Organisational Change Management Volume 2

22. Sleep

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I

Introduction

 

(includes light)
. Adequate sleep plays a pivotal role in underpinning all these factors that impact upon competitiveness in a modern society, such as promoting learning, concentration, imagination and creativity; sharpening problem-solving and accuracy; consolidating memory; improving mood and reaction time

 

. Sleep is like food, ie an essential factor in wellbeing. It is more about resting the mind than the body.

 

. In general, adults need around 8 hours of sleep per night as the human brain is only capable of around 16 hours of wakefulness; otherwise cognitive performance declines, ie

 

"...your reaction speed, short-term and long-term memory, ability to focus, decision-making capacity, math processing, cognitive speed, and spatial orientation all start to suffer......Cutback sleep......and the accumulated sleep deficit magnifies these negative effects..."

 

Charles Czeisler, 2006

 

. Research on American police officers (Alexandra Roginski, 2012) showed that a high number (40%) of police officers suffered sleep disorders that arose from a combination of

 

- lifestyle (poor diet and exercise)

 

- job-related stresses

 

- shift work factors

 

. More detail on "slumber blunders"from police study

Performance indicator

Percentage of increased risk for persons with sleep disorder (%)

Serious administrative error

41

Falling asleep while driving

57

Error or safety violation attributed to fatigue

53

Error or safety violation not attributed to fatigue

32

Occupational injury

26

Uncontrolled anger towards suspects or citizen

20

Absenteeism

24

Falling asleep during meetings

101

Falling asleep while stopped in traffic

51

Citizens' complaints

19

They are also more than twice as likely to suffer from depression

 

. Sleep loss and sleep disturbance show a complex and bi-directional relationship with mood, ie

 

"...Sleep loss impairs your ability to regulate mood, and mood disturbances in turn may have an adverse impact on sleep...... Disrupting the body's biological clock exposes.....the risk of many different things. It upsets the natural physiology of the body..."

 

Shantha Rajaratnam as quoted by Alexandra Roginski, 2012

 

. Previously it was thought that people like doctors became immune to the negative impacts of sleep deprivation and shift work owing to their gruelling medical training. Recent research has debunked this myth.

 

Purposes of sleep

 

. There are at least 3 purposes of sleep, ie restoration, regulation and learning

 

i) restoration - after a good night's sleep we feel refreshed, ie full of energy, our brains are alert, etc

 

"...Human growth hormone is released during the deepest stages of sleep and, apart from stimulating growth, one of its function is to trigger the repair of damaged issue. It is also significant that when we are ill, we tend to sleep more..."

 

Robert Winston, 2003

 

ii) regulation - our brain and body are organised into regular cycles known as circadian rhythms. This human body clock tells us when we feel sleepy, or when we should eat, etc

 

iii) learning, ie

 

"...sleep acts as oil for the cogwheels of the brain.......The importance of REM sleep in memorising and learning.......The brain goes over itself during sleep, reinforcing new firing patterns and etching them into the memory. Numerous studies have shown that human and animal subjects perform tasks more quickly and more thoroughly after sleep that follows the learning procedure..."

 

Robert Winston, 2003

Sleep is important in managing stress as cortisol levels increase every time you are deprived of sleep; this can contribute feeling overwhelmed

Four stages of sleep

 

. They are 4 separate stages that the brain goes through in sleep. The first stage starts with closing our eyes and relaxing. This involves reduced activity of our brain waves (such as beta waves that appear on charts as are a series of short, tightly-spaced teeth - like serrated edges of a bread knife). The peaks of activity become slightly larger, more regular and more spaced out compared with when we are awake; this involves going from

 

"...alert wakefulness into a gentler, more rhythmic sequence of pulsed activity, like the hum of distant machinery. This is a shift from beta to alpha wave activity..."

 

Robert Winston, 2003

 

Still part of the first stage of sleep is the theta wave formation

 

"...Theta waves are less regular, more like handwriting on the paper roll of the EEG (electro-cardiographic) machine. We can be easily aroused from this stage of sleep and may not even be aware that we are asleep. While this is going on, we may see vivid images before our eyes - sometimes a version of what we may see in the room as if we were awake. We may experience sudden jolts in our arms and legs - which sometimes wake us with the sensation that we have fallen to the earth with a sudden bump..."

