Sleep is one of the most influential yet least discussed factors affecting health, safety and performance in the construction industry.
We talk openly about physical injuries, mental health, occupational exposures and safety-critical behaviours – but when it comes to sleep, the conversation is still far too quiet.
In Series 2, Episode 4 of the Build & Thrive podcast, host Jennie Armstrong sits down with Dr David Garley – GP, sleep specialist and Director of The Better Sleep Clinic – to unpack the science, the risks and the practical realities of sleep in a sector that depends heavily on alertness, precision and decision-making under pressure.
This blog summarises the conversation and key insights from the episode. If you prefer to watch or listen, the full podcast and video are available now.
Why Sleep Deserves Serious Attention in Construction
Right at the start of the conversation, Jennie captures the mood shared by many in the health and safety profession: “Fatigue is something the industry knows is an issue – but I don’t think people fully understand what we mean by it.”
Fatigue is frequently lumped in with “tiredness”, yet the two are not the same. As Dr Garley explains, sleepiness is the urge to nod off; fatigue is deeper – a combination of physical and mental exhaustion that undermines concentration, coordination, motivation and risk perception.
Sleep is at the heart of both.
And the consequences aren’t minor. As David puts it: “Poor sleep impacts our health across the board – cardiovascular risk, metabolic health, mental health, concentration, memory, decision-making.”
For a sector where high-risk environments are the norm, this should matter to every leader.
The Science: How Poor Sleep Harms the Body and Mind
David outlines the now overwhelming evidence linking sleep to long-term health conditions. Poor sleep increases the likelihood of:
- Heart disease and stroke
Night-time is the period of cardiovascular “rest”. Less sleep means more time in a heightened stress state. - Type 2 diabetes
Poor sleep disrupts metabolic health to the extent that it becomes a recognised risk factor, comparable to obesity. - Mental health decline
Anxiety and depression both cause and are caused by poor sleep. This “bidirectional” relationship is why problems often escalate together.
One particularly striking example he shares involves cognitive performance:
“Twenty-four hours without sleep impairs you to the same level as being over the drink-drive limit.” – Dr David Garley
It’s an uncomfortable comparison, especially when we consider how often construction workers push through long shifts, commutes and life demands without adequate rest.
Why Construction Workers Face Higher Sleep Risks
The episode highlights three major contributors to fatigue in construction:
1. Shift Work and Early Starts
Many projects require long shifts, rotating patterns and early call times. Even with good intentions, this disrupts natural circadian rhythms in a way that is difficult to stabilise.
2. Workload, Travel and Time Pressure
Long commutes, overnight stays in digs, and limited downtime all reduce sleep opportunity – not just sleep quality.
3. Cultural Norms
Jennie raises the often-unspoken attitude that sleep is a luxury: “There’s almost a badge of honour around pushing through and being able to work after four hours’ sleep.”
David agrees, adding that one of the biggest myths is the fatalistic belief that “nothing can be done”. Many workers assume sleep problems are just part of the job.
But as he notes: “The idea that sleep can’t get any better is one of the most damaging myths. Most conditions are treatable – sometimes quickly.”
Sleep Disorders Are Far More Common Than We Think
David points to two major disorders that are highly relevant to construction:
1. Insomnia
Affects around 10% of adults consistently.
2. Obstructive Sleep Apnoea (OSA)
In construction, due to demographic factors such as age, gender and physical profile, OSA may be present in up to 30% of the workforce.
That’s nearly one in three.
What makes this more concerning is that 85% of people with OSA remain undiagnosed.
OSA leads to:
- Depressed oxygen levels
- Hundreds of micro-awakenings
- Severe daytime sleepiness
- Significant impairment in concentration
- Increased risk of accidents – including microsleeps while driving or operating machinery
And yet, it is one of the most treatable sleep issues. As David explains: “With the right treatment, sometimes it’s two days later that you’re looking at a completely different person.”
The impact is often immediate and profound.
Sleep, Safety and Accident Risk: The Hidden Connection
The research David shares is hard to ignore:
- Sleep-deprived individuals are eight times more likely to report an industrial accident.
- One in five road accidents is linked to poor sleep.
- Fatigue affects judgment, reaction time, hazard perception and risk tolerance.
- Driving tired can mirror the cognitive impairment of drinking alcohol.
In a safety-critical environment, these risks compound quickly.
Jennie points out: “If 20% of road accidents are caused by poor sleep, imagine what that looks like in construction if we traced it properly.”
The problem isn’t lack of awareness – it’s lack of structured action.
Why Asking Workers About Sleep Is So Difficult
Many supervisors are told, “Check if your team are fit for work.”
But as Jennie says, very few workers would ever admit to sleeping poorly the night before.
David sees the same pattern:
- Workers fear losing their licence.
