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An employers’ guide to promoting healthy employee sleep and mental health

Why is sleep so important to general and mental health? And how can employers promote good sleep to support employee wellness and productivity?

In 2007, two years after founding the Huffington Post Media Group, Arianna Huffington awoke in a pool of blood, her worried daughter hovering at her side. The hard-driving executive had worked herself into a state of exhaustion that led her to fall asleep at her desk and break her cheekbone. Save for her injury, Huffington’s situation wasn’t unusual; in 2008, the Sleep Foundation’s Sleep in America poll found that 29 percent of people had either fallen asleep or become very sleepy at work.1,2,3

Huffington awoke that day in more ways than one. Realising her gruelling schedule was endangering both her own and her company’s health, she began pursuing a healthier lifestyle, which included improving the quality and amount of sleep she got. Four years later, she sold her young company to AOL for $315 million. ‘I have to assure you that the success at the Huffington Post happened after I started taking care of myself’, she said in 2018.

Of course, Huffington isn’t the only business leader to have ever considered sleep to be optional. Microsoft cofounder Bill Gates once pulled frequent all-nighters and envied those who seemed to thrive on three or four hours of sleep a night. ‘I used to work all night in the office, but it’s been quite a while since I lived on catnaps’, he has written. ‘I like to get seven hours of sleep a night because that’s what I need to stay sharp and creative and upbeat’.4

Unfortunately, ‘sharp and creative and upbeat’ describes a shrinking number of workers today because fewer people than ever are getting enough sleep. In 1942, eight hours sleep a night was the global average, but by 2014 no country in the world was achieving that standard.5

‘It’s easy to think we face uniquely weighty challenges today that require us to skimp on sleep’, says Dr Lori Stetz, Senior Medical Director, Aetna International. ‘However, we should remember that in 1942 World War II was at its midpoint, yet people were still managing to get sufficient sleep then’.

Causes of sleep deprivation

A major factor in the decline of sleep is undoubtedly technology, which allows many professionals to take work home (or on an airplane or to the beach or anywhere else they go). As the Sleep Foundation has found, ‘People spend an average of 4.5 hours doing work at home each week, with 20 percent spending 10 or more hours working at home. This could represent a cycle in which people are less productive at work because they’re tired, so they bring work home, only to have it interfere with their sleep’.

As sleep researcher Christopher M. Barnes, Ph.D., at the University of Washington, notes, ‘when you use your smartphone late at night, it means you fall asleep later, you get less sleep the next day, you go to work tired and you’re lower in work engagement. So by trying to cram in some more work on your phone late at night you actually work less the next day’.6

What’s more, as the Harvard Business Review has noted, ‘Responsiveness breeds the need for more responsiveness. When people are “always on”, responsiveness becomes ingrained in the way they work, expected by clients and partners and even institutionalised in performance metrics. There is no impetus to explore whether the work actually requires 24/7 responsiveness; to the contrary, people just work harder and longer, without considering how they could work better.’7

Some employers may exacerbate the problem in other ways. According to Rand Health Quarterly, ‘an employee who works irregular hours, commutes 30 to 60 minutes to work (one way) and is exposed to a set of different measures of workplace psychosocial risks, such as unrealistic time pressures, sleeps on average about 28.5 minutes per day less than an employee that has regular working hours, commutes only up to 15 minutes (one way) and is not exposed to psychosocial risk factors at the workplace. This equates to over 173 hours of lost sleep per year’.8

‘Expatriates may well lose even more sleep due to workplace-related issues, especially when they’re working several time zones away from home’, says Dr Mitesh Patel, Medical Director, Aetna International. ‘Emails from headquarters fill their inboxes while they sleep, they have to get up early or stay up late to participate in conference calls and frequent travel throws off their circadian rhythms’.

But there are other factors at play as well. The lifestyle issues that have led to a marked increase around the world in preventable diseases like diabetes also affect people’s sleep patterns. Rand Health Quarterly notes that people who are overweight or obese, who smoke, who regularly consume sugary beverages and/or who are physically inactive are more likely than their peers to get insufficient sleep. Tempur’s The Science of Sleep report adds alcohol to the mix, reporting that ‘only 8 percent of those who drink alcohol every day enjoy good sleep versus nearly 40 percent of those who only drink once a week’.9

Lack of sleep link with productivity

Employers don’t need to pry into their workers’ sleep patterns. However, understanding the impact of sleep deprivation on productivity and taking steps to address it could have significant benefits. A study by RAND Europe and Cambridge University said that a lack of sleep is the leading cause of low productivity.10

According to Rand Health Quarterly, ‘a worker sleeping less than six hours loses around six working days due to absenteeism or presenteeism per year more than a worker sleeping seven to nine hours. A person sleeping six to seven hours loses on average about 3.7 working days more per year’.11

