Written by Managing Principal Consultant Sarah Booth
March 14th marks the 2025 edition of World Sleep Day, an annual event designed to raise awareness of sleep and provide evidence-based information to those who need it.
The theme this year is Make Sleep Health a Priority. Increasingly, we are recognising sleep health in a more holistic manner, not simply focussing on sleep duration, but adding in sleep quality, the timing of our sleep and (potentially most importantly in the short-term) how it makes us feel. Are we waking in the morning feeling ready to take on the day (maybe after a coffee), or is it a struggle with the snooze button and dragging ourselves out of bed far too soon after falling into it?
Growing sleep awareness
Many of us have developed an increasing interest in our sleep in recent years – from recognising the importance of sleep for our long-term health, to changing working patterns for some that may have allowed us to embrace our natural sleep-wake cycles a little more rather than falling into the 9-5 office day that suits larks much more than owls.
However, many of these conversations still focus on the duration of our sleep, targeting the ‘magic 8 hours’ or mathematically working out the ‘best’ bedtime by taking your wake time and working backwards in 90-minute cycles so that you wake from light sleep. Whilst these strategies contain some truth, they may not help everyone (around 90% of us need somewhere between 7-9 hours of sleep to be at our best; 8 hours just happens to be in the middle. Average sleep cycles are said to be 90 minutes, but the balance of sleep within the cycle does vary through the night. Not everyone is average, and what if you need extra time to fall asleep?). Considering sleep health as a whole helps us to think more broadly about how we might improve our sleep (if we want to), where small changes in multiple areas can add up to an overall sleep improvement.
Pressure is sleep's worst enemy
Firstly, it is important to say that with many elements relating to sleep, if you put too much pressure on your sleep, trying to force improvements, it may backfire. Victor Frankl said that ‘sleep is like a dove, which has landed near one’s hand and stays there so long as one does not pay any attention to it’. If you don’t have any issues with your sleep, carry on doing what you are doing, clearly, it is working. If you do see the potential for improvement, try making some changes and see what happens. Just try and avoid placing pressure and stress on your sleep – as that is one thing guaranteed to make sleep worse.
RU-SATED model
There are several ways that we can define sleep health, there isn’t a single agreed-upon definition. One approach that I like to use, and is contained in some of our training courses, is the RU-SATED model developed by Professor Daniel Buysee in 2014.
The RU-SATED model consists of 6 elements of sleep health, which are scored in terms of how often you experience each of the positive statements. Lower total scores indicate poorer sleep health, whilst higher total scores reflect better sleep health.
|
Element |
Question |
Scoring Options |
|
Regularity |
Do you go to bed and get out of bed at about the same time (within one hour) every day? |
Never / Rarely (0 points) Sometimes (1 point) Usually / Always (2 points) |
|
Satisfaction |
Are you satisfied with your sleep? |
|
|
Alertness |
Do you stay awake all day without dozing? |
|
|
Timing |
Is the middle of your sleep between 0200 – 0400? |
|
|
Efficiency |
Do you spend less than 30 minutes awake at night? This includes the time it takes to fall asleep plus awakenings during sleep |
|
|
Duration |
Do you sleep between 7 and 9 hours per day? |
Some of these elements are challenging if you are a shift worker; working rotating or differently timed shifts can make it impossible to go to sleep and wake up at the same time every day. You may be regularly dissatisfied with your sleep, which might be linked to the timing – having to sleep during the day will be associated with poorer sleep quality, lower efficiency, less likely to fall asleep at all, and probably lower satisfaction then if we can sleep during the time our circadian rhythm supports the best sleep.
Challenges of managing sleep health
This is one of the reasons why managing fatigue, sleep, and overall health is more challenging in a shift work environment. Work that drives us to sleep in a way that is less compatible with our sleep health will reduce the sleep that we obtain and increase fatigue levels. Mitigating these elements to try and move towards improvements is a more realistic strategy than trying to fix them all. For example, wherever possible, you should try to make sure that some of your sleep period occurs in the window 0200-0400. If you cannot have your full 7-9 hours of sleep that touches this window due to late finishes or very early starts, then a concept called ‘anchor sleep’ could help. An anchor sleep period is a short/not full sleep period that occurs in your body clock window of circadian low (WOCL) – between 0200-0600. Then you have a second sleep to increase the total sleep in 24 hours – the timing of which is probably determined by your work schedule.
Good sleep health supports our mental and physical health – topics that we are focussing on this week in the lead-up to World Sleep Day. Be sure to follow us on LinkedIn to see our latest updates and check out our collection of FRM white papers exploring a range of sleep and fatigue topics.
Do you manage a shift-working team of safety-critical staff? We can help you understand their sleep patterns and how this contributes to the risk in your organisation. To find out more, contact us at +44 (0)1276 535 725 or enquires@bainessimmons.com.
We offer a range of Fatigue Risk Management (FRM) services, from Building and Implementing Effective FRM to Developing Competence to Manage Fatigue Risk, as well as training with our Understanding How to Manage Fatigue Risk course. To discuss your FRM challenges and how we can best support you, speak to our experts at enquires@bainessimmons.com.