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Quality, Health, Safety and Environment

Fatigue Improvement Programme

Fatiguepedia Prepared by: Julian Hendon

Programme Manager

Reviewed by: Amanda Webster Project Manager

Approved by: N/A

Version control: Version 1.0 First Issue Date: 9th August 2018

Version 2.0 Second Issue Date: 21st September 2018

Date:

Contents Quality, Health, Safety and Environment ..................................................................................................... 1

Fatiguepedia ................................................................................................................................................. 1

Contents ....................................................................................................................................................... 2

1. Overall objectives ................................................................................................................................. 5

1.1. Background ................................................................................................................................... 5

2. Fatiguepedia ......................................................................................................................................... 6

2.1. Why We Sleep – The science behind sleep. ................................................................................. 6

20 June 2018 – Weight Gain ................................................................................................................. 6

28 June 2018 – Body Clock ................................................................................................................... 6

29 June 2018 – Sleep Debt .................................................................................................................... 7

19 July 2018 – Mental and Physical Fatigue ......................................................................................... 7

20 July 2018 – Teenage Sleep ............................................................................................................... 8

20 August 2018 – Sleep through The Ages ........................................................................................... 8

2.2. Sleep Preparation – Building the Foundations for Quality Sleep. .............................................. 10

2 July 2018 – Exercise and Sleep ......................................................................................................... 10

26 July 2018 - Naps ............................................................................................................................. 12

13 August 2018 – How to Rest 1/3 ..................................................................................................... 14



2.3. How to Sleep – Tips for Obtaining Quality Sleep........................................................................ 17

21 June 2018 – Tips for Better Sleep .................................................................................................. 17

25 June 2018 – Sleep Bulimia ............................................................................................................. 17

26 June 2018 – Waking in the Night ................................................................................................... 17

27 June 2018 – Sleeping in the Heat ................................................................................................... 17

23 July 2018 – Sleeping when Pregnant ............................................................................................. 20

24 July 2018 – Sleeping on Holiday ..................................................................................................... 21

31 Aug 2018 – Sleep Hygiene ............................................................................................................. 21

06 Sept 2018 – Two Minutes to Sleep – US Military Technique ......................................................... 22

07 Sept 2018 – Natural Sleep Aids ...................................................................................................... 23

2.4. Causes of Fatigue – Why We May Become Fatigued. ................................................................ 25

3 July 2018 – Sleep and the Menopause ............................................................................................ 25

27 July 2018 – Fatigue and Mental Health ......................................................................................... 25

30 July 2018 – Coping with Sleep Issues in Grief. ............................................................................... 26

31 July 2018 – Snoring (1/2) ............................................................................................................... 27

01 Aug 2018 – Snoring (2/2) ............................................................................................................... 29

03 Aug 2018 – Chronic Fatigue Syndrome .......................................................................................... 30

07 Aug 2018 – Presenteeism (1/3) ..................................................................................................... 31



16 Aug 2018 – Caffeine ....................................................................................................................... 34

17 August 2018 – Pets ........................................................................................................................ 35

29 Aug 2018 – Restless Leg Syndrome ............................................................................................... 37

12 Sept 2018 – Asleep at the Wheel ................................................................................................... 38

2.5. Recognising Fatigue – Signs, Symptoms, Consequences............................................................ 40

22 June 2018 – Signs of Fatigue .......................................................................................................... 40

2.6. Management of Fatigue – How Best to Deal With Fatigue Causes. ........................................... 41

4 July 2018 – Personal Fatigue Management ..................................................................................... 41

5 July 2018 - Hydration ....................................................................................................................... 41

9 July 2018 – Boost Energy/Beat Fatigue (1/4) ................................................................................... 43

10 July 2018 – Boost Energy/Beat Fatigue (2/4) ................................................................................. 43



16 July 2018 – Fatigue of the “Go To” person. ................................................................................... 45

17 July 2018 – Young Families ............................................................................................................ 45

18 July 2018 – Driver Fatigue .............................................................................................................. 46

02 Aug 2018 – Management of Self ................................................................................................... 47

21 Aug 2018 – Fatigue Beating Yoga .................................................................................................. 48

10 Sept 2018 – Meeting Fatigue ......................................................................................................... 50

11 Sept 2018 – Fatigue Beating Colours ............................................................................................. 51

14 Sept 2018 – Fatigue Commitment ................................................................................................. 53

18 Sept 2018 – Meditation for Sleep .................................................................................................. 54

2.7. Technology – Fatigue Related Technology ................................................................................. 55

10 Aug 2018 – Fatigue Related Technology in Cars ............................................................................ 55

19 Sept 2018 – Stress Busters ............................................................................................................. 56

2.8. Tools – To Help You and Your Teams. ........................................................................................ 59

22 Aug 2018 – Meeting Planning ........................................................................................................ 59

23 Aug 2018 – Fatigue Video .............................................................................................................. 59

24 Aug 2018 – Fatigue Safety Hour .................................................................................................... 60

28 Aug 2018 – The Fatigue Evaluation ................................................................................................ 60

12 Sept 2018 – Driving Preparations .................................................................................................. 61

17 Sept 2018 – The Fatigue Evaluation ............................................................................................... 62

20 Sept 2018 – Describing Fatigue...................................................................................................... 63

2.9. Miscellaneous – General Fatigue Factlets. ................................................................................. 66

6 July 2018 – Fatigue Awareness Week 2019 ..................................................................................... 66

13 July 2018 – Recording Fatigue ....................................................................................................... 66

25 July 2018 – History of the Bed ....................................................................................................... 67

06 Aug 2018 – Arianna Huffington ..................................................................................................... 68

29 Aug 2018 – Exxon Valdez ............................................................................................................... 69

03 Sept 2018 – Sleep in the Animal Kingdom ..................................................................................... 70

05 Sept 2018 – 3 Mile Island ............................................................................................................... 71

1. Overall objectives

1.1. Background

• The purpose of the Fatigue Improvement Programme is to reduce the risk of fatigue related incidents and ill health within Network Rail and its supply chain to as low as reasonably practicable (ALARP). This process also demonstrates the means by which Network Rail complies with UK Health and Safety legislation.

• In addition to the development of the standard and the delivery of the enablers for the programme, Education

on fatigue plays a crucial role. Education on the programme is taking many forms and one of these is the use of social media, Yammer. The programme team are placing a Fatigue Fact on Yammer every day to provide a serious, but sometimes, light hearted insight into all things fatigue related.

• This Fatiguepedia aims to provide a record of these facts, sorted by subjects, for people to dip into at leisure.

These may be used for Safety Hours or just to amaze your friends and colleagues with your knowledge of fatigue.

• The Fatiguepedia is divided into 8 subjects, these being: • Why We Sleep – The science behind sleep. • Sleep Preparation – Building the foundations for quality sleep. • How To Sleep – Tips for obtaining quality sleep. • Causes of Fatigue – Why we may become fatigued. • Recognising Fatigue – Signs, symptoms, consequences. • Management of Fatigue – How best to deal with fatigue causes. • Technology – Fatigue related technology • Tools – Useful tools to help you and your teams • Miscellaneous – General fatigue factlets.

2. Fatiguepedia

2.1. Why We Sleep – The science behind sleep. 20 June 2018 – Weight Gain Appetite, weight and food consumption are all regulated by sleep. Lack of sleep makes you eat 300-550 more calories per day, and makes you eat more high sugar and high carb foods.

28 June 2018 – Body Clock Today’s Factlet relates to your Body Clock. The mechanism of which ticks away in all of us. (Apologies but this does get a little scientific)

In 2017 the Nobel Prize in Physiology or Medicine was awarded to three scientists for their discoveries of the molecular mechanisms that control circadian rhythms. The Americans—Jeffrey C. Hall, Michael Rosbash, and Michael W. Young used fruit flies to isolate a gene that dictates the biological clock ticking away inside all living organisms.

Circadian rhythms help determine our sleep patterns. The body’s master clock, a group of about 20,000 nerve cells (neurons) that form a structure called the suprachiasmatic nucleus, or SCN, controls the production of melatonin, a hormone that makes you sleepy. It receives information about incoming light from the optic nerves, which relay information from the eyes to the brain. When there is less light—like at night—the SCN tells the brain to make more melatonin so you get drowsy. Exposure to light from mobile devices during the night alter circadian rhythms and sleep-wake cycles hence it is good practice to limit screen time for an hour before sleep. The opposite hormone to Melatonin is Serotonin. Serotonin and melatonin are almost literally day and night in hormone terms. They perform opposite jobs and yet they must work in harmony to keep the body balanced.

Serotonin can be described as our body’s natural happiness drug. It’s a feel-good hormone that increases positivity and relaxation, as well as helping us feel all-around more energized. This energy is particularly important because we all need it to get us going in the morning and wash away the lethargy that would otherwise keep us in bed.

The Image below shows a typical body clock.

29 June 2018 – Sleep Debt What is Sleep Debt? “Sleep debt” is a term used to describe cumulative sleep loss resulting from ongoing sleep restriction. If you regularly get less sleep than you need, your accumulated sleep debt will grow larger over time. Some say this looming sleep debt makes you tired, grumpy, and prone to accidents and illness. Calculating Your Sleep Debt What’s your personal sleep debt? Start with the amount of sleep you need to feel rested and alert. If you need 8 hours of sleep each night but only get 7 hours on average, you accumulate a sleep debt of 7 hours each week. Over the course of a year, you’ve lost 364 total hours of sleep, equivalent to nearly 7 weeks of sleep. Can you Repay Your Sleep Debt? With the increased awareness of the dangers of sleep deprivation, many night owls and chronic sleep-skippers wonder if they can repay their looming “sleep debt.” The answer is no, for the most part. Once sleep is missed, it’s gone for good. Sleeping more for a night or two can help restore some of the cognitive decline caused by a large sleep debt. But clearly, it’s not possible to “repay” a sleep debt totaling hundreds of hours. However, when a sleep-deprived individual slumbers, the body works to “make up” some lost sleep by spending more time in the deeper, more restorative stages of sleep, and less time in lighter-stage sleep. Scientists observe changes to the sleep stages in people who don’t sleep enough, which generally resolve if the person starts sleeping more. But because each sleep stage is vital to our mental and physical wellbeing, it’s vital to allow enough time for the body to move through all stages of sleep, and not chronically deprive yourself of the rest you need. Erasing your Sleep Debt The best way to stay out of sleep debt? First, stop adding to your sleep debt by making a real effort to get adequate sleep each night. Determine the amount of sleep you need to feel well-rested, and create a schedule that allows enough time for sleep. A sleep journal can help track your sleep patterns to help you see how much you’re sleeping overall. Once you decide how much sleep you need each night, solid sleep hygiene habits will help keep your sleep routine on track

19 July 2018 – Mental and Physical Fatigue Hello all. Fatigue can come in two forms: Physical and Mental. Todays post highlights the difference between the two.

Mental fatigue Those who routinely obtain less than 7-9 hours of interrupted sleep per 24-hour period will have a high homeostatic (The tendency of the body to seek and maintain a condition of balance or equilibrium within its internal environment) drive for sleep as the body struggles to restore balance. In addition, scheduling inconsistencies often lead to a high circadian drive for sleep at exactly the wrong times of day as well as to sleep-initiation problems at night. So, when athletes lose sleep due to any number of factors, when they’re unable to stick to a consistent bedtime due to travel or social engagements, and when they have to train or play at the “wrong” times in a new time zone, they’ll be faced with both a high homeostatic and a high circadian drive for sleep. The result will be impaired judgment, reaction time, and situational awareness—the hallmarks of poor mental effectiveness. Physical fatigue Physical effectiveness, or energy, is different. It’s a function of non-sleep and circadian-related factors such as the type, intensity and volume of exercise (or physical labour) as well as muscle fibre composition, neuromuscular characteristics, high energy metabolite stores, buffering capacity, ionic regulation, capillarization, and mitochondrial density. Physical energy can be viewed as the capacity to perform a certain amount and intensity of physical activity for a given period of time. Elite athletes, who routinely engage in high-intensity

training, are far less susceptible to physical fatigue than those who are sedentary. They run faster, lift more weight, and perform for longer periods of time due to their enhanced physical conditioning. The difference between mental and physical fatigue Mental and physical energy are governed by very different underlying processes—they’re separate biological functions. Having said that, they can coexist. If one’s physically exhausted due to high-intensity physical activity, they may struggle to run, lift, or play, but their alertness and concentration will remain intact. In fact, most research concludes that physical activity has either a positive effect or more often, little or no impact on mental performance. However, when a person’s mentally exhausted due to sleep deprivation, their alertness will suffer while most aspects critical for physical performance will be preserved. And while sleep loss affects mood, motivation, judgement, situational-awareness, memory, and alertness, it doesn’t directly affect cardiovascular and respiratory responses to exercise of varying intensity, aerobic and anaerobic performance capability, or muscle strength and electromechanical responses. But, time-to-physical-exhaustion is shorter and their perception of exertion and endurance is distorted. Even though physical fatigue has little to no impact on mental alertness, the reverse is true—the psychological realm has a great deal of impact on the physical. This is how a competitive decline takes root under conditions of sleep loss. Tomorrows post is entitled "The Kevin and Perry" post. See you then.

20 July 2018 – Teenage Sleep "It’s so unfair.....! Today’s post is entitled "The Kevin and Perry Post" For those of a certain age (Which is me) you will make this connection, for everyone else look up Harry Enfield - Kevin and Perry" on YouTube. “Why are teens always tired?” Trouble getting up on school days, dozing off in class, marathon lie-ins at weekends... It may feel like your teenager is sleeping their life away. In fact, the opposite is probably true. Sleep experts say teens today are sleeping less than they ever have. This is a worry, as there's a link between sleep deprivation and accidents, obesity and cardiovascular disease in later life. Lack of sleep also affects teenagers' education, as it can leave them too tired to concentrate in class and perform well in exams. Teenagers' sleep patterns Our sleep patterns are dictated by light and hormones. When light dims in the evening, we produce a chemical called melatonin, which tells us it's time to sleep. The problem is that modern life has disrupted this pattern. Bright room lighting, TVs, games consoles, mobiles, tablets and PCs can all emit enough light to stop our bodies producing melatonin. On top of this, research suggests that teenagers' body clocks are set later than adults' and younger children's. In other words, they're programmed to stay up later, and also get up later, than the rest of us. This would not be a problem if your teenager did not have to get up early for school. These early morning wake-up times mean they're not getting the 8 to 9 hours of sleep they need. The result is a tired, cranky teenager. (Unfortunately, I can vouch that this lasts until they are 25!!!) Tips for better teen sleep Catching up on sleep at weekends is not ideal. Late nights and long lie-ins will just disrupt your teenager's body clock even more. However tired they feel, teenagers should avoid lie-ins at the weekend. They should also get out into the daylight during the day. Both these things will help to keep their body clock regular and make it easier to go to sleep and get up at a reasonable time. Have a great weekend with plenty of rest. Back next week.

20 August 2018 – Sleep through The Ages Good Morning everyone. Today's post is entitled "Sleep through the ages"

Sleep needs change over a person's lifetime. Children and adolescents need more sleep than adults. Interestingly, older adults need about the same amount of sleep as younger adults -- seven to nine hours of sleep per night. Unfortunately, many older adults often get less sleep than they need. One reason is that they often have more trouble falling asleep. A study of adults over 65 found that 13 percent of men and 36 percent of women take more than 30 minutes to fall asleep. Also, older people often sleep less deeply and wake up more often throughout the night, which may be why they may nap more often during the daytime. Night time sleep schedules may change with age too. Many older adults tend to get sleepier earlier in the evening and awaken earlier in the morning. There are many possible explanations for these changes. Older adults may produce and secrete less melatonin, the hormone that promotes sleep. They may also be more sensitive to -- and may awaken because of -- changes in their environment, such as noise. Older adults may also have other medical and psychiatric problems that can affect their night time sleep. Researchers have noted that people without major medical or psychiatric illnesses report better sleep. Not sleeping well can lead to a number of problems. Older adults who have poor night time sleep are more likely to have a depressed mood, attention and memory problems, excessive daytime sleepiness, more night time falls, and use more over-the-counter or prescription sleep aids. Poor sleep is also associated with a poorer quality of life. Many people believe that poor sleep is a normal part of aging, but it is not. In fact, many healthy older adults report few or no sleep problems. Sleep patterns change as we age, but disturbed sleep and waking up tired every day are not part of normal aging. If you are having trouble sleeping, see your doctor or a sleep specialist. There are treatments that can help. Source (Wording) Sleepeducation.org.

2.2. Sleep Preparation – Building the Foundations for Quality Sleep.

2 July 2018 – Exercise and Sleep How can exercise affect your sleep?

Exercise can give a boost to sleep in several ways. Making time to exercise can Improve sleep quality. Exercise can contribute to more sound and restful sleep. Physical activity increases time spent in deep sleep, the most physically restorative sleep phase. Deep sleep helps to boost immune function, support cardiac health, and control stress and anxiety.

Increase sleep amounts. In addition to improving the quality of sleep, exercise also can help you increase the duration of your nightly rest. Being physically active requires you to expend energy, and helps you feel more tired and ready to rest at the end of the day. Research indicates that exercise—in particular, regular exercise that’s part of a consistent routine—can help boost sleep duration, in addition to sleep quality.

Reduce stress and relieve anxiety. A regular exercise routine can help to reduce your stress levels. Stress is a common cause of sleep problems, including trouble falling asleep and sleeping restlessly during the night. Exercise is a potent remedy for anxiety and other mood disorders—just 5 minutes of exercise can trigger anti-anxiety responses in the body. Mind-body exercise such as yoga can help quiet the parasympathetic nervous system, which can help you relax. Research shows that mind-body exercises such as yoga and stretching can help to lower cortisol levels and reduce blood pressure, as well as having positive effects on mood.

Help with insomnia and other sleep disorders.

Scientific evidence indicates that exercise can be an effective natural therapy for insomnia. We have a lot to learn about how exercise may help treat insomnia and other sleep disorders. Studies suggest that aerobic exercise may be particularly effective in helping reduce insomnia symptoms. Research also indicates that for people with insomnia, the benefits of exercise kick in over time, rather than immediately. Studies have also found that exercise can help lower the severity of sleep disordered breathing and may help to reduce the severity of obstructive sleep apnea.

How much exercise is right?

There is no one right answer to this question. The National Institutes of Health and the American Heart Association recommend at least 150 minutes of exercise a week for healthy adults—that’s 30 minutes a day, five days a week. Studies indicate that sleep may receive some of its most significant benefits from exercise that is consistent and routine over time, especially for people who experience difficulty sleeping. It may surprise you to hear, but too much exercise can pose problems for sleep. Many people don’t give it much thought, but over-training is a common problem—and can lead to sleep difficulties. In fact, one of the first symptoms of over-training is insomnia and difficulty sleeping, according to research.

How bio time can help you exercise—and sleep—better

You can use bio time to help your exercise routine feel more like fun and less like work, to improve your fitness and athletic performance, and to get the maximum boost to your mental and physical health. There is no one right time of day to exercise. The best times to be physically active depends on your chronotype (do you know yours? Find out here: https://thepowerofwhenquiz.com). The right time of day for exercise also depends on what you what you want to achieve in your workout.

Here are some strategies for using your body’s bio time to make the most of your exercise:

• If you want to sleep more soundly, try a morning jog. Morning exercise gives a particular boost to deep sleep. Just be careful about doing any vigorous exercise—like running—too early in the morning. Running at dawn, when

your body temperature is still low and your muscles and joints are more vulnerable to strain, may make you more prone to injury.

• Looking to maximize your athletic performance? Physical performance peaks later in the day, for all chronotypes. Research indicates that athletic performance is strongly influenced by the timing of exercise in relation to your preferred wake time. Lions—who prefer to rise early—hit peak performance in the late morning, while Bears hit their strongest stride in the afternoon. With their preference for later wake times, Wolves are at their athletic best in the evening.

• If a fat-burning workout is what you’re after, consider exercising before breakfast. A fasting workout can help you burn more fat. Follow up your workout with a breakfast of 50-50 carbohydrates and protein to keep your metabolism revved and take full advantage of your body’s fat-burning rhythm. That fat-burning rhythm kicks in again at the other end of the day. A late-in-the-day workout can help suppress your appetite and make it easier to avoid over-eating in the evening.

• Do you like to stay active by playing team sports? Belong to your company’s softball team or indoor soccer league? The best time for team play is around dusk (a little earlier for Lions). You and your teammates will benefit from good moods, strong on-the-field performance, and a shared sense of fun.

