healthy, positive
causes a person to suddenly fall asleep mental outlook about sleep, as well as dealing
Click here to visit NHS Choices for
at inappropriate times. The brain is unable with worrying thoughts towards sleeping.
further information on insomnia
to regulate sleeping and waking patterns
normally. The condition is usually diagnosed One of the most widely used and successful
between the ages of 20 and 40 years. There therapies is Cognitive Behavioural Therapy
Restless legs syndrome (RLS)
is no cure, but making changes to improve (CBT). This is useful even for people who
RLS is a sleep-related movement disorder, sleeping habits and taking medication can have had insomnia for a long period of time.
which gives an overwhelming and often help minimise its impact. The charity A full course of such a therapy with a sleep
unpleasant urge to move the legs while at rest. Narcolepsy UK provides help and support specialist is potentially costly and is most
RLS is believed to affect about 10 per cent to those with the condition. appropriate for people with severe sleep
of adults, although the symptoms vary from problems. But some CBT principles can be
mild to severe. The worst cases can severely appropriate and easily practiced for anyone
disrupt sleep and cause insomnia. Click here to visit NHS Choices for who is experiencing a sleepless night.
further information on Narcolepsy
For further advice, click here to
Click here to visit the charity read ‘Sleep Matters’ by the MHF
Narcolepsy UK
Contents 38
Resources
for employers
Resources for employers Contents 39
Resources for employers

Further information about the business NHS Choices – Obstructive Sleep Apnoea Cancer Research UK – Support for
impacts from lack of sleep: www.nhs.uk/conditions/obstructive-sleep- chemotherapy and insomnia
apnoea www.cancerresearchuk.org/about-cancer/
RAND Europe – Why Sleep Matters cancer-in-general/treatment/chemotherapy/
www.rand.org/randeurope/research/projects/ NHS Choices – Sleep self-assessment side-effects/about/insomnia-chemotherapy
the-value-of-the-sleep-economy.html tool for individuals
www.nhs.uk/Tools/Pages/Sleep-self- HSE – Stress Management Standards
assessment.aspx www.hse.gov.uk/stress/standards
Further information and resources
about sleep and sleep quality: NHS Choices – Why lack of sleep NHS Choices – Tiredness in pregnancy
is bad for your health www.nhs.uk/conditions/pregnancy-and-baby/
HSE – Fatigue www.nhs.uk/Livewell/tiredness-and-fatigue/ pages/tiredness-sleep-pregnant.aspx
www.hse.gov.uk/humanfactors/topics/fatigue. Pages/lack-of-sleep-health-risks.aspx
htm TUC – Guidance on Supporting Working
Women through the Menopause
NHS Choices – Better sleep Information on managing specific www.tuc.org.uk/sites/default/files/TUC_
www.nhs.uk/LiveWell/sleep/Pages/sleep- circumstances relating to sleep: menopause_0.pdf
home.aspx
ACAS – Managing Bereavement
NHS Choices – How to get to sleep in the Workplace
www.nhs.uk/Livewell/insomnia/Pages/ www.acas.org.uk/media/pdf/7/a/Managing-
bedtimeritual.aspx bereavement-in-the-workplace-a-good-
practice-guide.pdf
NHS Choices – Insomnia
www.nhs.uk/conditions/insomnia Age UK – Aiding sleep in later life
www.ageuk.org.uk/information-advice/health-
NHS Choices – Narcolepsy wellbeing/mind-body/getting-a-good-nights-
www.nhs.uk/conditions/narcolepsy sleep
Resources for employers Contents 40
Resources for employers continued
Sleep and sleep condition Mental Health Foundation – HSE – Research report on working
organisations: How to sleep better guide long hours
www.mentalhealth.org.uk/file/1485/ www.hse.gov.uk/research/hsl_pdf/2003/
British Snoring and Sleep download?token=BUCq_Am1 hsl03-02.pdf
Apnoea Association
www.britishsnoring.co.uk Mind – Information on sleep IOSH – Research on the effects of shift
www.mind.org.uk/information-support/types- work on health
Narcolepsy UK of-mental-health-problems/sleep-problems/#. www.iosh.co.uk/Books-and-resources/The-
www.narcolepsy.org.uk Wha057SFhYJ effects-of-shift-work-on-health-(2015).aspx
Restless Legs Syndrome UK Safety Critical Offshore Workers –

