A real eye-opener: navigating the UK’s pandemic ‘sleep debt’ crisis

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With pandemic home working beginning to shift for many to more permanent ‘hybrid’ working, employers and occupational health may both be needing to take a more proactive approach to supporting employees in good sleep and sleep hygiene practices, argues Gosia Bowling.

The pandemic has played havoc with our routines both inside and outside of the workplace, with many required suddenly to work from home. Whilst many have embraced positive aspects of remote working – like a reduced commute, the opportunity for exercise or spending extra time with family – the change has taken its toll on other aspects of our lives.

Research shows the number of people experiencing insomnia has risen to one in four since the pandemic, with many turning to the internet for support. Google searches for ‘insomnia’ have soared, with most made in the early hours, around 3am.

As we look forward to restrictions easing, it’s important to note the ‘new normal’ won’t automatically facilitate perfect sleeping patterns. Businesses are likely to adopt a ‘hybrid’ approach to working and employees will have new challenges to face. That’s why it’s crucial employers ‘wake up to sleep’ and work with occupational health practitioners to support their workforce.

The impact of the pandemic on sleep

Disturbed sleep has been one of the many negative symptoms of pandemic life, with 50% of the UK experiencing sleep loss in the last year.

Our body clocks have been thrown-off by social restrictions, with individuals unable to rely on their usual ‘time anchors’ – like morning commutes, evening runs and general exposure to bright mornings and dark evenings. Our mealtimes and usual work-life routines have also been disrupted.

As a result, our bodies struggle to regulate the time and ‘switch-off’ at night when we need to rest and recharge.

Additionally, there are mental health consequences of the pandemic. The constant uncertainty surrounding our lives – from anxiety around job security to worrying about the physical risk of the virus – this leaves us in a constant heightened state of stress.

As our bodies remains in ‘alert mode’ with increased heart rate and blood pressure, it’s difficult to return to the level of relaxation needed to drift off at night.

The problem is, we can’t simply ‘start again’ or repay our sleep debt the next day.  It takes time to physically recover from lost sleep. Just one hour of lost sleep can cause the body to play catch-up for four days.

For chronic struggling sleepers, this sleep debt accumulates to have a significant impact on every aspect of their lives.

Measuring the long-term effects

Lack of sleep doesn’t just leave employees feeling a bit tired and groggy. Sleep deprivation can also lead to a weakened immune system, with our bodies unable to effectively target infections and inflammation. Employees are then more likely to experience colds and infection, which in turn impacts work performance and causes further disruption to their sleep going forward.

Long-term sleep deprivation is also linked to more serious health problems like increased risk of certain cancers, heart disease, ulcers and gastrointestinal problems.

Once people are in a poor sleep cycle it can be difficult to escape. As many as 35% of individuals who have suffered sleep problems have done so for five years or more. Unregulated sleep leads to higher levels of stress hormones in our bodies, as well as impacting our appetite regulators and musculoskeletal (MSK) health.

Occupational health practitioners have a role to play in helping employees manage the resulting impact from poor sleep, which can include fatigue, anger, anxiety and depression, hunger and even physical pain. This may include offering wider advice such as how to improve their remote working set-up, suggesting daily exercises to mitigate MSK problems and regulating their appetite by making more nutritional dietary choices.

Occupational health practitioners have a role to play in helping employees manage the resulting impact from poor sleep, which can include fatigue, anger, anxiety and depression, hunger and even physical pain. This may include offering wider advice such as how to improve their remote working set-up, suggesting daily exercises to mitigate MSK problems and regulating their appetite by making more nutritional dietary choices.

Through this support, individuals can be helped to break the vicious cycle of poor sleep.

Poor productivity

Sleep deprivation is believed to cost the UK economy £37bn a year in lost productivity, with poor sleepers having reduced reaction times and trouble concentrating. They also have an increased likelihood of having accidents or making costly mistakes.

Ultimately, chronic disrupted sleep increases the risk of work absence by 171%.

Those trapped in the vicious cycle of disrupted sleep may experience stress-related fatigue – a constant state of tiredness, more common in those experiencing anxiety and depression. Even if they achieve a period of quality sleep, they can still feel fatigued.

Despite the impact of tiredness on productivity in the workplace, 86% of UK working adults report they feel unable to speak openly and in confidence with their line manager about how fatigue is affecting their performance.

Taken together these figures should act as a ‘wake-up call’ for employers.

Will a hybrid work environment be different?

In the wake of successful flexible working, many businesses are likely to adopt a ‘hybrid’ work environment, with employees continuing to work from home a few days a week.

For many, this brings benefits in limited commuting and greater balance between work and personal tasks – reducing anxiety, which can improve sleep among those who find their minds racing when their head hits the pillow.

However, the impact of long-term remote working – even as part of a hybrid approach – can also take its toll on employees who struggle to switch-off.

Remote employees may regularly exceed their expected working hours, continue to reply to emails late in the evening and engage in ‘bedmin’. And while they may see this as harmless and proactive, the reality is, it’s difficult to relax when you’re used to being ‘always on’.

Employers can provide advice on separating work and home life. This may include encouraging proper ‘sleep hygiene’ for remote workers and suggesting ways to transition from work to personal life, for example by exercising after work or switching device notifications off outside work hours.

Employer support in the ‘new normal’

Businesses tend to overvalue individuals who undervalue sleep. However, for those looking to maximise employee potential and nurture a positive, productive workforce, it’s important to reduce the business and health risks of sleep deprivation.

Those adopting a hybrid work approach should outline their expectations from the outset. This means defining working hours and letting employees know they aren’t expected to reply to emails outside of them. Employees should also be encouraged to work around their natural sleep patterns where possible, for example, avoiding scheduling early-morning or late-evening calls.

It can be difficult for career-focused employees to notice signs of difficulty in themselves, so line managers should be equipped to recognise distress in others and be confident in supporting them. Emotional literacy training and mental health awareness training for managers are designed to equip leaders with effective knowledge, tools and skills.

Occupational health specialists also play a key role in helping employees achieve quality sleep. This may include supporting them in understanding how to structure their day, such as avoiding putting in potentially stressful meetings late in the afternoon, when they risk taking the stress home with them when their body needs to relax.

Offering advice around nutrition and caffeine can help individuals make healthier choices, avoiding unhealthy habits which may exacerbate feelings of tiredness or fatigue, or stimulants that have the opposite effect, raising their heart rate and making them especially alert, interfering with rest and sleep.

It is also important to emphasise the benefits of exercise in regulating sleep patterns, just not right before bed, as we remain in an ‘activated’ mode for a while after exercising, making it difficult to sleep. Instead, an outdoor run or power walk during lunch hours not only gets employees away from their desks but also exposes them to natural daylight, promoting healthy sleep hormones.

Employers who are concerned that their teams are not taking healthy breaks or are reluctant to switch-off may even consider arranging group exercise classes. For example, inviting a fitness instructor to run a lunchtime session over a video call and letting employees know they’re encouraged to attend. It’s important to lead by example and announcing directors and managers will be attending these sessions can boost uptake throughout the wider company.

Additional employer support may include inviting a sleep specialist to run an online seminar on best practice habits before bed, such as avoiding blue light devices and keeping the bed for sleep only – not work.

Similarly, offering cognitive behavioural therapy (CBT) is an evidence-based approach that helps employees recognise and break unhelpful thought patterns which trigger the anxiety and stress keeping them up at night.

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About Gosia Bowling

Gosia Bowling is emotional wellbeing enhancement and prevention lead at Nuffield Health
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