• Your physical power—your ability to exert strength and speed—fluctuate throughout the day, in accordance with your body temperature changes. The higher your core body temperature, the more flexibility you’ll have, the quicker your reflexes will be, and the more stamina you’ll bring to your workout. For Bears, physical power peaks in the early evening, starting around 6 p.m. Lions will hit their power peak a couple of hours earlier and Wolves about an hour later.

• Muscle strength reaches optimal levels in the late afternoon and early evening for most chronotypes. That’s when you’ll get your best performance from strength training. The worst time to strength train? Very early in the morning, when your body temperature is at its lowest.

• Want to build muscle mass? Research suggests it’s not the time of day that matters, but the consistency of your strength-training routine.

• For exercise that requires flexibility, it’s a good idea to schedule for when your body temperature is at its peak. For all chronotypes, that’s about three hours after waking and again in the early evening. (Yoga is a great end-of-day exercise, as it helps you relax and unwind physically and mentally.) You’re most likely to be stiff when your body temperature is at its lowest—that’s during the first 90 minutes of your waking day, again around mid-afternoon, and starting around three hours before bed.

When exercising, watch out for bedtime

When it comes to the timing of exercise, all chronotypes should be aware that exercising too close to bedtime may interfere with sleep. Working out too late in the day can leave you feeling energized and stimulated right before bed, and delay your transition to sleep. Body temperature stays elevated for about four hours after you finish exercising. A higher body temperature can interfere with your ability to sleep. What does body temperature have to do with sleep? As your body prepares itself for sleep, you experience a drop in core body temperature—a drop that begins in the late afternoon. Falling core body temperature contributes to feeling drowsy. Exercise too close to bedtime can reverse that downward shift in body temp, and keep you awake. For all chronotypes, it’s a good idea to avoid everything but the gentlest forms of exercise—light stretching, relaxed yoga, and after-dinner stroll—within 3-4 hours of bedtime. Get out for a jog, cycle around your neighborhood, hit the gym for some weight training or a cardio session on the treadmill. Every bit of exercise you commit can help you feel better during the day and sleep better at night.

26 July 2018 - Naps Hello Everyone. Today’s factlet is around my favorite Saturday past time: Naps and their advantages. I love naps. I think most of us do. Especially on Saturday afternoon, while watching Car SOS. Have you ever noticed that Car SOS is the perfect show for napping? To get all the potential benefits—and avoid the pitfalls—naps need to be used correctly. I can’t count the number of friends I have who try to catch some rest during the day, only to have their naps interfere with their night time sleep and throw their sleep-wake cycles out of sync. Let’s talk through good napping. Then I’ll show you nine types of naps you can choose from. Here’s a quick recap of the benefits of napping, which are pretty powerful if done correctly. Naps can: •Boost your brain function, including focus, accuracy, and concentration •Enhance your creativity •Improve your critical thinking skills •Lower your stress levels and lift your mood •Give you more energy and improve your physical performance When it comes to napping, choose wisely. Know first what you want to get out of your nap before you decide when and for how long you’ll sleep. •Are you looking to re-claim mental sharpness in your busy working afternoons? •Want to have more power and energy for your end-of-day gym session? •Need to prepare for—or recover from—a long-distance trip? The timing and duration of your nap depend a lot on your individual needs and circumstances. Those needs and circumstances change over time—which mean your nap needs change, too. What nap is right for you? The CEO nap. If you’re looking for a boost to your daily energy, focus, and mental performance, then a short power-nap (25 min) in the mid-afternoon (1-3 p.m.) is a good napping option for you. Any longer and you will feel terrible. Whether you’re the CEO of a start-up or your family’s household, you can stay sharp throughout the day with a brief rest between 1-3 p.m. Just don’t stop paying attention to getting the nightly rest you need. The Nap-A-Latte. This is my favourite strategy for those days when your energy is really lagging and you need a quick lift. The Nap-A-Latte combines a moderate amount of caffeine with a short period of rest to deliver you the benefits of both at once. Here’s how it works: •Drink a 6-to-8-ounce cup of coffee, quickly. (Add ice cubes to cool it down–if you’d like.) You want about 90-100 mg caffeine, which is roughly the content of a regular cup of coffee—not a super-sized version. •Quickly, find a quiet place to lie down and take a 20-minute snooze. Set a timer so you don’t oversleep. You’ll wake just as the stimulant effects of the caffeine are kicking in (roughly 20 minutes), having also relieved some of the sleep pressure that’s been building and making you feel tired. The Nap-A-Latte is not an everyday napping strategy. I recommend using this nap no more than two times a week. If you find yourself seriously tired during the day on a routine basis, it’s time to take a close look at your sleep routine, including how much sleep you’re getting and your sleep hygiene habits. The New Parent nap. Moms and Dads taking care of newborns and young children not sleeping through the night: the strategy here is to

nap when your child naps. Resist the temptation to try to be productive in other ways while your child is sleeping. As a parent getting the sleep you need, you’ll have more energy, more patience, and more focus for your child and all the other parts of your busy life if you’re not chronically sleep deprived. The Sports nap. Sleep is a not-so-secret weapon in sports performance—so long as you time it right. Whether you’re playing in a cutthroat doubles’ tennis tournament, running a 10K road race, or tearing up the field in an evening indoor soccer league, a well-timed nap can give you an edge. A short, 15- to 20-minute nap will deliver immediate benefits to physical and mental performance for a period of time—without any sleep inertia upon waking (feeling like you just can’t wake up). A longer nap can also deliver significant physical and mental benefits, and they will last longer once they kick in—after a period of clearing the cobwebs. If you don’t give yourself enough time for sleep inertia to pass, you’ll be sluggish and groggy on the field rather than stronger, faster, and more energized. The Disco nap. This is a classic nap strategy that comes from the days of the Bee Gees and Donna Summer. (Some of you may need to google these names) When you’re planning a late night, take a 90-minute nap before you head out for the evening. You can combine this rest with the Nap-A-Latte for an even greater energy boost. This is an effective way to give yourself the stamina and energy for an evening celebration that you know is going to run late into the night (or early morning). A couple of important caveats: •This is a special occasion nap! A lifestyle that makes the Disco nap a regular habit isn’t good for your sleep or your health. •Get up at your regular time the next morning. Yes, even if you stayed up until sunrise. Your day will feel long and sleepy, but you’ll be ever-so ready for sleep come night time, and you’ll keep your sleep schedule intact. The Siesta nap. Some cultures are way ahead in embracing the practice of a rest period during the day. In Spain, Greece, Mexico, Costa Rica, the Philippines and other nations around the world, naps are a part of daily life. I’d love to see workplaces in the U.K. and other non-napping societies start to dim the lights and close the shop doors at 2:30 P.M. to give everyone time to re-charge. If your life and culture incorporate a daily rest period, fantastic. If they don’t, be on the lookout for ways you can adjust your daily routine to make time for some downtime during the day. The Shift Work nap. Shift workers face a number of challenges to healthy sleep because they’re so often awake and active when their bodies are meant to be asleep. As a result, they’re more likely to be sleep deprived. They face particular risks to their health, linked to their atypical sleep-wake schedules, and they also face elevated risks for accidents and injury because of fatigue. Shift workers are more likely than the rest of us to need to break up their sleep into segments, and they can benefit greatly from strategically timed naps. Depending on your schedule and the requirements of your job, napping as a shift worker might include: •A short nap before your shift begins, and/or napping on short breaks during shifts •Scheduling sleep in two or more segments, including a longer segment (4-5 hours) at the end of a shift, combined with one or two 90-minute naps throughout the day leading up to your next shift. Shift workers can benefit greatly from workplaces that allow—and encourage—nap breaks during a shift. Nap rooms and nap pods are popping up at companies including Google, Procter & Gamble, and Zappos, among others. Knowing what we do about the cognitive and psychological benefits of napping, encouraging employees to take rest periods during the workday is a smart move for employers. The Teen nap. Teens experience a significant shift to their circadian clocks, making them biologically driven to stay up late and

wake late. That biological drive to be awake and alert at night, combined with early school start times, leaves a great many teens with a chronic sleep debt. Their lack of sleep puts them at greater risk for academic, behavioural and emotional problems, as well as health problems later in life. For teens, a short 20-minute nap after school, or some longer recovery sleep—up to 90 minutes—on the weekends, can help. Just so long as it doesn’t push their weeknight bedtimes even later, or leave them with Sunday night insomnia. The Jet Lag nap. Travel-related naps spare me frustration and fatigue, reduce jet lag, and help me keep my energy up even with a very rigorous travel schedule. Naps can help your body transition to new time zones, can make up for lost sleep during travel, and can supplement night time sleep when your itinerary is very busy. The most important thing to know about scheduling sleep for travel is to adopt the schedule that fits your destination time zone. Sleep when the locals sleep. An extended nap on a long flight can help you begin to transition your body to your new time zone, provided you’re sleeping during a time when you’d be sleeping if you lived at your destination. A short, 20-minute nap can help you make it through the first, jet-lagged day in a different time zone, and still allow you to fall asleep on local time. CAUTION: Remember, naps aren’t for everyone. If you’re suffering from depression, you’re likely experiencing some type of sleep issue, and your circadian rhythms may be disrupted. Napping can make your depression worse. People with insomnia also shouldn’t nap. For insomniacs, a daytime nap can make it harder to fall asleep on schedule at night. Naps should work with your night time sleep routine, not undermine it. See you tomorrow if I have not melted.

13 August 2018 – How to Rest 1/3 Good Morning Everyone.

We have spoken a lot on this forum about sleep but very little about rest. The ORRs “Managing Rail Staff Fatigue” guidance states “8 hours for sleep, an hour for waking, washing, breakfast etc and a minimum of an hour on returning home for a meal, shower, family time and winding down to get some quality sleep”. It is these rest periods between work/commuting/sleep that we will examine over the next three days by sharing 10 ideas to increase the quality of your rest periods.

1 – Take rest seriously

Too often we treat rest as merely the absence of work, or something that gets in the way of reaching our goals. In reality, hard work and deliberate rest are partners; each sustains and supports the other. Rest helps restore our mental and physical well-being; giving us energy, focus, and resilience; and helps us to be more productive. Downtime is also when we are more likely to have ideas, inspiration, and creative breakthroughs. In our busy lives, we can’t treat rest as something we will do when we have finished everything else. Being able to carry our work around in our pockets, it’s easy to never be finished. A block of time will never magically make itself available for rest. We HAVE to MAKE the time for it.

2- Focus

One way to create space for rest is to structure our daily schedules around unbroken periods of focused work. Very creative people work in highly intensive daily bursts of four or five hours (divided into 90 to 120-minute periods, with short breaks) and call it a day. But even if your boss would object to you trading 9-to-5 for 9-to-1, you can still organise your day to get more focused time. Concentrate your morning on your biggest, most cognitively demanding tasks; put off meetings until after lunch; check email a couple of times a day.

3- Layer work and rest

Super creative people alternate periods of intensive work with periods of deliberate rest. Concentrating hard on a problem tempts their subconscious minds into working on it. But this requires time and space – by resting immediately after a period of focused work, you can give your subconscious mind time to discover solutions to problems that are eluding your conscious effort. Ever tried and failed to remember the name of an actor, only to have the name pop into your head when you’re doing something else? That’s your subconscious – specifically called the default mode network – working on the problem after you have turned your attention elsewhere. Creative people organise their day to give themselves lots of time to access that network. So after a couple of hours sustained focus, don’t pick up your phone or start answering emails. Take a few minutes, find a quite corner, and let your mind wander. Better yet, go for a walk.

Source: Rest – Why you Get More Done When You Work Less. By Alex Soojung-Kim Pang.

14 August 2018 – How to Rest 2/3 Hello everyone. Today we continue our look at rest and how to improve it. 4- Get an early start Many creative people do their most important work in the early morning. People who are night owls (as most of us are) are actually more creative in the morning. There are fewer distractions, so it is easier to focus. An early start also gives more time during the day for rest, and makes it easier to feel you have earned a break. 5 – Detach from work Taking the time to rest is important, but so is paying attention to the quality of your rest. Phycologists find that people who keep busy during their free time, who do not check their email at night and on weekends, and who truly leave work behind when they go on vacation are happier, more productive, and more resilient at work. They call it “Detachment” and the more of it you have, the more restorative your downtime will be. What creates detachment? It is partly a matter of not doing certain things. If you check your email at the dinner table, or schedule calls during vacation, you have less chance to detach – and you defeat the whole purpose of your vacation or your downtime. It is also about doing things that occupy your mind enough to keep work from intruding. Making dinner and watching your favourite TV show in the evening, spending time with friends and family on the weekend, or doing interesting things on vacation – all keep work in its place by creating a positive and enjoyable alternative. 6- Detach from devices To experience the kind of rest that recharges our bodies and minds and fuels creativity and productivity, we need to detach from work. But in our technology obsessed reality, we carry our entire work world with us wherever we go. So, it is not enough to leave the office if the office goes to dinner or to a game or home with us. Nor is it enough to refrain from checking our devices or just put them on vibrate. Achieving the kind of detachment, we need for productive rest, cannot really be done without regularly disconnecting from our devices. 7 – Take a week off every season Scientists have found that the happiness and relaxation we feel on vacation peaks after about a week., while the phycological benefits of a vacation last up to two months. The ideal vacation schedule is to take a week off every three months. This increases the amount of vacation-based energy and resilience we can draw on at work. And, for some people, it is easier to plan a short vacation than a long one and easier to leave the office if they know they will be back in ten days. (Don’t forget about weekends in your vacation) But if you can’t take a week off every three months, take a vacation that fits your schedule. The only bad vacation is the one you did not take! The key is to make it a real vacation, and not just a week of working in a place with more sand. See you tomorrow for the last in this series. Coming up will be posts on coffee, babies and a cat named Bunny!!!

15 August 2018 – How to Rest 3/3 Happy Morning everyone. Today is the last of our three days looking at rest and how we can improve it.

8 – Proactive deep play

People who have long productive lives practice deep play. They have hobbies or enjoy sports or activities that offer some of the psychological rewards as their jobs but in a different setting, and without the frustrations of work. Different people can find the same activity restorative for different reasons. Scientists who mountain climb say that it combines the focus and problem-solving ability they need in science with intense physical challenges. Executives who climb, in contrast, talk more about the rewards of being part of a team of climbers, and the challenge of making life and death decisions together. Both groups appreciate the clarity they feel in climbing: you either reach the peak or you don’t, based on your own strength and stamina. Deep play is especially important for people who do not have a lot of control over their daily schedules, have to work long hours, or who love their jobs but are prone to overdoing them. For them, deep play is also valuable because it provides a more compelling alternative to work than sitting on the beach (Although that is great for many people)

9 – Get plenty of exercise

Lots of accomplished, creative people are physically active. Office work is actually very physically demanding: even when you are sitting in a chair looking at a computer screen, your brain is using all the food and oxygen and energy it can get. The more movement you have in your life, the better your brain can perform. Exercise also makes us more resilient, better able to handle stress, and helps us live longer, healthier lives. So, make time to exercise. If you work in a place with an on-site gym or nearby walking path, use it! If you take public transport to work, get off a stop earlier on your way home. Instead of taking the lift, take the stairs. Get out there. Just move – and that includes moving regularly during the day.

10 – Get plenty of sleep

Perhaps the most destructive myth of our work-obsessed culture is that sleep deprivation is a sign of commitment to one’s job. Sleep does not just provide physical rest: it is actually a time of incredible mental activity, giving our brains time to consolidate memories and skills, and clear out toxins that are associated with dementia later in life. Sleep deprivation, meanwhile, increases the odds that we’ll underperform, make mistakes, react emotionally, or overlook that important detail that makes the difference. Sleep deprivation is not a sign of strength. Professional athletes now routinely hire sleep coaches, travel with special mattresses, and pay as much attention to their nap schedules as they do their diets and workout regimes.

Source: Rest – Why you Get More Done When You Work Less. By Alex Soojung-Kim Pang.

As I write this post I am enjoying my morning Vanilla Latte. So tomorrow lets discuss Coffee.

2.3. How to Sleep – Tips for Obtaining Quality Sleep. 21 June 2018 – Tips for Better Sleep Pythons sleep for up to 18 hours a day. Giraffes generally sleep for less than two. It is widely recognized that Humans need at least 8 hours a day.

To sleep better, make sure that you:

•Have a comfortable bedroom - not too hot, not too cold, not too noisy. •Have a mattress that supports you properly. •Get some exercise. Start slowly with some regular swimming or walking, best in the late afternoon or early evening. •Take some time to relax before going to bed. •Don't take alcohol, •Try writing any worries down before going to bed, and then tell yourself to deal with them tomorrow. •Get up if you can't sleep, and do something you find relaxing. Read, watch television or listen to quiet music. After a while you should feel tired enough to go to get back to sleep.

25 June 2018 – Sleep Bulimia Bingeing on sleep over the weekend and not sleeping during the week – what Harvard sleep expert Robert Stickgold, PhD, calls ‘sleep bulimia’ – upsets your circadian rhythms and makes it even harder to get refreshing sleep. To achieve good quality sleep, regularity of bedtimes is key. Going to bed and getting up at roughly the same time, all the time, will programme your body to sleep better.

26 June 2018 – Waking in the Night If you wake up in the middle of the night, should you stay in bed? If you can stay relaxed in bed, experts say that can help you fall back asleep. But if you're starting to feel agitated or simply can't drift back off, sleep experts say you should stop trying so hard. If it's been longer than 20 minutes, go do something else. Avoid things that'll trigger strong emotional responses and stay away from stimulating screens like your computer, phone, or television. Try and read a book or drink some tea.

27 June 2018 – Sleeping in the Heat It is forecast to be another hot day today. If like me, you will struggle to nod off in these temperatures. It can be even harder if you work nights and must sleep during the day. So, todays factlet is entitled "Cool as a cucumber – How to beat the heat and get a restful night’s sleep".

Here are 24 tips on how to maximise your chances of getting a good night’s sleep in the current heatwave.

1. Choose cotton. Save the ooh-la-la satin, silk, or polyester sheets for cooler nights. Light-coloured bed linens made of lightweight cotton (Egyptian or otherwise) are breathable and excellent for promoting ventilation and airflow in the bedroom. 2. Feel the freezer burn. Stick sheets in the fridge or freezer for a few minutes before bed. I recommend placing them in a plastic bag first (unless eu de frozen pizza is your fave aromatherapy scent). Granted, this won’t keep you cool all night, but it will provide a brief respite from heat and humidity. 3. Get cold comfort. Here’s a four-seasons tip for keeping utilities charges down: Buy a hot water bottle. In winter, fill it with boiling water for toasty toes without cranking the thermostat. During summer, stick it in the freezer to create a bed-friendly ice pack.

4. Be creative. If you thought fans are just for blowing hot air around, think again! Point fans out of the windows so they push hot air out, and adjust ceiling fan settings so the blades run counter-clockwise, pulling hot air up and out instead of just twirling it around the room. 5. Sleep like an Egyptian. If there seem to be a lot of Egyptian references in this list, it’s because they knew how to do it right. The so-called “Egyptian method” involves dampening a sheet or towel in cool water and using it as a blanket. I recommend laying the damp sheets on top of a dry towel to avoid soaking the mattress. 6. Get loose. Less is definitely more when it comes to summertime jammies. Pick a loose, soft cotton shirt and shorts or underwear. 7. Go old-school. Remember when refrigerators were boxes that contained actual blocks of ice? This stay-cool trick is straight out of the icebox era, though. Make a DIY air conditioner by positioning a shallow pan or bowl (a roasting pan works nicely) full of ice in front of a fan. The breeze will pick up cold water from the ice’s surface as it melts, creating a cooling mist. 8. Create a cross-breeze. In this case, hanging out in the cross-hairs is a good idea. Position a fan across from a window, so the wind from outside and the fan combine in a cooling cross-breeze. Feeling fancy? Go buck-wild and set up multiple fans throughout the room to make the airflow even more boisterous. 9 Pamper your pulses. To chill out super-fast, apply ice packs or cold compresses to pulse points at the wrists, neck, elbows, groin, ankles, and behind the knees. 10. Get tech-y. I can’t vouch for its effectiveness, but the chillow—a high-tech pad that stays cool through water circulation—seems like a genius idea. 11. Be a lone wolf. Sorry couples, but sleeping alone is way better for staying cool. Cuddling with a partner increases body heat, making the bed hot instead of a cool, calm oasis. 12. Release your inner Tarzan. Feeling ambitious (or just really, really hot)? Rig up a hammock or set up a simple cot. Both types of beds are suspended on all sides, which increases airflow. 13. Fill up the tank. Get a leg up on hydration by drinking a glass of cold water before bed. Tossing and turning and sweating at night can result in dehydration, so get some H20 in the tank beforehand. (Pro tip: Just eight ounces will do the trick, unless you’re really into those 3 a.m. bathroom runs.) 14. Cool off. A cold shower takes on a whole new meaning come summertime. Rinsing off under a stream of tepid H20 brings down the core body temperature and rinses off sweat (ick) so you can hit the hay feeling cool and clean.