www.rls-uk.org Information about work patterns, Hours, shifts and schedules
driving and long hours: www.offshoreworkers.org.uk/files/Publications/
The Sleep Apnoea Trust Association Offshore%20report%2028%204%2016.pdf
www.sleep-apnoea-trust.org ACAS – Changing patterns of work
www.acas.org.uk/media/pdf/5/b/B09_1.pdf ROSPA – Resources on driver fatigue
The Sleep Council www.rospa.com/road-safety/advice/drivers/
https://sleepcouncil.org.uk/ Gov.uk – Health assessments for fatigue
night working hours
www.gov.uk/night-working-hours/health-
Mental health resources: assessments
Business in the Community and HSE – Guide to managing shift work

Public Health England – Mental www.hse.gov.uk/pubns/priced/hsg256.pdf
Health Toolkit for Employers
https://wellbeing.bitc.org.uk/sites/default/files/
mental_health_toolkit_for_employers_-_small.
pdf
Contents 41
Case studies
Case studies Contents 42
Anglian Water
Joe Perry, Head of Employee Relations, Anglian Water Services
At Anglian Water, the topic of sleep finds its way This is easier in an environment where there with a complete break from work. I try not
into everyday conversations. We are the largest is a culture that fosters open and honest to email before 8am or after 6pm. I don’t
water and water recycling company in England conversations about health and wellbeing. want my team checking their phone after
and Wales by geographic area, so many staff The senior leadership of Anglian Water has work and on weekends.
unavoidably spend a lot of time on the road. a strong commitment to health and wellbeing.
The organisation has adopted Business in This holistic approach has many benefits
Travel time can be significant and has to be the Community’s Workwell Model, which for wellbeing, including creating the right
factored into a typical working day. That often puts employee wellbeing at centre stage conditions for healthy sleep. By doing so,
means deciding whether to stay overnight in a in boardroom discussions. Our Healthier, we all benefit.
hotel, or planning the day around a long drive. Happier, Safer programme has transformed
Not surprisingly, many staff prefer to return the way that we think about wellbeing in
home, even at the end of a long, challenging the workplace, with demonstrably positive
day. A judgement has to be made about safety; outcomes. We work with employees to embed
whether it would be better to drive up the day practices that support physical and mental
before a meeting, or return home the day after. health across the organisation.
This opens up a natural opportunity to talk In such an environment an employee is less

about sleep and sleeping habits. How do likely to feel uncomfortable if his or her line
you get a good night’s sleep in an unfamiliar manager asks them how they are sleeping.
room and bed? More importantly, how does They are also more likely to come forward
this compare to how you sleep at home? if they have a concern that is affecting his or
The discussion is now about sleep hygiene, her sleep, knowing that it will be addressed
although we may not think of it as such. We sympathetically. Across the organisation,
are sharing information and advice about we adopt practices that are conducive to
sleep that will help employees, whether they good health and wellbeing which are, by
are working or at home. Any workplace extension, good for sleep and good for
conversation that encourages discussion recovery. We are encouraged not to work
about sleep or, more broadly, health and at the weekends and to take all our holidays
wellbeing, is a good thing.
Dystonia and long-term conditions

