The lawyers get it worst. James MacFarlane, a Toronto sleep specialist and director of education at MedSleep, a Canadian chain of sleep clinics, regularly sees their bleary faces and hears a similar refrain: awoke around 3 a.m. and couldn’t get back to sleep, the mind racing ahead to the morning’s tasks. “They get into terrible states and end up being referred here for sleep-maintenance insomnia,” he says. Another type he sees often is the middle manager whose job frustration or insecurity — caused by an unsympathetic boss or work overload — keeps him tossing till near dawn. And then there are the shift workers, their lives flipping between days and nights until some claim disability for “shift work disorder,” and MacFarlane finds himself testifying before tribunals about the toll sleep deprivation can exact on performance and health. “If you’re in a chronic pattern of sleep loss and disruption, combined with high stress, that can be a prelude to depression. And it’s just not on most companies’ radar.”
Clinicians like MacFarlane, who see armies of the tired tramp through their offices, aren’t shy to call sleep deprivation a silent epidemic. And statistics back them up. A third of respondents to polls by various American and Canadian health organizations report getting a good night’s rest at best a few times per month; more than one in 10 — some studies say almost 50% — suffer from insomnia. The effect is predictable: a third of us fall asleep or get drowsy at work at least monthly. Arshad Chowdhury founded an international chain of urban “nap centres” called MetroNaps after seeing his investment banking colleagues sneaking off to doze in bathrooms.
The cause of all this sleepiness may be largely a lifestyle choice, but it’s a lifestyle driven by a corporate culture that rewards long hours as a mark of productivity. Our “sleep machismo,” says Charles Czeisler, director of sleep medicine at Harvard Medical School, “glorifies sleeplessness in the way we once glorified people who could hold their liquor.” The average person needs 8.25 hours of sleep per day — 95 minutes more than that average person actually gets. And an hour of that deficit has crept in over just the past 30 years. “If sleep is part of the evolutionary process, that [loss] is going to have consequences,” says Colin Shapiro, who runs the University Health Network’s Sleep and Alertness Clinic in Toronto. “People don’t realize there’s a difference in their performance. That’s the scary part.”
Those consequences can be lethal. Think of the most egregious industrial disasters — Bhopal, Chernobyl, Three Mile Island, the Exxon Valdez spill; all had sleep-deprived workers at the proverbial switch. What’s more, drowsiness is one of the Top 3 causes of car accidents. Several companies, including McDonald’s, have successfully been sued in the U.S. when employees got into crashes after working long shifts and then driving home. Indeed, researchers have found that getting five or fewer hours of sleep five nights in a row has an impact on memory, attention and speed of thinking equivalent to being legally drunk.
But sleeplessness has more subtle and pervasive effects on the workplace. Several studies published in recent months examined the financial impact of a sleep-deprived workforce. One group looked at the effect of sleep loss on productivity at four American companies and found employees who weren’t sleeping well or enough to be roughly twice as likely to report difficulties with time management, decision-making and motivation. The resulting drops in performance cost those businesses an average of US$1,967 a year per employee (US$3,556 for those with frequent insomnia), and US$54 million at the four companies combined. What’s more, those figures didn’t include the cost of absences (which another study found to be 50% higher for workers with sleep problems) or drowsiness-caused accidents. Another recent paper, this one in Quebec, put the annual financial toll of insomnia in the province at $6.6 billion; three-quarters of that amount stemmed from work absences and reduced productivity, meaning they were absorbed largely by employers.
As for who among us is most likely to go on inadequate sleep, there’s a recent study on that, too. The answer: corporate executives — even more than transportation workers.
Sleep deprivation tends to be a vicious cycle: work-related stress, the leading cause of sleeplessness for Canadians, produces tired people who then struggle to cope with work pressure the following day. Yet while scientists insist that sleep is one of the three pillars of well-being — alongside nutrition and exercise — our sleep literacy lags. Just ask the steel-willed Alpha type who rouses groggily after a few hours of shuteye to get to the early-morning spinning class. A growing chorus of scientists and pundits, however, is pushing companies to promote better rest among their employees. “It’s time to sleep our way to the top,” Arianna Huffington charged readers of The Huffington Post earlier this year as part of the online newspaper’s Sleep Challenge 2010. Corporate Canada needs to wake up to the fact that the hard driver still at the office at 11 p.m. may be there not because he’s exceptionally productive, but because he’s not productive enough.
