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About Sleep Disorder
Several types of sleep disorders exist and have various symptoms. Insomnia, sleep apnea, narcolepsy, and restless legs syndrome are among the most common. Sleep disorders are neurological conditions that change the way you sleep. They can affect general health, safety and quality of life. Sleep deprivation can affect your ability to drive safely and increase your risk of other health problems.
Some of the signs and symptoms of sleep disorders include excessive daytime sleepiness, irregular breathing or increased movement during sleep, and difficulty falling asleep. There are many different types of sleep disorders. They're often grouped into categories that explain why they happen or how they affect you. Sleep disorders can also be grouped according to behaviors, problems with your natural sleep-wake cycles, breathing problems, difficulty sleeping or how sleepy you feel during the day.
Some common types of sleep disorders include:
• Insomnia involves difficulty falling asleep or staying asleep throughout the night.
• Sleep apnea, in which you experience abnormal patterns in breathing while you are asleep. There are several types of sleep apnea.
• Restless legs syndrome (RLS), a type of sleep movement disorder. Restless legs syndrome, also called Willis-Ekbom disease, causes an uncomfortable sensation and an urge to move the legs while you try to fall asleep.
• Narcolepsy, a condition characterized by extreme sleepiness during the day and falling asleep suddenly during the day.
There are many ways to help diagnose sleep disorders. Doctors can usually treat most sleep disorders effectively once they're correctly diagnosed. Accommodation may help individuals adjust during treatment or to new sleep patterns.
JAN's Accommodation Solutions: Executive Functioning Deficits is a publication detailing accommodations for individuals with limitations related to executive functioning. These ideas may be helpful in determining accommodations.
Sleep Disorder and the Americans with Disabilities Act
The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Sleep Disorder
People with sleep disorders may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people who are aging will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.
A new university employee attending out-of-town training for the first time realizes that he will be required to share a room with a co-worker.
He asks for an accommodation of his own room so that his sleep disorder and the use of a CPAP machine will remain confidential. His employer agrees. Although the employer stated that the feasibility of the accommodation may need to be evaluated each time a separate room was required, at this time there would be no financial hardship in providing this employee with the accommodation of his own room.
An employer requests medical documentation from an employee to substantiate the need for an adjustable desk that she says will keep her awake.
The employee states that she was diagnosed with narcolepsy many years ago, but has no current documentation and has no desire to go through medical channels again. The employer suggests some simpler, less expensive accommodations to help, but denies the request to purchase the desk without medical documentation that confirms the disability and the need for the product.
Due to ongoing issues related to a sleep disorder, a law enforcement officer who works daytime shift asks for the accommodation of not being called out during the evenings and weekends.
Due to the nature of the area, officers are called out when needed to handle situations that require extra personnel, frequently in the evenings and on weekends. The employer determined that it was an essential function of the officer’s position to be ready and available at all times. The accommodation was denied, and the employer began looking for a position for the officer where nights and weekends would not be required.
A long-term employee with a sleep disorder has begun to have difficulty completing the mandatory overtime recently instated by the employer.
The employee is fatigued, inattentive, and has trouble getting through his regular schedule at times. He discloses to his employer and asks to be exempt from the overtime. After much discussion with the employee and the consideration of medical information from his doctor, the employer agrees to exempt the employee from some of the overtime, but isn’t able to take him completely off of the schedule. The employer states a business need requires all hands on deck during the busiest seasonal times.
A financial analyst with sleep apnea often fell asleep while working at her computer.
The employer provided her with a small device called a Doze Alert that fits in her ear and sounds whenever her head starts to drop forward as she falls asleep.
A veteran, who is now a delivery truck driver, had PTSD that resulted in a sleep disorder.
He was having difficulty with his nightshift schedule. His employer transferred him to a dayshift when an opening became available.
A customer service representative with hypersomnia had difficulty waking up for his morning schedule, which resulted in him being late for his shift.
The employer accommodated him by moving him to the afternoon shift.
An employee who has recently been diagnosed with hypersomnia and takes new medications continues to struggle with getting to work on time.
Her employer agrees to a temporary flexible schedule during the current “quiet” period while she adjusts to the medications her doctor feels will be effective. A more long-term solution of a shift change was brought up by the employee as a possibility if the flex schedule proves unsuccessful. They also looked at accommodations to help her remain more alert throughout the day.
A nurse with fibromyalgia working in a county health clinic experienced a great deal of fatigue and pain at work.
The nurse typically worked evening shifts, but her doctor recommended a schedule change so she could regulate her sleep patterns. Accommodation suggestions included changing her shift from evening to day, restructuring the work schedule to eliminate working two consecutive twelve hour shifts, reducing the number of hours worked to part time, and taking frequent rest breaks.
An employee at a manufacturing site had been successfully working the second shift with seasonal affective disorder (SAD).
He experienced fatigue and difficulty with concentration due to disruption of his sleep patterns and couldn’t work the early shift a new manager assigned him to. The employee was accommodated with the ability to remain on his current shift. The new manager found many employees willing to switch and work the day shift.
A grocery store bagger with seasonable affective disorder (SAD) had difficulty working an early schedule due to oversleeping.
She also experienced fatigue and depression during late fall and winter months. She was accommodated with an afternoon schedule and was moved to the front of the store, which had windows that let sunlight enter her workspace.
An applicant with hyperthyroidism disclosed that she has difficulty sleeping because of her condition and may have problems making it into work punctually.
The employer agrees to allow the individual to have some flexibility in their start time and make up the time at the end of their shift to accommodate this need.
An office worker with a sleep disorder had trouble waking up in the morning and was often tardy for work.
He asked not to be disciplined for his tardiness. His employer accommodated him with a thirty minute arrival window and allowed him to extend his day to make up the time.
A bus driver recently diagnosed with sleep apnea asked for a light duty position.
The employer contacted JAN asking for other options. JAN suggested a flexible schedule, temporary reassignment to shorter bus runs, and time off for treatment.
A federal employee experience neuralgia from shingles when trying to sleep.
His physician stated that the most severe effects should pass within two months. He was granted telework with a flexible schedule to accommodate his fatigue and lack of sleep.
A dispatcher with shift work sleep disorder worked rotating shifts that caused his sleep disorder to be exacerbated.
The employer changed the rotating shift schedule for all employees to shifts that were assigned by seniority.
An accountant with restless leg syndrome was often 10-15 minutes late for work every day due to amount and quality of sleep.
The employer provided this employee with a half an hour flexible start time. Depending on when the employee arrived, the time was made up either in a break or at the end of the day.
A clerical employee with insomnia had a hard time maintaining concentration on the job and his stamina was often poor because of inadequate sleep.
This employee was allowed frequent breaks to help improve his stamina.