Anonymous
Long-term conditions can have a profound Typically, that task was completed by 1am. I love strong, black coffee and I am inclined
impact on sleep. I have a neurological condition By then, I would be too wound up to sleep to drink too much of it. Sensibly, I should only
called dystonia, which affects people in and my dystonia was wide awake. have coffee in the morning, or after lunch.
different ways. In my case, dystonia affects the Anything later than that seems to encourage
upper left side of my body, causing involuntary These days, I have a better work life balance spasms that disrupt my evening.
spasms in my arm, shoulder and neck. but dystonia is a constant and it still intrudes
Fortunately, I am right-handed so it does not on my sleep. I combine work with fostering, One issue with my dystonia is that it is invisible
affect my handwriting, for example. But I have so I often work in the evening once the children to most people (although my wife knows
to make adjustments to do basic tasks, such are asleep. I have to be firm about my routine. when it is causing me problems). It has a
as tying shoelaces and hammering in a nail. I try to switch off my laptop at least one hour limited impact on my life, particularly when
I cannot carry a mug of tea with my left hand. before I intend to go to sleep, although 90 compared to many other long-term conditions.
minutes is better. It is easy to cheat by simply It is also fiendishly difficult to explain. So,
However, dystonia is most affecting when using my mobile phone instead and it takes discussing it with colleagues or line managers
I am trying to relax or go to sleep. Even though a lot of willpower not to check emails one last has been awkward and is generally best
my body is ready to sleep, my left arm and time. But the benefit of switching off in terms avoided. I know many people with long-term
shoulder have other ideas. Eventually, it settles of quality of sleep and how much better I feel conditions will feel the same way. Yet talking
down. But on a bad night it might cost me, the next day is immense. about it is important and the first step towards
say, 30 minutes of sleep, which is a lot over putting in place support which might make
the course of a week. Exercise is critical for me. It is an important a significant difference.
antidote to my desk-bound work, but it also
Stress has a big impact on my dystonia, as seems to reduce the impact of my dystonia.
does the cold. Coffee also seems to aggravate On days when I have been able to get out Click here for more information
the symptoms. Yet I am my own worst enemy on the bike or go for a run, the spasms abate about dystonia
when it comes to managing my condition. As and are easier to manage. The opposite is
a journalist and editor, I worked unusual hours also true. If I go several days without exercise,
and often against deadlines. For some years, I the spasms can be really intrusive. My sleep
could not sleep until I had seen and responded suffers and I am definitely less productive
to, the first editions of the national newspapers. the following day.
Guy’s and St Thomas’ NHS Foundation Trust

Dr Ali Hashtroudi, Clinical Director and Honorary Senior Lecturer
We consider sleep and recovery issues The second strand of our sleep and recovery Historically, sleeping on shifts used to be
in relation to our staff in two capacities at work is proactive. We run a number of discouraged. We are working to promote
Guy’s and St Thomas’. Many of our staff work initiatives as part of our ‘5 ways to a healthier taking a short nap at long breaks during night
in shifts and we know first-hand the potential YOU’ programme which encompasses all our duties as it helps improve sleep patterns. To
impact this has on health and wellbeing. health and wellbeing offerings for staff, such establish this, some ground work is needed to
The risks of shift work causing different types as smoking cessation, gym memberships, shift the culture to accept that taking breaks
of ill health is documented in literature too. exercise groups, healthy eating support etc. and sleeping during breaks is important, but
We run monthly campaigns themed around also to support this to happen. For instance,
We have two strands of work around sleep different topics. One recent campaign was you need a place for people to sleep, planning
and recovery at Guy’s and St Thomas’. We under the slogan HALT (hungry, angry, late, for breaks in advance and proper handovers
have around 15,300 staff (and an extra 3,000 tired) when we reiterated the importance of to ensure the continuity of care.
Bank staff), many of whom work in shifts, maintaining a healthy work-life balance and
so we know the importance of the issues. taking breaks. As part of this campaign, we The Working Time Directive (WTD) often
The first strand is ‘reactive’, involving those also focused on the importance of sleep and comes up and it is essential that it’s embraced
who come to the Occupational Health team how to maintain a sleep pattern – especially by all. This doesn’t just mean paying attention
because they are struggling with shift work. for those who do shift work. to working hours, it means providing health
We deal with these issues on an individual checks for staff who undertake shift work.
basis, understanding what the problems We’ve worked with a leading specialist The bottom line is to ensure everyone, staff
are and how best we can address them. (Dr Michael Farquhar) to develop workshops and managers, recognise the importance
For example, people on insulin may struggle and seminars, including training on sleep of sleep in the context of productivity, health
with shift patterns, so we provide them with and recovery, for our paediatric junior doctors. and wellbeing.
expert training to manage their medication We’re currently working to roll out the ideas to
and their work pattern. Sometimes referrals staff in other directorates.
onto other services like sleep disorder
specialists are necessary. Whatever the
action, the end product of these interventions
is to advise staff and managers on how best
to handle these issues.
Menopause and sleep deprivation

