Give it a rest

If you haven’t stopped to appreciate the effects of sleep (or a lack of it) on yourself and your employees, it’s time for a wake-up call.

Sleep is vital. It restocks the body’s immune system to help combat illness and infections, and optimises the body’s metabolic rate. There’s not a single major organ in the body or process within the brain that is not optimally enhanced by sleep, or impaired by a lack of it.

To understand how important sleep is, you have to understand what it does. Sleep is far more than just a passive, ‘non-awake’ state. It’s an active process with its own very specific cycles and functions. During sleep your memories are ‘filed away’, as short-term memories become long-term memories and irrelevant information is discarded. During sleep the body’s cells regenerate, and most growth takes place. Metabolic processes are put on ‘pause’, while your heart rate and breathing slow down, and your blood pressure drops.

On the other hand, a number of negative things happen when you don’t sleep. Hundreds of medical studies have investigated the relationship between sleep and human performance, showing how sleep deprivation reduces productivity, and forces individuals to take more time to accomplish a goal. As a result, sleep-deprived workers can get trapped in a negative loop of having to work longer hours, thereby further reducing their sleep times. Brain scans on sleep-deprived patients show how the frontal lobe – which is critical for self-control and managing emotional impulses – disengages during extreme fatigue. In other words, you’re tired because you’re cranky … and you’re cranky because you’re tired.

The new on-the-job injury

Stress and anxiety – which often manifest as sleeplessness – are a growing problem in the modern economy. ‘While this modern world of work is opening up amazing  possibilities, it has also brought a new set of challenges and health risks,’ Clement Chinaka, MD of Old Mutual Corporate, said in a recent statement. Chinaka’s comments came in the wake of the publication of the 2017 Old Mutual Corporate Disability Monitor, which analysed disability trends in South Africa. One of its key findings was that 43% of survey respondents (who were corporate businesses, intermediaries, reinsurers and assessors) reported that the nature of disability claims had changed.

‘Following the digital revolution, it appears that the focus of workplace health issues has shifted from physical injuries to stress related and psychological problems,’ Chinaka said. Backing this up, 54% of survey respondents cited stress as a leading cause of disability claims, while 39% cited psychological issues.

Old Mutual’s interest in the issue is obvious: as an insurer, it’s paying out more and more disability claims to companies whose workers aren’t physically injured on the job, but who are being overworked to the point of exhaustion.

Those stressed, depressed and/or sleepless workers cost the South African economy a total of R218 billion in lost productivity, according to research by the South African Depression and Anxiety Group (SADAG).

 

Of that, R28 billion is attributed to absenteeism (unscheduled absence from work), and R190 billion to presenteeism (working when you’re unwell).

 

Most depressing of all are the results of a 2015 Boston University study, which found that overworking actually makes no difference at all. Managers in the study could not tell the difference between employees who worked an 80-hour week and those who just pretended to. What’s more, the study found no evidence that those ‘pretending’ workers accomplished less than their double-time colleagues; nor any evidence that the overworking employees accomplished more than the ones who did no actual work.

 

The dangers of sleep deprivation

Seeking to combat the effects of employee fatigue and burnout, France introduced a law in 2017 that establishes workers’ ‘right to disconnect’. This law requires companies with more than 50 employees to set hours during which staff are not allowed to send or answer work-related emails. The law aims to ensure that employees are fairly paid for their work, while also preventing burnout by protecting their private time and encouraging them to ‘switch off’.

Similarly, in 2014, German automotive company Daimler allowed employees who went away on holiday to forego out-of-office email replies, and rather have all new emails automatically deleted while they were away. These changes to company culture may seem drastic, but they make sense in the long run. When workers are fatigued or sleep deprived, they put themselves and others at risk. Disasters like the nuclear incidents at Three Mile Island and Chernobyl, the grounding of the Star Princess cruise ship, and the catastrophic Exxon Valdez oil spill have all been attributed to worker fatigue. In 2003, the South African Medical Journal cited a Wits University study that showed that, of a small sample of 102 Gauteng truck drivers, some 9% showed signs of sleep apnoea, while 23% reported regular snoring. Wits physiologist and study author Claudia Maldonado reported positive correlations between sleep apnoea and vehicle accidents. This finding was supported by insurance companies, which reported a road accident rate that’s two to five times higher among drivers with sleep apnoea.

Consider the results of a University of New South Wales study published in 2000 in the journal Occupational and Environmental Medicine, which found that being awake for 17 hours straight is equivalent to having a blood alcohol level of 0.05%. Being awake for 20 hours is equivalent to having a blood alcohol level of 0.1%. It’s worth remembering that in South Africa, the legal blood alcohol limit is 0.05%.

 

Finding rest

While it’s not the only sleep disorder, sleep apnoea is certainly one of the most common. In this potentially serious – and often chronic – disorder, the patient repeatedly stops breathing during sleep. Symptoms include loud snoring, and feeling tired even after a full night’s shuteye. ‘The bulk of patients at most sleep centres around the world come in for sleep apnoea,’ says Dr Marlene Gounder, a clinical neurophysiologist at the Sleep Disorder Centre at Cape Town’s Life Vincent Palotti Hospital. ‘Most are your snorers or your constantly tired patients. In many cases they get quantity, but not quality, of sleep.’

Dr Gounder says that sleep centres will monitor a patient overnight, and provide diagnostic information as to why they are not sleeping effectively. ‘Patients often wait far too long,’ she says, ‘so in many cases by the time we see them they’ve had the symptoms for years. Fortunately there is more awareness about sleep deprivation these days, so people know more about it. Google also helps a lot of patients to realise that they have the symptoms.’ Gounder emphasises that patients who are sleep deprived simply cannot function as they should. ‘They do not have optimal function during the day,’ she says. ‘Fatigue and sleep deprivation in general can have a huge impact on your life, with negative effects on both the body and the mind.’ Speaking about conditions like sleep apnoea specifically, Gounder says that these are linked to many other medical conditions. She lists these as including high blood pressure, diabetes, heart conditions, stroke, depression, anxiety, panic attacks, mood swings, weight gain …

‘The list goes on,’ she says. ‘Whatever happens during the night affects your day, and whatever happens during the day affects your night.’