With chronic insomnia costing the UK economy up to an estimated £34 billion per year due to productivity loss in the workplace, what can be done to help?
Alistair Paice, UK Country Medical Director at Idorsia Pharmaceuticals UK Ltd. explores findings from first-of-its-kind research which reveal the substantial impact chronic insomnia has on individuals, society and the economy – including targeted policy and clinical practice strategies to mitigate the burden of the condition better.
What is chronic insomnia?
Chronic insomnia is quite different from a brief period of poor sleep – it is a persistent medical condition that impacts a person’s ability to fall or stay asleep, for at least three nights per week, for at least three months.
Chronic insomnia results from neurobiological dysregulation, where wake-promoting areas in the brain remain active at night.
However, it’s not only a condition of the night – a key symptom is the impairment of daytime functioning.
How does chronic insomnia affect people’s day-to-day lives?
Sleep is an essential pillar for good physical and mental health, and its importance can often be overlooked.
Without adequate, restorative sleep, individuals can face many issues that negatively affect their daily lives, placing a serious toll on their well-being and quality of life.
Chronic insomnia is strongly linked with significant decrements in health status, such as fatigue, reduced energy, mood alteration and cognitive difficulties.
A lack of quality sleep because of chronic insomnia can have direct consequences such as decreased productivity in the workplace, injuries, and increased accidents.
In a recent UK survey of 155 chronic insomnia patients, more than 80% of respondents reported that their insomnia impacted their ability to sustain a healthy level of physical activity, perform at work, maintain their stress levels, concentrate and feel in a good mood during the day.
Respondents also highlighted their concerns about putting themselves at risk following a night of interrupted sleep. More than three-quarters of respondents surveyed felt they had exposed themselves to risky situations, such as accidents and falls, due to their chronic insomnia.
There is a clear stigma regarding sleep and chronic insomnia
The survey results showed that nearly three-quarters of respondents felt misunderstood, and a similar portion said they were worried that others around them didn’t consider insomnia to be a recognised medical condition.
The unhelpful stigma surrounding chronic insomnia perpetuates the problem and can potentially hinder people from seeking help.
The findings of this survey are important as they highlight the significant physical and mental health impact that continued lack of sleep can have on people’s day-to-day lives.
What are the wider socioeconomic consequences of chronic insomnia in the UK?
The consequences of chronic insomnia extend far beyond the individual; the condition also has significantly broader societal and economic impacts.
First-of-its-kind research from RAND Europe, commissioned by Idorsia Pharmaceuticals Ltd. Switzerland, estimates that chronic insomnia costs the UK economy up to an estimated £34 billion in gross domestic product (GDP) per year due to productivity loss in the workplace.
The report reveals the indirect and ‘hidden’ costs that sleep disorders place on the UK economy, which are typically overlooked in healthcare cost calculations.
Findings from the report show that in the UK, chronic insomnia is associated with approximately 11 to 18 days of absence from work, 39 to 45 days of working whilst sick, and 44 to 54 days of overall productivity loss annually for an individual.
Because of chronic insomnia, the UK GDP loses 1.31% in productivity per year
When calculated at a population level, these working days lost to chronic insomnia result in an overall cost to the UK GDP of 1.31% in lost productivity per year, meaning that around £1 in every £76 of national wealth is lost.
“Ensuring the health of our workforce is fundamental to building economic growth, and these new findings highlight what a critical impact sleep conditions like chronic insomnia disorder can have on this,” says Kevin Bampton, CEO, British Occupational Hygiene Society.
The well-being impacts of chronic insomnia were examined in the report
The findings further highlight the serious toll that insomnia places on the quality of life and well-being, with those affected willing to trade, on average, an estimated 14% of their annual per-capita household income to recuperate the well-being loss associated with the condition.
When extrapolated across the UK population, the total well-being costs of insomnia in the UK could be close to £17.7 billion.
While such “hidden costs” cannot be directly observed through economic transactions, they still impact an individual’s health or well-being, placing further knock-on effects on health systems, employers and societies.
Furthermore, inadequate sleep caused by conditions such as chronic insomnia places a significant burden on healthcare spending and resources.
Despite being a common condition, research into the broader societal consequences of insomnia and its indirect economic impacts has, until now, been very limited.
Understanding the socioeconomic effects of the condition is crucial in helping to identify opportunities for scalable interventions.
What more can be done to support patients and reduce the burden of chronic insomnia?
There are a series of targeted recommendations provided in the report for policymakers, clinicians and employers, which, if implemented, could potentially help to reduce the burden of sleep conditions in the UK.
According to RAND Europe, strategies are needed to better mitigate the burden of chronic insomnia through policy, clinical practice and future research to positively impact the health, well-being and productivity of individuals and society as a whole.
One of the recommendations included in the report is the need for public health campaigns to emphasise the importance of sleep quality and quantity.
For example, campaigns could educate people on ways to improve the quality of their sleep, such as maintaining a consistent sleep-wake schedule and adapting appropriate sleep hygiene techniques.
Policies can also be adopted in clinical practice; the report highlights the need to incorporate screening for insomnia into routine clinical visits to improve diagnosis and treatment.
Early detection of sleep disorders and their related causes may ultimately reduce downstream health and productivity consequences, as well as the burden on the healthcare system in the UK.
RAND Europe and clinical-care pathways
Additionally, RAND Europe recommends that clinical-care pathways within healthcare systems – from screening to diagnosis and management to treatment – are established and standardised to ensure patients receive timely access to diagnosis and treatment.
The report also suggests that medical training for healthcare professionals could be revised to include a more in-depth focus on sleep health and the identification and clinical management of sleep disorders, such as insomnia.
Continuing education regarding evidence-based treatments for chronic insomnia could also support clinical decision-making to improve patient care.
The report highlights the importance of policies and interventions to mitigate the impacts of chronic insomnia in the workplace, as the immediate effects of the condition are likely to be felt when people are at work.
The report suggests that employers, particularly HR departments, and employees could be better educated on the signs and symptoms of chronic insomnia, its impact on cognitive function, health and wellbeing and its risks related to workplace-related errors, accidents and injuries.
Policies can also be adopted encouraging employers to create workplace environments that support sleep health – such as providing access to wellness apps or programmes, limiting email traffic after working hours, and providing flexible hours to support a work-life balance.
“Recent years have shown the difference employers can make in protecting the health of their workforce by implementing preventative measures.
Elevating the importance of sleep health and supporting employees to achieve the restorative sleep, they need not only supports workers’ health but has the potential to improve productivity, to the benefit of all,” Kevin Bampton concludes.
RAND Europe’s research findings underscore a clear need to address the current burden of chronic insomnia in the UK to reduce its impact on individuals and society.
The report, The Societal and Economic Burden of Insomnia in Adults: An International Study, which includes further policy and clinical practice recommendations, can be found on RAND Europe’s website.
This piece was written and provided by Alistair Paice, UK Country Medical Director at Idorsia Pharmaceuticals UK Ltd.