Sleep Deprivation: Is it Affecting Your Care and Career?

It’s an issue for about a third of American adults

Ever since we were kids, we’ve heard about the importance of getting (choose a number) hours of sleep. When you’re small, the number can be ten, or even twelve for some ambitious parents. Moving into your adolescent and teen years, it usually comes out to about eight, then as the realities of adulthood set in the popular figure seems to be seven hours.

That’s all well and good, but not always realistic. But what happens when people get into a pattern of 4-5 hour nights of sleep? The physical tolls are clear enough, but what about the impact on mental health. A group of researchers at Ball State University recently took a look at that very question and came back with some interesting results.

The researchers took data from the National Health Information Survey (NHIS) since 2010 to examine the epidemiology of short-sleep duration American adults (defined as those sleeping less than seven hours per night.) They found that in the past nine years, the prevalence of short-sleep duration adults has increased significantly (from 30.9 percent in 2010 to 35.6 percent in 2018.)

But what puzzled the researchers was identifying characteristics that defined those adults most prone to short-sleep durations. Demographic considerations (age, race, marital status, number of children in the household, residing region, level of education) were no stronger an indicator than occupational characteristics – and that’s a large part of why we’re covering this story.

In 2018, the highest level of short sleep duration was found for police and military at a whopping 50 percent. Not especially surprising. But guess what profession came in just behind, at 45 percent? That’s right, a group the researchers described as “healthcare support occupations.”

“There’s no definitive cause found for these trends in sleep duration in the working American population,” said Ball State University health professor and lead author Jagdish Khubchandani. “We see the workplace is changing as Americans work longer hours, and there is greater access and use of technology and electronic devices, which tend to keep people up at night. 

“Add to this the progressive escalation in the workplace stress in the United States, and the rising prevalence of multiple chronic conditions could be related to short sleep duration in working American adults.”

A few more interesting statistics from the study:

  • For men, about 30.5% reported getting 7 or less hours of sleep in 2010 and by 2018 about 35.5% reporting inadequate sleep.
  • Among women, those reported too little sleep grew from 31.2% in 2011 to 35.8% in 2018.
  • By race and inadequate sleep prevalence, the trend from 2010-2018 was 29.2 to 34.1% for whites, 40.6 to 46.5% for African-Americans, 29.5 to 35.3% for Asians, and 35.2 to 45.2% for multiracial adults.
  • From 2010 to 2018, the largest increases in sleep deprivation were reported by men, multiracial individuals, older adults, those living in the western U.S., and widowed, divorced, or separated people.

Impact on Healthcare Workers and Patients

No magic pill exists that will take away all of the stressful, time-consuming factors that may eat into your sleep. But gaining control over a couple of key areas may make a world of difference. Seven hours is the number chosen for this study and the most commonly offered figure for a healthy standard, but if you can get from four hours of sleep per night to six hours per night for starters, you’ll obviously be on the right track.

The first place to look is work. If you’re a supervisor or manager, what steps can you take to ensure proper sleep habits among your staff? “Employers have a major responsibility and should use health promotion strategies to ensure that workers who struggle with sleep problems are assisted,” Khubchandani said. “We all suffer when our bus and truck drivers, doctors, and nurses are sleep deprived.”

One suggestion from the researchers was sleep hygiene education. The idea itself is younger than many of us, but sleep hygiene education gained popularity in the late 20th century when working overtime and long hours became a norm and an expectation rather than an exception. Initially recommended primarily for people with insomnia and other conditions such as depression, the effects of sleep hygiene education have limited research to support or refute the recommendation.

Recommendations include:

  • establishing a regular sleep schedule 
  • using naps with care
  • not exercising physically or mentally too close to bedtime 
  • limiting worry
  • limiting exposure to light in the hours before sleep
  • getting out of bed if sleep does not come
  • not using a bed for anything but sleep and sex
  • avoiding alcohol as well as nicotine, caffeine, and other stimulants in the hours before bedtime 
  • and having a peaceful, comfortable and dark sleep environment

Got all that? Fulfilling each and every one of those requirements would likely be a full-time job on its own. But a few keys to put into practice would be:

Get your sleep at night whenever possible. It’s hard to beat a good nap when you are sleep deprived, but in the long run, naps can detract from your nighttime sleeping routine.

The schedule doesn’t allow you to sleep at night? Do everything in your power to get your sleep at a regular time. If you’re working 6 p.m. to 6 a.m., perhaps sleep time is 9 a.m. to 4 p.m. Find what works for you, but once you do, stick to it.

Keep exercising – just do it at the right time. Activities that reduce physiological arousal and cognitive activity promote falling asleep, so engaging in relaxing activities before bedtime is recommended. Conversely, continuing important work activities or planning shortly before bedtime or once in bed has been shown to delay falling asleep.

As such, strenuous physical activity shortly before bedtime is discouraged.

Again, the research behind sleep hygiene therapy is limited. But the concepts are solid, common-sense ideas that, if nothing else, promote a relaxing, de-stressing environment that will hopefully move you closer to that “magic number” of sleep hours, whatever it may be.

Resources:

https://www.cdc.gov/sleep/data_statistics.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2817902/

https://link.springer.com/article/10.1007/s10900-019-00731-9

https://www.ncbi.nlm.nih.gov/pubmed/31489537

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