And that’s just the beginning, according to sleep researcher Christopher M. Barnes. ‘When you are sleep-deprived and you’re trying to get a really important task done, you are going to be less creative and less innovative, which is a really big problem in industries where innovation is the lifeblood’.12

You’re also more likely to make mistakes. The Sleep Foundation reports that on-call medical residents who work overnight ‘have twice as many attention failures and report 300 percent more medical errors that lead to death than those who work a 16-hour shift’. By contrast, the foundation says, ‘In one study, researchers capped the workweek of medical school interns at 80 hours and found that these interns had less than half the rate of failures in attention than did the interns who worked more than 80 hours’.13

Barnes also points out that hospitals and airlines have guidelines in place to ensure that key workers can get the sleep they need. But, he argues, ‘I would say that pilots and surgeons are not the only people in this world doing important work; many of the rest of us have important outcomes at work that can be harmed by sleep deprivation’.

Sleep deprivation and mental health

While eight hours of sleep is a commonly recognised goal, everybody’s sleep needs are different. Some of us don’t need that much sleep; some of us need more. Many highly productive people these days do try to sleep more to improve their overall health and wellness, improving their focus and productivity in turn.

Besides affecting work performance, sleep deprivation also creates or exacerbates both physical and mental health problems. A lack of sleep can have a significant impact on mental health, playing a role in depression, anxiety and moodiness. Between ‘50 and 80 percent of psychiatric patients suffer from chronic health problems, and those who sleep less than 6 hours face a 13 percent higher mortality rate than those who average seven to nine hours of sleep’.14

Research has shown that without enough sleep we can become less cooperative, more selfish and less inclined to behave ethically. For those already struggling with anxiety and stress, removing behavioural filters could exacerbate their fragile emotional or mental health.15

Given the toll poor sleep habits take on workers, and the follow-on impact on productivity and health care costs, employers have a vested interest in helping their workers understand how to get better sleep. Here are five actions organisations can implement to help employees achieve better sleep:

Set boundaries: Just because people can work anytime and anywhere doesn’t mean they should. A decade ago, researchers at Harvard Business School worked with teams at the Boston Consulting Group to study what happens when workers are required to take regular time off. ‘After only five months, consultants on teams with predictable time off perceived their work situations more favourably — on every dimension — than peers on non-experiment teams’, researchers reported. (The dimensions measured were job satisfaction, long-term career, work/life balance, learning/development, open communication and value delivery.) One man spoke for many when he said, ‘My project manager pushed me out of the office to make sure I took the time off, even though it was a busy week. I came back really refreshed’. Employers can provide their workers with access to health coaching and work-life balance support, such as employee assistance programmes (EAP). Such a programme can help employees ensure their lives run more smoothly, supporting better mental and physical health.16

Set a good example: Writing in MIT Sloan Management Review, Christopher M. Barnes and his colleague Gretchen Spreitzer, Ph.D., indicated how examples can work both negatively and positively: ‘If leaders send messages late in the evening, employees will feel pressure to watch their email late into the night. To minimize this problem, one executive continued to craft emails late at night but used a scheduling feature so they would not be sent until normal business hours in the morning’.17

Promote wellness benefits that address root causes: As noted above, negative lifestyle factors can impact sleep quality. Smoking cessation programs, onsite fitness facilities and wellness programs that reward workers for getting in shape can mitigate these factors, helping workers improve both their sleep quality and their overall quality of life. ‘People facing chronic insomnia should also see their GPs or family doctor, as insomnia can be a symptom of a problem like sleep apnoea’, says Dr Stella George, Senior Medical Director, Aetna International.

Encourage on-site napping: PricewaterhouseCoopers included ‘nap pods’ when it built a new office in Switzerland. The building’s designer, Stefan Camenzind, CEO of Evolution Design, says, ‘Most people are told that the harder you work, the longer you work, the better it is. That’s not sustainable, and that’s probably also not true. It’s about smart working, and that means you need to recharge. In this context, nap rooms become more and more important.’18

Promote meditation, mindfulness and yoga: It is claimed that some meditation and yoga practises can enhance the quality of sleep. Physical breathing techniques or breathwork is reported to be beneficial to sleep ‘by bringing harmony between body and mind’. The National Sleep Foundation cites meditation as a ‘cheap and easy way to treat insomnia’ stating that ‘the deep relaxation technique has been shown to increase sleep time, improve sleep quality, and make it easier to fall (and stay) asleep.’19 Studies have shown that meditation has a beneficial impact on blood pressure and stress levels immediately after practising the technique. While Neuro Science and Neurophysiology experts state that yoga practices such as Sudarshan Kriya Yoga (SKY) can help to “retain slow wave sleep and enhance REM sleep in middle age participants.” Study Meditation practise can also be combined with mindfulness.20