Anonymous
The menopause is a significant cause Inevitably, I suffered from severe fatigue during and easy access to water. But what really
of sleep deprivation or poor sleep. It is the day, which made me short-tempered and will make a difference is creating a culture
a normal and natural part of ageing and affected my ability to concentrate and to make where employees are able to discuss issues
affects all women. Yet its impact, which can good decisions. There were many times when like the menopause with their line manager,
last several years, is not easily discussed I felt too unwell to go to work. But knowing that knowing that they will be treated sensitively
in a workplace environment. This makes this was something that was likely to persist and without prejudice.
it difficult for organisations to make the for a long time, several years even, meant that
necessary adjustment to support women I knew I had to find a way to manage the way
at this stage of their lives. I felt.
I have a senior position in a large organisation, The average age for the onset of menopause
with significant responsibilities and a busy is 50. But the transition phase can take place
schedule every day. I have worked through over several years, so it is not unusual for
the menopause, but it has sometimes been a women in their early to mid-40s to feel the
challenge to maintain the same pace because effects. Treatment for other conditions, such as
of a lack of sleep, which may have built up ovarian cancer, can bring on the menopause
over several nights. much earlier.
Knowing that I’d wake up in the early hours Employers need to become more aware of the
of the morning sweating profusely several impact of the menopause, particularly if they
times a week meant I could never go off to are serious about equality of opportunity for
sleep peacefully. I rarely enjoyed deep sleep. women and about the recruitment and retention
At times, the sweating was so bad that I of older workers. There are simple, practical
needed to take a shower and change the steps that will help, such as giving more people
bed sheets. The disruption prevented me the opportunity to work from home, flexible
from going back to sleep. hours, better air conditioning in the workplace
NATS
Julie Elder, HR & Corporate Services Director
NATS looks after the vast majority of aircraft Even with these controls in place, people vary
flying in the airspace above the UK. Our in how they cope with shift work depending An excerpt from a recent article on shift
air traffic controllers are responsible for on their health, fitness, age, lifestyle and work and sleep on the NATS in-house
the safe passage of aircraft 24 hours a day, domestic responsibilities. Some adapt well, intranet site:
7 days a week. They work a shift system to others do not. Recognising this, NATS Human Working shifts that differ from the routines
accommodate this. With increasingly busy Factors specialists run a programme to inform of friends and family can leave you feeling
air traffic, our controllers can be just as controllers about the importance of proper rest isolated and it is important to make the
busy at 5 o’clock in the morning as they and sleep to promote high performance in the effort not to lose contact with them.
are at 5 o’clock in the afternoon. work place. For example, all staff in NATS with
a role that has safety implications (and this • Talk to friends and family about shift
The safe and efficient movement of aircraft extends beyond air traffic controllers to include work. If they understand the problems
depends heavily on the skill and performance engineers, managers, etc.) have to complete you are facing, it will be easier for them
of our controllers. Controllers have to process a detailed e-learning course on fatigue to be supportive and considerate
large amounts of information, make timely management. This helps them to recognise • Make your family and friends aware of
decisions and be vigilant continually for the signs of tiredness and fatigue and to know your shift schedule so they can include
potential problems. Our regulator, the Civil how to prevent these things affecting the jobs you when planning social activities
Aviation Authority, recognised nearly 30 years they do. This training material is augmented
ago that to maintain consistently high levels by regular ‘campaigns’ that promote various • Plan your domestic duties around your
of safe performance, the amount of time topics, such as techniques to maintain alertness shift schedule and try to ensure that
controllers can ‘talk to pilots’ needs to be and maintaining good sleep habits. you do not complete them at the cost of
tightly regulated. Our controllers’ working rest/sleep. You may need to change the
hours and rest breaks are therefore carefully times/days when some jobs are done
controlled – probably to a greater extent
than any other profession in the UK.
continued overleaf
NATS continued
To help controllers tackle tiredness as their Finally, NATS has a fatigue risk management
working day progresses, NATS air traffic policy and strategy which underpins all our
controllers are encouraged: efforts in this area. The overarching principle
of this is that fatigue management must
• To use their mandated rest breaks in such be a shared responsibility between both
a way that their recovery from a spell in management and staff. Simply speaking, this
front of a radar display or in the control tower means that everyone in the Company needs
is maximised. For example, getting some to take seriously the risks that fatigue can
fresh air is promoted but sitting down at a bring to the air traffic control operation and
computer to check emails is discouraged. take steps both when at work and when at
• To take short (20-30 minute) naps where leisure to rest, sleep and recover from the
their duties allow, as these have been demands of the job.
shown to boost productivity and alertness
later in the day. NATS provides suitable
facilities for this.
• To set up their working environment in
such a way that it is conducive to aid
concentration and minimise physical fatigue.
Royal Mail Group

