Want a safe, healthy, ALERT team?

As an employer, have you considered the impact of sleep, on the health and wellbeing of your team?

Lack of sleep could be putting you and your employees at risk.

Most people who don’t get enough sleep, don’t recognise the impact it has on their cognitive and mental health. Stay awake for 18+ consecutive hours and your reaction speed, memory, ability to focus, decision-making capacity, maths processing, cognitive speed and spatial orientation all start to suffer.1

Modern society often sees sleep as a luxury, yet sleep actually improves learning, memory and insight. On a cellular level the body is literally repairing and restoring itself.2

Workplace wellness schemes cover many elements from health insurance to gym membership to employee assistance schemes. Sleep is only just being recognised as a critical factor in health in wider society as well as at work and so is not often considered – until now.

PWC research3 states that workplace wellness schemes make commercial sense due to the following factors:

  • An increase in workforce age and change in its composition leading to employee expectation of wellness programmes and work-life balance initiatives
  • Rising costs of chronic disease and ill-health
  • External governmental and business pressures such as corporate social responsibility and competition.

The impact of sleep on your business?

There are more than 80 recognised sleep disorders, varying from mild to life-threatening. Common sleep disorders are insomnia, obstructive sleep apnoea (OSA), restless leg syndrome and narcolepsy.

What is OSA?

OSA is a condition where a person stops breathing temporarily during their sleep, sometimes several hundred times a night, due to their throat collapsing and becoming blocked.

The brain needs to arouse from sleep to start the person breathing again, and this causes a partial awakening, which the person may or may not be aware of.

This disruption to sleep can lead to a person feeling very sleepy during the day, and is linked with other serious health consequences.7

Apnoeas can cause sleep disruption and poor-quality sleep, leading to daytime sleepiness with reduced productivity8 and an increased risk of serious road traffic incidents and other accidents.

Research has also shown that the impact of untreated OSA is similar in magnitude to that of alcohol consumption9.

If left untreated, OSA can be a risk factor for stroke, cardiovascular problems or diabetes. There is also a link between OSA and obesity.

Sleep apnoea prevalence in society is increasing, while an estimated 93% of women and 82% of men with moderate to severe obstructive sleep apnoea syndrome (OSAS) have not been clinically diagnosed.10

The current prevalence estimates from 201311 for moderate to severe sleep disordered breathing are:

Unfortunately many adults who are obese also have sedentary lifestyles, a factor that further increases their risk for developing OSAS.
We all know how the loss of just one night’s good sleep may result in headache, mood changes, reduced concentration and increased appetite. Imagine the cumulative effect of that over months and years.
If you want to raise performance, you need to pay attention to [the] fundamental biological issue [of sleep]. 12
Why don’t my employees just go to the doctor?

It’s a good question… Sleepy individuals don’t go to their doctor for a number of reasons that may include:

  • Lack of symptom awareness (or putting them down to something else).
  • Failure to recognise that a condition has worsened over time – similar to how brakes gradually degrade on a car and you only notice when they fail!
  • Don’t want to admit that they’re ill – pride/ego/fear of showing weakness.
  • Fear of immediate lack of income due to delays in getting diagnosed and treated.
  • Concerns over data confidentiality and longer-term career impact.
  • Guilt – as if they’ve done something wrong.
  • Responsibility for family such that they ‘cannot’ be ill.
  • Fear of discrimination.

Furthermore, the British Lung Foundation found that:

9% of patients were initially told by their GP to either lose weight or that nothing needed to be done about it, and over 20% had to see their GP three or more times with symptoms before they were referred for a sleep study.13

The combination of people not consulting their doctor, and when they do they have to visit multiple times, shows that there has to be another way…

We have laws to prevent and protect us from accidents, yet for some people the fear of the impact of a diagnosis on their life, stops them from coming forward.

A survey undertaken by the Freight Transport Association (FTA) in the UK found that 98% of members agreed that drivers were unlikely to raise concerns about OSA with their GP, the DVLA or their employer, for fear of losing their licence.

That’s a staggering statistic, and when combined with the estimate of around 21% commercial drivers having undiagnosed sleep apnoea, that they are unlikely to come forward for help, and if they do it is likely to take multiple GP appointments to get tested and treated, it is little wonder that so many drivers continue to drive whilst drowsy, putting themselves and others at risk.

Researchers have estimated that sleep-related fatigue costs US businesses $150 billion a year in absenteeism, workplace accidents and other lost productivity.14

The impetus to support individuals to get help or seek treatment will often fall on the employer.

Reasons include:

  • the commercial and ethical benefits of having a healthy, productive, alert workforce
  • the impact of becoming an employer of choice
  • removing the risk of HSE or civil prosecution and
  • removing the risk of an incident to the employer brand reputation (“A XYZ company truck crashed on the M40 today killing X people. The Police are investigating the possibility that the driver fell asleep“)

So what can my company do?

Some individuals will recognise their sleepiness and get forwarded for testing and treatment via their GP.

However, the current model, as described above, clearly doesn’t work for all. Some individuals either don’t or won’t come forward for testing, or if they do, they might be turned away by their GP, and according to the British Lung Foundation, 85% of the UK population don’t have access to the most appropriate treatment.15

The BLF OSA Next Steps (2013) report stated that:

“…action is needed to support screening for signs and symptoms”

and the September 2015, The NHS Atlas of Variation report asked NHS commissioners and service providers to:

“…review referral and delivery models for sleep services… [and] review models for initial diagnostic testing and triage approaches to referral management.”16

I was wrongly diagnosed with asthma by my GP.