 

Robert Winston, 2003

 

During the second stage of real sleep, breathing becomes more regular and we are harder to wake. Theta wave activity is still present with occasional bursts of activity, called "sleep spindles"and "k-complexes"

 

The last two stages of sleep are associated with delta wave activity (high and low patterns with regular peaks and troughs). We are increasingly oblivious to our surroundings, and if woken suddenly, feel startled and disorientated. On the other hand, we are still receptive to particular sounds, such as a parent being instantly aroused when she/he hears a child crying.

 

After around 90 minutes of sleep, the cycle goes into reverse, ie rapidly going back to stages 3 and 2, and then 1. Then we move into the rapid eye movement sleep (REM) or paradoxical sleep as there is a contrast between our sleeping body and our alert mind. In fact, some areas of the brain, such as the brain stem, are more active during this stage than in our normal waking state. If woken during this REM sleep, most people will say they have been dreaming; while if woken during non-REM sleep, fewer people will claim to have been dreaming. Furthermore, the types of dreams are different, ie

 

"...non-REM dreams have a procedural nature - for example, performing dull, day-to-day activities, like typing, or dialling numbers of the telephone. REM dreams, by contrast, are a more fantastical mixture of reality and the outright bizarre. They can involve intense emotions, illogical events and a suspension of the normal rules of time and space. Familiar people may turn into strangers, and vice versa......the sleep cycle repeats itself throughout the night (or whenever we are sleeping) - becoming shorter as we move towards the appointed hour of the alarm clock. As the cycle shortens, more time is spent in REM sleep. We may pass through this cycle to the point of actually waking up several times a night, but if our brain is healthy and there is an absence of distracting stimuli, we will go back to sleep and not remember these intervals..."

 

Robert Winston, 2003

 

NB The most refreshing form of sleep occurs when lying horizontal

 

Four major sleep related-factors affect our cognitive performance

 

i) homeostatic drive for sleep at night (this is determined above the number of consecutive hours that we've been awake. The longer we are awake, the stronger is the drive for sleep. If the homeostatic pressure to sleep becomes high enough, the brain "switches off")

 

ii) total amount of sleep-deficit accumulated over several days (an accumulating sleep deficit makes it more difficult for the brain to function. Furthermore, the brain needs to wind down before sleep starts; the impact of sleep-deficit is similar in impact to drinking too much alcohol)

 

iii) our body clock (circadian and ultradian rhythms) determines our energy and concentration levels during the day.

 

- Circadian rhythms control whether we get a good, restful sleep and are dependent upon many factors, such as sunlight on our eyes, body temperature and regular sleeping patterns.

 

- Ultradian rhythms last for 90 minutes, send us in and out of deep sleep during the night, and are linked to our alertness during the day. Usually, after 90 minutes, performance dips and the ability to think cognitively decreases. Furthermore, performance is linked with glucose levels which are dependent on what, and when, you have eaten.

 

It is of interest to note that the homeostatic drivefor sleep works in the opposite direction to the circadian pacemaker:

 

"...the circadian pacemaker sends out its strongest drive for sleep just before we habitually wake-up, and its strongest drive for waking one to three hours before we usually go to bed, just when the homeostatic drive for sleep is peaking..."

 

Charles Czeisler, 2006

 

Reasons for this are not clear.

 

"...In the midafternoon, when we are already built a substantial homeostatic sleep drive, the circadian system has not yet come to the rescue......the circadian pacemaker sends out a stronger and stronger drive for waking as the day progresses. Provided you're keeping a regular schedule, the rise in sleep facilitating hormone melatonin will then quiet the circadian pacemaker one to two hours before your habitual bedtime, enabling the homeostatic sleep drive to take over and allow you to get to sleep. As the homeostatic drive dissipates midway through the sleep episode, the circadian drive to sleep increases toward morning, maintaining our ability to obtain a full night of sleep. After a usual wake time, the levels of melatonin begin to decline. Normally, the two mutually opposing processes work well together, sustaining alertness throughout the day and promoting a solid night of sleep..."

