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Home Archive

Sleep matters: part two

2021/03/25
in Archive, Wellbeing
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This article (the second in the series on sleep) was written by Alison Cottrell, CEO, BSB.

Good sleep health matters to firms at every level and in every part of the business. Fatigue affects how we react, think and engage with other people. It has implications for individual health and wellbeing, and at a firm level for risk management, operational resilience, productivity, [1]staff retention and engagement, customer service and professional and ethical behaviour. A lack of sleep affects both the person concerned and the people around them;[2] but while poor sleep health has collective consequences, it is also often a deeply personal issue. In this, our second of two articles on sleep, we explore the impact of Covid-19 on our sleep, and ask how employers can help – and are helping – to promote good sleep health.

If the past few years have seen a heightened awareness of the importance of sleep, the past twelve months have brought no shortage of factors to disrupt it. As well as its many direct consequences for physical health, the arrival of Covid-19 introduced or accentuated a range of potential sleep stressors including social isolation, loneliness,[3] economic insecurity, disrupted routines and boundaries, heightened concern for family and friends, general anxiety,[4] less exposure to daylight and (particularly for those fortunate enough to be able to work from home) more exposure to blue screen light.

The actual impact on individuals has of course, and as with every other aspect of the pandemic, been different for different people. Working from home with space, privacy and the right equipment, is very different to working without some or any of these, and different again to being a key worker unable to work at home[5] or being self-employed, furloughed or unemployed. Some research suggests that socioeconomic status and sleep quality tend to go together (with higher socioeconomic status associated with fewer sleep complaints); [6] a sleep differential that the very inequitable impact of Covid-19 may only exacerbate.

For employees able to work from home, a morning commute that now extends only as far as a different chair may allow for a later waking up time and a sleep pattern on working days that is closer than before to that of non-working days.[7] Data gathered globally via fitness tracking devices in the first half of 2020 suggested that the imposition of lockdown had led (at least among the part of the population that uses a wearable device to assess their sleep patterns) to slight increases in average sleep duration[8]. More time in which to sleep does not, however, necessarily equate to better sleep, and the evidence suggests that increased sleep duration has tended to be accompanied by increased sleep disruption.

A quarter of respondents to a survey undertaken towards the end of the first UK lockdown periodsaid that they were sleeping for longer and feeling more rested.  Around 2 in 5, however, said that they were sleeping less, and 3 in 10 that they were sleeping for longer but feeling less rested. [9] The National Sleep Survey, also from the first lockdown period, found more than 2 in 5 respondents finding it harder to fall or to stay asleep, with women particularly affected.[10] A further study from the same period exploring the impact of the pandemic on sleep and mental health, found more than two thirds of respondents reporting altered sleep patterns with almost half feeling sleepier than previously, and a strong association between sleep disruption and self-assessed mental health.[11] This pattern of longer sleep duration and lower sleep quality is echoed in studies from countries as various as Austria, Switzerland and Germany[12], Italy,[13]Argentina[14], China,[15] Iran[16]  and Nepal.[17]

Ongoing research, including the globally collaborative International Covid-19 Sleep Study, [18]will cast more light on the impact of the pandemic on our sleep. As the situation continues to evolve, however, how can firms – in the here and now – practically and appropriately support good sleep health, recognizing that this can be influenced by numerous factors that may have nothing to do with work? [19]

Business in the Community and Public Health England have offered useful advice on how employers can promote good sleep health.[20]  Our own research has found that support by firms for good lifestyle habits such as healthy eating, sleep health or stress management is appreciated by many employees.

Even the best advice will, however, struggle to have an impact when work is characterised by (for example) unpredictable or long working hours, poor line management, unclear accountability, or processes and behaviours that are viewed as unfair.[21]  Firms cannot ensure that their employees sleep well. They can, however, try to ensure that work itself is not part of the problem – that the firm’s own policies, strategy, structure and culture are not creating or exacerbating the ‘normalisation’ of fatigue.

Our discussions with member firms have informed a number of thoughts and ideas that may be helpful for leaders and managers in establishing and maintaining an organisational culture that supports good sleep health, and good health and wellbeing more generally.[22] These include:

  • Ensure that, barring exceptional reasons, everyone (including you) takes their annual leave.
  • Equip and encourage employee networks, mental health first aiders etc to talk about how to recognise fatigue, why it matters and (as appropriate) where to go for help.
  • Listen to what these same networks and mental health first aiders may be hearing about the incidence of fatigue in different parts of the firm, and especially where this changes.
  • When talking with employees about the firm’s BSB Survey results, draw attention to the two questions on work-related pressure and wellbeing (Questions 28 and 29) and encourage discussion within teams and networks.
  • Avoid giving, and actively counter, any impression that getting by routinely on too little sleep is a good thing or something that is expected.
  • Talk about how you have learned to manage stress and how important good sleep health has been in your career. Or – if neither applies – about why you now appreciate the importance of managing stress and getting enough sleep.
  • Within teams, agree protocols and boundaries relating to remote or hybrid working, e.g. on sending or responding to emails outside (traditional) working hours. This is particularly challenging but all the more important when the working day starts and finishes at different times for different team members or needs to flex around caring responsibilities.
  • Use focus groups, suggestion boxes, networks, surveys or other ‘safe’ channels to identify sources of workday stress and how these might be alleviated. Invite people to suggest any changes that they think would help them work more effectively or efficiently. Make sure that you respond to all suggestions or feedback offered, whether or not action is taken.
  • Pay particular attention to any indications of perceived unfairness in how employees feel they are being treated, and address or explain the underlying issue.
  • Communicate any corporate or staffing changes as clearly as possible, more than once and via more than one channel What you are saying may not be what is heard, and not everyone will be present or listening each time you speak. If you are in a senior leadership position, brief your management team first as they will have to interpret what you have just said, as soon as you have said it; and when you speak, remember that you are almost certainly doing so from a position of greater financial and professional security than many of those listening.
  • Managers sit at the heart of an organisation’s culture and may face particular pressure, juggling demands from those both above and below them in the hierarchy. As a senior leader, equip your line managers with the skills and confidence to invite feedback and challenge, and to listen carefully and without defensiveness. Equip yourself with the same skills so that you are similarly able to listen to and support your line managers.