Dr Shaun Davis, Global Director of Safety, Health, Wellbeing & Sustainability
At Royal Mail, we recognise that there are potential resulting behaviours – if people been instrumental – it’s easier for staff to
links between sleep and a range of physical aren’t sleeping well, their anxiety levels engage with wellbeing issues under the
and mental health issues and for the benefit might rise and they may get trapped in banner of a branded campaign with its own
of our staff, we wanted to consider ways to a negative cycle of poor diet and lifestyle. identity and to talk openly about sleep and
approach the issues of sleep and recovery. recovery in the workplace without it feeling
Alongside this, we have an employee like a taboo topic.
One of the ways we have done so is through assistance programme, including a 24/7, 365
our ‘Feeling First Class’ programme. It’s a helpline that families and staff can access. We
comprehensive health and wellbeing initiative signpost to legal and therapeutic services and
which promotes good work, exercise and Occupational Health can refer to counselling.
sleep and is available to all our 141,000
permanent staff and 20,000 Christmas casuals. Poor sleep and fatigue go hand in hand and
The programme promotes balance – for good fatigue is extremely dangerous – it’s often the
health and wellbeing, you have to do everything cause of accidents at work and on the roads.
together and everything in moderation. Diet, We recognise that we have a responsibility to
exercise, alcohol consumption and sleep all our shift workers to promote safety and so we
affect how you are at work. have moved to full compliance with Working
Time Regulations. This is key not just because
Through the programme, we ran a mini it’s a legal requirement, but because it means
campaign on sleep, promoting information we’re giving people time to recover.
on good habits. We’ve also empowered and
coached line managers to have conversations Sleep is a difficult subject – it is intensely
with staff about health and wellbeing on personal, but it is also essential to people’s
a range of difficult to approach topics – ability to perform at work. For us, creating a
relationship or financial issues, stress and, positive culture around wellbeing has been
crucially, sleep. Managers have been trained key to opening up conversations on difficult
to spot signs of sleep deprivation and the subjects like sleep. ‘Feeling First Class’ has
Unilever PLC
Marcus Hunt, Health & Wellbeing Manager UK, IRE & Europe
We have made sleep a priority at Unilever. into a competition to win a sunrise alarm items and resources such as our Employee
Throughout 2015, we launched a range of clock. All of this helped ensure employee Assistance Programme (including financial
sleep initiatives, among them our national involvement and engagement with the topic. advice support), our support of daily physical
‘Sleep Well’ campaign, which we connected activity and the promotion of mindfulness.
very closely to our annual celebration of A sleep psychologist helped to inform our We also encouraged the promotion of our
World Mental Health Day. approach and, with their input, we co-wrote materials and resources to colleagues’ family
a sleep handbook for employees. This members to help support their ongoing needs
Sleep is fundamental to good health and provides key information on sleep hygiene, at home – which may be directly or indirectly
wellbeing and we decided to approach lifestyle factors, sleep enablers, sleep and related to sleep.
the issue in a range of ways. The ‘Sleep shift work and sleep and mental health.
Well’ campaign included a number of We received great employee feedback
options, with each site given a selection We also developed a practical workshop following the ‘Sleep Well’ campaign, with
of resources to help meet the needs of the for employees, focusing on sleep, lifestyle almost 60% of national employees engaging
diverse working environments across the and stress factors. The one hour sessions with our resources, but things didn’t end there
UK. Our colleagues broadly work across were delivered either face to face or online, – we have an ongoing commitment to this
manufacturing, distribution, research and to ensure another way to reach employees issue and, for example, we are now running a
development and office work spaces. directly. We also produced evidence based global programme on sleep with a supportive
webinars, podcasts and literature with top webinar to colleagues globally.
One of the particularly engaging and tips on sleeping well.
interactive options was a pop-up roadshow
set, showing a typical bedroom and the This campaign and the materials continue
key factors in it that can affect sleep. The to be part of our ‘Unilever Global Health &
pop-up set had moveable discs showing Wellbeing Strategy’ – which has the four pillars
sleep ‘preventers’ (like mobile phones of physical, mental, emotional health and
and bright lights) and ‘enablers’ of sleep. purpose. As we discuss and promote good
Employees were encouraged to move the wellness behaviours, our ongoing dialogue
discs around to select correct enablers about sleep continues to be especially
and preventers, which then entered them connected with emotional and mental health
Yorkshire Building Society