Programs like Mindfulness-Based Stress Reduction have been proven to alleviate psychological conditions that negatively affect sleep. In one study, participants without formal training in meditation were taught how to do four practices (mindful breathing, body scans, mindful focus on an everyday task and loving kindness meditation) each day before and after work. According to Greater Good Magazine, ‘The results indicate that over the course of the two-week period, meditators experienced steady improvements in sleep quality, sleep duration and mindfulness, but did not demonstrate significant enhancements in their ability to psychologically detach from work’. Researcher Ute Hülsheger, Ph.D., who organised the study, says, ‘The more workload and time pressure people have, the less mindful they are. So if organizations are serious about mindfulness, they should not only offer trainings but should also give employees space to focus on one task at a time — not force them to do five things at once.’21

Share tips and advice: Regularly sharing articles and information with employees can prompt them to make small adjustments to their behaviours, gradually helping to improve their well-being over time. As an example, read and share ‘10 tips to help you sleep for peak performance, health and well-being’.

Check out our Sleep Facts, Stats and Tips infographic

For more information

Employee Assistance Program (EAP). To help your employees handle their stressors so that they don’t spill over into the workplace or impact their work-life balance, find out more about Aetna International’s EAP service. Contact your sales or account manager for more information. To provide eligible employees with access to EAP to help them stay productive while taking care of personal issues, direct your employees to log in to (or register for) the Health Hub — the online member portal. Workplace Options (WPO), a leading global provider of integrated employee wellbeing services, powers our EAP service. According to a WPO study, 58 percent of employees would consider using free confidential counselling made available by their employer.22

Wellness webinars: Aetna International also provides customers and their employees with access to wellness webinars to help employees live well and feel better.  To find out how to tap into the webinars, email the Aetna CARE team here. Currently available during EST working hours, the webinars regularly attract Aetna International Americas members living around the world, including the Middle East, Europe, Africa and the U.S..

Corporate health and wellness programmes: From smoking cessation to mindful eating, we often work with customers to design and roll out in-office health and wellness programmes. These are designed to help employees adopt healthier behaviours, thereby improving their overall well-being. For example, in a 2018 workshop designed to help people give up smoking, 71 percent of the programme’s participants gave up the habit within 6 weeks and stuck with it.

Read ‘10 tips to help you sleep for peak performance, health and well-being’ article or share it with your employees to provide clear guidance on how people can improve their sleep hygiene, improve their health and come to work refreshed and energised.

For support looking after the health and well-being of your employees, contact your regional sales or account manager. You can also find more Fit for Duty materials here.

Aetna® is a trademark of Aetna Inc. and is protected throughout the world by trademark registrations and treaties.

Additional Sources:

1 https://www.cnbc.com/2018/03/11/arianna-huffington-became-successful-after-she-started-sleeping-well.html
2 https://www.cnbc.com/2016/06/28/media-mogul-arianna-huffington-describes-the-epiphany-that-changed-her-life.html
3 https://www.sleepfoundation.org/excessive-sleepiness/performance/good-nights-sleep-helps-job-performance
4 https://www.cnbc.com/2017/08/02/jeff-bezos-and-bill-gates-say-they-work-best-after-sleeping.html
5 https://www.aetnainternational.com/en/about-us/explore/health-care/lifestyle-better-health/sleep-facts-stats-tips.html
6 https://www.youtube.com/watch?v=z8rpaCSm708
7 https://hbr.org/2009/10/making-time-off-predictable-and-required
8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627640/
9 https://www.raconteur.net/healthcare/global-sleep-trends
10 https://www.raconteur.net/healthcare/global-sleep-trends
11 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627640/
12 https://www.youtube.com/watch?v=z8rpaCSm708
13 https://www.sleepfoundation.org/excessive-sleepiness/performance/good-nights-sleep-helps-job-performance
14 https://www.health.harvard.edu/newsletter_article/sleep-and-mental-health
15 https://www.youtube.com/watch?v=z8rpaCSm708
16 https://hbr.org/2009/10/making-time-off-predictable-and-required
17 https://sloanreview.mit.edu/article/why-sleep-is-a-strategic-resource/
18 https://www.inc.com/zoe-henry/google-uber-and-other-companies-where-you-can-nap-at-the-office.html
19 https://www.sleepfoundation.org/articles/how-meditation-can-treat-insomnia
20 https://link.springer.com/article/10.1111/j.1479-8425.2006.00233.x
21 https://greatergood.berkeley.edu/article/item/how_mindfulness_improves_sleep
22 https://www.workplaceoptions.com/polls/more-than-half-of-employees-who-experienced-a-traumatic-event-affecting-their-workplace-say-their-employer-did-not-make-counseling-available/

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