Sleep Disorders: The Unacknowledged Drain on Worker Productivity

Sleep disorders affect up to 40% of the US adult population (70 million).¹ According to the National Institutes of Health, over 50% of patients with these problems remain undiagnosed and untreated.¹ Inadequate sleep has been linked to the onset and exacerbation of various chronic conditions including²:

• diabetes
• cardiovascular disease
• obesity; and
• depression.

Additionally, fatigue and certain sleep disorders, narcolepsy and sleep apnea increase the risk of motor vehicle accidents. Sleep disorders contribute to 12% of all motor vehicle crashes and 10% of all near-crashes.²

Common sleep disorders include:

• Insomnia: Characterized by an inability to initiate or maintain sleep.³ Affects approximately 10% to 33% of the US population.⁴
• Narcolepsy: Neurological disorder caused by the brain's inability to regulate sleeping and waking states. The main feature of narcolepsy is excessive daytime sleepiness.⁵ Affects approximately 1 in every 2,000 Americans.⁶
• Obstructive sleep apnea (OSA): Caused by a blockage of the airway in the rear of the throat during sleep that results in intermittent snoring. Breathing repeatedly stops during sleep, sometimes hundreds of times and often for a minute or longer. Affects 12 million adults nationwide.⁷
• Restless leg syndrome (RLS): Neurological disorder that causes an overwhelming urge to move the legs when they are at rest. Affects approximately 10% of the US adult population.⁸

Economic Costs and Why Employers Should Care
As the baby boomer generation ages, incidence of sleep disorders is projected to rise and lead to increased health care utilization and costs.² The economic impacts of insomnia, sleep apnea and narcolepsy have been investigated in terms of increased health care utilization.⁴ Suggested indirect costs include costs associated with illness-related morbidity and mortality, absenteeism, disability, reduction or loss of productivity, industrial and motor vehicle accidents, hospitalization and increased alcohol consumption.⁴

• Fatigue
  • Results in $150 billion annually in absenteeism, workplace accidents, and other lost productivity for employers.²
  • Fatigue and sleep-disordered breathing are associated with a combined 10% to 20% increase in health care utilization.⁴
• Insomnia
  • The most recent data for national annual expenditures on insomnia and its treatment was $13.96 billion.²
  • Those diagnosed with insomnia were twice as likely to seek treatment for emotional problems, have double the number of physicians visits and twice as many hospital admissions.²
• Obstructive Sleep Apnea (OSA)
  • 80% to 90% of OSA cases remain undiagnosed.²
  • The total cost to test and treat every American with OSA would be $17.5 billion and $3 billion, respectively.²
  • Undiagnosed children with OSA had a 226% increase in health care utilization and a greater number of emergency room visits.²
• Automobile accidents attributed to sleepiness
  • Total between $29.2 to $37.9 billion annually.²

What Employers Can Do
A recent survey found that 29% of adults reported falling asleep at work or becoming very sleepy while at work in the last month.⁹ Furthermore, adults who spent less than 6 hours in bed on workdays were more likely to have injured themselves or someone else at work or have a serious accident at work.⁹ Recommendations for managing employees with potential sleep disorders include:

• Determine prevalence of sleep disorders in your workforce.
• Develop employee communications on healthy sleep habits.
• Cover safe and effective sleep treatments

Those experiencing potential symptoms of a sleep disorder should contact their physician to discuss testing and treatment. For more resources about sleep and sleep disorders, please reference the Centers for Prevention and Disease Control (CDC) Sleep and Sleep Disorders: A Public Health Challenge. Additional information about national foundations and research is also available at CDC's Additional Sleep Resources and The American Academy of Sleep Medicine's SleepEducation.com.

References

1. 2003 National Sleep Disorders Research Plan. National Center on Sleep Disorder Research. National Heart, Lung and Blood Institute. National Institutes of Health; 2003.
2. George C. Sleep apnea, alertness, and motor vehicle crashes. American Journal of Respiratory and Critical Care Medicine. 2007;176:954-956.
3. Centers for Disease Control and Prevention. Sleep and sleep disorders: key sleep disorders. Available at: http://www.cdc.gov/sleep/disorders.htm. Accessed June 22.
4. Colten HR, Bruce M Altevogt. Sleep disorders and sleep deprivation: Institute of Medicine (U.S.) Committee on Sleep Medicine and Research; 2006.
5. National Sleep Foundation. Narcolepsy and sleep. Available at: http://www.sleepfoundation.org/article/sleep-related-problems/narcolepsy-and-sleep. Accessed June 22.
6. National Institute of Neurological Disorders and Stroke (NINDS). Narcolepsy Fact Sheet. Available at: http://www.ninds.nih.gov/disorders/narcolepsy/detail_narcolepsy.htm. Accessed June 22.
7. American Sleep Apnea Association (ASAA). Sleep Apnea Information. Available at: http://www.sleepapnea.org/info/index.html. Accessed June 22.
8. National Sleep Foundation. Restless Legs Syndrome (RLS) and Sleep. Available at: http://www.sleepfoundation.org/article/sleep-related-problems/restless-legs-syndrome-rls-and-sleep. Accessed June 22,.
9. National Sleep Foundation. 2008 Sleep in America Poll: Summary of Findings. Washington, DC: 2008.