15. Get low. Hot air rises, so set up your bed, hammock, or cot as close to the ground as possible to beat the heat. In a one-story home, that means hauling the mattress down from a sleeping loft or high bed and putting it on the floor. If you live in a multi-floor house or apartment, sleep on the ground floor or in the basement instead of an upper story. 16. Turn off the lights. This tip is pretty self-explanatory. Light bulbs (even environmentally-friendly ones) give off heat. Fortunately, summer means it stays light until eight or nine at night. Take advantage of natural light as much as possible, and keep rooms cool after dark by using lights minimally or not at all (romantic candle-lit dinner, anyone?). 17. Hang out. Cool down a whole room by hanging a wet sheet in front of an open window. The breeze blowing in will quickly bring down the room’s temperature. 18. Stay away from the stove. Summer is not the time to whip up a piping hot casserole or roast chicken. Instead, chow down on cool, room-temperature dishes (salads are good) to avoid generating any more heat in the house. If hot food is in order, fire up the grill instead of turning on the oven. And swap big meals for smaller, lighter dinners that are easier to metabolize. The body produces more heat after you eat a huge steak than a platter of fruits, veggies, and legumes. 19. Encourage cold feet. Those ten little piggies are pretty sensitive to temperature because there are lots of pulse points in the feet and ankles. Cool down the whole body by dunking feet in cold water before hitting the hay. Better yet, keep a bucket of water near the bed and dip feet whenever you’re feeling hot throughout the night. 20. Unplug at night. As in, literally disconnect electronics. Gadgets and other small appliances give off heat, even when turned off. Reduce total heat in the house (and save energy!) by keeping plugs out of sockets when the appliances are not in use. 21. Camp at home. Got access to a safe outdoor space like a roof, courtyard, or backyard? Practice those camping skills (and stay cooler) by pitching a tent and sleeping al fresco. 22. Hog the bed. Sleeping alone (see No. 11 above) has its perks, including plenty of space to stretch out. Snoozing in spread eagle position (i.e. with arms and legs not touching each other) is best for reducing body heat and letting air circulate around the body. Hit the hay in this sleep position to keep limbs from getting crazy sweaty. 23. Go rustic. When temperatures soar, trade in that extra-comfy mattress for a minimalist straw or bamboo mat. These all-natural sleeping surfaces are less comfortable, but they don’t retain heat like a puffy, cloth-covered mattress. 24. Get creative with grains. Rice and buckwheat aren’t just for eating! These cupboard staples can also keep you cool on hot nights. Stock up on buckwheat pillows, which don’t absorb heat like cotton and down. And for a cold compress on really hot nights,

fill a sock with rice, tie it off, and stick it in the freezer for an hour or so. The compress will stay chilly for up to 30 minutes, enough time to nod off.

23 July 2018 – Sleeping when Pregnant Good Morning All. As I drove in today Chris Evans mentioned his pregnant wife and the fact that they were having a scan later. Today’s post is therefore entitled Tiredness in Pregnancy. Is it normal to feel tired in pregnancy? It's common to feel tired, or even exhausted, during pregnancy, especially in the first 12 weeks. Hormonal changes at this time can make you feel tired, nauseous and emotional. The only answer is to rest as much as possible. Make time to sit with your feet up during the day and accept any offers of help from colleagues and family. Being tired and run-down can make you feel low. Try to look after your physical health – make sure you eat a healthy diet and get plenty of rest and sleep. Later in pregnancy, you may feel tired because of the extra weight you're carrying. Again, make sure you get plenty of rest. As your bump gets bigger, it can be difficult to get a good night's sleep. You might find lying down uncomfortable or that, just when you do get comfortable, you have to get up to go to the toilet. Feeling tired won't harm you or your baby, but it can make life feel more difficult, especially in the early days before you've told people about your pregnancy. Strange dreams during pregnancy. Some women have strange dreams or nightmares about the baby, and about labour and birth. This is normal. Talking about them with your partner or midwife can help. Remember, just because you dream something, it doesn't mean it's going to happen. Relaxation and breathing techniques may be helpful in reducing any anxiety you might be feeling. Bump-friendly sleep positions The safest position to go to sleep is on your side, either left or right. Research suggests that, after 28 weeks, falling asleep on your back can double the risk of stillbirth. This may be to do with the flow of blood and oxygen to the baby. Don't worry if you wake up on your back – the research looked at the position women fell asleep in, as this is the position we keep for longest. If you wake up on your back, you can just turn over and go to sleep again on your side. You can try supporting your bump with pillows and putting a pillow between your knees. Try not to let it bother you if you can't sleep, and don't worry that it will harm your baby – it won't. If you can, nap during the day and get some early nights during the week. Avoid tea, coffee or cola drinks in the evening, as the caffeine can make it harder to go to sleep. Try to relax before bedtime so you're not wide awake. Relaxation techniques may also help. Your antenatal classes may teach you some techniques, or you could borrow a relaxation tape, CD or DVD from your library. You could join an antenatal yoga or pilates class. Make sure the instructor knows you're pregnant. Exercise can help you feel less tired, so try to do some activity, such as a walk at lunchtime or going swimming, even if you feel tired during the day. If lack of sleep is bothering you, talk to your partner, a friend, doctor or midwife. Read about preventing insomnia, including daytime habits, such as exercising, and bedtime habits, such as avoiding caffeine. Medical reasons for insomnia in pregnancy Occasionally, sleeplessness – when accompanied by other symptoms – can be a sign of depression. If you have any of the other symptoms of depression, such as feeling hopeless and losing interest in the things you used to enjoy, speak to your doctor or midwife. There is treatment that can help. Read about mental health problems in pregnancy. More on a fatigue related subject tomorrow.

24 July 2018 – Sleeping on Holiday Hello everyone. This time of year brings lighter evenings, warmer weather (that’s an understatement!) and the holiday season! Yippee. To feel refreshed and rested are just some of the reasons why people go away but ensuring better sleep on holiday is important. From unfamiliar environments to irregular bedtimes and the biggest culprit, jet lag, your sleep can get disrupted in many ways when you’re away from your own bed. Try the following tips for getting a good night’s sleep when you are on holiday: • You can’t take your bed with you but if it’s possible, take your pillow. Not only is it familiar but it may provide the right comfort and support, allowing you to get a better night’s sleep. • Check the temperature. Many hotel rooms set temperature so make sure it suits you. The right temperature for sleep is between 16-18 degrees. • If you think outside noise or light might bother you take some ear plugs and an eye mask. • Make the bed a ‘sleep zone’ and don’t use it for anything else. • When you return to your hotel room/caravan/tent etc, start your wind down routine as normal and spend at least 15 minutes relaxing. • Try to keep to regular hours as much as possible especially if you have children. Here are some helpful tips for travelling long haul and dealing with jet lag: • The day before your flight, ensure you eat three balanced meals, including at least five servings of fruit or green vegetable and one of protein-rich food eg white fish or tofu. • During the flight set your watch to the local time at your destination. Note what extraordinary time the airline feeds you and try to keep back a roll or biscuit to eat at “normal” mealtimes according to the time at your destination. • Take an eye mask and ear plugs with you. Use the mask and your seat’s nightlight to reflect the time at your destination – wear the mask if it is night time where you are going; keep the light on and mask off if it is day time. • Drink plenty of water throughout the flight to prevent dehydration and also to help mobilise your energy reserves for your arrival. Avoid alcohol. • Take regular walks up and down the aisle. Try some simple stretching exercises in your seat – straighten your legs and point and flex your toes; or stretch your arms high above your head. Do both these exercises for one minute every two hours. • When you arrive at your destination use your diet to help you control your wakefulness: high protein meals increase your alertness; high carbohydrate meals will make you feel more sleepy. • Daylight can help reset your internal clock, so take an early morning walk when you wake up in your new destination and spend as much time as possible outdoors. Be safe in the sun, ensure you stay hydrated and I will see you tomorrow.

31 Aug 2018 – Sleep Hygiene Morning all, Today’s post is about Sleep Hygiene. Did you know there’s a term for your bedtime rituals and nightly habits? Collectively, these behaviours are known as sleep hygiene. Whether you practice good or bad sleep hygiene is up to you. But if you want to get a better night’s sleep, the answer often begins with improving your sleep hygiene. What is Sleep Hygiene? The rituals, behaviours, and norms you follow around sleep are referred to as sleep hygiene. Regularly pulling all-nighters or sleeping in on the weekends so you can “make up” for lost sleep are both examples of poor sleep hygiene. Conversely, following a regular sleep schedule and avoiding caffeine late at night are good sleep hygiene

practices. Improvements in sleep hygiene offer an “easy win” in the search for better sleep, and should be the first thing you go after when sleep troubles show up. In fact, sleep hygiene education is an essential part of the cognitive-behavioural therapy used to treat insomnia. Why is sleep hygiene important? Good sleep hygiene ensures you consistently enjoy higher-quality, more restful sleep for a sufficient amount of time each night. Bad sleep habits, on the other hand, lead to poor quality and inadequate sleep. You already know sleep is important. Otherwise you wouldn’t be reading this article. Good sleep on a regular basis is critical to maintaining balanced mental, emotional, and physical health. It helps you stay focused during the day, regulate your mood, and feel more productive and functional on a daily basis. What’s bad sleep hygiene? The short answer: bad sleep hygiene is doing the opposite of any of the tips we discuss below. But the answer you’re probably looking for is this: if you’re waking up unrested each morning, wake frequently during the night, feel tired during the day, or have trouble falling asleep at night, there’s a very good chance that you have bad sleep hygiene that’s messing with your sleep. What’s good sleep hygiene? he most important elements of sleep hygiene require the following from your bedroom: •Temperature – neither too hot nor too cold •Darkness – the darker, the better •Quiet – the quieter, the better •A comfortable place to lie down and stretch out If you have those things covered, great news: you are most of the way to good sleep hygiene. Source: www.tuck.com Hope you all have a great weekend. Join the movement again on Monday as we are going to share with you - how to practice good sleep hygiene!

06 Sept 2018 – Two Minutes to Sleep – US Military Technique Good morning everyone. Today’s factlet has been suggested by a member of the group and I thought I would share it here. Is this the end of insomnia? The secret US military technique that could help you fall asleep in as little as TWO MINUTES. Many of us toss and turn at night as we struggle in vain to try and get some sleep, but it seems as if there might finally be a solution that could have you nodding off in as little as two minutes. A book titled 'Relax and Win: Championship Performance' features a secret US military method that can help anyone get to sleep in just 120 seconds. The title was originally published in 1981, but the method has recently resurfaced online according to Joe.co.uk. It's used by soldiers to ensure that they are able to get some rest - even when on a battlefield - and is said to have a 96 per cent success rate after six weeks of practice. The technique was reportedly developed after army bosses tried to eliminate mistakes made by pilots because of tiredness. The technique involves a combination of relaxing your muscles, breathing techniques and visualisations. Insomnia is a huge global problem, affecting around a third of men and women in their 30s and 40s and nearly half of women over 65. There are two types, Type 1 insomnia where you can't get to sleep and Type 2, where you can get to sleep okay, but tend to wake at least once during the night.

Chronic lack of sleep has been linked to serious problems including diabetes, heart disease and strokes, and it can even affect the structure of the brain. Firstly, you have to relax the muscles in your face, including your tongue, jaw, and the muscles that are around your eyes. Then you should drop your shoulders as low as they'll go before relaxing your upper and lower arm on one side, and then the other. Step three involves breathing and says you should breathe out, relax your chest and then, finally, relax your legs. You should start with your thighs and then move to your lower legs. Once you've relaxed your body for ten seconds, you have to then clear your mind completely.

07 Sept 2018 – Natural Sleep Aids Happy Friday to all. Today I am posting some information around the best natural sleep aids. 1. Food Is Medicine! It’s a well-known fact that having a heavy meal just before bed can cause you to have a poor night of rest, but did you know that there are some foods that could help you sleep better? That doesn’t mean you need to add calories necessarily or eat a huge meal right before bed, but it could mean that you can incorporate some of these foods into your dinner or as a small after-dinner snack. Probably the most commonly known characteristic that can help through food is tryptophan — yes, that sleepiness from the Christmas turkey is no joke. Tryptophan is an amino acid that can help the brain get into a relaxed state, similar to serotonin and melatonin. You can obtain tryptophan and serotonin from carbohydrates, particularly 100 percent whole grain oats, brown rice, corn or quinoa. A study published in Sports Medicine out of France was conducted to help better understand ways to improve the sleep of elite soccer players given their chaotic schedules, late-night games and need for recovery through a good night of sleep. The study found that by consuming carbohydrates — such as honey and whole grain bread — and some forms of protein, especially those that contain serotonin-producing tryptophan like turkey, nuts and seeds, it helped promote restorative sleep. Even tryptophan-filled tart cherry juice, which also contains healing properties like antioxidants, could be a great option. 2. Calcium for Relaxation Did you know that calcium influences your sleep cycle? It’s true. According to the European Neurology Journal, calcium levels are at their highest during our deep rapid eye movement (REM) sleep periods. What this means is that if you never get to the REM sleep phase or if it’s limited, it could be related to a calcium deficiency. Researchers indicate that the calcium is important because it helps the cells in the brain use the tryptophan to create melatonin — a natural body-producing sleep aid. A glass of warm goat’s milk kefir could do the trick by providing calcium and magnesium, both of which work best when consumed together. 3. Magnesium May Help You Get the Slumber You Need Now let’s roll into more about magnesium and how it can help with that your sleep state. If you have trouble sleeping, it could be due to a magnesium deficiency. Studies have shown that higher magnesium levels can help induce a deeper sleep, and as I noted, this is especially true when taken together with calcium for better absorption. Research from the Biochemistry and Neurophysiology Unit at the University of Geneva’s Department of Psychiatry indicate that higher levels of magnesium actually helped provide better, more consistent sleep since magnesium is a calming nutrient. In addition to the goat’s milk kefir, foods like spinach, pumpkin seeds and even dark chocolate can help since they’re loaded with magnesium.

Here are a few snacks to consume for getting a good night of sleep: •Half a banana with a few almonds •Crackers with almond butter •Gluten-free oatmeal with honey and dark cherries •Small Ezekial wrap with turkey and cranberries •Small glass of warm goat’s milk kefir with turmeric and a dash of cinnamon •Chamomile, passion flower and valerian tea •Small glass of tart cherry juice 4. Essential Oils for Sleep It’s no secret that essential oils are a natural method for just about anything you can think of, and sleep is no different. Prescription medications can cause numerous side effects and make you feel jet-lagged upon waking, among other negative side effects. Essential oils, on the other hand, don’t cause these adverse reactions. A study published in Complementary Therapies in Clinical Practice was conducted with cancer patients, a common group that has serious issues with sleeping well, to better understand whether aromatherapy using essential oils could help provide some much-needed healing shut-eye. Aromasticks were given to patients over a 13-week period. Of the participants, 94 percent reported using the aromasticks with 92 percent reporting that they would continue use. Bergamot oil and lavender oil, in addition to sandalwood, frankincense and mandarin, were combined to create the useful sleep-inducing blend. 5. Passion Flower for Calming and Restful Sleep In my article about passion flower, you can see the numerous benefits, including calming and anti-anxiety effects. When we have anxiety, it can greatly affect how we sleep because you just cannot seem to turn the brain off — especially while you’re trying to rest. Passion flower can provide the calming effect needed to help stop that vicious circle of thought. Clinical trials have shown that passion flower can reduce anxiety as effectively as the prescribed drug known as benzodiazepine oxazepam. A four-week, double-blind study of patients with generalized anxiety disorder compared passion flower to the common anti-anxiety drug. While the oxazepam worked a little faster, both were the same in terms of effectiveness — however, the passion flower did not cause problems with job performance, such drowsiness while on the job, unlike the oxazepam. This shows that passion flower is one of the most powerful anti-anxiety natural sleep aids that doesn’t cause lingering tiredness the next day. 6. Valerian Root to Induce Sleep Valerian root is a plant with roots that contain many healing properties, in particular for a relaxation and sedative effects. It’s often found in combination with chamomile in a tea. By increasing the amount of gamma aminobutryic acid (GABA), it helps calm the nerve cells in the brain, resulting in a calming effect. GABA works by blocking brain signals that cause anxiety and that ongoing trickle effect that can come from it. This calming effect has made it a favourite natural remedy for anxiety too. If you’re not fond of the tea, you can go with a capsule form that can be found at your local health food store. 7. St. John’s Wort May Help Provide Sleep Through Less Depression Depression is a common characteristic that can lead to lack of sleep. St John’s wort may be able to help. More recent studies indicate that chemicals, such as hyperforin and adhyperforin, are found in St. John’s wort, acting as little messengers in the brain that drive mood and work as powerful antidepressants. The National Sleep Foundation reports that insomnia is common among those who are depressed and notes that people with insomnia have a much higher risk of becoming depressed. Research from the Department of Psychology at the University of North Texas shows that depression may affect many aspects of sleep, from getting to sleep to staying asleep. By treating depression using St. John’s wort, you may be able to find that restful sleep your body and mind longs for. Have a restful weekend and I hope to see you all back in the group on Monday.

2.4. Causes of Fatigue – Why We May Become Fatigued. 3 July 2018 – Sleep and the Menopause Good Morning everyone. The subject today is Menopause and how it may affect sleep. Menopause is a time of major hormonal, physical and psychological change for women although menopausal symptoms vary from woman to woman. During the perimenopause or transition phase, a woman's ovaries gradually (over several years) decrease production of estrogen and progesterone. One year after menstrual periods have stopped, a woman reaches menopause, on average around the age of 50. From peri-menopause to post-menopause, women report the most sleeping problems. Most notably, these include hot flashes, mood disorders, insomnia and sleep-disordered breathing. Sleep problems are often accompanied by depression and anxiety. Generally, post-menopausal women are less satisfied with their sleep and as many as 61% report insomnia symptoms. Snoring has also been found to be more common and severe in post-menopausal women. Snoring, along with pauses or gasps in breathing are signs of a more serious sleep disorder, obstructive sleep apnea. Changing and decreasing levels of estrogen cause many menopausal symptoms including hot flashes, which are unexpected feelings of heat all over the body accompanied by sweating. They usually begin around the face and spread to the chest affecting 75-85% of women around menopause. Prior to the hot flash, body temperature rises accompanied by an awakening. Hot flashes last on average three minutes leading to less sleep efficiency. Most women experience these for one year, but about 25% have hot flashes for five years. While total sleep time may not suffer, sleep quality does. Hot flashes may interrupt sleep and frequent awakenings cause next-day fatigue. Things you may try to help you cope better and increase your sleep. • Eat healthy. Avoid large meals, especially before bedtime. Maintain a regular, normal weight. Some foods that are spicy or acidic may trigger hot flashes. Try foods rich in soy as they might minimize hot flashes. • Avoid nicotine, caffeine and alcohol, especially before bedtime. • Dress in lightweight clothes to improve sleep efficiency. Avoid heavy, insulating blankets and consider using a fan or air conditioning to cool the air and increase circulation. • Reduce stress and worry as much as possible. Try relaxation techniques, massage and exercise. Talk to a behavioural health professional if you are depressed, anxious Please do see your GP if you're finding your symptoms particularly troublesome, as treatments are available.

27 July 2018 – Fatigue and Mental Health Happy pay day Friday everyone. Today’s Factlet is in response to Richard Norman's question on Tuesday, "Is there a link between fatigue and mental health? Does one affect the other?"

The simple answer is yes. There's a close relationship between sleep and mental health. Living with a mental health problem can affect how well you sleep, and poor sleep can have a negative impact on your mental health. Poor sleep leads to worrying. Worrying leads to poor sleep. Worrying about sleep is like your mind trying to fight itself. That's a horrible place to be.

