Employees who live with sleep problems are likely to have health-care costs averaging as much as $3,000 more annually than people who normally get a good night’s sleep. Those with sleep disturbances also are more likely to miss work and have higher rates of “presenteeism” – they show up for work but do not get as much done.
Those are some of the conclusions of a study published in the October 2015 Journal of Occupational and Environmental Medicine. The study is based on employees’ answers to health questionnaires administered as part of the Kansas State Employee Wellness Program. The data showed 56 percent of 11,700 employees who completed the surveys had some degree of trouble getting a good night’s sleep.
“I’m hoping this raises some eyebrows,” said sleep and health researcher Michael A. Grandner, PhD, MTR, assistant professor of psychiatry at the University of Arizona College of Medicine – Tucson. “I would like employers to take the sleep of their employees as seriously as obesity and exercise and diet. They offer healthful food in their cafeterias, but sleep is related to many of the same health outcomes.”
Dr. Grandner is the second author on the study, which he and colleagues began in 2014, when he was an instructor in the Department of Psychiatry at the Perelman School of Medicine at the University of Pennsylvania. The lead author of the study is Siu-kuen Azor Hui, PhD, MSPH, a research assistant professor at Fox Chase Cancer Center in Philadelphia at the time the study was conducted. She is now with Public Health Management Corporation in Philadelphia.
“Employers need to be invested in the well-being of their employees by allowing them proper time during and after work to recover from workplace stress,” said Allison Gabriel, assistant professor of management and organizations at the UA Eller College of Management, and an expert in employee well-being. “Sleep is a critical component of that equation.”
Their findings echo those of a 2010 World Economic Forum report that said employees’ sleep problems lead to absenteeism, poor performance and workplace injuries that cause $150 billion in indirect costs to employers.
Of the 56 percent of Kansas state employees who reported some sleep problems, nearly 12 percent said they often or always had trouble sleeping, while 44 percent said they seldom or sometimes experienced sleep problems, and the other 44 percent said they never had trouble sleeping. Those 12 percent with the most frequent problems also missed the most work, had the lowest levels of performance and were responsible for the highest health-care expenditures.
The Kansas state employees who took part in the surveys “were a real cross section of the diverse workforce,” Dr. Grandner said. “They included a wide range of job types, from manual laborers to teachers to office workers.”
Employees who said they only seldom had sleep problems ran up annual health-care expenses $550 higher than people who said they never experienced trouble sleeping. Those who sometimes had sleep problems cost their employers $1,900 more a year in health care than those in the “never” category. Health-care costs for those reporting “often” having sleep problems were $3,600 more a year, while those in the “always” group ran up health-care costs of more than $5,000 higher a year than those who said they never missed a good night’s sleep.
After adjusting the analysis for age, gender and health status, the people who said they always have trouble sleeping still had about $3,500 more health-care expenses annually than those who always slept well, Dr. Grandner said.
Employees participating in the Kansas State Employee Wellness Program also reported absenteeism and diminished work performance They were asked: “During the last four weeks, how many days did you miss an entire or part of a work day because of problems with your physical or mental health?”
After adjusting for demographics, socioeconomics and health variables, those who were poor sleepers were two to six times as likely to miss work in the past month. In particular, individuals who reported trouble sleeping "often" or "always" were two to four times as likely to miss three to six total workdays in the last month and four to seven times as likely to miss at least a week of total work days during the past month.
Employees also were asked to rate their own performance and the performance of other employees doing the same job in the last four weeks, using a scale of zero (worst) to 10 (best). Compared to workers who reported never having trouble sleeping, those with trouble sleeping rated their own job performance as 3 to 4 percent worse. In addition, those with trouble sleeping said their own performance was 2.5 percent worse than others doing the same job.
“Current science tells us a healthy lifestyle really needs three life components to work together: diet, exercise and sleep,” said Dr. Hui, “but sleep is often a neglected health behavior in health-promotion programs, like employee wellness programs offered by many employers. They offer nutrition counseling and weight management, but very few also offer sleep improvement in their wellness programs. Employers really don’t invest enough to help their employees develop good sleep habits.”
Drs. Hui and Grandner concluded, “If employers were to invest in their employees’ healthy sleep, they may see lower rates of injuries, accidents and illness, including serious diseases like heart disease and diabetes. They also may see fewer missed workdays and improvement in productivity. At the end of the day, healthy sleep may be a good investment.”