Sarah Moore, Wellbeing Lead
You wouldn’t expect employees of Yorkshire We followed up with campaigns around sleep, An important consideration is that it became
Building Society to be at risk of sleep framed as an integral part of our approach clear to us that for many employees a barrier
deprivation. We don’t have shift workers as to health and wellbeing and co-created to a good night’s sleep is their children not
such and many of our staff work in branches, by employees. Our aim was to provide the sleeping well. So, we signposted to advice to
which keep regular office hours. But when information people need to understand why help their children at bedtime, knowing that this
we started talking about sleep as part of our sleep is good for you and to help people get is a positive step towards also helping parents.
approach to health and wellbeing at work, more sleep. We posted articles about sleep,
we quickly realised how important sleep is with practical advice about how to get a good Sleep is a deeply personal experience and
as an issue. night’s sleep, which have proven very popular not everybody will want to talk about it. But,
across the organisation. as we found, it is an issue that concerns many
In the first instance, the subject of sleep was employees. Having an open conversation in
raised by an employee during one of our Working with the Mental Health Foundation, the workplace encourages people to think
regular discussions. A follow-up post on our who support our wellbeing programme, we about their own sleep patterns and whether
intranet was widely read and attracted more provided additional advice about how to heal there are things they can do to help themselves
than 40 responses from our colleagues, who after a period of poor sleep. This encompassed sleep better.
shared tips and advice for getting a good health, environment, attitude and lifestyle. We
night’s sleep. We used one of our weekly made available an eight-week sleep course
staff intranet polls to find out more about and encouraged employees to access
sleeping habits and 30 per cent answered: ‘Unmind’, our own health and wellbeing portal,
“Sleep? What’s that?” So, we knew that our which includes sleep support.
colleagues would welcome more support.
Acknowledgements Contents 51
Thank you to the following organisations for contributing

to the development of this toolkit:
• ACAS • Health and Safety Executive • Sleep Apnoea Trust Association