 

Charles Czeisler, 2006

 

iv) sleep inertia (the grogginess most people experience when we first wake-up), ie

 

"...the part of your brain responsible for memory consolidation doesn't function well for five to 20 minutes after you wake-up and doesn't reach its peak efficiency for a couple of hours.... There is a transitional period between the time you wake-up and the time your brain becomes fully functional..."

 

Charles Czeisler, 2006

 

Sleep squeeze

 

. In today's world of long working hours, there is a "sleep squeeze", especially for those who are ambitious about their careers. Sleep squeeze impact is negative as

 

"...poorly slept and overworked people are unlikely to be innovative, creative and flexible, especially if they are led by managers who are often so exhausted that they find it difficult to think straight, let alone laterally..."

 

Charles Leaderbeater as quoted by James Hall , 2004d

 

Furthermore, when the brainisdeprived of a couple of days' sleep, it is the routine or repetitive tasks, such as driving a car, that suffer more than the performance of complex, challenging tasks.

 

. Who doesn't get enough sleep? (based on UK data)

organisational development change management

Notes

i) including junior management and non-manual workers such as call center staff

. What do people do when they don't get enough sleep? (based on UK data)

                                                     %

Become irritable and shout             42

Argue with partner                         22

Feel like sleeping at work               21

Make mistakes at work                  13

Nearly have a car accident               5

. Research has shown that the longer we go without sleep, the more disorientated we become:

 

"...sleepy workers are about seven times more likely to have an accident, three times more likely to be absent from work, less innovative and less able to focus on the task at hand..."

 

Ron Grunstein has quoted by Brad Hatch, 2005b

 

. It is felt that the best way to handle this is to have facilities where staff can have power naps, and to be more accommodating of workers needing sleep, such as providing nap rooms in offices, allowing more people to work from home, and allowing sleep catch-up days (essential for those working particularly long hours). The power nap of around 10 minutes will increase alertness and performance for around 3 hours. However, a longer nap of over 20 minutes can cause post-nap grogginess. The best time for the nap is in the mid afternoon when the circadian rhythm slumps.

 

Ways to get the best out of each day, while keeping in mind the circadian and ultradian rhythms, and their links with glucose levels

 

. Get up at the same time each morning

 

. If you need to catch up on sleep, go to bed early as sleeping in resets your body clock

 

. Breakfast on carbohydrates and proteins

 

. Get at least 15 minutes exercise before work

 

. Schedule the most strategic work for your peak hours, ie are you a lark or an owl?

 

. Snack mid-morning and afternoon with carbohydrates and proteins; avoid sugary foods as they only give you a short-lived energy lift

 

. Schedule meetings before 3 pm, ie before glucose levels drop

 

. Keep lunch light and include a protein

 

. Sit in the sun for around 15 minutes per day as lack of sunlight can make you feel listless and depressed

Length of time asleep
(around 8 hours) is about 20% less than 100 years ago; 1/3 of us have less than 6 hours.  Inadequate sleep causes "sleep squeeze" that has a negative impact on

 

  1. cognitive ability like learning, creativity, problem-solving, imagination, etc
  2. immune system , ie become more susceptible to colds, cancers, heart attacks, obesity (over- eat when tired), depression, diabetics, etc

 

. Power nap (10 minutes) is very effective; if sleep longer go into a deeper speak pattern.

 

Sleep impacts on the body's internal workings

"...It enhances our immune system so that when deprived of it, we are not only liable to catch a cold, but also more susceptible to other types of cancer - and if we already have cancer, it will probably grow faster. We are more likely to have heart attacks or become depressed. We overreach when tired and because our metabolism alters too, we are far more prone to obesity and diabetes..."

Rosie Blau, 2014

Sleep Deprivation

Signs of sleep deprivation include irritability, indecision and being quick to anger.
Most of us need around 8 hours sleep per night. Only 5% of people possess a "short sleep gene" and are able to handle less than 6 hours a night (Patrick Durkin, 2014a)
The most common cause of bad sleep is anxiety about the next day.
It is best to switch off your phones from 10.30 pm to 7.30 am
so that you get the right amount and quality of sleep
The 2 extremes on the sleep bell curve, ie larks and owls
-
larks (first peak at around 8 am to 11 am; hit a lull from 2 pm to 4 pm and bounce back to their best after 6 pm to around 9 PM. Some examples are Margaret Thatcher, Tim Cook- Apple's CEO and George W Bush.
- owls (peak from 11 am to early afternoon; experience a lull from 4 pm to 6 pm; then hit their straps from 8 pm till late. Examples include Paul Keating, Winston Churchill and Thomas Edison
As we get older, our schedules resemble owls more than larks.

