Waking up to the dangers of inadequate sleep
5 Feb 2019
We all know improving our diet and fitness can help us lead happier, healthier lives. According to a growing body of research, there’s a third element that’s just as crucial to our wellbeing: sleep.
However, a report commissioned by the Sleep Health Foundation found one in four Australian adults aren’t getting enough shuteye – and it’s costing them, their employers and the economy dearly.
The independent report, produced by Deloitte Access Economics and titled Asleep on the Job: Counting the cost of poor sleep, highlights just how significant the issue is. It estimates the total cost of inadequate sleep to the Australian economy in 2016-17 was $66.3 billion.
At a human level, inadequate sleep affects learning and decision-making and increases the risk of mental and physical illness. It can also lead directly to work-related accidents, and fatalities, as a result of things like employees falling asleep while driving or medical staff making medication errors.
Given the implications for those in charge of workplaces, sleep health should be on the agenda of all Catholic organisations.
Professor David Hillman, founding Chair of the Sleep Health Foundation, has dedicated his professional career to sleep research and medicine. This year, for his ‘significant service,’ he was recognised in the Queen's Birthday Honours List and made a Member of the Order of Australia.
“This is a very important time for sleep in Australia,” he says.
A parliamentary inquiry into sleep health awareness is underway with the Standing Committee examining a range of issues including workplace awareness of inadequate sleep and sleep disorders.
“One of our hopes,” he says, “is that the inquiry will lead to a national awareness campaign, rather like the very successful campaigns we’ve had in other areas quit smoking, drink driving, etc.
“Australia is very good at public education and I think the community is quite good at listening. Smoking’s been an absolute triumph. When I first started in medicine you’d hear, ‘Look Doc, I’d rather have a few fags and die happy.’ You don’t hear that argument anymore.”
According to the Asleep on the Job report, sleepy employees reduce productivity. In 2016-17, they cost Australian businesses $17.9 billion.
Professor Hillman says, “the productivity losses are threefold, really. One is premature retirement. Absenteeism is quite common in sleepy people. And thirdly, the phenomenon, presenteeism – being at work but not at the optimum.
“If you are short of sleep accident risk goes up, people are more irritable, they’re mistake-prone and their decision-making isn’t as good or as quick as it should be. Along with all that comes apathy and indifference. We can all identify with those things because we’ve all had sleep deprivation at various times in our lives.”
He believes one of the big problems is that people think they can get by with less sleep than they need.
“You know you are suboptimal, or maybe you don’t even recognise it, but you’re getting by in this imagined world where more time awake means I’m more productive.”
He says it simply isn’t true.
“You can’t train yourself to function normally on less sleep. These are ancient, welded in, physiological requirements. The necessity for sleep is no less important than the necessity for food, drink and regular exercise.
While the parliamentary inquiry is increasing national awareness of sleep issues, and reaching those who can instigate change at the highest levels, it’s not just the government that needs to act.
The Asleep on the Job report recommends workplace health and safety authorities tighten regulations in sectors where sleep is irregular but responsibility is high, such as transport and health.
It also suggests those scheduling shift work adopt evidence-based principles that minimise disruption to the circadian and sleep wake systems. One of the major drivers for sleep is our internal day/night awake/sleep rhythm.
“It thrives on regularity,” says Professor Hillman. “If you push and prod it all over the place by having irregular sleep then achieving sleep when you want it will be more difficult.
“There are things employers can do in their workplaces to make sure they have decent shift schedules: not too long, forward rotation – from morning to afternoon to evening – rather than all over the place, and allowing plenty of time for rest and recovery. That’s the duty of care.”
Employees have a responsibility to be fit for duty. However, Professor Hillman says, “You can’t regulate people’s private hours, that’s their business. But employers can give their employees the information they need to make some wise decisions about having adequate sleep.”
He is still surprised by how few people fully appreciate the fact that the average adult requires around seven and a half to eight hours sleep a night. He says problems can occur when a person in charge of a workplace is a genuine short sleeper (about 3% of the population can getaway with six hours sleep a night, or less, and still function normally).
“Sometimes these people will conclude that everyone else’s sleep requirements are an indulgence. ‘Look, I can get by on six hours sleep, so can you.’ Having that sort of person as your boss is a bit of a nightmare.”
Something to sleep on
There’s a big price to pay for inaction, says Professor Hillman, “not just medical expenses, which are big enough, and the human costs, which are enormous, but also all the attendant costs: insurance claims, damages, litigation and all those sorts of things that follow.
Ultimately, everyone in the community suffers the consequences so the responsibility for reducing sleepiness must be shared by all, from employees to employers, from industry to government.
“CCI is recognising inadequate sleep as an issue,” says Professor Hillman. “I think that is very prescient of them.”
Sleep hack - Screen time
Late night screen time came under scrutiny in the Asleep on the Job report. Whether people are using their smart phones for social media or a laptop for work, most screens emit light at wavelengths that affect the major sleep-promoting hormone. The consequence of late evening use is reduced alertness the next day.
One simple way to minimise this is for employers to provide employees with software that reduces exposure to screen light at harmful wavelengths.
Sleep fact - Motor vehicle accidents
The Asleep on the Job report found that lack of sleep causes an estimated 23% of all motor vehicle accidents. It suggested the possibility of implementing restrictions for drivers who’ve had less than a set minimum hours of sleep prior to driving.
“I suspect, in time, in workplaces where there is occupational driving, there will be instruments that detect driver fatigue and ring alarm bells whenever it occurs. If you’re on the road and you’re sleepy, you’re a danger to yourself and a danger to everyone around you.” Professor David Hillman.