You may find a sleep problem can lead you to:

•have negative thoughts, feel depressed or anxious – if you have little sleep you may feel less able to rationalise worries or irrational thoughts

•feel lonely or isolated – if you feel tired you may not want to be sociable or see friends

•experience psychotic episodes – if you have a psychotic disorder or bipolar disorder, a lack of sleep may trigger mania, psychosis or paranoia, or make existing symptoms worse

For some sleep problems are a tell-tale sign of declining mental health. The worse they sleep, the less they feel able to cope during the day. The less they are coping, the worse they seem to sleep.

How can my mental health problem affect my sleep?

There are number of ways a mental health problem can affect your sleep. For example:

•Anxiety can cause thoughts to race through your mind, making it difficult to sleep.

•Depression and seasonal affective disorder (SAD) can lead to oversleeping – either sleeping late in the morning or sleeping a lot during the day. If you experience difficult or troubling thoughts as part of depression, this can also cause insomnia.

•Post-traumatic stress disorder (PTSD) can cause nightmares and night terrors, disturbing your sleep. This can mean you feel anxious about falling asleep, which could lead to insomnia.

•Paranoia and psychosis may make it difficult for you to sleep. You may hear voices or see things that you find frightening, or experience disturbing thoughts, which make it hard to fall asleep.

•Mania often causes feelings of energy and elation, so you might not feel tired or want to sleep. Racing thoughts caused by mania can make it hard to fall asleep and may cause insomnia.

•Psychiatric medication can cause side effects including insomnia, disturbed sleep or oversleeping. You may also experience sleep problems after you stop taking psychiatric drugs.

Next week’s factlets will cover, Arianna Huffington, Sleeping through grief and the history of the bedroom, but of course all of that could change if you request a subject we should cover.

Have a great well rested weekend. Julian

30 July 2018 – Coping with Sleep Issues in Grief. Good Morning Everyone. Today’s factlet provides tips for coping with sleep issues in grief. Disruptions in normal sleep patterns are very common in the first weeks and months of grief. If you're having trouble sleeping, you might try some of the simple methods recommended by experts in accredited sleep centres: •If your spouse is the one who died, sleep on your spouse’s side of the bed; it’s easier if your own side is empty. •Avoid self-medicating and alcohol which can offer only temporary escape, have serious side effects, can affect motor coordination and mental acuity, may lead to dependency, can magnify feelings of depression and can disrupt patterns of sleep. •Use sleeping aids only as prescribed by your doctor, and only as a temporary way to break the cycle of sleeplessness. •Condition yourself to fall asleep to guided imagery, using pre-recorded audio programs with soothing music and voice tones. •Avoid going to bed hungry, or after a heavy meal late in the evening. •Drink a cup of warm water at bedtime. •Sleep with something warm, such as a pet, a heating pad or hot water bottle. •Separate yourself from the stresses, worries and distractions of the day. Wind down by reading, or taking a relaxing bath or warm shower before bed. •Put on a night light, but keep your bedroom as cool, quiet, and as dark as possible. •Maintain a consistent sleep-wake cycle. Stick to a regular routine; retire and get up at the same time each day, even on weekends.

•Avoid naps lasting longer than 30 minutes, especially after 3:00 p.m. •Establish a bedtime ritual. Cue your body to slow down and relax by preparing for bed the same way each night, and go to bed when you are sleepy. •Follow a deep relaxation routine; perform deep breathing exercises in bed. •Listen to music that soothes your soul and decreases tension. •Visualize being in your most favourite and pleasant place. • Associate your bed only with relaxing, sleeping and sexual pleasure – don’t use it for other activities that can initiate or stimulate worries and concerns.

31 July 2018 – Snoring (1/2) Good Morning everyone. Today’s factlet is day one of a two-part series on a condition that can stop you or your partner from sleeping. It is of course Snoring. It is a long one so apologies in advance. Snoring is a pretty common problem. This makes it easy to accept and ignore. We’re going to explain why you shouldn’t and tell you how to stop snoring. Often, snoring affects those around you the most. It can put pressure on relationships if a partner is constantly kept awake by snoring, with some couples even forced to sleep in separate rooms because of it. At its worst, snoring can be a symptom of a condition called obstructive sleep apnoea, where you actually stop breathing while you’re asleep and your body wakes itself up to deal with the situation. Over time, this can increase your chances of high blood pressure, heart attack and stroke. You can’t cure snoring. What you can do is manage it. We’ve asked our smart network of UK doctors for their top tips on how to have a quieter night’s sleep. Why do you snore? This is an important question. Finding out what sort of snorer you are will help you decide which of our stop snoring tips are most likely to help you, while you’ll also learn something about your body! Nose snoring If your nostrils don’t stay open properly while you’re asleep, or your allergies mean you regularly have a blocked nose, you’ll have to breathe through your mouth instead. You’ll be sending air to the back of your throat when you breathe in, which causes the soft tissue in your throat to vibrate. You probably don’t need us to tell you what happens next! How do you know if you’re a nose-snorer? •Hold your nostrils shut and try to make a snoring sound. •Let them go. •Your nostrils should open by themselves. If they remain collapsed, you’re probably a nose-snorer. •Now try to make the same noise while holding your nostrils open. •If the noise was louder the first time, you’re probably a nose-snorer. This brings us to our first of nineteen stop snoring tips: 1. Keep your nostrils clear If you’re a nose-snorer, logic tells us that you won’t snore as loudly if you can breathe freely through your nose. There are many ways to achieve this. You can buy nasal dilators that go into your nostrils to prevent them collapsing, or nasal strips that stick to the outside of your nose and hold your nostrils open. It’s also worth seeing a doctor to check whether a medical problem such as nasal polyps is contributing to your narrow nostrils. Mouth snoring

We’ve already established that when air hits the back of your throat while you’re asleep, it leads to snoring. Mouth-snorers naturally have their mouth open during sleep, which makes snoring more likely. How do you know if you’re a mouth-snorer? •Open your mouth and make a snoring sound. •Now close your mouth and try to make the same noise again. •If the noise was much louder the first time, you’re probably a mouth-snorer. 2. Keep your mouth closed Obviously, you can’t control the fact that your mouth opens while you sleep. Not by yourself, anyway. What you can do is buy a device that will keep it closed, such as a chin strap. Granted, it’s not the most glamorous thing to wear, but if it helps, it’ll be worth it. Tongue snoring When some people are asleep, the tissue around the base of their tongue vibrates when they breathe. If the tongue is blocking the back of the throat, it takes more effort to force air through. This can cause very loud snoring and potentially lead to sleep apnoea. How do you know if you’re a tongue-snorer? •Put your tongue out as far as it’ll go. •Try to make a snoring sound. •If the noise isn’t as loud when your tongue is in this position, you’re probably a tongue-snorer. 3. Move your jaw forward Any issue that could be causing sleep apnoea needs to be dealt with straight away. But keeping your jaw still all night is easier said than done. Many tongue-snorers are given a Mandibular Advancement Device (MAD), which brings their lower jaw forward to keep their tongue away from their airways. You can’t just walk into a shop and buy one, so you’ll need to see a doctor about this. If you go down the MAD route, it’s important to find one that’s both effective and comfortable enough to sleep in. 4. Lose weight Being overweight or obese makes snoring much more likely. It can result in more fatty tissue around your neck, which closes your airways and makes it harder for air to flow while you sleep. It also increases your risk of developing sleep apnoea. You know the drill here. A healthy diet and regular exercise is the best way to maintain a healthy weight. 5. Eat a smaller portion Not only will eating larger portions all the time make it more likely that you’ll put on weight, a full stomach puts pressure on your chest muscles and makes it difficult for you to breathe normally while you’re asleep. Remember that it takes your brain around 20 minutes to realise that your stomach is full. Try eating a smaller evening meal, or eat more slowly so that you have a better idea of when you’re actually full. 6. Try the tennis ball trick Snoring is often more likely if you sleep on your back, particularly if you’re a tongue-snorer. Sleeping on your side can help keep your airways open, but how can you make sure you don’t roll onto your back after you’ve nodded off? One trick is to sew a tennis ball into the pocket of an old t-shirt and wear it back-to-front. The idea is that it’ll be too uncomfortable to be on your back. It may seem a drastic step, but it’s a better option than a dig in the ribs from your partner!

7. Avoid alcohol before bed Alcohol causes your muscles to relax. This means you’ll have less control over your tongue and throat muscles, so they’ll probably vibrate more than usual when you breathe in and out. The faster the vibration, the louder you’ll snore. It shouldn’t surprise you to hear that the best way to avoid this problem is to avoid drinking alcohol in the hours leading up to bedtime. 8. Don’t smoke Smoking irritates the lining of your airways and causes a build up of mucus that means air flows less freely. Of course, this is bad for your breathing generally - not just when you’re asleep! Catch you tomorrow for the remaining tips.

01 Aug 2018 – Snoring (2/2) Once again good morning. Today sees the continuation of our post on snoring and covers tips 9 to 19.................But first a little joke to make Wednesday seem a little easier: "I keep waking myself in the night with my snoring. I should be fine tonight though, I’m going to sleep in the spare room." 9. Treat your allergies We’ve already mentioned that a blocked nose is the last thing you need before bed, so if you’re regularly left bunged up by hay fever or other allergies, you’re more likely to snore. You should also be aware of potential triggers in your home, such as pet hair, dust or the material your bedding is made from. Treating these allergies will give you a better chance of a quieter night, but some antihistamines may come with side effects that disrupt sleep in other ways. It’s best to discuss this with a doctor to choose the best option for you. 10. Be careful with sleeping tablets Sleeping tablets relax your muscles in a similar way to alcohol, so they can contribute to snoring. They don’t provide a natural, refreshing sleep anyway, so they’re not the best option if you’re looking for ways to help you nod off. If you’re really having trouble with insomnia, it’s worth seeing a doctor to check if there’s an underlying cause. Treating this will mean you won’t need medication to get to sleep and can remove one possible cause of snoring. 11. Change your pillow A good pillow should align your head with your spine. When it comes to snoring, this could help stop your airways from narrowing or becoming blocked. For example, if you can only get to sleep lying on your back, a plump pillow will stop your head from falling backwards. This is especially useful for tongue-snorers, as it will help prevent your tongue from blocking your airways. 12. Try an air humidifier Dry air can irritate your throat and nose, causing swelling that leads to snoring. An air humidifier is far from the cheapest option on this list, but if your snoring is really causing problems, it’s worth testing out. 13. Don’t eat dairy While there haven’t been any clear studies yet, there’s plenty of anecdotal evidence that suggests dodging dairy in the hours before bedtime can help deal with snoring. It’s thought that to digest dairy, your body produces a thick layer of mucus. While this isn’t a big deal during the day, it’s exactly the sort of thing that could narrow your airways just before you head to bed. 14. Eat a pineapple

Your favourite tropical fruit is one of the best natural sources of bromelain, an enzyme with anti-inflammatory properties. This could help clear your blocked sinuses, while some studies have also claimed it decreases mucus production, which would stop your sinuses from becoming blocked in the first place. 15. Do some throat exercises The idea behind this is to get your throat muscles strong enough that they don’t move about so much while you’re asleep. Just like training in the gym can build up muscles in your arms and legs, a few vocal exercises can help strengthen your throat. A popular trick is to repeat the vowel sounds for a couple of minutes before bed every night. Even if it doesn’t stop you snoring, it may make the noise quieter or less powerful. 16. Sing Don’t fancy repeating vowel sounds to yourself? That’s fair enough. Why not get the same results from belting out your favourite tune instead? Whether this is more annoying than snoring is probably up to your partner to decide! 17. Stay hydrated This doesn’t mean you must drink lots of water before bed. That has obvious drawbacks. All you need to do is stay well hydrated throughout the day, which will prevent your airways becoming dried out and sticky. 18. Ask your family Even if you try everything on this list, snoring can be to do with your genetic makeup. If you know that other people in your family snore, ask them what they did to help them stop snoring. You never know, it just might work for you too! 19. Finally, see a doctor to silence your snoring Whether it’s for the sake of your partner or your health, there are plenty of reasons to deal with your snoring. While these tips can help, you can also discuss your problems face-to-face with a doctor and get recommendations specifically tailored to your lifestyle, sleep habits and the type of snorer you are. Post you tomorrow.

03 Aug 2018 – Chronic Fatigue Syndrome Thank you, Amanda, for yesterday’s post. It is back to me today and I am going to post about Chronic Fatigue Syndrome. Chronic fatigue syndrome (CFS) is a long-term illness with a wide range of symptoms. The most common symptom is extreme tiredness. CFS is also known as ME, which stands for myalgic encephalomyelitis. There's some debate over the correct term to use for the condition, but this post will refer to it as CFS/ME. CFS/ME can affect anyone, including children. It's more common in women and tends to develop between your mid-20s and mid-40s. Symptoms of CFS/ME The main symptom of CFS/ME is feeling extremely tired and generally unwell. In addition, people with CFS/ME may have other symptoms, including: •sleep problems •muscle or joint pain •headaches •a sore throat or sore glands that aren't swollen •problems thinking, remembering or concentrating •flu-like symptoms •feeling dizzy or sick •fast or irregular heartbeats (heart palpitations)

Most people find over exercising makes their symptoms worse. The severity of symptoms can vary from day to day, or even within a day. The symptoms of CFS/ME are similar to the symptoms of some other illnesses, so it's important to see your GP to get a correct diagnosis. Diagnosing CFS/ME There isn't a specific test for CFS/ME, so it's diagnosed based on your symptoms and by ruling out other conditions that could be causing your symptoms. Your GP will ask about your symptoms and medical history. You may also have blood and urine tests. As the symptoms of CFS/ME are similar to those of many common illnesses that usually get better on their own, a diagnosis of CFS/ME may be considered if you don't get better as quickly as expected. Treating CFS/ME Treatment for CFS/ME aims to relieve the symptoms. Your treatment will depend on how CFS/ME is affecting you. Treatments include: •cognitive behavioural therapy (CBT) •a structured exercise programme called graded exercise therapy (GET) •medication to control pain, nausea and sleeping problems Most people with CFS get better over time, although some people don't make a full recovery. It's also likely there will be periods when your symptoms get better or worse. Children and young people with CFS/ME are more likely to recover fully. Causes of CFS/ME It's not known what causes CFS/ME, but there are a number of theories – for example, it may be triggered by an infection, or certain factors could make you more likely to develop the illness. Suggested causes or triggers for CFS/ME include: •viral infections, such as glandular fever •bacterial infections, such as pneumonia •problems with the immune system •a hormone imbalance •mental health problems, such as stress, depression and emotional trauma •your genes – CFS/ME seems to be more common in some families Living with CFS/ME Living with CFS/ME can be difficult. Extreme tiredness and other physical symptoms can make it hard to carry out everyday activities. You may have to make some major lifestyle changes. CFS/ME can also affect your mental and emotional health, and have a negative effect on your self-esteem. As well as asking your family and friends for support, you may find it useful to talk to other people with CFS/ME. ME Association is a charity that provides information, support and practical advice for people affected by the condition. You can find a local support group on their website. Thank you all for your visits this week and I hope to post you all next week. Have a great and relaxing weekend.

07 Aug 2018 – Presenteeism (1/3) Good morning everyone. Over the next three days we are going to discuss Presenteeism. Today and tomorrow I will present potential causes and on Thursday potential consequences.

Presenteeism is defines as “the practice of being present at one's place of work for more hours than is required, especially as a manifestation of insecurity about one's job.” Presenteeism or working while sick can cause productivity loss, poor health, exhaustion and workplace epidemics. While the contrasting subject of absenteeism has historically received extensive attention in the management sciences, presenteeism has only recently been studied. Certain occupations such as welfare and teaching are more prone to presenteeism. Doctors may attend work while sick due to feelings of being irreplaceable. Jobs with large workloads are associated with presenteeism. People whose self-esteem is based on performance, as well as workaholics, typically have high levels of presenteeism. Presenteeism may have many motives. An employee may come to work because they simply need the money and cannot afford to take time off due to illness. Additionally, one could go to work due to a love and devotion to the job. In this case, presenteeism could be considered an act of organizational citizenship and inspire admiration from colleagues. Other reasons include feeling that their career prospects may be damaged if they take time off, and an expectation of presence driven from management. Potential Causes of Presenteeism 1. Temporary and permanent employment Temporary and permanent employment are often considered when examining the causes of presenteeism. More specifically, researchers have studied these positions with the thought that lack of job security will cause those who do not have permanent positions to come to work more often. 2. Occupations and work environments Individuals working in certain occupations may be more prone to presenteeism. In a study in Sweden, Aronsson et al. found that those offering welfare and teaching services demonstrated higher rates of presenteeism. 3. Ease of replacement The ease with which one can be replaced on the job also affects levels of presenteeism. Specifically, if one feels that he or she cannot be replaced, that individual is more prone to attend work while sick. Doctors are often examined in this regard. For example, Jena et al. studied residents in training and noted high rates of presenteeism, which they concluded were the result of feeling irreplaceable. Tomorrow we explore another four potential causes.

08 Aug 2018 – Presenteeism (2/3) Hello everyone. A little later posting today. I had a lie in. So it is day two of our three day series on Presenteeism. I continue with the potential causes. 4. Workloads and job demands Jobs that have large workloads and many demands are often associated with higher levels of presenteeism. Studies of Canadian firms found that presenteeism was often not the result of job insecurity. Instead individuals felt they had to come to work while ill or injured because they believed they had high workloads, many deadlines, and often very little backup support. Complementing this finding, it was also found that individuals feared their work would pile up if they did not go to their job. 5. Workaholism Those who exhibit workaholism tend to demonstrate higher levels of presenteeism. Workaholics tend to work excessively and compulsively, and they are internally motivated to work to an excessive extent. In addition to their

high levels of presenteeism, workaholics also displayed the highest burnout and lowest happiness levels relative to other groups who were not defined as workaholics. 6. Performance-based self-esteem Performance-based self-esteem (PBSE) has also been considered another cause of presenteeism. This term describes the idea that individuals’ self-esteem may depend on their performance. Employees who demonstrate high levels of this have to prove their worth while on the job. It has been found that PBSE positively predicted presenteeism; however, the authors also discovered that the relationship between PBSE and presenteeism was strengthened when workers experienced high physical and psychological work demands. This finding suggested that demanding work environments could interact with employees’ overambitious work styles, which could result in over performance and increased levels of presenteeism. 7. Health factors Certain health factors serve as risk factors for presenteeism as opposed to absenteeism. Scientists have examined a variety of emotional and physical health symptoms and noted that the odds of reporting presenteeism were largest for those with high stress compared to those without stress. Those with poor diet and less emotional fulfilment also reported higher levels of presenteeism than those without these conditions. Individuals who partook in no physical activity were more prone to report higher levels of both absenteeism and presenteeism compared to those who took part in some physical activity. Tomorrow we conclude with consequences.

09 Aug 2018 – Presenteeism (3/3) Welcome to Thursday and the last day of our three part "Presenteeism" feature. Today we look at potential consequences of Presenteeism.

1. Productivity loss

One consequence of presenteeism is productivity loss, and scholars have attempted to estimate these productivity numbers. A large study by Goetzel et al. estimated that on average in the United States, an employee’s presenteeism costs or lost on-the-job productivity are approximately $255. Furthermore, the authors concluded that of all the health related costs faced by employers, one fifth to three fifths of those expenses could be attributable to on-the-job productivity losses.

2. Poor health and exhaustion

Exhaustion and future poor health are often other consequences of presenteeism. For example, scientists found that sickness presenteeism was a risk factor for future sick leave. Furthermore, in their study of job demands and presenteeism, Demerouti et al. found that presenteeism resulted in increased exhaustion.

3. Presenteeism can also have an effect on occupational injuries for workers.

A 2012 study from the National Institute for Occupational Safety and Health showed that workers with access to paid sick leave were 28% less likely overall to suffer nonfatal injuries than workers without access to paid sick leave.

4. Workplace epidemics

In the case of an infectious disease such as influenza, a culture of presenteeism will inevitably also lead to further infections throughout the workforce, compounding the ill-effects and leading to a much wider problem. In a 2014 survey by Canada Life Insurance, over 80% of respondents stated that they had become ill as a result of an infection contracted in the workplace

See you tomorrow when we will be looking at fatigue related technology in cars.

16 Aug 2018 – Caffeine Good morning everyone on this rain soaked Thursday. I made my regular stop at Starbucks (Other coffee retailers are available) and purchased my daily large vanilla latte this morning. As mentioned yesterday, todays post is around caffeine and has been put together by Richard Whitfield from our Programme Team. (Thank you Richard)

If you struggle to function without your morning pick-me-up, you could have caffeine dependence. Caffeine is the most common mood-altering drug in the world. It is a mild stimulant that affects the central nervous system.

