As a night nurse for 23 years, Monica Aurilio, BSN, RN, nurse-in-charge on Braunwald Tower 10CD and 12B, has become well-acquainted with how sleep and fatigue affect wellness.
So, when Aurilio heard about the Sleep Health and Wellness (SHAW) Program, a free educational and screening program geared to employees at the Brigham, she was excited to enroll.
“Being a night nurse for my entire career, I have a particular interest in sleep deprivation and fatigue issues,” she said. “It was wonderful to see a program that covers sleep health and strategies for improving sleep.”
Originally launched 15 years ago as a nationwide study of first responders, the SHAW Program comes home to the Brigham this year as a free service for faculty, staff and trainees. Building on a strong research foundation laid out by Brigham investigators, the program seeks to change the culture of sleep and improve health, safety, performance and well-being for employees at the Brigham and beyond.
The program is among the cornerstones of the Sleep Matters Initiative, a clinical and research program of the Division of Sleep and Circadian Disorders. Established more than two decades ago by a Brigham team of sleep experts — led by Charles Czeisler, MD, PhD, FRCP, division chief — Sleep Matters has provided sleep health education and/or sleep disorders screening to more than 30,000 people. It has served physicians, nurses and other health care workers, police officers, firefighters, federal air marshals and even astronauts.
“Sleep deficiency is a serious public health issue, and it is rampant among many employee populations,” Czeisler said. “Promoting healthy sleep is a win-win for both employers and employees, enhancing quality of life and longevity for workers while improving productivity and reducing health care costs for employers.”
Helping Those Who Help Others
The SHAW Program includes a one-hour, expert-led session in a small-group setting. After learning how sleep affects our health and ways to improve sleep hygiene, attendees are invited to complete a questionnaire on an iPad to screen for common sleep disorders. About one in three people have a sleep or circadian disorder, and 90 percent are undiagnosed and untreated. Those who screen positive through the SHAW Program can immediately schedule a follow-up diagnostic evaluation and, if needed, treatment.
After attending the in-person session, enrollees receive sleep tips and personal challenges via email for six months to help maintain momentum on healthy sleep practices.
About half of physicians and nurses nationwide report symptoms of burnout, including emotional exhaustion, depersonalization and perceived lack of accomplishment. Stuart Quan, MD, clinical chief and medical director of the Brigham’s Sleep Disorders Service, points out that the symptoms of burnout and sleep issues are similar.
“Sleep and burnout are so closely related,” said Quan. “There are a lot of studies looking at how to make wellness improvements, such as offering benefits to help employees stop smoking or lose weight. We’re looking to demonstrate that a sleep intervention program delivers a return on investment. If we can improve the sleep health of health care professionals, we may be able to help improve the sleep health of society in general.”
Aurilio, who has a longstanding interest in self-care for health care providers, was so impressed with the SHAW Program that she wants to help increase awareness of it among her nurse colleagues.
“I believe that many employees at the Brigham work long hours and could benefit from such a program,” she said. “I would like to expose them to those strategies for self-care.”
Measuring the Impact
Last year, the Sleep Matters team received a Partners HealthCare Innovation grant to study the impact of fatigue in the workplace. In an interim analysis of nearly 1,000 Brigham employees, the team found that 94 percent of people who screened positive for a sleep disorder were previously undiagnosed or untreated, and that positive sleep disorder screening was associated with nearly four-fold increased odds of burnout.
While a limited follow-up analysis has not yet shown a change in the prevalence of burnout, early results are promising. Six months after participating in the SHAW Program, 86 percent of participants reported going to bed earlier; 53 percent reported prioritizing sleep; and 43 percent made sleep clinic appointments. And 90 percent of participants considered the program important and helpful and said they would recommend it to others.
“When you change the culture of sleep, it can make an extraordinary difference in people’s lives,” said Czeisler.
SHAW Program sessions are ongoing. To sign up, visit brighamandwomens.org/calendar.For questions, email firstname.lastname@example.org or call 617-525-2617. For more information about the services provided by Sleep Matters Initiative, visit brighamandwomens.org/sleepmatters.