In some industries — emergency medicine, airlines, trucking — long shifts with little sleep are the norm, and managers worried about potentially deadly oversights are paying increasing attention to the effects of sleep deprivation (many railways now have directors of alertness or similar roles). Then there are other professions — investment banking, for example, and certain types of law and consulting — where forsaking sleep to get the job done is simply an implicit expectation, and no one frets much about the potential costs of fatigue. One Bay Street lawyer who specializes in corporate finance and requested anonymity, says that during transaction closings, it’s common for the legal team to work 36 hours straight. “Sometimes, it’s an obvious requirement to be at the office [to finish by the deadline], and those requirements are not a surprise to anyone. It’s part of the job,” he says. “You hope to get out of here at 2 a.m., but it never happens.”
He commonly sleeps two to three hours a night, and believes it’s not because of work stress. “I’m just more comfortable finishing what I’ve started” before going to bed, he says. In fact, he contends that even during overnighters, fatigue isn’t a factor. “Everybody worries about making mistakes,” he says, “but when it comes to choosing between working 24 hours [and risking] having your mental faculties function at less efficiency, and spreading that out over more time, most lawyers would tell you the former is more likely to result in fewer mistakes. You’ll spend the time more carefully and do it more deliberately.”
Sleep scientists would strenuously disagree. The mechanics of human sleep remains a scientific mystery, but the fact that we need sleep is incontrovertible. Sleep sustains the immune system, balances the hormones, repairs the body and helps the brain process and archive information. The incidence of many illnesses, including diabetes and high blood pressure, increases with lack of sleep, and a growing amount of research suggests that poor sleep may be a key factor in the rising rates of obesity.
Yet modern work culture treats sleep as practically expendable. Harvard’s Czeisler, perhaps the leading expert on sleep and productivity, points out that while corporations have policies around harmful practices such as smoking and drinking, they tacitly encourage long hours unrelieved by sufficient rest. He often meets executives who go from 7 a.m. breakfast meetings to late-night dinners, for days on end. His research has found that going on five hours of sleep for 10 consecutive days produces cognitive impairment equivalent to 48 hours without shuteye. Yet these individuals go on to make multibillion-dollar decisions, manage sensitive workplace relationships — and get into their vehicles.
How the mind responds to a lack of sleep and how that translates into decision-making and workplace performance has been intensely studied in recent years. Scientists have found, for example, that the well-rested can catch up from the occasional all-nighter fairly easily, but not so the chronically sleep-deprived. They may function normally soon after they wake up, but their reaction times and performance drop as the day wears on. In a German study, researchers gave two groups of subjects, one well-rested and one sleep-deprived, a math test. Those who’d had a full eight hours of sleep were three times more likely than the under-rested group to solve an embedded puzzle.
Sleep deprivation often affects our abilities in ways we’re not aware of. In January, a team from Washington State University published a study that suggests the sleep-deprived brain distorts information before it’s processed. People appear to function normally, says Hans Van Dongen, a professor in the WSU Sleep and Performance Research Center who directed the study. “But if you measure objective performance, you see a build-up of impairment over days,” he says. “It’s comparable to chronic pain: after a while you don’t realize it, until someone gives you a pain killer.”
Sleeping seems to actually help us reach rational decisions. Researchers have noted that unconscious thought during sleep tends to eliminate the biases that influence our conscious thinking. For certain kinds of decisions — ones that are complex and in which a person has expertise — sleeping on it, in effect, may be more useful than hours of reviewing spreadsheets. Sleep also appears to boost creative powers, producing flashes of insight upon awakening — especially among those who enter REM sleep (a stage of sleep characterized by rapid eye movement). In one study, subjects who entered that deep-sleep phase saw a 40% increase in creative problem-solving.