Caffeine can be found in many products such as tea, soft drinks, energy drinks, and some over-the-counter medications, the leading dietary source of caffeine among adults is coffee. According to the National Institutes of Health adults couldn’t consume more than 400mg of caffeine per day, three to four cups is considered moderate consumption and won’t harm you.

Regular consumption can result in physical dependence where abstinence can lead to withdrawal symptoms such as; depressed mood, headaches, irritation, anxiety, fatigue and difficulty concentrating. Excessive consumption use can produce physical side effects such as tremors, anxiety, insomnia, and could result in a “crash” of extreme fatigue once the effects start to wear off. Regular consumption can also lead to tolerance, where the drinker requires a higher dosage to get the same brain-boosting effects as before.

Consuming caffeine later in the day can interfere with sleep. The majority of individuals will not be affected if they don't consume caffeine at least six hours before going to bed, however, sensitivity may vary depending on metabolism and the amount of caffeine regularly consumed. People who are more sensitive may not only experience insomnia but also have caffeine side effects of nervousness and gastrointestinal upset.

Though excessive consumption can impact sleep, it doesn’t mean you need to cut out caffeine completely, instead, you can manage what you drink throughout the day. Here are a few ideas for managing consumption:

• Don’t consume caffeine after 4pm. The effects take a while wear off and can cause sleeping problems. For this reason, it’s best to limit coffee consumption for the morning hours and early afternoon at the latest.

• Use a smaller mug. When we fill up a cup, we’re tempted to fill it up to the top to give ourselves more. When given a choice between a larger and a smaller mug, choose the smaller one to give yourself the illusion that you’re drinking more.

• Limit coffee to a maximum of four cups per day. Too much caffeine can cause increased anxiety and irritability. If you have the urge to drink more than 4 cups of coffee per day, choose decaffeinated.

• Reduce caffeine intake as the day progresses. You are more likely to feel like you need caffeine early in the morning, when you are possibly feeling lethargic and need a boost. This is the best time to drink coffee if you need it. Later in the day try to wean yourself off the caffeine by opting for tea or decaffeinated coffee instead so your body can be caffeine-free by evening.

17 August 2018 – Pets Hello on this lovely Friday. It's the middle of the night, and 16-year-old Bunny awakens her household with the clatter of footsteps and loud cries. Sometimes she's hungry, and other times she just wants some attention. No, Bunny is not an annoying adolescent. She's a demanding cat. And her owner, Grace Fontana, says she and her husband are seriously sleep deprived because of their four-legged friend's nightly routine. "We may be in bed for seven to eight hours, but my husband feels like he is existing on five hours of sleep," Grace laments. And the Fontana family is not alone…….A study conducted by Mayo Clinic sleep researchers found more than half of the patients seeking consultations at their sleep clinic are pet owners complaining of nightly sleep disturbances by their furry companions. And while 41 percent of sleepy pet owners said the disruptions came from allowing their pets to share their beds, another 58 percent reported the problems stem from simply allowing their pets to sleep in the same room. Weary owners also complained that their pets' snoring steals away shut-eye time. On average, 21 percent of the patients slept with dogs who snore, and 7 percent with snoring cats. "I suspect that the degree of sleep disruption experienced may be significantly greater than we believe," says Dr. John Shepard, lead author of the study and medical director of the Sleep Disorders Centre at the Mayo Clinic. Sharing the Covers Christine Lawson of Stockton, Calif., shares her bed not just with her husband but also with their four cats, who sneak under the covers after she's fallen asleep. "One has chosen my legs to sleep on, the other sleeps or will try to sleep with her head in my hand, so I am literally hugging the cat," says Lawson. "The others sleep on the bed between my husband and me. I am constantly aware of the presence and try not to roll over on them. I am deprived of sleep when I awaken, and am exhausted before my day begins. " Even ABCNEWS' own medical editor, Dr. Timothy Johnson, has his sleep disturbed by his 8-pound dog, Mozart, with whom he and his wife share their bed. "Mozart sometimes gets thirsty during the night and sometimes he needs to you-know-what," Johnson explains. "So I have to get up with him usually once a night because my wife is sleeping so soundly. Sometimes I can get back to sleep quickly, and sometimes I can't. And it's the 'can't' times that remind me how much having a pet in bed with you can disrupt your sleep." Serious Sleep Deprivation Experts say the average person typically needs at least eight hours of sleep each night. Sleep disturbances, caused by pets or otherwise, have both physical and mental effects. "You don't perform well, you don't make good decisions, and over time it really adds up," says Dr. Joyce Walsleben, director of sleep disorders at New York University. "Sleepy people tend to be more irritable, have a slower reaction time, and have difficulty with decision making. You can also have real problems with things such as driving."

After a few months of observing Bunny the cat wake her husband repeatedly during the night, Grace Fontana has begun to see signs of sleep deprivation. "My husband definitely feels exhausted," she says. "His response and reaction time is much slower, and he is not as efficient as he normally would be. He is not getting enough of the 'good sleep.' " What's an Owner to Do? Walsleben says something definitely needs to be done. "Enough of life interferes with your sleep, and a pet could certainly be removed, or have their habits changed," says Walsleben. "You probably can't control your kids coming in and waking you up, but you can control your pet." According to Shepard, one simple solution is to train the pet to sleep in a different location. And remember, for the pet, comfort is key. "You should make a spot that is warm and comfortable for them with pillows and blankets, so you don't feel as guilty about excluding them from the bedroom," says Shepard. "People will go to extreme lengths to make their pets comfortable in the beds that they purchase and buy for them." John C. Wright, animal behaviourist and author of the new book Ain't Misbehavin': Groundbreaking Program for Happy, Well-Behaved Pets and Their People, says pets disturbing sleep has been a big problem for years. And there are many explanations for their bad behaviour. "It all depends on what biological or social need is not being met," explains Wright. "You have to figure it out and address the problem." "Cats can be just as active when you're awake as when you're asleep," he adds. "Or sometimes they're hungry because they eat a little bit 10 or 12 times a day, instead of one or two big meals. Kittens may jump up on you at night and lick or knead you. Or they're cold, and when you're lying down under the covers, cats like it because it's warm." Dogs, says Wright, have different needs and subsequently different reasons for waking their owners up. "They may need to go outside and urinate in the middle of the night, others want to be fed," explains Wright. "If they're puppies, they may need a little attention. And if you do that once, they're likely to try that the next night, and so on." Lay Down the Law For both cats and dogs, Wright recommends setting a schedule and sticking to it. "Move up your pet's feeding time so you can let them out earlier, or just don't answer them when they start to bark or cry. A few sleepless nights are worth it in the long run," says Wright. Fontana says she's now paying the price for not following that advice. "I think we created a monster by getting up in the first place, but then again, the low meow is harder on the ear than hearing a baby cry," she says. "It is quite obnoxious." Source ABCNEWS.com Oh and if anyone can tell me how my cat, Dexter, can pull a fully grown live Crow through the cat flap then please do let me know. The flap is barely large enough for him to get through let alone him and a "friend". (The picture is Dexter giving that "Dont you dare tell him" look) Have a restful weekend and I will see you all next week.

29 Aug 2018 – Restless Leg Syndrome Good Morning Everyone. Restless legs syndrome, also known as Willis-Ekbom disease, is a common condition of the nervous system that causes an overwhelming irresistible urge to move the legs. It can also cause an unpleasant crawling or creeping sensation in the feet, calves and thighs. The sensation is often worse in the evening or at night. Occasionally, the arms are affected, too. Restless legs syndrome is also associated with involuntary jerking of the legs and arms, known as periodic limb movements in sleep (PLMS). Some people have the symptoms of restless legs syndrome occasionally, while others have them every day. The symptoms can vary from mild to severe. In severe cases, restless legs syndrome can be very distressing and disrupt a person's daily activities. What causes restless legs syndrome? In the majority of cases, there's no obvious cause of restless legs syndrome. This is known as idiopathic or primary restless legs syndrome, and it can run in families. Some neurologists (specialists in treating conditions that affect the nervous system) believe the symptoms of restless legs syndrome may have something to do with how the body handles a chemical called dopamine. Dopamine is involved in controlling muscle movement and may be responsible for the involuntary leg movements associated with restless legs syndrome. In some cases, restless legs syndrome is caused by an underlying health condition, such as iron deficiency anaemia or kidney failure. This is known as secondary restless legs syndrome. There's also a link between restless legs syndrome and pregnancy. About 1 in 5 pregnant women will experience symptoms in the last 3 months of their pregnancy, although it's not clear exactly why this is. In such cases, restless legs syndrome usually disappears after the woman has given birth. Treating restless legs syndrome Mild cases of restless legs syndrome that aren't linked to an underlying health condition may not require any treatment, other than making a few lifestyle changes. These include: •adopting good sleep habits (for example, following a regular bedtime ritual, sleeping regular hours, and avoiding alcohol and caffeine late at night) •quitting smoking if you smoke •exercising regularly during the daytime If your symptoms are more severe, you may need medication to regulate the levels of dopamine and iron in your body.

If restless legs syndrome is caused by iron deficiency anaemia, iron supplements may be all that's needed to treat the symptoms. Who's affected by restless legs syndrome? Restless legs syndrome is a common condition that can affect anyone at any point in their life, But women are twice as likely to develop restless legs syndrome as men. It's also more common in middle age, although the symptoms can develop at any age, including childhood. Outlook The symptoms of restless legs syndrome will usually disappear if it's possible to address an underlying cause. But if the cause is unknown, the symptoms can sometimes get worse with time and severely affect the person's life. Restless legs syndrome isn't life threatening, but severe cases can disrupt sleep (causing insomnia) and trigger anxiety and depression. The charity Restless Leg Syndrome UK provides information and support for people affected by restless legs syndrome. They may be able to put you in touch with other people in your area affected by the condition.

12 Sept 2018 – Asleep at the Wheel Good Morning All Today we are once again back in the Car! Today’s post is made up of extracts from the attached booklet “Asleep at the Wheel”. Dozing off while driving can have tragic consequences. Research suggests it contributes to more accidents than was previously suspected. Until recently driver fatigue was not placed very high on the list of road safety priorities. Sleep related incidents are not recorded in UK accident statistics, and a major problem in determining the extent of the problem is that drivers who have fallen asleep at the wheel are likely to be reluctant to admit it — especially where an accident has resulted. There is growing evidence that driver fatigue plays a part in a significant proportion of road traffic accidents. Regional studies have indicated that drowsiness accounts for some 16% of all road accidents, and over 20% of motorway accidents. One study carried out on the M180 in South Humberside indicated that driver fatigue could have been implicated in all four of the fatalities that occurred on the road over a 12-month period, plus 47% of the serious injuries and 34% of the slight injuries. It is an increasing problem because we travel in quieter and smoother cars, we try to cover greater distances, our eyes may be very tired from focusing on a computer screen all day long and increasingly we use aids such as cruise control that give us less to do at the wheel. While it’s true that a comfortable drive is less stressful, you actually need a minimum of stress to keep you awake.’ Ultimately, drivers must recognise the dangers of continuing to drive while they are tired and have the self-discipline to stop and take a break instead of pressing on, even if they are running late. Source: britishsnoring.co.uk

2.5. Recognising Fatigue – Signs, Symptoms, Consequences. 22 June 2018 – Signs of Fatigue In order to assist people in recognising the signs and symptoms of fatigue in both themselves and others, I list some of the common ones below:

•weariness, •tiredness, •sleepiness, including falling asleep against your will ("micro" sleeps), •irritability, •reduced alertness, concentration and memory, •lack of motivation, •depression, •giddiness, •headaches, •loss of appetite, •digestive problems, and •increased susceptibility to illness. Don't forget, be aware of these, not just in yourself, but in your friends and colleagues.

2.6. Management of Fatigue – How Best to Deal With Fatigue Causes.

4 July 2018 – Personal Fatigue Management Good morning everyone. Well today we wake up with World Cup Dreams and Baddiel and Skinner ringing in our ears so I thought I would speak around personal fatigue management. No one knows your level of Fatigue as much as you do. We all have personal responsibilities regarding fatigue and ensuring we do not put ourselves or those around us in harm’s way. Sleep has an image problem, we stigmatize sleep and think it is lazy and slothful - people wear lack of sleep as a badge of honour to be celebrated. Nothing could be farther from the truth. There are a number of things we can all do on a daily basis to personally manage our Fatigue risk. Some of these are listed below: • Educate yourself on Fatigue (Ask questions, read, discuss with friends and loved ones) • Recognise your own Fatigue symptoms early enough to do something to reduce your levels, • Identify the sources of your fatigue (Young family, stress, work/life balance, football!!) • Feel empowered to discuss your fatigue situation (Line manager, friends, partner) • Take action to overcome your sources of fatigue (exercise, diet, sleep hygiene, environment) • Set yourself achievable goals in the quest to manage your fatigue, • Form a local fatigue support group (with colleagues, friends, family) • Monitor your sleep patterns (Keep a sleep diary) • Share personal experiences and information on fatigue with others around you. Another Fatigue factlet will be with you tomorrow.

5 July 2018 - Hydration Hello all. The heatwave continues. some of us celebrate but others can also struggle. I thought I would concentrate on the importance of Hydration today, which is one of the key tools in fighting fatigue. Dehydration occurs when the body has insufficient water to function properly. While mild dehydration may be just uncomfortable, more severe dehydration can lead to blood clots, seizures, and other potentially fatal complications. Clearly, severe dehydration must be treated promptly, but even mild dehydration can have adverse effects on mood and energy. It’s important to catch any degree of dehydration early, but the signs of dehydration aren’t always obvious ones like thirst and fatigue. Here are six surprising signs and symptoms of dehydration. 1. Bad Breath Saliva has antibacterial properties, but dehydration can prevent your body from making enough saliva. If you’re not producing enough saliva, you can get bacteria overgrowth in the mouth, and one of the side effects of that is bad breath. 2. Dry Skin A lot of people think that people who get dehydrated are really sweaty, but in fact, as you go through various stages of dehydration, you get very dry skin. Skin may appear flushed as well. When pinched, the skin of a dehydrated person may remain “tented” and take some time to return to its normal, flat appearance. 3. Muscle Cramps Dehydration is only one potential cause of muscle cramps, but it’s one worth considering if you get cramps while exercising or carryout intensive work, particularly in hot weather. The hotter you get, the more likely you are to get muscle cramps, and that’s from a pure heat effect on the muscles. As the muscles work harder and harder,

they can seize up from the heat itself. Changes in the electrolytes, such as sodium and potassium, can lead to muscle cramping as well. Even in cooler weather, dehydration is possible if you don’t drink enough fluids while working. 4. Fever and Chills If your body is severely dehydrated you may experience fever and chills. Fever, in turn, can worsen dehydration, and the higher the fever, the more dehydrated you may become. In infants, so-called dehydration fever may develop if there is inadequate fluid intake, diarrhea, or vomiting. Any fever in an infant or toddler is cause for concern. Ask your doctor for guidelines on when to call for help. 5. Food Cravings, Especially for Sweets When you’re dehydrated, it can be difficult for organs like the liver, which uses water, to release glycogen [stored glucose] and other components of your energy stores, so you can actually get cravings for food. While you can crave anything from chocolate to a salty snack, cravings for sweets are more common because your body may be experiencing difficulty breaking down glycogen to release glucose into the bloodstream to use as fuel. It’s also not uncommon for the body to confuse the feeling of thirst with hunger, meaning that you may feel hungry when all you really need is water. 6. Headaches Even mild dehydration can cause a dehydration headache and even trigger a migraine headache. Since it’s often not clear what is causing a headache, drinking a full glass of water and continuing to sip more fluids during the day is an easy way to ease your pain if, in fact, dehydration is contributing to it. How to Tell if You’re Dehydrated If you’re thirsty, you’re already dehydrated. But lack of thirst doesn’t necessarily mean you’re well hydrated. Here are two other ways to check whether your body is dehydrated: Try this skin test. Use two fingers to pinch up some skin on the back of your hand, then let the skin go. The skin should spring back to its normal position in less than a couple of seconds. If the skin returns to normal more slowly, you might be dehydrated. Check your urine. If you’re well-hydrated, your urine will be mostly clear with a tinge of yellow (the color of light lemonade before it hits the bowl). Darker yellow or orange are the “warning” colours to watch for. If you see those colours, start drinking fluids. Tips for Staying Hydrated When it comes to daily water intake, it is recommended that most women get about 2.7 litres of water a day (or about 12 cups), and most men get about 3.7 litres a day (or about 15 cups). Those totals include water gained from foods and beverages like tea, milk, and fruit juice.

Here are some tips for getting all the fluids you need and avoiding dehydration: Keep your water bottle handy. If it's right next to you, you'll likely get into the habit of sipping it without even realizing it. If you don't love plain water, jazz it up by adding a splash of fruit juice or chunks of fresh or frozen fruit. Try different teas. It is recommended drinking unsweetened teas, which are available in lots of different flavours. “Sip fruity iced teas during the day (with lots of ice if it's hot out), or cozy up with a mug of hot peppermint or chamomile tea at night — they all count toward your daily fluid goal. Make over your snacks. “Swap dry snacks like crisps, pretzels, and crackers — which have a very low water content — with refreshing munchies like fresh or frozen fruit, yogurt, healthy smoothies. Pile on the produce. Aim to make half your plate vegetables or fruit at meals. All those vegetable and fruit servings will supply water as well as a hearty dose of vitamins, minerals, and fibre. “In fact, some fruits and vegetables are more than 90 percent water — including cantaloupe, strawberries, watermelon (of course), cucumber, celery, lettuce and leafy greens, zucchini, tomatoes, and bell peppers. Sip more during meals. “Sipping water with meals will help you eat more slowly, pace your eating, and, of course, stay hydrated. So in summary "A wet person is an awake person"

9 July 2018 – Boost Energy/Beat Fatigue (1/4) Good Morning All. Fatigue is not just about getting enough sleep. There are many things you can do in your waking hours that can help you beat fatigue and boost your energy. Over the next 4 days I am going to provide a few hints and suggestions around: • Diet • Lifestyle • Psychological Issues • Mid Afternoon energy Slumps. Energy explained: Food, which gives us energy, is broken down by the digestive system. Some elements, such as water, are absorbed through the stomach. The rest are absorbed through the small intestine. The body's preferred energy source is glucose, from carbohydrates , but it can also use fatty acids (from fats) and amino acids (from proteins). Glucose is delivered to virtually every cell in the body by the bloodstream, and is then burned with oxygen to produce energy. Hormones control every step in this process; for example, the pancreas makes the hormone insulin, which helps to control blood sugar levels. Dietary suggestions: If you want more energy, look at your diet and make sure you're following these basic guidelines: • Drink lots of water. A dehydrated body functions less efficiently. • Be careful with caffeine. 1 or 2 caffeinated drinks per day like coffee, tea or Coke Cola can boost your energy and mental alertness, but more than 6 caffeinated drinks per day may make you anxious, irritable, and negatively affect your performance. • Eat breakfast. Food boosts your metabolism and gives your body energy to burn. The brain relies on glucose for fuel, so choose carbohydrate-rich breakfast foods such as cereals or whole grain bread. • Don't skip meals. Going without food for too long allows blood sugar levels to dip. Try to eat regularly to maintain your energy levels throughout the day. • Don't crash diet. Low calorie diets or diets that severely restrict carbohydrates don't contain enough energy for your body's needs. The typical crash diet also deprives the body of nutrients such as vitamins, minerals and trace elements. • Eat a healthy diet. Increase the amount of fruit, vegetables, whole grain foods, low fat dairy products and lean meats in your diet. Reduce the amount of high fat, high sugar and high salt foods. • Don't overeat. Large meals can drain your energy. Instead of eating 3 big meals per day, try eating 6 mini-meals to spread your calorie intake more evenly. This will result in more constant blood sugar and insulin levels. You'll also find it easier to lose excess body fat. • Eat iron rich foods. Women in particular are prone to iron-deficiency (anemia). Make sure your diet includes iron rich foods such as lean red meat. Tomorrow we will look at some Lifestyle suggestions. See you then

10 July 2018 – Boost Energy/Beat Fatigue (2/4) Happy Tuesday Everyone. Today I continue the post I started yesterday and mention a few Lifestyle suggestions that can help you manage fatigue. Lifestyle can play an enormous part in creating or reducing fatigue. Lifestyle suggestions: • Have a bedroom routine. If you can, go to sleep and wake up at the same time. Leave at least 30 mins to relax before you go to bed and, of course, take the gadgets out of the bedroom. • Don't smoke. Cigarette smoke contains many harmful substances. There are many reasons why smokers typically have lower energy than non-smokers. For example, the body needs to combine glucose with oxygen to make energy, but carbon monoxide in cigarette smoke reduces the amount of oxygen available.

