Most adults spend a significant number of their waking hours at work. The work relatedness of employees' sleep is not always obvious to employers, as sleep is usually a private behavior. Yet there is much about how work is organized that influences the opportunity to sleep, the quality of sleep that is achieved, and the risk for sleep disorders. Circadian rhythm disruptions influence sleep when work schedules include very early start times, night shift work, or shift rotation. Reduced sleep opportunity from long working hours, shift overruns and overtime, long commutes, and being called in during time off may cause sleep deprivation. The physical surroundings of the job (light, noise) can increase or inhibit alertness, and over time can alter circadian rhythms. When work is physically or psychologically stressful, it can inhibit sleep by increasing sympathetic nervous system activity that is incompatible with restful sleep. Certain occupational groups (health care, transportation, public safety, food service, mining, construction, executive travel) are at particular risk for impaired sleep because of work stress and the scheduling of work hours. Because nurses care for workers throughout the life span in all health care settings, the nursing curriculum must teach the basics of sleep to entry-level nurses, nurse practitioners, and occupational health nurses (OHNs). (See Chapter 24, Future Directions in Sleep Promotion: Nursing Practice, Research, and Education.) This chapter discusses the work-related impediments to sleep and interventions to improve sleep, with implications for health promotion and occupational health programs in the workplace. The consequences of acute and chronic sleep deprivation for workers are well documented. Workplace injuries and accidents are more frequent, causing pain and suffering, as well as lost productivity for the worker who is sleep deprived. Frequent or high cost claims can lead to higher costs to the employer for health benefits. Chronic sleep deprivation increases the risk for cardiovascular diseases such as hypertension, stroke, and heart disease, as well as metabolic disorders such as obesity and diabetes. These work-related health hazards can be addressed with active health promotion and occupational health programs and practices that minimize serious adverse outcomes. Sleep promotion is ideally a shared responsibility of workers, their employers, and health care providers. Workers themselves must consider the priority they place on sleep when competing demands threaten to derail a healthy lifestyle and performance at work. They must also be aware when their sleep is abnormal, seek treatment, and adhere to treatment recommendations if a sleep disorder is detected. Employers who are trying to create a healthy work environment must have a systematic plan at all levels of the organization to recognize sleep-related aspects of the physical work environment, the intensity of workplace stressors, and how work is organized to advantage workers' sleep. They must provide health insurance coverage to ensure that workers receive specialty treatment for their sleep disorder-related symptoms and provide accommodations if chronic sleep disorders continue to impair functioning. The employee health unit is the best place to coordinate the health promotion activities at work as well as screening, clinical care, referrals, and accommodation. The personnel in the employee health and/or safety departments should conduct exposure assessments of scheduling practices and monitor trends in injuries to inform healthy scheduling practices, When the exposure assessment identifies possible risk factors for sleep deprivation or sleep disorders, the occupational health nurse clinicians must incorporate thorough sleep and occupational exposure histories, provide health education regarding sleep and work, and tailor interventions to improve sleep quantity and quality. The health care providers in the employee health department can also recognize sentinel occupational health events, such as sleep complaints, drowsiness at work, and accidents and injuries which might indicate additional workers at risk for occupational sleep disorders. In the ideal situation, all are motivated to create a healthy workplace where workers can be safe and productive and then go home, sleep restfully and long enough, and enjoy a high quality of life, Combined, these concerns clearly have implications for workplace policy development to ensure worker safety and productivity.