Resting (part of sleep)

Even though 50% of strong aerobic performance is based on genetics; the rest is consistent with hard work backed up by efficient recovery. Workouts provide stimulation for growth but growth happens when we rest, ie
"...everybody knows how to work hard. But if we're not resting, then that sharpness and that readiness for that work out for that challenge is put in jeopardy......in Western cultures we average about 5 1/2 hours sleep a night...... that is not sufficient for stabilising the brain, so we not growing. And if you're male, two nights without seven hours and you have the testosterone curve of a woman..."
John Sullivan as quoted by Jacquie Hayes, 2015

Meditation

· There is much discussion about diet, exercise, sleep, light, etc in the 24/7 world. At times there is a need to hit the pause button and refocus. Meditation allows this to happen

· Meditation is not about a religion; it is more about spirituality; to find a balance and clarity in your thinking; clarity in your life. It can help create resilience and there is some evidence that helps cure diseases

· The best way to meditate

 

"...is sitting up. If you lie down you tend to fall asleep, and your posture is incredibly important with meditation, having a straight back and having your palms upwards. It's an open posture so your muscles aren't engaged because the idea of meditation is to relax, so as you relax the body, you relax the mind......so the more relaxed your body is, the easier it is to quiet the mind..."

 

Tami Roos as quoted by Lucille Keane et al, 2014

Light (links with sleep)

· For most of our history, time has been determined by the solar cycle, ie we evolved to spend hours outside every day; with bedtime coming soon after sunset when the sky was black. Now most of us pass our waking lives inside offices, factories, schools, hospitals, shops, nurseries, etc away from natural light in poorly lit rooms with sealed windows. Once day begins to fade, we flick the switch and light returns. Compared with our ancestors, our working hours are gloomy and our nights dazzling!

 

· There is a link between light and health. For example, over the last few decades, medical professionals have warned us about the negative impacts of ultraviolet rays in contributing to skin cancer. More recently, there is concern that too little daylight can have long-term damage on your health. By overriding the light-dark cycle of the natural world, we could be disrupting the internal workings of the human body. One consequence is that we sleep less. Most young adults sleep for about 8.5 hours per day (one third of us have 6 hours or less); this is 20% less than a century ago (United States National Sleeping Foundation). Furthermore, most of our children are sleeping around 75 min less each school night than a century ago. Whereas tired adults become sluggish and lethargic, kids become hyperactive and distracted. This may explain the increasing number of children who are now diagnosed with "attention deficit hyperactive disorder" (ADHD), ie 1 in 10 children in USA. ADHD symptoms are remarkably similar to those of sleep deprivation.

 

· Being tired makes us less productive, more forgetful and apt to make mistakes. For example, human error in the early hours of the morning contributed to the Exxon Valdez oil spill and nuclear accidents at Chernobyl (Russia) and 3 Mile Island (USA).

 

· Research is showing that in brighter environments, we are more alert, complete visual tasks better and make fewer mistakes

 

· Our bodies respond to light

 

- gloomy winters' days are known to trigger a form of depression (seasonal affective disorder - SAD); this can be reversed by exposure to light

 

- bipolar patients in east-facing hospital rooms stayed almost 4 days fewer than those in west-facing ones

 

- people recuperating from spinal and cervical cancer in bright rooms took fewer painkillers

 

- female heart attack patients treated in intensive care units recovered faster if they were exposed to plenty of natural light

 

- mortality is consistently higher in dull rooms (Rosie Blau, 2014)

 

· Light impacts our body clock.

 

i) even if we are kept in the dark, we still wake and sleep at precise intervals over a 24 hour period; this indicates that an internal clock controls the sleep-wake cycle, ie circadian pacemaker. It also responds to the environment, especially light and dark.