• Limit the time you sit down. Reduce sedentary behaviours such as watching television and using computers. • Increase physical activity. Physical activity boosts energy levels, while a sedentary lifestyle is known to cause fatigue. Being active has many healthy effects on the body and mind. It reduces blood pressure, helps to maintain a healthy weight, and is an effective treatment for depression and anxiety. A good bout of exercise also helps you sleep better at night. • Seek advice. If you haven't exercised in a long time, are obese, are over age 40 or have a chronic medical condition, seek advice from your doctor regarding small steps you can take towards a more active lifestyle. • Seek treatment for substance abuse if you need it. Excessive alcohol consumption or recreational drug use contributes to fatigue. It's also potentially dangerous. • Workplace issues. Demanding jobs, conflicts at work and burnout are common causes of fatigue. Take steps to address your work problems. A good place to start is to talk with your line manager. Tomorrow I shall offer a few tips regarding psychological issues.

11 July 2018 – Boost Energy/Beat Fatigue (3/4) Good Morning. Well if ever there was a day where we need to consider fatigue management it could be today bearing in mind a lot of people may have a late night tonight celebrating. I hear sleeping in M&S waistcoats can significantly aid sleep for excited fans!!!!!! Anyway back to our 4 part series on some of the things you can do in your waking hours that can help you beat fatigue and boost your energy. Today's topic is Psychological Issues. Studies suggest that between 50 and 80% of fatigue cases are mainly due to psychological factors. Suggestions include: • Assess your lifestyle. Are you putting yourself under unnecessary stress? Are there ongoing problems in your life that may be causing prolonged anxiety or depression? It may help to seek professional counselling to work out family, career or personal issues. • Relaxation training. Constant anxiety drains the body of energy and can lead to burnout. Relaxation techniques, such as meditation and yoga, help to 'switch off' adrenaline and allow your body and mind to recover. • Learn to do nothing. (I am particularly good at this) A hectic lifestyle is exhausting. Try to carve out a few more hours in your week to simply relax and hang out. If you can't find a few more hours, it may be time to rethink your priorities and commitments. • Have more fun. Are you so preoccupied with commitments and pressures that you don't give yourself enough time for fun? Laughter is one of the best energy boosters around. Tomorrow we shall conclude this series by looking at coping with the mid-afternoon energy slump. (Some of you may need this advice tomorrow)

12 July 2018 – Boost Energy/Beat Fatigue (4/4) Welcome to Thursday. Today is the last day of the 4 part series looking at things we can do in our waking hours. This last post focuses in on that dreaded after lunch energy slump. Most people feel drowsy after lunch. This mid-afternoon drop in energy levels is linked to the brain's circadian rhythm and is 'hard wired' into the human body. Preventing this drop in energy may be impossible, but there are ways to reduce the slump, including: • Introducing fatigue fighting strategies, previously posted, into your lifestyle. A fit, healthy and well-rested body is less prone to severe drowsiness in the afternoon. • Eating a combination of protein and carbohydrates - like a tuna sandwich - for lunch. Carbohydrates provide glucose for energy, and protein provides the amino acid tyrosine, which allows the brain to synthesize the neurotransmitters dopamine and norepinephrine to keep your mind attentive and alert. • Get moving! A brisk walk or even 10 minutes of stretching at your desk can improve your blood flow and boost

your energy. • Remain hydrated. Drink plenty of water throughout the day. • Not only keep your body moving but ensure your brain remains active. Plan group workshop sessions for after lunch where you exercise your body and mind.

16 July 2018 – Fatigue of the “Go To” person. Good Morning Everyone. I hope the tips for sleeping during the hot weather are helping. There does not seem to be any let up in the glorious weather. Today’s post is around the fatigue you may encounter if you are the person that the whole office seems to go to to sort out their issues. The “Go To Person” and the risk of becoming the “Gone to Sleep Person”. You are staring at your computer screen and you are stressed. Yet another day has passed, and you haven’t really made any progress with your work: instead, the whole day has gone by helping your colleagues. You’re known as the go-to person in your office when it comes to sorting issues, and although you love to help people out with their problems, this activity is starting to burn you out. There may also be a price to pay when it comes to your unofficial role: you help others at the expense of missing deadlines in your own assignments and projects. This can lead to further consequential stress. The situation becomes unbearable: you want to help your colleagues, but at the same time, you’d like to take care of your work as well. Unfortunately, you have run out of ideas on how to solve the situation and your fatigue levels may be dangerously high. In many cases those people suffering from fatigue may not actually recognise it because it has become their “Norm” When looking more closely at your situation, it’s very easy to understand why you are feeling stressed and burned out: you’re a nice person and you want to help others, and you probably feel good about yourself when you have fixed issues for other Your open door policy and unwillingness to say “no” is like an open invitation to others: You are kind to them, you do what they ask you to do, and you are always available. There is most likely a conflict deep inside you, as part of you wants to change the situation, but again, you are afraid to do it. You might be scared of what other people would think of you if you say “no” to their requests—you want to please others, not make them feel bad, making it difficult to say “no” to them. Ultimately, this niceness is causing more harm than good to you as you end up having a hard time doing your own work on time. To make things easier and to solve the situation, you need to set a framework that defines how these unofficial tasks are going to be handled: this framework will determine your general accessibility, how you will communicate with others and how others will communicate with you, as well as the official routes when dealing with the problems of others. To make the framework more powerful, you have to define it with your line manager, and it has to be communicated clearly to your colleagues—only in that way will things will get better and you will finally be able to focus on yourself and your work life balance.

17 July 2018 – Young Families Tuesday is looking good, 3 more days till Friday I’m Funlola from The Fatigue team. I’ll be discussing Fatigue around people with young families If like me you have a young family (or some caring responsibility) you know that work is almost considered ‘rest’ and walking out the door of the office is where the ‘real’ work starts balancing and struggling with tasksϑ. So I’ll be talking about how we manage our bodies so we are self-aware and don’t become drained or Fatigued?? I know I don’t have all the answers, but here are some things that have helped me and might be helpful for you Have a routine – as a friend of mine says, just like we ‘try’ and keep routines for our kids ensuring they eat right, drink loads, sleep early, do their homework etc. because we know they need these things to function optimally, we should also try to do the same for ourselves. A routine can help us fight fatigue, it helps our bodies know what to

expect and adjust. To do this, you can take a step back to see all that you do regularly and then think of better ways to spread it out over time. For example, spreading housework over the week, cooking simple meals, ordering shopping online, not having excessive TV/device time and more time to relax. Little adjustments like this help our bodies’ better cope with our lifestyle and reduce the likelihood of us becoming fatigued Take time to unwind – make out time for yourself, I know it sounds incomprehensible as those days of singleness where it was simply all about you seems like a distant memory ϑ, but take a few mins each day to just ‘BE’ it might be a few mins reading a book, painting your nails, getting your hair done…….. whatever would give you that feeling of being taken care of. Your mental state affects your fatigue and so taking that time out to unwind is super important Ask for help – ‘No one can do it like I can’ ……..I can’t count how many times I have thought that …… haven’t said it much so I don’t offend, but it doesn’t stop me thinking itϑϑ But truthfully we must leverage the people around us that love us and are willing to help. When help is offered, graciously accept it and where it is not offered ask for it, especially from those we know have the ability or responsibility to support us… a ‘no’ won’t kill usϑ it might dent our pride, but we will survive. Remember when we are fatigued we can’t give our best, we lose our patience, become grouchy and are not a joy to be around. A famous proverb says ‘It takes a village to raise a child’, we should leverage the people around us to support us and our young ones. That’s my little piece on helping to manage our fatigue with a young family. For me it an everyday struggle, so please encourage me or share some more helpful tips. I’ll be back in a few weeks to talk about how we can help those with caring responsibility around us cope better and avoid fatigue Enjoy the rest of the week……. It’s almost Friday

18 July 2018 – Driver Fatigue Good Morning Everyone. I hope you enjoyed Dee and Funlola's posts. Very informative. Well it is back to me and today I am going to post on the subject of how to beat driver fatigue on long journeys. According to the Department of Transport's THINK! campaign, nearly a fifth of accidents on major roads are sleep-related. Crashes caused by drivers falling asleep typically involve vehicles running off the road or into the back of another vehicle. Crashes involving drivers falling asleep tend to be high-speed crashes, as drivers don't brake before crashing, resulting in a high risk of death or serious injury. But it's not just falling asleep at the wheel that's a risk. Drowsy driving can be as dangerous as drink driving as motorists share many of the same impairments, such as difficulty focusing and slowed reaction time. So, how can you beat driving tired? In a study by road safety charity Brake, one in eight drivers admitted to nodding off at the wheel for a period of 2-30 seconds. That equates to 4 million people falling asleep while driving. To make sure you beat driver fatigue: • Make sure you have plenty of rest before you set off, especially if you're driving early in the morning. It is recommended drivers have at least seven to eight hours of sleep. • You should plan your journey before you set off to allow enough time to take breaks of at least 15 minutes every two hours or as soon as you start to feel tired or lose concentration. • Find a safe place to stop if you start to feel tired on your drive. Research found having a 15-minute nap is more effective at reducing driver fatigue than getting out and stretching your legs. • For a short-term solution, have a caffeinated drink. Allow the caffeine time to kick in by drinking it before taking a 15-minute nap. • If possible, share the driving on a long journey. This gives each driver time to relax and recoup after their driving stint. • Also remember the time of day can increase your risk of driving tired as your body clock reaches a natural dip.

• If you begin new medication you should ask your doctor or pharmacist if it can make you feel drowsy. If there is even a small chance that your medication could affect your driving ability then you should avoid driving long distances. Similarly, if your doctor informs you that you cannot drive when taking your medication then you must heed this warning. • We all know that drinking and driving is a no go. However, the following day is a grey area for many drivers. You should avoid driving 12 hours after you had your last drink, although this does depend on the amount of alcohol consumed. Alcohol can cause drowsiness behind the wheel, so be extra cautious. The best mitigation is to not drink at all. • Modern vehicles are usually quiet and comfortable for the driver, meaning a more relaxed drive. This can lull drivers, particularly in vehicles fitted with comfort-enhancing features such as cruise control, into sleep. Did you Know? • The most common time to fall asleep behind the wheel is between 2:00am–6:00am • The body clock also dips between 2:00pm–4:00pm making you feel tired • A micro sleep of just six seconds could mean you travel 200 meters on the motorway, which is enough time to veer across three lanes of traffic or into the central reservation • Motorways and dual carriageways are the most common roads for sleep-related crashes, due to the monotonous road environment and lack of interruptions or driver stimulation

02 Aug 2018 – Management of Self So, this morning’s post is an opportunity to consider how well each of us are managing our own fatigue and our knowledge surrounding this. The RSSB have put together two interesting documents to help us answer the question (please find the links below). The first attachment is a questionnaire which asks “How well do you manage your own fatigue?” This has been designed to help you understand if you may be suffering from fatigue. • If you answered ‘yes’ to any of the questions, it may be a sign that there is room for improvement when managing your fatigue; The programme wants to provide education around fatigue, looking at signs of fatigue and effective management of fatigue. The second attachment focuses on “Are you suffering from fatigue today?”. • This document asks questions such as ‘Have you had enough sleep? It outlines the ‘symptoms of fatigue’, and provides examples of elements in our lives which could cause us to suffer from fatigue. All the above and attached relate very closely to our education work stream within the Fatigue Improvement Programme. Traditionally education has been limited to standards briefings which concentrate on the key changes in the new standard. We feel, however, that our education work stream is key to the change taking place across the business and the behavioural outcome. We are also, therefore, focusing on the educational elements of fatigue itself, the behaviours relating to Fatigue Management and the health and wellbeing activities associated with the change. We have found both documents very interesting and hope you do too. Please do take the opportunity to read and share. Please do share your thoughts and ideas around our programmes educational approach, we are very keen to understand what forms / methods of communications work best for you.

21 Aug 2018 – Fatigue Beating Yoga Hello to all. Sometimes unusual mental or physical exertion, stress, and lack of sleep can make people tired. Prevention in these cases simply requires self-observation and needs us to listen to our bodies. It means not pushing the body and mind beyond its limits. Other times it means walking or doing some physical work to help increase the energy levels. Some yoga poses are excellent to reduce fatigue and adjust the hormone cortisol - too little of which can zap your energy. As your stress levels go down, energy levels improve you can increase energy with balancing poses and backbends. Here are 8 Yoga postures to increase energy and reduce fatigue. Practicing yoga increases your energy, power, strength and endurance, whilst strengthening weak or under-activated areas of the body. Cobra Pose Cobra pose strengthens the upper back, neck, shoulders and chest. It also stretches the spine, improving spinal mobility of the upper and mid-back. It opens 4 chakras within the body, reduces tension, stress and fatigue. To do this pose, start by lying on your stomach with your hands on the floor by your chest. Keeping your legs together, point your toes back while pressing feet into the ground. Keep your elbows bent in by your sides as you slowly lift your head and chest off the floor. Look straight ahead and hold anywhere from 20 seconds upwards to a minute. Inhale as you lengthen the sides of your body, then exhale, pressing your tailbone down. Press the lower tips of your shoulder blades toward the back of your heart while keeping the upper shoulder blades broad and open. Root your hands into the earth, and curl up toward the sky. Downward Dog Has a very restorative and rejuvenating effect on the mind, body and spirit. It opens and lengthens the back of the body and creates great sensations within the body. Bow Pose This pose, which looks like an archer's bow, strengthens the back while lengthening the front of the body. To do this pose, lie on your belly with your arms by your sides, palms facing up. Bend your knees and bring your heels close to your buttocks. Reach back with your hands and grab your ankles (not the tops of the feet). Keep your knees about hip-width apart. Lift your heels away from your buttocks while simultaneously lifting your thighs away from the floor. This will lift your upper torso and head off the floor. Press your shoulder blades down and away from your ears. Keep your gaze forward. Hold this pose anywhere from 20 to 30 seconds. Release your ankles as you exhale, and rest quietly for a few breaths. Tree Pose Tree pose strengthens the muscles of the lower extremities around your knees. It is a balancing pose, requiring focus and attention. This pose starts in a standing position with your hands on your hips. Bend your right knee and place your right foot on the inside of your left thigh. Press the thigh against the foot. Bring your hands together in front of your chest, or for a further challenge reach your arms up overhead. Gaze forward at a fixed point. Hold for 30 seconds to a minute. Repeat on other side. Wheel pose Energises you physically and mentally; it is a back bend that strengthens, lengthens every vertebrae therefore increasing elasticity and flexibility of the spine as well as reducing fat build up from the oblique area and reduces stiff hips.

Bridge Pose Helps alleviate stress, stimulates abdominals, lungs and thyroid, reduces fatigue, backache, headaches and insomnia. Shoulder stand Reverses the effect of gravity by revitalising the organs as pressure is relieved from the lower areas of the body, it stimulates all the digestive, nervous, hormonal and endocrine systems of the body improving our overall health, reducing fatigue and alleviating insomnia. It also changes our perspective. Fish Pose The destroyer of all disease. It helps control the hormonal function in the body, releases tension and induces deep relaxation. This sequence engages your core and energises your system from the inside out. The poses also require balance, which sharpens your focus, as well as lots of deep breaths, which increase your oxygen intake to help you feel more alert. Do each of these moves in order, holding the poses for 10 - 20 deep breaths. Repeat the sequence on the other side when appropriate. Other major causes of fatigue include anaemia, low gastric fire, and weakness of the liver. If the fatigue is due to anaemia, eating iron-rich foods and blood builders such as pomegranate juice, grapes or grape juice, and beets or beet/carrot juice, can help. Right nostril breathing is also helpful, as it stimulates the liver, which plays an important role in building blood. For fatigue caused by physical exertion, drinking fresh orange juice with a pinch of rock salt gives a quick boost. Add 10 drops of lime juice to help the body cool down. When agni (the digestive fire) is low, digestion will be sluggish, bringing the energy level down. One way to raise agni is to chop or grate a little fresh ginger, add a few drops of lime juice and a pinch of salt, and chew it before meals. Also, it is best to avoid cold or iced drinks, as they counteract agni and impede effective digestion. Instead, take small sips of warm water while eating. Source: Justine Glenton – Health and Fitness Travel

10 Sept 2018 – Meeting Fatigue Good Morning Everyone. Todays post is entitled "Meeting Fatigue"

How many meetings does it take to reach too many meetings status? If your answer is one, I fear for you. Meetings can be terribly un-useful, draining, and wasteful, but they shouldn't be. Meetings should make a team run more efficiently. They should be deliberate, concise, and last only as long as they need to.

If you are experiencing meeting fatigue I would caution against quickly jumping to the conclusion that the solution is to hold less meetings. It might be, but there are many factors contributing to your current state of annoyance. Are your meetings purposeful? Do they have a clear goal going in and coming out? Are team members coming in prepared to solve whatever challenge is on the table for the day? Is the venue appropriate? The time?

Agendas

It might feel a little rigid but having at least a rough agenda drives focus throughout a meeting. It also clarifies what this meeting IS and what it IS NOT. One symptom of having a culture of "meetings suck" can be that there's not enough coordination and planning happening, so every opportunity to meet bleeds on and on. Stand-ups (if your team decides to hold them) have a purpose, iteration planning has a specific purpose, a retrospective has a specific purpose, etc. When you clarify the purpose of each meeting, often by including an agenda, you put the proper mechanisms in place to enable the planning channels, feedback loops, and opportunities for team members to voice their opinion. When you don't, you often run into long, tangential meetings that, although important to one or two, can tire out the rest of the group to a dangerous level.

Separation of duties

Don't try to accomplish too much in one meeting. I'd much prefer three short, effective meetings to one 2.5 hour doozy of a meeting. This is a big reason why I'd argue that we should not try to solve the meeting fatigue problem by cancelling meetings left and right. A meeting to plan out other meetings? That sounds ridiculous but give some thought to your upcoming meetings (or lack thereof). If your bases aren't covered or overlap, then it's likely your meetings are going to get sidetracked.

Preparation

If you're hosting/running the meeting do you prepare for it? Probably. It's not uncommon to ask or expect attendees to do the same. Sending out an agenda the day before the meeting can help serve as a reminder, or if you have a tactful manager maybe they can be a positive voice for effective meetings. Regardless of the strategy, a little meeting prep can go a long way, or maybe even reveal that the meeting itself is unnecessary or should be shelved for later. Better than figuring that out 30 minutes through a 10 person meeting.

Venue

Have you considered the walking meeting? On 1-on-1s and small meetings rather than hold up in a stuffy little room walk around the city and chat. The change of scenery is nice and the health benefits aren't bad either. Take your next 2-3 person meeting outside. Lots of business park areas have walking trails running through them that you might not even know about.

Meeting fatigue is real, but the answer is more complex than to just hold less meetings.

Source: Kyleclegg.com

11 Sept 2018 – Fatigue Beating Colours Welcome to Tuesday everyone.

As I was relaxing last night I asked Alexa to change the colour of the lounge lights from white to blue. Not comfortable with blue, I went through the full spectrum, finally settling on Orange. It was strange how differing colours made my mood feel different. This got me thinking of how colour affects mood and therefore can help or hinder fatigue. Colour Psychology: How Colours Affect Your Mood Colours appear to us in numerous forms, appearances. Individuals are able to perceive with free eye at least 2000 different shades, the complete picture and synergy of room are created by combination of different colours. The fact is that we get around 87% of all sensual impressions via a coloured world. People use colours and express themselves through them. Colours are basically divided into: •Primary colours – red, yellow, blue •Secondary colours – colours, composed of two primary (e.g. orange) •Warm colours – red, orange, yellow, brown •Cold colours – blue, green, purple •Neutral colours – white, brown, beige •Strong colours – intensive colours, not diluted with black, white or complementary colour •Pale colours – less intensive colours due to mixing with white, black or complementary colour Psychology of colours and colours in a space Colours are very important in our lives as they directly influence our well-being and mood. Each of us has their own range of popular colours and colours that do not respond to. Consequently, the colourful world around us affects our health. Perception of colours depends on several factors: shade, type of light (daylight or artificial, intense or dim…) our general welfare, biological rhythm etc. Influence of basic colours to our feelings: Red colour Red is optimistic, vital colour of activity, heat, movement, struggle, of passionate life. It is the most human expressive, extroverted colour associated with fullness of life, courage, sacrifice, love, strong emotions and acts of passion. Red leaves nobody cold. You can love or hate, but it is hard to stay indifferent at red. Red increases muscle tone, promotes the pulse, raises blood pressure, promotes blood circulation, excretion of adrenaline and hepatic function. Deepens breathing, can cause headaches, but it is not suitable for fast and emotionally unstable persons.