I told my GP I felt weak and depressed. It took five years to be referred to a sleep clinic.

Snorer.com provided a new channel for potential sleep apnoeaics – anonymous home sleep testing. We called it the ASAP Anonymous Sleep Apnoea Process™. But sadly, due to lack of commercial success we have had no option but to withdraw it.

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1. Harvard Business Review; Sleep Deficit: The Performance Killer, Bronwyn Fryer, 2006. https://hbr.org/2006/10/sleep-deficit-the-performance-killerexternal_link3 [accessed 26 July 2015]↩
2. Barry Krakow MD, cited by Camille Peri in “What lack of sleep does to your mind” published by WebMD. http://www.webmd.com/sleep-disorders/excessive-sleepiness-10/emotions-cognitiveexternal_link3 [accessed 26 July 2015]↩
3. Building the case for wellness. Dept for Work and Pensions. Gov.uk website. First published 8 July 2013. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/209547/hwwb-dwp-wellness-report-public.pdfexternal_link3 [15 Oct 2014]↩
4. The NHS Atlas of Variation in Healthcare, Public Health England, September 2015. Problems of the Respiratory System, Map 19: Rate of sleep studies undertaken per weighted population by CCG. pP81. ↩
5. Sivertsen, B., Björnsdóttir, E., Øverland, S., Bjorvatn, B. and Salo, P. (2013), The joint contribution of insomnia and obstructive sleep apnoea on sickness absence. Journal of Sleep Research, 22: 223–230. doi: 10.1111/j.1365-2869.2012.01055.x http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2869.2012.01055.x/abstract.external_link3 Research conducted in Norway in 2012 with 6,892 people aged 40-45 years. [Accessed 24th March 2014]↩
6. Berger M(1), Varvarigou V, Rielly A, Czeisler CA, Malhotra A, Kales SN. Employer-mandated sleep apnea screening and diagnosis in commercial drivers. Journal of occupational and environmental medicine. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415601/external_link3 [accessed 4th Sept 2014] ↩
7. British Lung Foundation, OSA Next Steps – why obstructive sleep apnoea must be a health priority. 2013, p4, https://www.blf.org.uk/sites/default/files/OHE-OSA-health-economics-report—FINAL—v2.pdfexternal_link3 ↩
8. Sivertsen, B., Björnsdóttir, E., Øverland, S., Bjorvatn, B. and Salo, P. (2013), The joint contribution of insomnia and obstructive sleep apnoea on sickness absence. Journal of Sleep Research, 22: 223–230. doi: 10.1111/j.1365-2869.2012.01055.x http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2869.2012.01055.x/abstractexternal_link3. Research conducted in Norway in 2012 with 6,892 people aged 40-45 years. [Accessed 24th March 2014]↩
9. Institute of Medicine (US) Committee on Sleep Medicine and Research; Colten HR, Altevogt BM, editors. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006. 4, Functional and Economic Impact of Sleep Loss and Sleep-Related Disorders. Available from: http://www.ncbi.nlm.nih.gov/books/NBK19958/external_link3 [Accessed 24th March 2014]↩
10. Young T, Evans L, Finn L, Palta M. Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997b;20(9):705–706. [PubMed]↩
11. Paul E. Peppard, Terry Young, Jodi H. Barnet, Mari Palta, Erika W. Hagen, and Khin Mae Hla. Increased Prevalence of Sleep-Disordered Breathing in Adults. Am. J. Epidemiol. (2013) 177 (9): 1006-1014 first published online April 14, 2013 doi:10.1093/aje/kws342. These estimated prevalence rates represent substantial increases over the last 2 decades (relative increases of between 14% and 55% depending on the subgroup). http://aje.oxfordjournals.org/content/177/9/1006external_link3 [Accessed 24 March 2014]↩
12. Harvard Business Review; Sleep Deficit: The Performance Killer, Bronwyn Fryer, 2006. https://hbr.org/2006/10/sleep-deficit-the-performance-killerexternal_link3 [accessed 26 July 2015]↩
13. British Lung Foundation, Obstructive sleep apnoea patient experience survey; J Harris, R Reeves, M Allen, I Jarrold, J Horne; 2013↩
14. Institute of Medicine (US) Committee on Sleep Medicine and Research; Colten HR, Altevogt BM, editors. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006. 4, Functional and Economic Impact of Sleep Loss and Sleep-Related Disorders. Available from: http://www.ncbi.nlm.nih.gov/books/NBK19958/external_link3 [Accessed 24th March 2014]↩
15. Juan Carlos Rejón-Parrilla, Martina Garau, Jon Sussex. Obstructive Sleep Apnoea Health Economics Report. British Lung Foundation, September 2014. https://www.blf.org.uk/Page/OSA-UK-health-economics-report.external_link3 ↩
16. The NHS Atlas of Variation in Healthcare, Public Health England, September 2015. Problems of the Respiratory System, Map 19: Rate of sleep studies undertaken per weighted population by CCG. pP81. external_link3 ↩

Created by Emma Easton nbsp;| Page last updated 3rd June 2020  

ASAP™ manufacturer is Snorer.com Ltd. 2 Baynards Green Farm Cottage, Baynards Green, Bicester, Oxfordshire, OX27 7SG, UK