 

ii) some types of light have more impact than others. Our eyes see 3 main colours of light, ie red, green & blue, with each working at different wavelengths. In the morning, high concentrations of blue occur naturally; by dusk we are left mostly with green and red. The blue light has the greatest impact on our circadian clock, ie informing the brain that it is morning, time to be alert and setting the clock for the rest of the day.

 

iii) our brain and body function better if the internal signals of the body clock are synchronised with the external cues of day and night.

 

iv) unfortunately, artificial light does not represent the same colours of the natural world. Most electric light has a high intensity of blue which deceives the brain into thinking that it's day when it is not. Just 10 minutes of regular electric light can make some changes to our internal clock.

 

"...We have evolved to be blue sensitive, we need...... many of us get a tonne of it, particularly in the evening when we get home. We spotlight the kitchen so we can make dinner, then plug into our laptops smart phones  bringing blue light into our eyes at close range. So we bombard our internal clock with mixed messages: they are gloomy morning sends a weak signal to be alert; our overbright evening shouts at our brain to rise and shine. We also have less than contrast between light and dark that our circadian system relies on the function. All of which makes us more prone to insomnia..."

 

Satchin Panda as quoted by Rosie Balu, 2014

 

Traditionally, we sleep during the night time. With development of electricity, we can turn night into day

 

. Research is showing that in natural light or brighter environments, we are more alert, complete visual tasks better & make fewer mistakes

 

. Don't confuse brightness with light, eg TV & some offices seems bright but have little light; an overcast day has plenty of light

 

. Trends in urbanisation, eg home, offices, etc mean that people are exposed to less natural light

 

. Daylight is not intrinsically better for us than electric light. It's just that getting artificial light to do the same job is more expensive, uses more energy & it is more difficult to get right balance

 

. Having a good night's sleep depends on having the right amount of light at the right time during the day, eg exercise outdoors in the morning

 

. We need more light to synchronise the circadian system than we do to see

 

. There are 3 types of light, ie

 

- blue

 

- green

 

- red.

 

Blue is important in the morning & to keep us awake; while green & red at dusk encourage sleep

 

. Unfortunately, artificial light does not represent the same colours of the natural world; it has too much blue which is harmful at night.

 

. This blue light is generated from screens (computer, iPads, etc), bright lights, etc and suppresses melatonin (sleep-promoting hormone). Thus these are OK to view in the mornings but a problem at night time

 

. Sleep disturbances magnify as we age. Most people over 65 have serious problems going to sleep, waking up often at night or struggle to keep their eyes open during the day.

 

. Disrupted sleep is linked with declining physical condition and immunity

 

. We need more devices that are circadian-friendly, ie programmed to radiate less blue light in the evenings & more in the mornings

 

. In addition to light & dark, the body clock responds to the direction of rays & movement in a scene

 

12 tips to better handle light & sleep

 

  1. get up and go to bed at the same time every day
  2. let natural light into your bedroom when you get up
  3. maximise time in the sunlight
  4. keep blinds/curtains open that are near to your desk
  5. work near a window
  6. play video games by day, not at night
  7. buy an extra desk lamp
  8. eat dinner with the lights dimmed
  9. don't use your computer or tablet for 2 hours before bedtime
  10. reduce blue glare from your computer
  11. make your bedroom dark or wear a facemask
  12. turn off the lights half an hour earlier

· Food can help synchronise a biological clock

· More research is required on life to determine

 

- How much light do we need?

 

- Does it matter if the light is natural or electric?

 

- Does getting lots of light on one day compensate for less on another?

 

- What could be the long-term impact of spending days in "dark" rooms?
In summary (linking enegry, water, sleep & light)
Lack of energy and/or water and/or sleep and/or inappropriate lighting impacts adversely on executive functions, eg

 

- making poor decisions

 

- choosing impulsively

 

- being cranky

 

- struggling with problem solving/memory tasks

 

- being more susceptible to negative health issues

 

. Ideally don't want an organisation of hungry, tired &/or thirsty people who don't breathe correctly and work in poorly lit workplaces !!!

(sources: James Hall, 2004d; Brad Hatch, 2005b; Sora Song, 2006; Robert Winston, 2003: Fiona Smith, 2006b; Susannah Moran, 2006; Charles Czeisler, 2006; Alexandra Roginski, 2012; Rosie Balu, 2014)

 

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