• Amacus • Heineken • Society of Occupational Medicine
• Anglian Water Group • HM Revenue & Customs • Sunderland University
• Bone and Joint Research Group, • IOSH • Teesside University
Royal Cornwall Hospital
• Linklaters • The Sleep Council
• Bupa
• Mental Health Foundation • TUC
• CIPD
• Muckle LLP • Unilever
• Circadian
• NATS • Yorkshire Building Society
• Connect Health
• Newcastle United Foundation
• Council for Work and Health
• R AF
• Crisis
• R AND Europe
• Crossrail
• Royal Mail Group
• Faculty of Occupational Medicine
• Sainsbury’s
• Guy’s and St Thomas’
• Shine Offline
Foundation Trust
Contents 52
Business in the Community

137 Shepherdess Walk Resources for employers
London N1 7RQ
Business in the Community and Public Health England have developed
T +44 (0)20 7566 8650 a range of toolkits to support employers with employee health and wellbeing:
E info@bitc.org.uk
www.bitc.org.uk Mental Health Toolkit for employers
January 2018 Crisis management in the event of a suicide: a postvention

toolkit for employers
Reducing the risk of suicide: a preventative toolkit for employers
Musculoskeletal health in the workplace: a toolkit for employers
Sleep and recovery: a toolkit for employers
This report was written, designed and produced by Forster Communications.
© 2018 Business in the Community. Business in the Community is registered in England and Wales. Charity No 297716. Company No 1619253.

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Sleep and recovery:

a toolkit for employers

In association with Sponsored by

Sleep in numbers Health risks:

around of lost sleep

affected by insomnia3 hours of

Identify external resources you can

We spend about a third of our lives Increasing awareness of sleep deprivation

Foreword from Peter Simpson Chief Executive Officer, Anglian Water

Your legal responsibility as an employer

1/ Key issues to consider

1/ Key issues to consider Contents 14

1/ Key issues to consider Contents 15

1/ Key issues to consider Contents 16

Travel and working across time zones

1/ Key issues to consider Contents 17

Long working hours, irregular shifts,

1/ Key issues to consider Contents 18

“Fatigue is known to contribute to

2/ Understanding sleep deprivation Contents 20

Understanding sleep deprivation Signs of sleep deprivation

Poor cognitive Poor mood/

Inability to make Increased intake

2/ Understanding sleep deprivation Contents 21

Causes of sleep deprivation Work-related causes

2/ Understanding sleep deprivation Contents 22

Changes in health and wellbeing

Read ‘How to sleep better’ from MHF

2/ Understanding sleep deprivation Contents 23

Personal and lifestyle factors Bereavement

2/ Understanding sleep deprivation Contents 24

“The serious impact of those “It’s important to take employee welfare

2/ Understanding sleep deprivation Contents 25

People sometimes get confused about

2/ Understanding sleep deprivation Contents 26

Mental health and

Good Thinking is an online service

2/ Understanding sleep deprivation Contents 27

Sleep hygiene: the right conditions for a good night’s sleep

Fixed times for going to Regular physical activity Maintaining a comfortable

Avoiding the use of a

2/ Understanding sleep deprivation Contents 28

3/ Taking action to support

3/ Taking action to support good sleep Contents 30

Actions for employers

3/ Taking action to support good sleep Contents 31

2. Early intervention: recognising and addressing

3/ Taking action to support good sleep Contents 32

“There are a number of determinants of

A guide to sleep Non-REM sleep REM sleep

Clinical sleep conditions

Clinical sleep conditions continued Cognitive Behavioural Therapy

Resources for employers Contents 39

Resources for employers

Resources for employers Contents 40

Resources for employers continued

Restless Legs Syndrome UK Safety Critical Offshore Workers –

Business in the Community and HSE – Guide to managing shift work

Case studies Contents 42

This opens up a natural opportunity to talk In such an environment an employee is less

Case studies Contents 43

Dystonia and long-term conditions

Case studies Contents 44

Identify external resources you can

1/ Key issues to consider

3/ Taking action to support

• ACAS • Health and Safety Executive • Sleep Apnoea Trust Association