The way work, in turn, affects our sleep has also come under scrutiny, and the results suggest it’s not the number of hours we work but the stress during them that has the most impact. Workplace bullying, such as belittling comments or being excluded from meetings, have been found to be particularly detrimental to good sleep. Researchers at the University of Michigan who followed 2,300 adults for up to a decade reported in 2008 that even common work irritants interfere with good rest more than long hours, night shifts or fears about job loss. Respondents who frequently felt upset at work or had conflicts with bosses or co-workers were 70% more likely than others to develop sleep problems. And because of the study’s duration, the team could conclusively state that work affected the sleep patterns, not the other way around. “For many workers, psychological stress has replaced physical hazards,” sociologist Sarah Burgard, who led the study, observed in a science journal. “Physical strain at work tends to create physical fatigue and leads to restorative sleep, but psychological strain has the opposite effect, making it more difficult for people to sleep.”
Part of the problem is the relentless nature of modern work. We now put in an average of 4? off-schedule hours a week from our homes, but we’re never really “off.” A female executive at one of the big banks finds herself waking in the middle of the night and getting up to send e-mails to colleagues. It so happens that the project that’s keeping her so stressed and busy is about work-life balance. “Yes, I’m aware of the irony,” she says. Such patterns aren’t unusual. Adam Haight, a Toronto television producer recalls a recent night when he found himself awake at 4 a.m. He decided to take the opportunity to send a file to a colleague. “Twenty minutes later, I had a response from them,” he recalls.
As a producer, he’s accustomed to stretches of long days and all-nighters during shooting, but that’s not what he finds most detrimental to rest. “The unlimited access that your job has to you and you to your job blurs the line of the compartmentalized workday,” he says. When you wake up with your BlackBerry already loaded with messages since you went to bed the previous night, he says, “you feel like you come in [to the office] already behind. We’re managed by our inboxes, and that leads to anxiety.”
James Wilson, a Canadian chiropractor and naturopath, argues that this constant anxiety causes a specific physical response. After studying numerous patients with circadian rhythms out of sync, he hypothesized that their adrenal glands were overworked and producing lower levels of the hormones needed to cope with stress. When he boosted those hormones, the patients’ sleep improved. He called his diagnosis “adrenal fatigue” — more pithily dubbed the “21st-century stress syndrome” in a subsequent book — and estimates it hits half the North American population at some point in their lives.
What all the science is telling us, says WSU’s Van Dongen, is that our emphasis on staying up to be productive is wrong-headed. The evidence is mounting that people get more done, faster and better when they regularly get a good night’s sleep. “We should recognize that coming back to something rested will require less time investment,” he says. “We get caught up in this mode of being available all the time. It’s not as valuable as we believe.”
Even as it remains largely beneath the corporate radar, sleep deprivation, like any new cultural malady, is drawing plenty of entrepreneurial attention. There are dozens of sleep devices on the market, ranging from myriad headgear and a shirt that monitors breathing during sleep to an iPhone app that turns your cellphone into a sleep-tracking device (already a bestseller in parts of Europe and Asia). Ever new studies feed the flow of novelties, such as pillows and duvets filled with Swiss stone pine strands that, according to the University of Graz, induce better sleep. Zeo, a headband that communicates wirelessly with a device that looks like a clock radio, has been drawing praise from users and sleep doctors alike. Sensors in the headband record brain waves emitted during sleep, producing a readout in the morning on how much and what kind of sleep you had. Not enough slow-wave sleep? Better hit the sack earlier tonight. Two years ago, at the Venture Capital Challenge organized by the famous Silicon Valley VC Draper Fischer Jurveston, the hands-down winner of the $250,000 prize was a new sleep-monitoring gizmo called NeuroVigil.