- Others worry about being removed from safety-critical tasks.
- Some don’t believe anything can be done.
- And many simply accept fatigue as part of the job.
This creates what David calls an “iceberg problem”: the majority of sleep issues remain hidden unless organisations take proactive steps.
What Construction Companies Can Do: A Practical Framework
Across the conversation, David outlines a clear, achievable pathway for organisations to start addressing sleep risks:
1. Begin with an Anonymous Sleep Assessment
This is essential, because honesty is only possible when people know their job isn’t at risk.
“The only way to understand what’s really happening is anonymous assessment. Otherwise you’ll never hear the truth.” – Dr David Garley
2. Look Beyond Shift Patterns
Shifts matter – but they aren’t the whole story.
Factors uncovered in assessments often include:
- Childcare
- Long commutes
- Poor diet
- Stress
- Sleeping environments in digs
- Medical conditions
- Undiagnosed OSA
- Use of online sleeping tablets
Understanding root causes shapes better interventions.
3. Provide Tailored, On-Demand Education
Generic “toolbox talk” sleep advice isn’t enough.
Workers need targeted guidance based on the specific issues affecting them.
4. Use Workshops to Break the Stigma
Once people see sleep being discussed openly, they start thinking differently about it.
5. Offer Individual Support Where Needed
This includes:
- Sleep specialists
- Cognitive behavioural therapy for insomnia
- Sleep apnoea diagnostics
- CPAP treatment
- Occupational health coordination
6. Build Clear Referral Pathways
David explains: “From GP referral to treatment through the NHS, some people are waiting six to nine months – sometimes a year. By then they’ve been off work far too long.”
Private referral routes can often diagnose and treat workers within two to three weeks, getting them safely back to work.
Simple Steps Workers Can Take Themselves
David shares several practical steps workers can implement immediately:
- Create a wind-down routine
Avoid work emails and stimulating tasks in the hour before bed. - Write down worries
As David says: “If something keeps popping into your mind, it usually needs attention. Give it that attention before bed – not while trying to sleep.” - Moderate alcohol and caffeine
Caffeine late in the day and alcohol before bed reduce sleep quality even if they help you drift off. - Protect sleep opportunity
Particularly important for people working long or night shifts. - Avoid trying too hard
Excessive focus on sleeping perfectly only increases anxiety and makes sleep worse.
Why This Episode Matters for the Industry
What makes this conversation so valuable is its balance of science, practicality and compassion.
Jennie articulates a truth many leaders feel: “Fatigue management conversations often default to hours and shifts. But understanding the individual – their stress, their home life, their health – is where real progress comes from.”
David echoes this with a clear, achievable hope: “We’ve actually got incredibly effective treatments. It’s not about inventing new things – it’s about helping people access what already works.”
Key Takeaways from the Episode
- Poor sleep is a major health and safety risk – not a lifestyle choice.
- Fatigue and sleep disorders are far more common in construction than most organisations realise.
- Sleep problems are treatable – often quickly – when properly diagnosed.
- Anonymous assessment is key to understanding real workforce challenges.
- A structured, stepped approach helps organisations support everyone from shift workers to those with clinical sleep disorders.
- Opening up the conversation is one of the most powerful steps leaders can take.
- A proactive sleep strategy is an investment in health, safety, productivity and retention.
Watch the full discussion between Jennie Armstrong and Dr David Garley, including practical examples and case studies on Build & Thrive – available now on YouTube, Spotify, Buzzsprout and all major platforms.
🎧 https://www.buzzsprout.com/2431164
📺 https://www.youtube.com/playlist?list=PLEoibJLDuFnnT3qSQw37LKPG6xlyvCj7B
Join the Conversation!
Do you have experiences or thoughts on addiction and recovery in construction?
Drop a comment below or share this post to help break the stigma. Together, we can make wellbeing part of the culture – not just the policy.
Thank you to GKR Scaffolding for sponsoring the Build & Thrive podcast and supporting our mission to improve health and wellbeing across the construction industry.
At Construction Health & Wellbeing, we help organisations create healthier, happier, and more sustainable workplaces.
Contact us today to learn how we can support your strategy.
Learn more about the people and organisations mentioned in this episode:
Jennie Armstrong: https://www.linkedin.com/in/jenniearmstrong/
Construction Health & Wellbeing: https://constructionhealth.co.uk/
The Better Sleep Clinic:
- Website: https://www.thebettersleepclinic.co.uk/
- LinkedIn: https://www.linkedin.com/company/better-sleep-clinic/
- Instagram: https://www.instagram.com/thebettersleepclinicuk/
- Facebook: https://www.facebook.com/TheBetterSleepClinicUK
Dr David Garley:
GKR Scaffolding (sponsor): https://gkrscaffolding.co.uk/
