Asleep on the Job: Counting the cost of poor sleep

04 Sep Asleep on the Job: Counting the cost of poor sleep

Four out of every ten Australians are suffering from inadequate sleep. Half of these people experience ongoing pathologically high levels of daytime sleepiness. The rest know that their sleep is routinely insufficient because they can’t function at normal levels of alertness, concentration and emotional control.

The Sleep Health Foundation have just released an updated report by Deloitte Access Economics investigating the economic consequences of sleep disorders in Australia.

There are three main causes of inadequate sleep:

  • sleep disorders such as insomnia, OSA and RLS,
  • other health conditions such as obesity, anxiety, depression, pain, breathlessness and side effects of medications that impact on sleep quality and quantity,
  • lifestyle / behavioural factors such as studying, working or partying too long, or shift work and other forms of circadian disruption

What is the report about? The report investigated the economic consequences of inadequate sleep.

Inadequate sleep and daytime excessive sleepiness can arise from poor personal sleep habits, shift work or when people experience common sleep disorders such as insomnia and obstructive sleep apnoea (OSA).

What is the cost to the Australian economy of inadequate sleep?

  • The total cost of inadequate sleep in Australia was estimated to be $66.3 billion in 2016 – 17
  • This total is made up of $26.2 billion in financial costs and $40.1 billion in the loss of wellbeing.
  • The $26.2 billion in financial costs due to inadequate sleep are estimated to be as follows:
    • health system costs of $1.8 billion, or $246 per person with inadequate sleep;
    • productivity losses of $17.9 billion, or $2,418 per person with inadequate sleep;
    • informal care costs of $0.6 billion, or $82 per person with inadequate sleep; and
    • other costs (inc. welfare payments, tax losses) of $5.9 billion or $802 per person with inadequate sleep
  • The $40.1 billion in loss of wellbeing is estimated using World Health Organisation and Australian Government metrics which assess the non-financial costs of healthy life lost through disability and premature death from inadequate sleep and associated conditions.

How prevalent is inadequate sleep and what are its consequences?

  • The report found that inadequate sleep is highly prevalent in Australia with an estimated 39.8% of Australian adults experiencing some form of inadequate sleep.
  • It affects Australians of all ages, with inadequate sleep affecting learning and decision-making as well as increasing the risk of mental and physical illness.
  • Inadequate sleep can lead directly to fatality or work-related accidents. Two examples include falling asleep while driving, and medical staff making medication errors when on shifts.
  • Chronic inadequate sleep can cause heart disease, obesity, depression and a range of other serious health conditions which impacts the health budget.

As medical practitioners, what can be done?

  • Continue to focus on public preventive health measures to promote healthy sleep, involving lifestyle choice eg smoking cessation, alcohol moderation, diet and exercise.
  • Work with Work Health and Safety authorities should tighten regulation in work sectors where sleep is irregular but responsibility is high, such as defence, transport and health.
  • Promote changes to shift work schedules, to minimise the disruption to the circadian and sleep wake systems.
  • Educate our patients, and police services on the risk of sleep deficiency and road accidents. Tired and fatigued drivers are as risky as speeding and inebriation (23% of all MVAs).
  • Encourage driving restrictions where the driver has had less than a set minimum hours of sleep in the past 24 hours.
  • Computer screens emit blue light at wavelengths that affect the secretion of melatonin, a major sleep-promoting hormone melatonin. This reduces alertness the following day. Software is available that can reduce blue light intensity, particularly important after dark. Employers are being encouraged to provide this software to their employees.
  • Ultimately, the responsibility for reducing fatigue must be shared amongst government, industry, the workforce, the public and the medical/ scientific community.
    • Behavioural economics has shown that carefully worded education campaigns can be of minimal cost and highly effective.  Reducing poor sleep behaviour will result in gains in productivity and thus taxation revenue, and savings in health system costs could offset any expenditure outlays.
    • Supporting further research in the area of sleep will help establish evidence bases for potential regulation, practice and policy regarding fatigue, sleep and accident risk.