I`ve had a recent discussion with another OH service that allows people with such problems (and things like CFS) to use the OH dept and their couch for "power naps" during the day. The rationale being that by allowing this they are keeping people at work. I can see all sorts of logistical problems with this approach, especially with an ever increasing demand on "space" - and cant make up my mind whether its a good idea or not....?

Date: Fri, 18 May 2012 09:21:33 +0100
From: [log in to unmask]
Subject: Re: [OCC-HEALTH] Insomnia
To: [log in to unmask]

Hello Sharon (and the rest of the list)


This is an interesting conundrum in the main because an individual does not appear to appreciate the potentially problems due to this condition / impact on their decision making processes etc as opposed to trying to avoid any particular work situations. 


I have already pointed them towards proper assessment etc.


Also am considering possible 'other' factors that would potentially 'help' a person to stay awake for several days at a time.


Ultimately I believe this to be a management issue in terms of performance problems.


Heather Bearpark

From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of sharon naylor
Sent: 17 May 2012 18:09
To: [log in to unmask]
Subject: Re: [OCC-HEALTH] Insomnia


 I have three people on my case load at the mo with sleep difficulties.
 One is citing "insomnia" as a reason not to be moved to an area where she will have more frequent night shifts, backed up with an unsolicited letter of support from the GP stating that individual had depression ages ago and fears a relapse if she does the shift rotation required, however apart from a past prescription for anti depressants has had no investigation nor treatment into her apparent difficulties (which appear to be that she stays awake for ages before dropping off, and then sleeps for about 4 -5 hours.)  Historically she has objected to moves because of possibly having to work opposite weekends to her partner, and the new shift pattern would likely mean this also. Management have declined her appeal after having sight of the GP report (it was addressed to her line manager), my input was to say that the views of her treating clinician were clear, and that without further evidence I did not feel I could add any more.
Case 2 has a myriad of problems which GP thinks may be related to sleep apnoea, referral to local clinic within weeks, is having an overnight assessment with pulse oximeter etc ASAP, he is working "normally" but struggles during the day with yawning, sleepiness etc. My involvement at the moment is advising him on various lifestyle issues that may be affecting him and this potential diagnosis.


Case 3 - sleep apnoea, well investigated and documented, struggles at work if he doesnt keep busy and would prefer to not work in an area that would involve long periods of looking at monitors as he fears he may "drop off". Has cited this as an appeal against job rotation into such an area. Reasonable in my view, and due to the nature of the business and the security critical role management have agreed to his request


I think my point is that "insomnia" is a fairly nebulous term, is very subjective and can mean different things to different people, (and also may be used as a pressure to ensure a desired outcome?) The last two cases above are working normally - case 1 is now taking recurrent short term absences citing "insomnia" but reports that no further referral is planned. I think that unless there is evidence that the problems are in fact emanating from a "clinical" issue its very difficult to advise or predict outcomes. If someone is in a safety critical role where fatigue may adversely affect performance maybe a fair amount could be achieved by management scrutiny of performance/work tasks rather than OH being required to predict outcomes on what appears to be fairly vague information. I would not be that chuffed to be put in a position where i was being asked whether an individual would be able to "cope" with a work practise because they have reported "insomnia" without a bit more relevant detail. Unless I`ve missed the point of your question...?


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