Orange colour Orange is a bright, shiny, warm colour of fire and sun. It is associated with sunrise or sunset, delicious fruits such as apricots, mandarins, oranges… To Indians it symbolizes courage and sacrifice. No more so aggressive and passionate as red, but as an emotional stimulant happy, nice colour, which helps to overcome fatigue. Due to the foregoing points it constitutes a useful additional aid in treatment of depressions. Orange reflects warmth, generosity, it is light and playful. It also promotes appetite and helps in the morning to stand up. Orange colour strengthens the lungs, pancreas and spleen and stimulates the activity of the heart. Digestion, increases appetite, it can either calm or excite. This colour can stabilise emotions, some individuals get depressed. All shades of orange have the same meaning and effect depending only on the dominant component (yellow or red). Yellow colour Yellow is the colour of sun, light and optimism, which stimulates, activates and frees from fear. It retains the alertness and promotes concentration, symbolizes the creativity and wisdom. Promotes motor skills, its strong feature is communicative. On the walls and elsewhere in the house it has a positive effect on welfare. Yellow has the greatest impact on the respiratory organs, helps in treatment of psychoneuroses, increases blood pressure, accelerates pulse and breathing rate, has positive effect on nervous system. The most common shades of yellow are: cloudy yellow (calming, thinking), live yellow (agility, boldness, relaxation), olive yellow (gloomy mood) and citron yellow (alertness, vivacity, liveliness, perfection). Green colour They say the colour of health. With green colours they try to cure hysteria and nervous fatigue as it has calming influence on nervous system and is effective for depression, migraines can be mitigated. Light green expands capillaries, reduces pressure, induces internal secretion juices. On the other hand the colour of peace, calmness, rest, reflection and study. Its symbolism affects human emotions, soothes and relaxes. It is a sign of balance. It is best for soothing bathrooms and bedrooms, it may also take the form of vegetation. It has adverse effects to red: lowers blood pressure, calms nervous system, migraines, establishes a personal balance, reducing fatigue and insomnia and expands capillaries. Blue colour Blue is a basic colour. Its opposite is yellow, a mixture of both is green, which combines features of both: in nature it is widespread in the azure sky, which is reflected in the water. The symbolism of blue: wisdom, intelligence, immortality, infinity, depth, nobility, spirituality, mysticism. Its psychological associations: clear, fresh, light (colour atmospheres), transparent, airy, distant, quiet………… Psychological effects of blue: slowing heart rate, reducing respiratory rhythm, soothing, encouraging mental activity, introspection, concentration, focus inwards – they say it is the colour of peace and rest. Violet colour Violet colour is a mixture of blue and red, more of one or the other you add a more characteristic colour shade you get and thus also an appropriate share of both – blue peace, remoteness, spirituality …. And red colours of movement, passion, vitality, heat, energy… Because it combines features of such extremely different primary colours (hot, cold…). White colour White is the colour of clarity and is a mixture of all three waves of natural colours: yellow, red and blue. As a result, to white we respond positively. It symbolizes clarity, innocence and purity, as well as a new beginning, rebirth. In conjunction with light blue shades it works very cold. It is also a symbol of divinity, perfection, pride, kindness and the eternal. A white house is light, it looks spacious, but too much white looks lean, sterile and almost like in a hospital, it is recommended that white walls are adorned with paintings, posters or framed pictures.

Source: theunboundedspirit.com Post you tomorrow.

14 Sept 2018 – Fatigue Commitment Good Morning Everyone Today we are going to talk around personal fatigue commitments. As a team you would expect us to “live and breathe” fatigue management and so to this end we have all signed up to our own personal commitment to manage both our own and others fatigue. We have chosen to record this on the attached template and so share myself and Amanda’s as examples to you all. All of the team have produced their personal commitments. In fatigue management there are 3 key layers of responsibility. We call this the “Responsibility Egg”. The outer shell is the Corporate responsibility layer. This is the Standard and it modules. The albumen (white) of the egg is the line managers responsibilities and the egg yolk is representative of the personal responsibility everyone holds. I have personally found that keeping to my commitment is not an easy task. The trials of everyday life can seriously impinge on my ability to gain adequate rest and sleep. It really does have to be worked at but I have found that the benefits are starting to show. I am much more relaxed and much more able to handle life’s stresses. We attach a Fatigue Commitment template for those who feel this may be of assistance to them, their colleagues and teams. The Fatigue Improvement Programme would be very interested to hear of people’s successes and tribulations in better managing fatigue. We all appreciate the self-journey is a rocky one, but our experiences can better aid others in their journey. Have a great weekend one and all

18 Sept 2018 – Meditation for Sleep Good Morning everyone. Today’s post is entitled “Quiet the mental chatter”. These Meditation Exercises Will Help You Fall Asleep In Minutes. It's an evil trick: We leave the office in an exhausted, zombielike state, fully intending to crash land in bed. (A recommended eight hours of sleep? Easy.) But once our head hits the pillow, our brain suddenly decides that now is the time to go into overdrive—between frantic thoughts dissecting our day (and yesterday, and tomorrow), we realize it's been hours and we're still awake. But what if you could consciously shut those thoughts off? With meditation, it's totally possible—which is why deeper, more efficient sleep and more energy are frequently reported side effects of a consistent mindfulness practice. These tips, courtesy of celebrated author and spiritual guru Sonia Choquette, will hopefully put even meditation newbies to sleep in minutes. So, turn off the light, get comfortable and practice. 1) Make yourself yawn. It's been proven time and again that even mimicking the action of yawning triggers all kinds of good feelings in the brain—including tension relief. "Before getting into bed, open your jaw and yawn a few times," says Sonia. "Even if it feels forced, this still releases stress and tells the brain that it is now time for the body to rest." 2) Visualize your breath as a colour. Offering a visual aid makes it easier to train your brain to focus and tune out the noise. "Imagine a single colour in your mind's eye, eyes closed, as you breathe," advises Sonia. "For example, inhale red. Exhale red. Then pause. Inhale green. Then exhale green. Then pause. Then another colour. And so on." 3) Try some aromatherapy. Breathing in the right essential oils (like lavender, ylang ylang, or chamomile) can do wonders to calm a busy mind—particularly if you apply them to trigger points and in places that will allow you to inhale them deeply. "Place several drops of lavender on your pillow case, and two drops on your temples before you lay down to go to sleep," suggests Sonia. We highly recommend massaging the oils gently into your temples to soothe the day's tensions away. 4) Wind down with some chill music at least 30 minutes before bed. "Listening to calming music for a half hour to an hour before going to sleep helps to unwind the thinking brain and helps relax your body as well." Lie down and let your brain focus on the music for the best effect. "This helps regulate your breathing and bring it into a deeper more relaxed meditative state," advises Sonia. Source: elle.com Post you tomorrow.

2.7. Technology – Fatigue Related Technology 10 Aug 2018 – Fatigue Related Technology in Cars Hello everyone. I must say with the cooler temperatures it is definitely easier to sleep. Today we get back in the car and examine: Sleepy Behind the Wheel? Some Cars Can Tell It’s something that many of us have experienced while driving, though we may not like to admit it. It’s called a microsleep, a brief state of drowsy unconsciousness that can happen even if your eyes remain open. Drowsy driving kills. According to the National Highway Traffic Safety Administration, drowsy driving caused 824 deaths in 2015, the last year for which figures are available. Several manufacturers, including Audi, Mercedes and Volvo, currently offer drowsiness detection systems that monitor a vehicle’s movements, such as steering wheel angle, lane deviation, time driven and road conditions. When drowsiness is detected, drivers are typically warned with a sound and the appearance of a coffee cup icon. But manufacturers and automobile suppliers are now working on advanced technological solutions that go beyond visions of coffee cups. To find out if drowsiness can be detected even earlier, Plessey Semiconductors has developed sensors, to be placed in a seat, that monitor changes in heart rate. Algorithms developed by the company indicate when breathing changes to patterns that are typical of someone who is sleeping, giving a warning before someone actually feels tired. “We could see this in a vehicle in five years,” said Keith Strickland, chief technology officer of the company, which is based in Plymouth, England. Bosch, a German supplier of technology to many automotive companies, is developing a camera-based system that will monitor head and eye movements, as well as body posture, heart rate and body temperature. When such a system is used in vehicles that allow for limited autonomous driving, the vehicle could take over once drowsiness is detected — either coming to an emergency stop or pulling itself off to the side of the road, said Kay Stepper, Bosch’s head of driver assistance and automated driving. In addition, sensors on the outside of the vehicle will monitor the state of traffic in which the fatigued driver is engaged. Once vehicles can communicate with each other — a capability expected in the next few years — other cars will be able to take appropriate manoeuvres to avoid the drowsy driver. In France, Valeo, another supplier of automotive technology, is developing an infrared camera system that will monitor children in the rear seat as well as the driver’s shoulder, neck and head movements, looking for deviations from the norm. Checking body temperature and even how the driver is dressed, the system will also be able to customize the interior temperature for each driver, said Guillaume Devauchelle, the company’s innovation director. Nvidia, chip supplier to Audi, Mercedes, Tesla and others, is developing the Co-Pilot, an artificial-intelligence tool that can learn the behaviours of individual drivers and determine when they are operating outside their norms. The system will eventually learn a driver’s standard posture, head position, eye-blink rate, facial expression and steering style, among other indexes. Based on a vehicle’s capabilities, the driver will be warned or automatically driven to a safe spot when conditions warrant. Until vehicles can drive themselves, it will be up to drivers to pull over once they feel drowsy. But drivers tend to make excuses, believing there is no danger because they are just a few minutes from home, or they are not really as tired as they may feel. “The more tired you are, the less able you are to change your behaviour,” such as by pulling off the road for a short rest, said Mikael Ljung Aust, a technical specialist working on drowsiness mitigation technologies at Volvo’s Safety Centre in Gothenburg, Sweden. To encourage drowsy drivers to take a break, Volvo,

with a grant from the European Commission, is studying the effects of offering drivers free coffee once erratic steering wheel movements, lane departures and other signs detect that they are falling asleep, using the navigation system to direct them to the nearest coffee stop. Audi is faced with a unique problem because of its scheduled introduction next year of a car capable of driving up to 35 miles per hour without any driver intervention. When its Traffic Jam Pilot feature is engaged, the vehicle will need to determine if a driver is alert enough to take control after being a passive passenger for long periods. Through its Driver Availability Detection system, sensors will scan the head and face to ensure that the eyes are open and the driver is alert before the car turns over the steering wheel. Advanced drowsiness detection systems exist today. For example, Mercedes’s Attention Assist monitors a driver’s behaviour for the first 20 minutes behind the wheel to get a baseline of behaviours. Then, the system checks those against as many as 90 indexes, such as steering wheel angle, lane deviation and external factors such as wind gusts and pothole avoidance. The system can currently detect drowsiness with 80 percent accuracy, said Christoph von Hugo, head of active safety for Mercedes-Benz. If drowsiness is detected, the driver is alerted to the nearest rest stop.(Julian Note: My seven year old Mercedes has this and I am afraid to admit it has activated a couple of times) For the past decade Volvo has offered its Driver Alert system. “To detect drowsiness, we study the car, not the driver,” said Mr. Aust of Volvo, looking at differences in the ability of the car to stay in lane, and other factors. The system detects drowsiness with 97 percent accuracy, Mr. Aust said. While N.H.T.S.A. reported 824 deaths in 2015 because of drowsiness, that number is likely to be considerably higher, the agency said. Drowsy driving can only be self-reported and not measured like drunkenness. Also, drowsiness is not reported when it is a complication of other factors like excessive drinking. “We’re a nation of tired drivers. People talk about sleep deprivation as if it’s a badge of honour,” said Deborah Hersman, the head of the National Safety Council and the former chairwoman of the National Transportation Safety Board. “As a society we have to realize that drowsy driving is really dangerous.” Until fully autonomous vehicles are a reality, “drowsiness is something everyone needs to worry about,” said Mark R. Rosekind, former head of N.H.T.S.A. and an expert on human fatigue. “Our tendency is to say we’re wide-awake when in reality we can fall asleep in a second.” Still, the obvious solution for a driver who feels fatigued is to pull over and rest. According to Mr. Rosekind, studies with airline pilots show that those who took a nap for 26 minutes improved their performance by 34 percent and alertness by 54 percent, compared with those who did not. Regardless of how good technology is at detecting drowsiness, fighting off sleep is futile. Because sleep is a biological need, the best solution for drivers is still a low-tech one: Pull over and take a nap. Source: The New York Times.

19 Sept 2018 – Stress Busters Happy Wednesday Everyone. Stress and Fatigue are very interlinked. One can be a significant cause of the other. Research from Mintel revealed that stress is a common part of life for most people with a whopping 85% of us in the UK suffering from anxiety or stress at least sometimes. Dr. Marilyn Glenville confirms this, adding that “stress can give you a number of symptoms including moods swings, anxiety, irritability, nervousness, fatigue, forgetfulness, and more. But while you may not be able to control

the stress, you can control how it affects you physically and also make sure you are not making it worse.” This emphasises the importance in looking after yourself both inside and out - and there are simple ways to do this. From scented diffusers, to sleep machines, we’ve gathered the best relaxation gadgets. Ellia Gather – Ultrasonic Aroma Diffuser Essential oils are the simplest and oldest method of reducing stress and improving wellbeing. Whether you opt for rose geranium oil to calm anxiety, lavender oil to encourage sleep or mandarin oil to uplift you, you can create a calming environment with a diffuser. This Ellia Gather ultrasonic option is composed of ceramic and natural wood in a basket weave design. Combining the soothing powers of oils and light, lie down, turn on the diffuser and relax. AVANTEK Sleep White Noise Machine It is widely known that a good night’s sleep is crucial to stress relief. There’s nothing like a long sleep to give you a new lease of life and leave you feeling utterly refreshed. This white noise machine will help you achieve this. With 20 soothing sounds on offer, from waves and rain, to birds and wind sounds, you will be sure to sleep through the whole night with all the disruptive background noises blocked out. Available in black and white to match your décor, there is a sleep timer setting and it is compact enough that it can accompany you on your travels. Terraillon Homni Smart Lamp This is not an ordinary lamp. Developed in collaboration with the European Sleep Centre, this lamp analyses our environment with motion sensors and monitors your sleep. Connect your smartphone so you can review the data or play music through the lamp, which doubles as a speaker. The lamp has both wake-up and sleep programs that use stimulated sunset and sunrises to ensure a natural and gentle wake up. There are also different relaxation programs such as the cardio coherence program to help you de-stress. Milklion Massage Roller Ball While its original purpose is to relieve tight and sore muscles, the massage roller ball also promotes relaxation. Measuring at just the size of your palm, the ball is an easy one hand control and can be used wherever you feel a build-up of stress. There is no electricity or batteries needed, the amount of pressure is controlled by how much you exert. Therefore, if you want a deeper massage, you just have to press harder. There is also a hole in the bottom to fill the ball with massage oil or cream and the compact size makes it easy to pop in your hand luggage when travelling. Head Massager An ideal gift for family and loved ones needing a quick stress relief; the head massager is the simplest way to relaxation. Don’t underestimate the power of this little device that will leave you with goose bumps all over. There are also back scratcher variation available too. Naipo Neck and Back Massager with Heat This neck and back massager will become your new best friend. It has four setting to a truly deep-kneading shiatsu massage to relax and relieve muscle tension. But it is not just limited to the neck and back, you can also use the massager on your shoulder, lumbar, waist, leg, calf, foot or anywhere that needs it due to its versatile shape. With heat and no heat options, it has a car adapter included so that you can use it on long car journeys. Samsung Gear IconX Wireless Earphones A handy running and workout companion, these Samsung earphones have an auto-tracking mode that detects what activity you are doing and logs your time, distance, and calories burnt. You can upload music from your phone directly to the earphones that features interactive taps to change the settings for that crucial phone-free zen time. Just plug in and zone out to the world.

Samesay Breo iSee 3S Electric Eye Massager Mask This stress therapy relief machine particularly targets headaches. There are three modes of air pressure; circulation, medium and hard that stimulate blood circulation around your face and eyes and reduces puffiness and dark circles. With 40 degrees of heat compression and cushion around nose for added comfort, you will not be able to get enough of this star product. It also has a built-in speaker for soothing music, it folds into a compact size and it is rechargeable with a USB cable. Source: Evening standard See you tomorrow.

2.8. Tools – To Help You and Your Teams. 22 Aug 2018 – Meeting Planning Today’s post is about planning and attending meetings which is something a lot of us do on a regular occasion. Do you think about yours and / or yours colleagues fatigue risk when planning meetings? Have you taken the time to think about where your attendees might be travelling from before sending out an invite? The Fatigue Improvement Programme team has pulled together the attached PDF as a reminder to consider and manage yours and others fatigue risk when planning and attending meetings. This won’t necessarily be new information for you, and it should act as a prompt / reminder to ask yourselves these sorts of questions when planning and attending meetings. We hope you find this information useful.

23 Aug 2018 – Fatigue Video Morning everyone! Today the Fatigue Improvement Programme team would like to share a fatigue video with you. This was produced and issued to the business some time ago, and we would like to relaunch it as the message here is very powerful and certainly makes you think about your choices to manage your fatigue risk. The Fatigue Improvement Programme looks forward to sharing future educational material with you throughout the duration of the programme. If you have ideas / thoughts on methods & content of future material for the programme please do get in contact with [email protected] . We look forward to hearing from you. Red-Day-Sleeper-MP4-Video

24 Aug 2018 – Fatigue Safety Hour Happy Friday everyone The Fatigue Improvement Programme (FIP) team has produced a fatigue related safety hour that we would like to share with you. This one is entitled - Fatigue and how it affects you. Please find attached the safety hour in PowerPoint which we encourage you to share with your teams and provide us with some feedback on the effectiveness of this. As a programme we would like to continually produce safety hour content to share with the business relating to fatigue. We welcome your ideas and thoughts about what you would like to see on future safety hours.

28 Aug 2018 – The Fatigue Evaluation Welcome back everyone after the bank holiday weekend. For those of you who have been off over the weekend, I hope you feel well rested. Today we would like to share with you a fatigue evaluation. Whilst answering these questions, reflect back over the last month, and rate yourself between 1 and 5 on all the questions. 1 = always, 2 = often, 3 = sometimes, 4 = rarely, and 5 = never. Once you have answered all the questions add up your scores and check your ratings below. - 15-22 You've got some really positive fatigue management behaviours! - 23-38 You've got some good skills, but need some improvement. - 39-75 You could be more at risk for the effects of Fatigue, look at the highest scores and think about change This evaluation is by no means the full answer to fatigue, and your ratings are personal to yourself.

12 Sept 2018 – Driving Preparations Good Morning Everyone. We all know that driving whilst tired is not acceptable. But there are many other things to consider. The attached is the HSE “Driving at Work” leaflet which provides employers with guidance for managing work-related road safety. Although it is intended for Employers, all of us can take some learnings from it and apply to our daily driving, be it work, or pleasure related. Are you competent? – Do you hold a valid licence? Have you had trailer training? Are you up to date with the latest Highway Code? Are you safe? – Are you well rested? When did you last have alcohol?, Have you checked your vehicles lights, tyres, wheel nuts, wipers etc?, are you wearing your seatbelt? Are you free from distractions? – Is your phone switched off and in the glovebox? Do you know where you are going?, Are you fit and healthy and well rested? – Eyesight? Fatigue and sleep disorders? Medication effects? Are you comfortable? – Driving position?

Is your route the safest route? – Do you actually need to drive? Can you travel with a passenger and share the driving? Can you travel at a safer time? Have you taken into account the type of vehicle you are driving?, Do you know the risks on route such as low bridges, level crossings etc. Have you allowed plenty of time? – Have you built in sufficient breaks? Have you taken account of weather conditions? Source: HSE

17 Sept 2018 – The Fatigue Evaluation Good morning all, Today we would like to share with you a fatigue evaluation. This evaluation is something personal to yourself, and your scores do not need to be shared / discussed with others. Whilst answering these questions, reflect back over the last month, and rate yourself between 1 and 5 on all the questions. 1 = always, 2 = often, 3 = sometimes, 4 = rarely, and 5 = never.

