South Africans need more sleep. Sleep-deprived employees are at higher risk of life-threatening chronic illness and disability, more likely to cause workplace accidents, less productive and more absent — adding up to an economic liability in the billions of rands.
The cost to just one medical aid scheme of treating the life-threatening diseases linked to sleeping less than the recommended eight hours a night is estimated at R22-billion annually in a recent study by Charles King, an MBA student at the University of Stellenbosch Business School.
He set out to determine the expected savings in healthcare costs if 25- to 40-year-olds could be “converted” to healthy sleeping habits in a world that expects employees to be “always on”.
“Lack of sleep is not only related to workplace issues such as absenteeism, lack of productivity, poor work performance and accidents — which have a direct cost impact on a business — but insufficient sleep has been directly linked with seven of the 15 leading causes of death,” said King.
“The research looked at the indirect costs of lack of sleep, particularly the cost to medical schemes of treating illnesses where inadequate sleep is a major risk factor. We asked what the potential savings would be to a medical scheme if individuals just got enough sleep.”
It is widely accepted that seven to nine hours sleep a night are optimal for wellness, productivity and lowering the risk of disease, but King said two-thirds (64%) of the people whose sleeping habits he tracked slept for less than seven hours a night, and men were more likely to be sleep-deprived.
Sleep problems have become one of the leading causes of physical and mental health illnesses, because of expectations of being always available for work, shift work and longer working hours, 24/7 availability of entertainment and addiction to technology such as mobile phones.
One night of less than six hours sleep is equivalent to two sleepless nights in its effect on cognitive performance — impairing memory and concentration, and making risky decision-making more likely — and the risk factors for disease increase exponentially as sleep time decreases below the seven-hour mark.
King said an average of less than seven hours sleep increased the risk of developing major depression by 22%, coronary artery disease by 73%, type 2 diabetes by up to 18%, and the risk of developing colorectal cancer by 50%.
Those who don’t get enough sleep are subject to a “double jeopardy” scenario — lack of sleep is a contributing factor to obesity, and both are individually linked to increased risk of cardiovascular disease, depression, cancers and diabetes.
Participants in King’s research who slept for less than six hours nightly had a body-mass index (BMI) 12% greater than those who slept for seven to nine hours.
In line with previous research done around the world, he found that the shorter the sleep duration, the higher the BMI measurement, and BMI lowered as individuals got sufficient sleep.
“On its own, obesity doesn’t have a direct financial implication but leads to many other health problems or aggravates them; for example, by preventing physical exercise, which will in turn increase the risk of coronary disease or of a low self-image, which may then fuel major depression,” he said.
People with habitually poor sleeping patterns also tend to have unhealthy lifestyle habits such as drinking alcohol, smoking and lack of exercise, which further increases the risk of developing chronic diseases.
“Medical schemes carry the burden of these diseases, directly and indirectly. The costs need to be established, to identify the risk for the schemes if members do not adhere to healthy sleeping patterns and other lifestyle choices,” King said.
There was a need for more research and analysis of the macro-economic and financial effects of insufficient sleep on individuals, society and medical insurers, as well as understanding and measuring how people reliant on the public health sector are affected, he said.
This would assist in raising awareness of the importance of healthy sleep patterns.
To ensure healthy sleep, he said the use of mobile devices, watching TV or working in bed should be avoided, along with consumption of nicotine, caffeinated drinks or any substance that would impair sleep quality, whereas regular exercise had significant benefits to improving sleep.
“It is important to educate people on the health benefits of healthy sleep norms, as well as the health risks of not getting enough good-quality sleep. Companies need to raise awareness of the benefits of adhering to a healthy sleep norm, like better work performance, less absenteeism, less injuries on duty and lower risk of developing life-threatening disease. Doctors who interact with patients must be aware of and communicate the risks of unhealthy sleep habits,” King advises.
Charles King gathered data from 658 employees, men and women aged between 25 and 40, of a national financial services group