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Sleep Deprivation Brings Lower Productivity, Higher Health Costs

By Stephen Miller  4/22/2006
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Sleep deprivation increases people's risk of serious health problems and costs U.S. businesses billions of dollars each year in lost productivity, medical costs and other expenses, according to a new report by the Institute of Medicine (IOM). The report also finds that 50 to 70 million Americans suffer from chronic sleep disorders that adversely affect daily functioning, health and longevity.

The study , Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem, confirms links between sleep deprivation and a wide range of health consequences, such as "an increased risk of hypertension, diabetes, obesity, depression, heart attack and stroke." Despite such huge societal consequences and costs, the IOM finds that the cumulative effects of sleep loss and sleep disorders are "under-recognized" and "awareness among the general public and health care professionals is low given the magnitude of the burden." The same could be said about employers, who bear the brunt of lower productivity and higher health care costs.

The IOM, one of the independent National Academies of Science that advise the federal government on scientific and health issues, found that billions of dollars are spent each year on direct medical costs associated with doctor visits, hospital services, prescriptions and over-the-counter medications. And almost 20 percent of all serious car crash injuries in the general population are associated with driver sleepiness, independent of alcohol effects.

According to Ira S. Wolfe, founder of the Lancaster, Pa.-based consultancy Success Performance Solutions , the work absences of employees with insomnia cost an average of $3,025 per employee each year, while the missed days of good sleepers cost an average of $1,250 (these figures are from a study released in the February 2006 issue of the journal Sleep ).

The High Price of Sleep Disorders
HR consultant Ira S. Wolfe compiled the following list facts relating to the effect of sleep-deprivation in the workplace. (More workforce trends and demographics can be found on his Perfect Labor Storm web site.)

Sleep deprivation and sleep disorders are estimated to cost Americans over $100 billion annually in lost productivity, medical expenses, sick leave, and property and environmental damage ( National Sleep Foundation).

Insomniacs miss an average of 5.8 days of work per year, while good sleepers miss only 2.4 days. ( Sleep, February 2006)

Fatigue is a factor in at least 100,000 auto crashes and 1,500 deaths each year. (National Highway Traffic Safety Administration)

Sleep deprivation becomes debilitating when individuals get less than six hours of sleep a night, Wolfe says. Even less than seven hours can have a noticeable impact.

"We all can recognize the problem with lack of sleep's effect on alertness and potential mistakes," he observes. The symptoms are obvious in any office, including employees "half-dozing during meetings" and being unable to pay attention. Of much greater concern is the effect on workers making life-or-death decisions, particularly in the health care and transportation industries.

Making matters worse, workers with chronic insomnia often take over counter sleep medications and, says Wolfe, "the effects don't wear off in 3 to 4 hours."

Wolfe draws a parallel between chronic fatigue due to sleep deprivation and intoxication. As with the misuse of alcohol and drugs, "minimal sleep affects accuracy of critical thinking and responsiveness," he notes. "Sleep loss impairs memory, vigilance, mental processing of complex information and decision-making skills."

And then there's the impact on health care costs. "The stress that sleep deprivation puts on the heart and the rest of the system is enormous," Wolfe says, "especially for workers who are overweigh or otherwise at risk for cardiovascular disease. Insufficient sleeping compounds these health problems."

A Wellness Issue

Employers need to develop a greater awareness about the effects of sleep deprivation in the workplace, Wolfe says.

"There's a tendency to push for more overtime in many industries, especially those with 24/7 operations," he notes, but there's a "tipping point where that becomes a concern. Employers need to be aware of how far they can push employees."

Wolfe's next recommendation is likely to be met with a bit more employer resistance: allowing workers to take a 20-minute "cat nap." He recognizes that "If the boss walks in and sees somebody snoozing at their computer, there's not likely to be a favorable response." But "a 20-minute nap has significant regeneration benefits."

He notes, however, that snoozing longer during the day, such as for 45 minutes to an hour, has negative effects, putting individuals into a deep sleep that disrupts their body's natural rhythm.

Is Sleep Apnea the Culprit?
According to the Mayo Clinic, more than 18 million Americans suffer from obstructive sleep apnea, robbing them of a good night's sleep and putting them at greater risk for health problems, including cardiac disease. Heavy snoring may be an indication of sleep apnea, which is a treatable condition.

Employers spend a great deal on workers' comp and wellness programs, Wolfe says. "Just as at lunch time they may provide an activities areas for exercise, the same thing holds true about letting employees nap." That doesn't necessarily mean creating rooms with beds, but "being more tolerant of letting people put their heads back and grab a nap" in an employee lounge or other "break" areas.

Wolfe admits, however, that as with other kinds of breaks, this leeway "must be managed for abuses."

Some additional employee actions, via the National Highway Traffic Safety Administration, are provided in the box below.

Employer Interventions: Helping Employees Get to Sleep
The financial incentives are strong for employees to work late night and rotating shifts. And changing the structure of those incentives is unlikely, since covering those hours is often necessary for employers. A more feasible intervention is to work with people to alter how they schedule sleep time and to help them set priorities on how to best use their time.

Consider developing strategies to improve the sleep habits of shift workers. These strategies could include:

    Targeting family members to encourage them to get better sleep. 

    •  Providing suggestions about how to reduce distractions and improve sleeping conditions when they can sleep.

    Encouraging sleep before working a night shift rather than sleeping directly following work.

    Time management strategies to help shift workers set priorities and become more efficient with awake hours and clearing away time for proper sleep.

-- From Development and Testing of Countermeasures for Fatigue Related Highway Crashes, a report by the National Highway Traffic Safety Administration.

Looking at the issue more broadly, the IOM's report recommends a coordinated strategy to meet the public health and economic burden caused by sleep loss and sleep disorders. This strategy will require concurrent commitment to the following activities:

Increase awareness of the burden of sleep loss and sleep disorders among the general public.

Expand awareness among health care professionals through education and training.

Develop and validate new and existing diagnostic and therapeutic technologies.

Expand accreditation criteria to emphasize treatment, long-term patient care and chronic disease management strategies.

Strengthen the national research infrastructure to connect individual investigators, research programs and research centers.

Increase the investment in interdisciplinary sleep programs in academic health centers that emphasize long-term clinical care, training and research.

Stephen Miller is the editor/manager of SHRM Online's Compensation & Benefits Focus Area.

Related SHRM Articles:

Employers Can Control Some Fatigue Factors, HR News, January 2011

Naps Not Pipe Dream for One-Third of US Adults, HR News, August 2009 

Other Related Reading:

Zzzzz: Is Sleep Deprivation a Bigger Personnel Productivity Threat than Alcoholism?, Business 2 Business (March 2006)

Despite Evidence Workplace Naps Can Increase Productivity, Employers Skeptical, San Antonio Express-News (Oct. 14, 2004)

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