Once you have answered all the questions add up your scores and check your ratings below. - 15-22 You've got some really positive fatigue management behaviours! - 23-38 You've got some good skills, but need some improvement. - 39-75 You could be more at risk for the effects of Fatigue, look at the highest scores and think about change This evaluation is by no means the full answer to fatigue, and your ratings are personal to yourself. If your score comes out higher than you thought, ask yourself - what could I do to improve my fatigue score? You could consider some small changes to help better manage your fatigue and then retake the evaluation in a couple of weeks time to see if things have changed. Have a good week all.

20 Sept 2018 – Describing Fatigue Welcome the Thursday one and all.

Whilst researching for these daily Fatigue Factlets I came across this interesting article from the MS Trust. Whilst it centres on Fatigue for those suffering MS it does have potential meaning for others.

Describing Fatigue to Others

Attempting to describe fatigue to someone who has never experienced it before can be a thankless task. As an invisible symptom of MS, people often don’t understand the sheer scale of what you’re going through. Here, Jane from our Information Team offers some advice on how best to explain what you're feeling to others.

What is it like to have fatigue (it is really awful) and how can we explain fatigue to others who have never experienced it? (almost impossible)

Fatigue is a common symptom in MS but seems to be invisible to most other people. This can seem incredible to the person who is experiencing fatigue as they may be leaning against the wall or holding onto their shopping trolley or the arms of their chair as if their life depended on it.

Would it be useful to be able to explain fatigue to other people so that they understood more about the difficulties and how much fatigue can vary from day to day or from morning to afternoon? Well, yes it would, but is this possible if they’ve never experienced fatigue themselves?

Perhaps the best place to start is to tell people what it isn’t. Fatigue is not sleepy tiredness. It won’t be sorted out by having a good night’s sleep or a kip in the afternoon. Of course, somebody can be sleepy tired as well as fatigued. For example, if they’ve had trouble sleeping due to pain or spasms, then a good sleep will help that side of things but not really their fatigue.

Fatigue is worse for some people than others. It can vary from one day to the next so predicting what you can do is really hard. Bad fatigue for one person might be really struggling at work. For someone else, it could be barely being able to cross the road for a pint of milk (despite being at home resting all day). For another person, it might be getting from the bed to the toilet only by clinging on to furniture and door frames. Fatigue is a big deal.

But this just says what it is hard to do when you have fatigue. What does it actually feel like?

Not everyone experiences fatigue the same way. In our book Living with Fatigue, people with MS describe their own experiences. Here are a few:

“As a physical sensation it reminds me of falling into quicksand/a swamp – it’s a viscous, heavy, pulling feeling, but if I try to fight it, it hurts like hell and robs me of breath. As a sound, it’s like a muted background noise of violins, scratching away, that seem to be ever increasing in speed and out of sync – while the outside world seems dampened and fading”

“Fatigue feels like being weighed down, as if you are trying to walk up to your neck in a deep, muddy river in heavy, wet clothes carrying shopping bags full of rocks”

“Fatigue feels as if I am an inflatable, and someone has pulled the airstopper out! My brain goes fuzzy and I can’t think clearly, my speech slurs, my eyesight goes and my eyes start to close – I think the room is full of smoke! Swallowing becomes more difficult, my balance gets worse, my legs feel heavy and clumsy”

These are great descriptions and should help someone who has never had fatigue have a better understanding of what it’s like.

A hangover, jet lag and the flu

Another way of explaining is to try and relate the feelings of fatigue to experiences that most people have had before. That way they should access their own memories and, hopefully, feel again the heaviness or disorientation or other unwelcome sensations so that they feel it rather than imagine it in a rather theoretical sort of way.

You could try this:

Firstly, ask them to remember the worst hangover they’ve ever had. Get them to think about what the circumstances were, exactly how they felt when they tried to get out of bed, how they staggered downstairs and how rough they felt for the rest of the day. Ask them to relive the memory strongly for a moment and then file it for later.

Then ask them to think about the worst jet lag they’ve ever had. How exhausted and disorientated were they? Did they feel almost sick? Did they feel really tired but couldn’t sleep at the right time of day? Ask them to bring this experience strongly to mind and then store that memory for a moment.

Now ask them to recall the worst flu they’ve ever had. How awful they felt all over their body, how getting out of bed was a struggle or almost impossible, how every little thing made them feel worse.

The next step is to get them to imagine what it might be like to have all three (a hangover, jet lag and flu) at the same time, to recall both the physical and the mental feelings. Horrendous! How bad would that be?

Now ramp it up and ask them to imagine that everything is ten times worse than they just imagined. It could be almost like going unconscious – a bit like fainting but without the woozy- sick sort of feeling. This is becoming unimaginable for anyone who has not been there but hopefully it makes the point about how bad fatigue can be. The frequently heard comment that “everyone gets tired sometimes” is way off the mark.

Although fatigue is very common in MS, it is possible to decrease fatigue and free up some energy. Fatigue management involves pacing yourself and using what energy you have for the most important things. It may involve asking others to help out or just accepting that not everything will get done. You can read more about managing fatigue in the A to Z of MS or about the invisible symptoms of MS in our blog.

Source: mistrust.org.uk

Tomorrow we publish the Fatiguepedia which brings together all of these daily factlets together into a handy reference document.

2.9. Miscellaneous – General Fatigue Factlets. 6 July 2018 – Fatigue Awareness Week 2019 Good morning everyone – today’s post is about Fatigue Awareness Week 2019. The Fatigue Improvement Programme team are starting to make plans for a Fatigue Awareness Week (11th to 15th March 2019) centered around World Sleep Day on Friday 15th March 2019. We realise it’s very early in the planning phase, however we are really keen to understand what you would like to see and hear about during an awareness week, so please post your ideas below. World Sleep Day is designed to raise awareness of sleep as a human privilege that is often compromised by the habits of modern life. World Sleep Day is an annual event, intended to be a celebration of sleep and a call to action on important issues related to sleep, including medicine, education, social aspects and driving. It is organised by the World Sleep Day Committee of World Sleep Society (founded by WASM and WSF), and aims to lessen the burden of sleep problems on society through better prevention and management of sleep disorders. World Sleep Day is held the Friday before Spring Vernal Equinox of each year. http://worldsleepday.org/ We are working very closely with our Health and Wellbeing team and our current thoughts are fatigue awareness days nationally (please post ideas of locations) to enhance the understanding of the programme and fatigue, guest speakers about Fatigue and sleep, sleep tracker / fatigue watch demonstrations & engagement with sleep & fatigue related charities. We look forward to hearing your ideas, and including them as part of Fatigue Awareness Week 2019.

13 July 2018 – Recording Fatigue To improve the management of fatigue across the business, one of the first aims has to be to raise awareness; helping people to recognise the signs and providing ideas to combat the effects. We hope that you are finding this yammer group helpful towards achieving that. To continue to help the business manage fatigue on an ongoing basis, one of the starting points is for us to have a clear picture on current levels of fatigue and future progress. With that in mind; Did you know – you can record fatigue as a reason for absence via Oracle. Once you have selected ‘Symptoms and Ill-Defined Conditions as the Absence Reason, you will be able to search for ‘Fatigue’ using the Sickness Medical Reason field (see below).

So what do we consider when recording absence? How much do we consider fatigue? More food for thought to come on Monday!

http://worldsleepday.org/

25 July 2018 – History of the Bed Hello once again. We all look forward to getting there and we all want to stay there when it is time to leave: I am talking, of course, about the bed. But has anyone ever thought about the history of the bed? Well todays factlet is a short history.

Neolithic period (4000 B.C): The mattress and bed are invented. Beds are raised off the ground to avoid drafts, dirt, and pests. The first mattress probably consists of a pile of leaves, grass, or possibly straw, with animal skins over it.

3600 B.C.: Beds made of goatskins filled with water are used in Persia.

3400 B.C.: Egyptians sleep on palm boughs heaped in the corners of their homes.

200 B.C.: Mattresses in Ancient Rome consist of bags of cloth stuffed with reeds, hay, or wool; the wealthy use feather stuffing.

15th century: During the Renaissance, mattresses are made of pea shucks, straw, or sometimes feathers, stuffed into coarse ticks, and covered with velvets, brocades, or silks.

16th and 17th centuries: During the Renaissance, mattresses are made of pea shucks, straw, or sometimes feathers, stuffed into coarse ticks, and covered with velvets, brocades, or silks.

Early 18th century: Mattresses are stuffed with cotton or wool.

Mid 18th century: Mattress covers begin to be made of quality linen or cotton. The mattress cane box is shaped or bordered, and fillings include natural fibres such as coconut fibre, cotton, wool, and horsehair. The mattress is tufted or buttoned to attach the stuffing to the cover and the edges are stitched.

1857: The steel coil spring is invented and is first patented for use in chair seats.

1865: The first coil spring construction for bedding is patented.

1871: The German Heinrich Westphal invents the innerspring mattress. He later died in poverty, never having profited from his invention.

1873: Sir James Paget presents a waterbed designed by Neil Arnott to St. Bartholomew's Hospital as a treatment and prevention of pressure ulcers.

1895: A few waterbeds, which resemble large hot water bottles, are sold via mail order by the British store Harrod's.

Late 19th century: The box-spring is invented, making mattresses less lumpy.

1904: Kingsdown opens first factory.

1929: The most expensive mattresses are constructed of latex rubber and are produced by Dunlopillow.

1930s: Innerspring mattresses and upholstered foundations become widely used, and artificial fillers become common. Pocket spring mattresses, which consist of individual springs sewn into linked fabric bags, are introduced.

1940s: The futon is introduced in North America.

1950s: Foam rubber mattresses and pillows are available for purchase.

1960s: The modern waterbed is introduced and gains its first widespread use with the invention of vinyl. Adjustable beds gain popularity.

1980s: Air mattresses constructed of vinyl are introduced.

1990: Spacious sleeping is once again on the rise.

1999: The queen-size mattress became America's most popular choice for mattress size - for the first time ever - beating the twin.

2000's: Choice and comfort are key words in contemporary bedding. In addition to an almost unlimited range of innerspring mattress designs, new types of foam mattress cores (such as "memory" or visco-elastic foam and refinements to traditional latex) as well as air beds, waterbeds and high-tech adjustable sleep sets offer consumers attractive, quality alternatives. Pillow top mattresses, a popular innovation in luxury, offer an extra layer of soft cushioning, and single-sided no-flip mattresses are common.

06 Aug 2018 – Arianna Huffington Welcome to Monday everyone. Today I am going to post about Arianna Huffington. Arianna Huffington is a Greek-American author, syndicated columnist, and businesswoman. Huffington was the co-founder and editor-in-chief of The Huffington Post. She was #12 in Forbes's first-ever list of the Most Influential Women In Media. In 2014, she was listed by Forbes as the 52nd Most Powerful Woman in the World. Arianna Huffington says she became successful after she quit one common bad habit. One day in 2007, Arianna Huffington was at home on the phone and checking emails when she passed out, fell, and woke up in a pool of blood, with a broken cheekbone and a cut over her eye. Huffington, who had been working 18-hour days building the Huffington Post website, was terrified. After weeks of medical tests, doctors finally came back with a simple, if disturbing, answer: She was exhausted. Though critics may point out that she managed to establish a successful media company, the Huffington Post, after years of losing sleep and prior to becoming a champion for wellness and balance, Huffington says that's not the case. Contrary to popular belief, she tells CNBC that she truly became successful when she quit working round-the-clock. "I have to assure you that the success at the Huffington Post happened after I started taking care of myself," says Huffington. Huffington adds that it's a "complete delusion" that if you get little sleep and take poor care of yourself, you are going to be more productive. "I'm not saying that you can't succeed by burning out. But you can succeed much more effectively, and much more sustainably, and with much less damage to your health and your relationships," says Huffington. "That's why they tell you on airplanes, put your own oxygen mask on first." Prior to finding balance in her life, says Huffington, she made bad decisions. Though the businesswoman would not specify what those were, she notes that other successful people have alluded to the importance of a full night's rest. Amazon founder Jeff Bezos, for example, prioritizes getting at least eight hours of sleep. Real rest "makes a big difference for me, and I try hard to make that a priority," he told Thrive Global in 2016. "For me, that's the needed amount to feel energized and excited." Microsoft co-founder Bill Gates also admitted that he can't think creatively if he isn't well rested. "I used to work all night in the office, but it's been quite a while since I lived on catnap," says Gates in a Microsoft FAQ. "I like to get seven hours of sleep a night because that's what I need to stay sharp and creative and upbeat." The more fully recharged and connected you are, Huffington contends, the more clearly you can look ahead. And "for me [looking ahead] was making sure that Huffington Post was a global company," she says. Looking ahead also meant knowing when the time had come for her to leave the media company, which she did in 2016. "I see some people stay in one place because it's convenient or it's comfortable. But they're missing out on their passion," says Huffington. "My passion is to help people live lives with less stress ... so thinking I could take that risk, and do it, and follow my new dream was something I wouldn't have done if I was simply operating on survival."

"Huffington Post was only a two-year-old baby when I collapsed," says Huffington, noting that the company had not yet achieved the influence and readership that it has today. After coming to realize the importance of sleep, Huffington started to see a difference in her work style and that's when, she says, her business began to grow. "I can tell you with authority that when I'm exhausted, when I'm running on empty, I'm the worst version of myself," says the entrepreneur. "I'm more reactive. I'm less empathetic. I'm less creative. And all of us can testify to that."

29 Aug 2018 – Exxon Valdez Good Morning Everyone. Today I post the first in a series of posts, over the coming weeks, of disasters that have occurred where fatigue has been a contributory factor. These bring home the consequences of fatigue and why we all need to manage our own and others. Exxon Valdez Oil Spill Anyone who has driven for too long or without enough sleep can attest to how difficult it is to stay within those narrow-painted lines on the road. Imagine the consequences of being at the helm of an oil super tanker with hardly any sleep at all. The results are just as you would expect. Considered to be one of the worst environmental disasters of all time, the Exxon Valdez oil spill dumped almost 42 million litres (11 million gal) of oil into Prince William Sound off the coast of Alaska on March 24, 1989. The vessel was headed for Long Beach, California, on a route that the Exxon Shipping Company had traversed over 8,700 times in the previous 12 years. So, this disaster came as a total surprise, although maybe it shouldn’t have. Captain Joseph Hazelwood was ultimately responsible for navigating the 300-meter (987 ft) ship through familiar waters to its destination. Unfortunately, the captain had downed a few drinks more than he should have and wound up turning over the helm to sleep-deprived Third Mate Gregory Cousins. Cousins was barely functioning because he had slept only six hours in the previous two days. Shortly after midnight, the Exxon Valdez collided with Bligh Reef, a well-known hazard on this route, which ruptured 8 of the vessel’s 11 cargo tanks. The super tanker called for help immediately, but it didn’t matter. Though there were no human lives lost, the damage to the environment and wildlife was already done. The wheelhouse contained a Pilot, Captain, Helsman and Third Mate, all of whom played their specific role in manoeuvring the vessel through the Valdez Narrows and around icebergs. Fatigue is speculated to be a contributing cause to the Third Mate inability to return the vessel back to its correct lane before it struck the reef. It’s alleged the Third Mate had inadequate sleep, in fact, supposedly only one “cat nap” (that may not have lasted more than two hours) in the 16 hours leading up to the disaster. A disturbing statement came from the Third Mate’s boss, who said that fatigue is simply part of the job: “This is just normal to me … this is how you will work … this is what is expected of you.” What kind of disaster has to happen before high-risk industries take the dangers and outcomes of fatigue seriously? The Exxon Valdez spill continues to hold the No. 1 spot for the costliest maritime accident of all time. Hundreds of miles of coastline were completely destroyed along with the ecosystem there. Source: Listverse.com and Optalert.com

03 Sept 2018 – Sleep in the Animal Kingdom Welcome to Monday everyone. Humans may rule the Earth, but the world is full of amazing animals of all shapes and sizes, and we're only just starting to learn how truly remarkable they are. Todays post is about amazing animals and their sleeping habits. When it comes to sleep, scientists still don't fully understand the ins and outs of it. We know that sleep is an essential part of life (total sleep deprivation leads to death), but we're still unsure as to the reasons why sleep is so important. Studying the various different sleeping habits of other animals, can help scientists crack the puzzle of sleep. Did you know that certain marine animals can sleep underwater? And that some migrating birds can fly for six months straight without ever touching the ground? Dolphins and whales have the ability to sleep with only one-half of their brain at a time. This prevents them from drowning in their sleep. The method is known as “logging” and it has been observed in bottlenose dolphins. During sleep, the bottlenose dolphin shuts down only half of its brain, whilst the other half remains ‘awake’ at a low level of alertness. This allows the dolphin to retain control of their blowhole (through which they breathe), preventing them from drowning. Although still a matter of discussion, most researchers feel that in order to breathe, a dolphin or whale must be conscious and alert to recognize its blowhole is at the surface. Sea Otters will sometimes hold hands when they sleep so they don't drift away from each other. Sea otters often eat, rest, and sleep together while floating in groups called rafts. A raft may have a few otters, or hundreds! Rafting sea otters sometimes “hold hands” to stay together. Giraffes can go weeks without sleep. Being large and rather slow animals, they're constantly vulnerable to attacks from predators, and therefore cannot sleep for long periods. Giraffes have developed some pretty unique sleeping habits, and sleep the least of any mammal. When they're young, giraffes lay down to sleep, tucking their legs underneath their bodies and curling their heads round to rest on their rumps. However, adult giraffes in the wild barely get a chance to sleep in such luxury; and are forced instead to sleep standing up in short bursts. In fact, they almost never sleep for longer than 5 minutes at a time. Migrating birds can sleep whilst flying. Some species of birds fly for 6 months straight migrating, drinking and sleeping whilst airborne. Scientists have found that migrating birds can fly for 200 days straight, eating and sleeping while soaring through the sky. The Alpine swift was studied by a group of scientists in 2011, and it was

discovered that they appeared to fly nonstop. The swifts eat bugs in mid-air, so that explains why they don't starve. But the results "raise the question of how or whether these birds sleep". The swift’s activity appeared to raise and fall during flight, and the researchers speculate that the birds might still be able to control their flying while sleeping. The team concludes that "swifts do at least to some extent sleep while airborne." - Conservation Magazine Cows like to sleep close to their families, and sleeping arrangements are determined by individuals' rank in the social hierarchy. Cows are actually very intelligent, and have a social hierarchy with a ‘boss’ cow. Any cows that don’t follow the leader become isolated from the herd. Cows are also known to have deep maternal instincts. There have been various stories of cows who have hidden their babies and ran away from farmers. Horses, Zebras and Elephants can sleep standing up. This is because they are 'prey' animals, and need to remain alert in case they are attacked. Horses, zebras and elephants are just 3 examples of animals that can sleep standing up, because it allows them to quickly escape an attack by a predator (the process of standing up can be slow and clumsy). However, horses, zebras and elephants will lie down when they require REM (Rapid Eye Movement) sleep. Typically, the amount of REM sleep they require is very small, so they don’t need to lie down often. Source: mybedframes.co.uk See you tomorrow.

05 Sept 2018 – 3 Mile Island Good Morning All Hope we are all well rested today! We will continue our series on major disasters that have occurred as a result of fatigued individuals. At approximately 4:00 AM on March 28, 1979, on the Three Mile Island Nuclear Generating Station (Pennsylvania, USA) an avoidable accident occurred at the Three Mile Island nuclear reactor. A valve became stuck open in the secondary nonnuclear section of the plant and began to leak coolant everywhere. The valve had opened automatically to relieve the pressure after a mechanical failure had prevented water from reaching the steam generators, which was intended to keep the reactors cool. The valve should have closed on its own when the pressure was stabilized, but it did not. Instruments in the control room showed the valve as closed. By the time the crew was able to locate the source of the problem, the reactor’s core had melted. Unaware that they were dealing with a cooling problem, crew members ultimately made decisions that worsened the situation. The problem was complex enough, but when fatigue was added into the mix, they had the perfect recipe for disaster. Investigators eventually ruled that sleep deprivation was a significant factor. The aftermath was devastating. It took 12 years to clean up the mess and cost around $1 billion. Hundreds were sickened within the immediate area, and many animals and plants perished. The TMI-2 reactor has since been shut down permanently.

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