For some sectors, the tired are a hot new market. Sleep retreats are gaining popularity at top spas, some of which now employ “directors of sleep.” Guest at Arizona’s ultra-posh Canyon Ranch, for example, can spend a night in a sleep lab, where doctors monitor their sleep patterns using polysomnography tests. It’s the pharmaceutical industry, however, that’s seeing the greatest benefits. Sales of over-the-counter sleep aids are expected to reach US$760 million in the U.S. alone within three years. The use of prescription sleep medications, meanwhile, grew by 52% among adults in the five years up to 2006. The spike in the use of sleeping pills has caused some alarm, with critics warning that these pills — sometimes known as benzos — actually cut down on critical REM sleep and slow-wave sleep during which we consolidate information, and pose a risk of dependence. Chronic use can also trigger a daytime “hangover effect,” including fatigue, irritability and anxiety. MedSleep’s MacFarlane points out, however, that many of these concerns have been addressed in the latest generation of drugs, such as Ambien and Lunesta. The problem, he adds, is that most of these new formulations aren’t available in this country due to trade restrictions.
All the newfangled technology and pharmacology, however, can’t beat what sleep experts agree is the simplest solution: a brief afternoon nap. Humans are bi-phasic sleepers, meaning we’re supposed to have two sleep periods within each 24 hours. Our body temperature drops between 2 p.m. and 4 p.m., and this is the ideal time for a 20- to 45-minute nap — short enough to prevent entering deep sleep. While naps can help bad sleepers pay off their growing sleep debt, studies shows they can make even good sleepers more productive by boosting their ability to learn. A NASA study led by renowned sleep scientist Mark Rosekind found that a short nap can boost workers’ output by 34%.
Afternoon naps, of course, are a venerable custom in many parts of the world. Even in work-crazy Japan, the practice of inemuri (“sleeping while present”), often sitting at one’s desk, is viewed as the ultimate sign of hard work at the expense of nighttime sleep. In North America, however, naps just don’t fit into the highly scheduled work culture. Sleep during work hours, in general, bears the stigma of indolence. A few large companies, such as Nike and Pizza Hut International, have implemented nap breaks and nap rooms, and have seen productivity rise as a result. Still, Mountain Equipment Co-op has found that the designated nap room in its Vancouver headquarters doesn’t get much use. Because the outdoor gear retailer discourages staff from working more than 50 hours a week and tends to attract active, fit employees, “my hunch is sleep deprivation isn’t as much an issue here,” says public affairs manager Tim Southam. Therein lies the irony: employers that embrace naps typically already subscribe to the work-life-balance mantra, and their workers are least in need of daytime rest.
Changing the broader attitude toward sleep will require education and initiative at the top of corporate hierarchies. Sleep specialists like MacFarlane and Shapiro are often called in by industrial companies to help workers adapt to shifts or optimize productivity through scheduling, but they’re rarely invited into the white-collar pressure-cookers like the trading floor or the boardroom in the midst of merger negotiations. And the errors that happen here are rarely linked toa poor night’s — or a poor week’s — sleep.
Yet errors, especially with numbers, are the clearest sign of sleep deprivation. Changes in mood and behaviour, growing irritability and high dependence on caffeine are other symptoms. Someone who comes in perky on Monday and grows progressively more tired and less efficient as the week goes on likely doesn’t get enough sleep during the week and tries to catch up on weekends. Some of these employees may suffer from common sleep disorders, such as sleep apnea, that can be corrected, making a huge difference in a person’s sleep quality and resulting productivity. Shapiro of the Sleep and Alertness Clinic says companies should encourage employees to get tested: “If they have sleepiness from their apnea and anextended shift, you get a multiplical effect — not just adding but multiplying.”
Most important, managers should stop rewarding long hours for their own sake. Harvard’s Czeisler recommends developing corporate policies around sleep, with scheduled work limited to no more than 12 hours a day, and at least 11 consecutive hours of rest in every 24-hour period. Employees should not be expected to work more than 60 hours a week and not be permitted to work more than 80 hours, he advises. They should avoid red-eye flights. They shouldn’t drive after working or travelling late. And if they have no choice, they should at least take a nap. Rosekind, the scientist who studied the benefits of naps and developed a “fatigue countermeasures” program for NASA, put it in terms business people can understand: “Which person do you want on the job, the one with 34% better performance [after a nap] and 100% more alert — or the other guy?”