South Africans need more sleep. Sleep-deprived employees are at a higher risk of life-threatening chronic illness and disability, are more likely to cause workplace accidents, are less productive and are more absent – adding up to an economic liability in the billions.

The annual cost of just one medical aid scheme to treat life-threatening diseases linked to sleeping less than the recommended eight hours a night is estimated to be R22-billion. This comes from a recent study conducted by Charles King, an MBA student at the University of Stellenbosch Business School.

King 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.

“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,” King says.

It is widely accepted that seven to nine hours of sleep a night are optimal for wellness, productivity and lowering the risk of disease, but King says that two-thirds (64%) of the people whose sleeping habits he tracked slept for less than seven hours a night, with men more likely to be sleep-deprived.

Sleep problems have become one of the leading causes of physical and mental health illnesses. Lack of sleep can be attributed to the pressure to always be available, shift work and longer working hours, as well as the 24/7 availability of entertainment and addiction to technology, such as mobile phones.

Even one night of less than six hours of sleep is equivalent to two totally sleepless nights in terms of its impact 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 descends below the seven-hour mark.

King says that getting an average of less than seven hours of sleep also increases 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, he says, are subject to a “double jeopardy” scenario: not getting enough sleep is a contributing factor to obesity, and both are individually linked to an increased risk of cardiovascular disease, depression, cancers, and diabetes.

Participants in King’s research on sleeping habits who slept for less than six hours nightly had a body-mass index (BMI) 12% greater than those who slept for the recommended seven to nine hours, while those who slept for less than five hours a night had some of the highest BMI measurements.

These findings are in line with conclusions from previous research done around the world: that the shorter the sleep duration, the higher the BMI measurement, while those who get sufficient sleep have lower BMI measurements.

“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,” King says.

Making the sleepless scenario worse, people with habitually-poor sleeping patterns also tend to have unhealthy lifestyle habits like drinking alcohol, smoking and lack of exercise – combine these with insufficient sleep and you have an increased 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 says.

He says there is a need for more research and analysis of the macro-economic and financial impacts of insufficient sleep on individuals, society and medical insurers, as well as research into the impact on people reliant on the public health sector.

This would assist in raising awareness of the importance of having healthy sleep patterns.

To ensure healthy sleep, he says that using mobile devices, watching TV or working in bed in the evening should be avoided, along with consumption of nicotine in the evening along with caffeinated drinks or any other substance that would impair sleep quality. He also says regular exercise has significant benefits for people’s 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… Doctors who interact with patients must be aware of and communicate the risks of unhealthy sleep habits,” King advises.

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