Sleep and work can make uneasy bedfellows. Leaders are being called to account for the sleep cultures they create and their own sleep deficits. There are steps that can be taken, however, to encourage more positive sleep behaviour.
It was a big number: A$66.3 billion. That was the estimated cost in dollars of insufficient sleep in Australia in 2016-2017, according to an analysis conducted by Deloitte Access Economics and the Sleep Health Foundation, published in the report Asleep on the Job.
The figure included financial costs such as to the health system and lost productivity, and the report helped to escalate sleep to a topic of national importance, resulting in the announcement of a parliamentary inquiry in late 2018 into sleep health awareness.
Report co-author Lynne Pezzullo, lead partner of health economics and social policy at Deloitte Access Economics, describes herself as a “stickler for best-practice methods” when estimating the cost of illness.
“You tend to see these really big costs when you are looking at an issue that contributes to other health conditions, where there is little awareness, stigma or cultural factors that maintain the problem.”
Sleep ticks a number of these boxes. In Australia, tiredness kills at least one person a day due to an industrial or motor vehicle accident. It is also a causal factor for conditions such as heart disease, stroke, diabetes and depression. The high rate of undiagnosed sleep disorders in the community suggests lack of awareness and an always-on culture, which extends into the workplace, can lead to sleeplessness being associated with strength.
There are signs, however, that this false association is starting to be dismantled. While in the past we may have been in awe of leaders such as former British Prime Minister Margaret Thatcher, who was reputed to have slept only four hours a night, world leaders are now being called to account for their sleepless ways.
When Hong Kong Chief Executive Carrie Lam said she barely managed three hours of shut-eye when life got tough and five hours after good days, we saw newspaper headlines reading, “Carrie Lam needs to sleep more for the sake of Hong Kong”. It seems that Hong Kong itself is in need of sleep reform, with a 2003 University of Hong Kong study reporting that 92 per cent of working age city residents suffered from sleep deprivation.
The Australian parliamentary inquiry will consider the economic costs of inadequate sleep and sleep disorders, access to treatment and whether sleep disorders are being diagnosed and managed, as well as workplace awareness.
It will in particular examine workplace practices and assistance available to people who may be impacted by inadequate sleep, rostering practices, heavy work requirements and how the transport industry compares to international best practice.
The effects of sleep deprivation on people making critical decisions that affect the lives of many is cause for public concern. Effective leadership and decision-making rely heavily on the prefrontal cortex of the brain, which is responsible for higher order cognitive processes such as problem solving, creative thinking, self-restraint, planning, and executing plans.
Neuroscientists have shown that while other parts of the brain can cope relatively well with tiredness, the prefrontal cortex cannot. Foul moods and fuzzy memory are just two of many problems arising from an under-slept prefrontal cortex.
“We are just starting to see white-collar fatigue being acknowledged as a safety and risk issue,” says Melissa Webster, CEO of SleepFit, a provider of sleep screening and behaviour change programs for workplaces.
“We know of a professional services firm where a large order claim came from someone making an error when working at 1am.”
Are workplaces aware of the hefty sleep debt they could be carrying? Asleep on the Job estimates that the costs to productivity of inadequate sleep, whether due to a sleep disorder or behavioural factors, is A$17.9 billion, or A$2418 per person in a year.
According to the 2016 Sleep Health Survey of Australian Adults, four in every 10 Australian adults aren’t getting enough good quality slumber. For a workplace of 1000 employees, this adds up to a cost of almost A$1 million a year.
Ryan Atkins, human resources director of health technology company Philips in Australia and New Zealand, champions adequate sleep in his organisation. Aware of the importance of leadership modelling, he has been participating in the sleep screening and education program SleepFit, which has been offered to all staff.
“It’s made me more aware of how poor my own sleep has been, and I’ve taken steps to improve that,” Atkins says.
This includes stricter rules about no electronic screens before bed or on waking. He has extended these rules to his children.
Sleep - mental health by stealth?
Mental health was the trigger for Philips deciding to address sleep. “In the last five years, our business has suffered the untimely death of an employee annually, with a number of them being suicides,” Atkins says.
“While these were unrelated to work, they highlighted what an issue mental health is in our community, especially for middle-aged men who typically don’t seek help.”
Philips employs engineers, primarily male, and the number who use its employee assistance program (EAP) is half the national rate.
After investigating several programs, Philips’ leadership team decided to promote good sleep as a gentle way to introduce mental health to staff, with managing stress and mindfulness included in the program.
Participation in the SleepFit screening was voluntary, with 27 per cent of Philips’ 500-plus staff taking part.
“That’s 10 times our annual EAP usage,” Atkins points out. The program seems to be attracting those at greatest risk. Of the 139 who did the initial sleep survey, 30 were identified as having sleep apnoea and 73 insomnia.
Atkins has even taken steps where most men fear to tread.
“I declined an 11pm teleconference run from the US and suggested we share the pain around the globe, rotating the times for international calls.” Initially, he was unsure how his stance would be received, but was informed of a new teleconference time: 9pm.
Time for serious sleep leadership
Many employees will not feel able to push back on the organisational drivers of disrupted sleep, especially if working against a backdrop of job insecurity.
“We can talk all we want about sleep, but if there is a culture of being on 24/7, especially in multinational companies, how can we expect employees to sleep?”
That was the sentiment Erica Crome, clinical psychologist and chief operating officer at SleepFit, encountered when she interviewed 12 HR managers from a range of industries, including finance. All expressed concern that leadership often encouraged behaviours that denied sufficient sleep, such as long hours and early-morning or late-night emails.
There is a way to go, it seems, before best practice in workplace promotion of heathy sleep is achieved. This requires organisations to address the workplace drivers of poor sleep and not simply expect individuals to get to bed early, despite the “ping” from the boss.
What organisations can do
Education: make sleep an essential component of workplace health and safety education for all staff.
Travel: encourage travel bookings that allow for arrival home in time for bed, or adequate recuperation from jet lag. Teleconference instead, when possible.
Teamwork: allow employees to work at times that best suit their body clocks. Have tag teams of employees in different time zones who can hand over every eight hours. When scheduling international calls, accommodate workers’ sleep preferences when you can and rotate the times to share the pain.
Emails: leaders should avoid sending late-night emails, or at least specify they do not expect an instant response. Consider whether a blackout on work emails after a certain hour could work for your organisation.
Curb excessive hours: for instance, tell full-time employees to stay out of the office from 9pm Friday to 9am Sunday.
Support work-free vacations: encourage and help staff to delegate work ahead of their holiday, so they feel better able to switch off. Schedule extra staff if necessary.
Sanction power naps: just 10 minutes of sleep is sufficient to boost energy for almost three hours – this enhances afternoon efficiency without interfering with a good night’s sleep.
Sources include: “Organisational costs of insufficient sleep”, McKinsey Quarterly, February 2016
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