A Nation Sleep-Deprived

High medical costs, safety risks linked to lack of sleep

By Tamara Lytle January 11, 2016

It’s not your imagination—we really are sleeping less.

In fact, people sleep an hour to an hour and a half less a night, on average, than they did 50 years ago, said Charles A. Czeisler, professor of sleep medicine at Harvard Medical School and chief of the division of sleep and circadian disorders at Brigham and Women’s Hospital in Boston.
The nation is chronically sleep-deprived. Lack of sleep, he said, has a profound effect on workplace safety and on employee health and productivity. Insomnia costs the nation $63 billion a year in lost productivity, according to Czeisler.

“It’s probably one of the easiest things we can address” to improve employee health and productivity, Czeisler added.

Companies where employees tend to be sleep-deprived have five times higher workers’ compensation costs than companies where workers tend to get adequate sleep. Companies tend to pay, on average, an extra $1,200 a year in medical and other costs for each worker who is sleep-deprived, said Dr. Leena Johns, global medical and wellness director for MetLife.

Inadequate sleep is linked to cancer, diabetes and cardiovascular disease, she said. People getting less than six hours of sleep at night are five times more likely to be obese and have a 56 percent increase in risk for Type 2 diabetes.

Johns dove into the topic this year with a paper titled Sleep: A Business Case for Bedtime. It’s certainly in employers’ interest to worry about sleep deprivation, since it affects not only productivity but also health care costs. Johns’ report pointed out that companies pay, too, when their insomnia-addled workers make poor decisions or have accidents.

Someone awake for 17 hours straight has the performance ability of a person with a 0.05 percent blood alcohol level—which is legally drunk in many jurisdictions. Johns said that most people need seven to eight hours of sleep each night.

And not just any sleep: Czeisler said the body needs a consistent quality of deep sleep, which is best achieved by sleeping in a cool, dark room free of distractions, and by addressing problems, like sleep apnea, with CPAP machines, weight loss and other lifestyle changes.

Sleep deprivation is on the rise because of these factors:

*Longer commutes to work.

*More time spent indoors away from natural light that tells the body when it’s time to go to sleep.

*More medical conditions like sleep apnea, which can be brought on by obesity and a sedentary lifestyle.

*Omnipresent screens, such as smartphones that emit blue light that make it harder to fall asleep.

*A culture that values overwork.

“It’s important we send a message out that this glorification of sleep deprivation has to stop,” Johns said. But employers, she added, have yet to recognize the importance of adequate sleep, even though employees say it’s one of their top concerns.

Employers can help encourage sleep by making scheduling changes—such as avoiding 12-hour shifts—and with education about healthy sleep habits. But Matt Nieman, an employment lawyer with Jackson Lewis in Reston, Va., said HR and management need to be careful when they ask employees about what might be sleep-related problems.

“Being a compassionate employer and saying ‘Hey, you look tired’—that’s not a problem,” Nieman said. But it’s important to avoid questions like “ ‘Is it because of X or Y?’—especially when it’s not something the employee mentioned,” he said.

Some sleep loss is caused by medical issues, and that’s where the Americans with Disabilities Act comes in. Nieman said medical inquiries need to be job-related and “consistent with business necessity.”

It’s important for companies to make sure that employees with sleep disorders actually get treatment if they’re in jobs where lack of sleep can cause safety concerns. And even if they’re not in a job where safety is a concern, encouraging workers to get enough sleep can mean getting more productivity from them during the day.

“Focus on their performance, and not what you believe to be the cause of it,” Nieman advised. If it’s a job with safety concerns—like driving a bus—employers can conduct a fitness-for-duty examination if they suspect an employee suffers from sleep deprivation, Nieman said.

Employee education can help.. For example, MetLife offers webinars for employees that discuss the importance of powering down their mobile devices, leaving the television out of the bedroom and focusing on sleep.

Companies can also hire vendors to conduct fatigue risk-management surveys and screening that can pinpoint which employees need treatment for sleep disorders such as sleep apnea. Czeisler said 34 percent of men and 17 percent of women suffer from sleep apnea.

Schneider National trucking company monitors their employees’ sleep as part of a comprehensive sleep apnea program. It has found that treating employees with sleep apnea—for instance, by providing them with CPAP machines—increased retention and reduced preventable accidents by 73 percent.

Finally, employers should make sure to have sleep-friendly policies in place, like limiting shift lengths and ensuring adequate time off between shifts.

Getting employees to change their sleep behaviors can be easier than convincing them to eat healthier or exercise more. “Sleep has so many benefits with so little effort,” Johns said.

Tamara Lytle is a freelance writer based in Falls Church, Va.


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