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The Price of Poor Sleep

April 19, 2021 by Hannah Whitesel, PharmD

How have you slept recently? Quarantine’s dissolution of normal schedules and routines has been catastrophic to sleep duration and sleep quality of countless Americans. Before COVID, a third of adults in the U.S. did not get enough sleep, with 15%-20% experiencing sleep disorders. COVID has only emphasized the worsening of this widely recognized yet overlooked public health problem. Among the constantly changing and stress-inducing environment we live in today, sleep is more important than ever.

Sleep deprivation in the workplace is linked to lower productivity through both absenteeism and presenteeism. A 2010 article published in the Journal of Occupational and Environmental Medicine estimated average annual fatigue-related productivity losses to be $1,967 per employee1. Economic modeling done in 2016 has estimated insufficient sleep costs the U.S. economy up to $411 billion per year; representing 2.28% of our GDP (gross domestic product)2.

Unfortunately, there are more long-term consequences of poor sleep than just the subsequent fatigue felt the following day or the adverse economic implications. Many chronic health conditions such as cardiovascular disease, diabetes, obesity and depression have been linked to insufficient sleep3. Ensuring adequate time to hit the sack is essential to repair and restore both the mind and body. Sleep is also deeply connected to immune system function and metabolic processing. Therefore, getting the recommended minimum of seven hours of sleep each night provides better protection against infections and helps your body regulate its energy balance. This innervation between sleep and metabolism is even more pronounced in childhood and adolescence, as short sleep duration has been associated with excess body weight or obesity throughout adulthood3.

Consistently getting less than six hours of sleep a night increases mortality risk by 13%2. This is a huge difference when considering the small and meaningful sleep habits that are easy to implement and make a lasting impact. The practice of developing sleep hygiene, or good sleep habits, is the first-line recommendation to anyone looking to maximize their time spent catching a few z’s. Sleep hygiene is an umbrella term for many different behaviors that affect an individual’s ability to fall and stay asleep. These behaviors can occur throughout the day, not solely before bedtime. Healthy sleep habits take advantage of the body’s natural clock, also known as the circadian rhythm. This means waking up and going to sleep around the same times every day and aiming to get seven to eight hours of sleep every night. Optimizing the bedroom environment by removing distractions like light or excessive noise and keeping the room at a comfortable cool temperature. Avoiding evening caffeine, nicotine and alcohol is ideal to get a good night’s rest. Caffeine and nicotine are stimulating substances, where alcohol reduces the brain’s ability to get quality sleep. Getting enough exercise throughout the day is also recommended to improve sleep quality and general health. Lastly, minimizing screen time via phone, laptop or TV before bed is important. The blue light emitted from these screens stimulates areas of the brain that promotes wakefulness therefore avoiding this light or adjusting the settings on these devices can help.

When combined with steadily growing costs of sleep disorder treatments, addressing concerns around getting enough shuteye is becoming more cost effective than ever before. Employers are becoming increasingly aware of newer high-cost medications like Xyrem, Xywav and Wakix, as a single prescription for the former racks up over $100,000 in pharmacy costs per year. As more medications are studied and approved, the demand for strategies to manage the spend on sleep disorder medications will increase as well. It will take a collective effort to transform the dream of maintaining happy, healthy and well rested employees into a reality.

For further discussion, please email Hannah at [email protected].


  1. Rosekind, Mark R. PhD; Gregory, Kevin B. BS; Mallis, Melissa M. PhD; Brandt, Summer L. MA; Seal, Brian PhD; Lerner, Debra PhD The Cost of Poor Sleep: Workplace Productivity Loss and Associated Costs, Journal of Occupational and Environmental Medicine: January 2010 – Volume 52 – Issue 1 – p 91-98 doi: 10.1097/JOM.0b013e3181c78c30
  2. Hafner, Marco, Martin Stepanek, Jirka Taylor, Wendy M. Troxel, and Christian Van Stolk, Why sleep matters — the economic costs of insufficient sleep: A cross-country comparative analysis. Santa Monica, CA: RAND Corporation, 2016.
  3. National Center for Chronic Disease Prevention and Health Promotion. Sleep and Chronic disease. August 2018.

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