Cost of sleep deprivation

A lack of sleep among the U.S. working population is costing the economy up to $411 billion a year, which is 2.28 percent of the country’s GDP, a new report finds. According to researchers at the not-for-profit research organisation RAND Europe, part of the RAND Corporation, sleep deprivation leads to a higher mortality risk and lower productivity levels among the workforce, putting a significant damper on a nation’s economy.

Effects of sleep deprivation.
Credit: Mikael Häggström & Wikipedia
A person who sleeps on average less than six hours a night has a 13 percent higher mortality risk than someone sleeping between seven and nine hours, researchers found, while those sleeping between six and seven hours a day have a 7 percent higher mortality risk. Sleeping between seven and nine hours per night is described as the “healthy daily sleep range”.
In total, the U.S. loses just over 1.2 million working days a year due to sleep deprivation among its working population. Productivity losses at work occur through a combination of absenteeism, employees not being at work, and presenteeism, where employees are at work but working at a sub-optimal level.

The study – ‘Why Sleep Matters – The Economic Costs of Insufficient Sleep’- is the first of its kind to quantify the economic losses due to lack of sleep among workers in five different countries – the U.S, UK, Canada, Germany, and Japan. The study uses a large employer-employee dataset and data on sleep duration from the five countries to quantify the predicted economic effects from a lack of sleep among its workforce.

Marco Hafner, a research leader at RAND Europe and the report’s main author, says: “Our study shows that the effects from a lack of sleep are massive. Sleep deprivation not only influences an individual’s health and wellbeing but has a significant impact on a nation’s economy, with lower productivity levels and a higher mortality risk among workers.”

He continues: “Improving individual sleep habits and duration has huge implications, with our research showing that simple changes can make a big difference. For example, if those who sleep under six hours a night increase their sleep to between six and seven hours a night, this could add $226.4 billion to the U.S. economy.”

The U.S. has the biggest financial losses (up to $411 billion, which is 2.28 percent of its GDP) and most working days lost (1.2 million) due to sleep deprivation among its workforce. This was closely followed by Japan (up to $138 billion, which is 2.92 percent of its GDP, and around 600,000 working days lost).

Germany (up to $60 billion, which is 1.56 percent of its GDP, and just over 200,000 working days lost) and the U.K (up to $50 billion, which is 1.86 percent of its GDP, and just over 200,000 working days lost) have similar losses. Canada was the nation with the best sleep outcomes, but still has significant financial and productivity losses (up to $21.4 billion, which is around 1.35 percent of its GDP, and just under 80,000 working days lost).

To improve sleep outcomes, the report outlines a number of recommendations for individuals, employers and public authorities:

Individuals – Set consistent wake-up times; limit the use of electronic items before bedtime; and physical exercise during the day.

Employers – Recognise the importance of sleep and the employer’s role in its promotion; design and build brighter workspaces with facilities for daytime naps; combat workplace psychosocial risks; and discourage the extended use of electronic devices after working hours.

Public authorities – Support health professionals in providing sleep-related help; encourage employers to pay attention to sleep issues; and introduce later school starting times.

Citation: Hafner, Marco, Martin Stepanek, Jirka Taylor, Wendy M. Troxel and Christian van Stolk. Why sleep matters — the economic costs of insufficient sleep: A cross-country comparative analysis. Santa Monica, CA: RAND Corporation, 2016. Link
DOI: 10.7249/RR1791
Adapted from press release by RAND Corporation.

Research shows that positive airway pressure therapy for sleep apnea has positive impact on hypertensive patients

A new study shows that positive airway pressure (PAP) therapy for sleep apnea may have a positive impact on sleep-related functional outcomes among patients who also suffer from hypertension. The findings suggest that untreated sleep apnea may explain the quality of life impairments reported by many patients with high blood pressure.

Results show consistent improvement of patient-reported outcomes in response to positive airway pressure therapy for sleep apnea in hypertensive patients. The study found significant improvement in daytime sleepiness, depressive symptoms and fatigue severity within a year following treatment initiation. Results were significant even in patients with resistant hypertension.

“We found that consistently and notably there was no difference in patient-reported outcomes between resistant hypertension and non-resistant hypertension groups,” said lead author Harneet Walia, MD, assistant professor of family medicine in the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University. “What we found was that the improvement in the patient-reported outcomes was more pronounced in those with objective adherence to positive airway pressure therapy.” Study results are published in the Oct. 15 issue of the Journal of Clinical Sleep Medicine.

According to the American Academy of Sleep Medicine, 30 to 40 percent of patients with hypertension also suffer from obstructive sleep apnea, which is a sleep-related breathing disorder characterized by repetitive episodes of complete or partial upper airway obstruction occurring during sleep. Adhering to sleep apnea treatment is a proven means of decreasing blood pressure and improving overall health.

The single-center, observational study involved nearly 900 patients with sleep apnea and hypertension, of which 15 percent had resistant hypertension. Their mean age was 58 years, 52 percent were male, and 72 percent were Caucasian. They were being treated with positive airway pressure therapy through the Cleveland Clinic Sleep Disorders Center. Questionnaire-based patient reported outcomes were evaluated using the Epworth Sleepiness Scale, Patient Health Questionnaire-9 (depression), and Fatigue Severity Scale.

The authors report that to their knowledge no previous study has examined changes in sleep-related functional outcomes with positive airway pressure therapy in a cohort comprising patients with hypertension, including some with resistant hypertension.

Citation: Impact of Sleep-Disordered Breathing Treatment on Patient Reported Outcomes in a Clinic-Based Cohort of Hypertensive Patients. Authors: Harneet K. Walia, Sandra D. Griffith, Nicolas R. Thompson, Douglas E. Moul, Nancy Foldvary-Schaefer, Reena Mehra.
DOI: http://dx.doi.org/10.5664/jcsm.6188
Journal: Journal of Clinical Sleep Medicine
Research funding: National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH), Center for Outcomes Research and Evaluation at the Cleveland Clinic Neurological Institute.
Adapted from press release by American Academy of Sleep Medicine

Research show sleep pattern disruptions can lead to increased risk of suicides

Adapted from press release by University of Manchester

The link between sleep problems and suicidal thoughts and behaviours is made starkly clear in new research from The University of Manchester, published in the BMJ Open.

In this study, conducted by researchers from the University’s School of Health Sciences alongside the University of Oxford, 18 participants were interviewed about the role sleep problems have on suicidal tendencies.

Three inter-related pathways to suicidal thoughts were identified arising from sleep problems. The first was that being awake at night heightened the risks of suicidal thoughts and attempts, which in part was seen as a consequence of the lack of help or resources available at night.

Secondly, the research found that a prolonged failure to achieve a good night’s sleep made life harder for respondents, adding to depression, as well as increasing negative thinking, attention difficulties and inactivity.

Finally, respondents said sleep acted as an alternative to suicide, providing an escape from their problems. However, the desire to use sleep as an avoidance tactic led to increased day time sleeping which in turn caused disturbed sleeping patterns – reinforcing the first two pathways.

Donna Littlewood, lead author of the study, said the research has implications for service providers, such as health care specialist and social services.

“Our research underscores the importance of restoring healthy sleep in relation to coping with mental health problems, suicidal thoughts and behaviours.

“Additionally, night time service provision should be a key consideration within suicide prevention strategies, given that this study shows that those who are awake in the night are at an increased risk of suicide.”

Publication: Understanding the role of sleep in suicide risk: qualitative interview study
doi:10.1136/bmjopen-2016-012113