Using full spectrum light during the day and filtering out blue at night is generally safe from a health perspective.  It will reduce the probability of cancer resulting from disruptions to melatonin suppression and release.  It will also help keep your workers' circadian rhythms anchored to their home base times.  There are times, however, when this strategy needs to be adjusted to specific scenarios.  For example, if daytime light is very bright and full spectrum  and it is being used too close to wake-up time, it can advance circadian rhythms making it difficult to remain awake in the evening and asleep in the morning.  If this light is being used too close to bed time, it can delay circadian rhythms, push sleep onset forward, and make it difficult to wake up in the morning.  These issues are usually referred to as sleep phase-advance and delay problems.  Workers with Seasonal Affective Disorder (SAD), a depressive syndrome that normally only occurs during the darker months of the year and can impair performance, may also need to be considered.  These workers may need their dose of light carefully manipulated and monitored to manage their SAD symptoms and fatigue.   

encourage use of the clinic in an accessible manner, services should be provided free of charge and at a variety of times including during night hours and frequently every month.  I suggest at least one day and one night clinic each month and temporarily increasing the frequency when work schedules change or a new strategy is introduced and new individual problems surface. 

During the sleep coaching sessions, the certified professionals gather detailed sleep health and work schedule histories, assess and diagnose workers’ problems and devise behavioural (i.e., non-medicinal) treatments which often include tailored education on sleep and fatigue, adjustments to organizational and personal sleep and fatigue management strategies, or additional strategies like lifestyle changes and stress management.  To be able to efficiently customize their treatments to your workers, your sleep coach should be well trained and have significant experience with shift-workers and fatigue management from an organizational perspective.  Be sure to check your prospective sleep coach’s background; even though they may be certified, many do not have this training and experience.  

Your sleep coach should also have access to external health resources like overnight testing facilities and accredited medical and psychological sleep doctors who can diagnose disorders using the International Classification of Sleep Disorders (ICSD).  These diagnoses are often required by insurers before they will pay for treatments that sleep coaches cannot offer like continuous positive airway pressure (CPAP) and hypnotic or stimulant medications.   

An added advantage of access to external health resources is that the sleep doctors can confirm a very concerning disorder, shift work sleep disorder.  Shift-workers with this disorder find it very difficult to obtain an adequate amount of good quality sleep during the day, and they have a lot of trouble staying awake at work, particularly during night shifts.  While most shift-workers sleep less than day workers and have more difficulty staying alert at work, people with this disorder may sleep four hours less than they would normally sleep when not working shifts even if their sleep environments are optimal.  Plus, the sleepiness they experience at work increases their need to nap and decreases their alertness more so than for other shift-workers.  When shift-workers with shift-work sleep disorder have time off work, much of their free time is consumed by sleep as they recover from acute and chronic sleep disruptions. This often has a negative impact on their relationships with friends, family, and romantic partners.  

In severe cases, workers with shift-work sleep disorder cannot work any shift that prevents opportunities for eight hours of night sleep.  The risks to their health and personal lives are too great, and their fatigue levels can lead to uncontrollably falling asleep during night shifts.  You might now be thinking along the lines of a funny suggestion I make during some of my training sessions.  I will often try to get a few laughs by saying, “Anyone tired of working shifts?  If you never want to work them again, get diagnosed with shift-work sleep disorder!”  This suggestion is only partly true.  Although some people cannot work night shifts, many with this disorder can continue night work if accommodations are provided.  Interestingly, these accommodations can make night shifts easier for all workers, but sadly they are infrequently used.  For example, ending night shifts at a time that allows a daily eight-hour consolidated sleep period to begin a few hours before sunrise, on the job napping, bright workplace lighting, and stimulant medications can make it easier for workers with less severe cases of this sleep disorder to obtain appropriate sleep and keep fatigue at manageable levels. 

You may now be asking, “How great a risk is this sleep disorder?” and “If I set up sleep coaching clinics, will I lose all my night shift workers to this diagnosis?”  These questions are difficult to answer because the prevalence estimates of shift-work sleep disorder vary greatly.  Some put it at 2% in the general population whereas others suggest that almost 40% of the shift-working population meet the criteria for diagnosis.  I guess it would be possible to lose quite a few night shift-workers to this diagnosis.  But remember that accommodations do help, and perhaps all you might have to do is make a few schedule alterations and train more people on sleep and fatigue management strategies.  If a few workers remain who still cannot work nights, then it is probably better they do not, the risks are too high. 

There are two ways to staff your clinics with a sleep coach.  First, you can contract one with the right training and experience.  This is often seen as an expensive strategy, contracted sleep coaches are not cheap.  I believe the expense is an illusion and can easily be justified using return on investment (ROI) logic.  For instance, your sleep coach’s fees will be offset by reductions in sick leave, long term disability, productivity losses, costly mistakes, and significant accidents that could cost your organization millions of dollars. 

The second staffing option is to use an internal sleep coach. You could hire one to work under you as a formal employee, or if you feel comfortable with your skillset and experience as a sleep and fatigue manager, you could take on the role.  The advantages of using this option are that it can be financially efficient because the sleep coach can assist with other initiatives when they are not coaching and they will understand your organization’s culture, approach to sleep and fatigue management, and systems better than an external sleep coach.  Understanding your organization means that your internal sleep coach will be able to provide your workers with remedies that align with your overall approach, processes, initiatives, and approved strategies.   

There is one obstacle that you should consider before you select option two.  Your workers may not feel comfortable talking with an internal colleague and may not attend your clinics.  Without an ideal sleep and fatigue culture, workers may fear confidentiality breaches, the possibility of real or perceived discipline for mismanaging or deprioritizing sleep, or they might simply not want a colleague to know anything about their sleep or personal lives.  If your sleep and fatigue culture is not yet ideal, contracting an external sleep coach will be a better option.