This is clearly a far from conclusive list, and additions would be welcome. Good sleep health is central to our health, cognitive functioning and emotional wellbeing. As such, it is important also to the health, functioning and wellbeing of the organisations we work for and the society we are a part of. and Covid-19 offers one more reason to remember this.

Firms cannot of course ensure that their employees sleep well. Sleep is affected by many factors other than work. But what employers can do, is try to avoid work-related factors disrupting sleep or exacerbating existing sleep problems. In a world in which Covid-19 has made us much more familiar with aspects of medical terminology and acronyms, the message for firms is perhaps even more apt than ever; to promote good sleep health, first, do no harm.

[1] More on the link between self-reported sleep duration and productivity in Association Between Employee Sleep and Workplace Health and Economic Outcomes, Wayne N.Burton et al, Journal of Occupational and Environmental Medicine February 2017, Vol 59, Issue 2 p177-183
https://journals.lww.com/joem/Abstract/2017/02000/Association_Between_Employee_Sleep_With_Workplace.7.aspx
[2] Work by the Rand Corporation, among others, highlights the multiple factors associated with short sleep in the context of estimating its impact on the economy. Why Sleep Matters – The Economic Costs of Insufficient Sleep, A Cross-Country Comparative Analysis, Marco Hafner et al, Rand health quarterly vol. 6,4 11. 1 Jan. 2017 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627640/
[3] Social isolation and loneliness are often linked in general usage but not necessarily in practice. A recent study found the two not to be correlated, but each to be associated with sleep disruption. Associations of loneliness and social isolation with actigraph and self-reported sleep quality in a national sample of older adults, Jade A.Benson et al, Sleep, Volume 44, Issue 1, January 2021, zsaa140, https://doi.org/10.1093/sleep/zsaa140
[4] The ONS provides a useful monitor of the ongoing impact of the pandemic on happiness, anxiety and life satisfaction. The latest at time of publication is https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandwellbeing/
bulletins/coronavirusandthesocialimpactsongreatbritain/19february2021
[5] A study in early 2020 of medical staff in China found that more than a third suffered symptoms of insomnia during the Covid-19 outbreak  Survey of Insomnia and Related Social Psychological Factors Among Medical Staff Involved in the 2019 Novel Coronavirus Disease Outbreak, Chenxi Zhang et al, Frontiers in Psychiatry, 14 April 2020 https://doi.org/10.3389/fpsyt.2020.00306
[6] Who Gets the Best Sleep? Ethnic and Socioeconomic Factors Related to Sleep Complaints Michael A. Grandner et al Sleep medicine vol. 11,5 (2010): 470-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861987/
[7]  Behavior: How a global social lockdown unlocks time for sleep,  Thomas Kantermann, Current Biology Vol 30, Issue 14  https://doi.org/10.1016/j.cub.2020.06.037 And for a clarion call against alarm clocks, COVID-19-mandated social restrictions unveil the impact of social time pressure on sleep and body clock, Maria Korman et al, Scientific Reports 10, 22225 (2020)  https://doi.org/10.1038/s41598-020-79299-7
[8] Fitbit news 2 April 2020  https://blog.fitbit.com/covid-19-sleep-patterns/ and Withings, 1 May 2020 https://blog.withings.com/2020/05/01/data-quarantine-isnt-making-us-gain-weight-or-slow-down/
[9] Kings College London in partnership with Ipsos MORI https://www.kcl.ac.uk/policy-institute/assets/How-the-UK-is-sleeping-under-lockdown.pdf
[10] Reported by The Sleep Charity https://sleepcouncil.org.uk/survey-reveals-covid-19-having-severe-impact-on-sleep/
[11] Impact of the novel coronavirus (Covid-19) pandemic on sleep, Laura Pérez-Carbonell, Imran Johan Meurling et al, Journal of Thoracic Disease Vol. 12,Suppl 2 (2020): S163-S175 https://jtd.amegroups.com/article/view/44896/html
[12] Effects of the Covid-19 lockdown on human sleep and rest-activity rhythms, Christine Blume et al, Current Biology, Vol 30, Issue 14 https://doi.org/10.1016/j.cub.2020.06.021
[13] Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy, Nicol Celline et al, Journal of Sleep Research Vol 29 Issue 4, I https://doi.org/10.1111/jsr.13074
[14] Effects of lockdown on human sleep and circadian rhythm (chronotype, or natural sleeping time during each 24 hours) during the Covid-19 pandemic, Maria Juliana Leone et al, Current Biology Vol 30 Issue 16 https://doi.org/10.1016/j.cub.2020.07.015
[15] Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional surveyYeen Huang, Ning Zhao, Psychiatry Research Vol 288, June 2020  https://doi.org/10.1016/j.psychres.2020.112954
[16] Negative impact of COVID-19 pandemic on sleep quantitative parameters, quality, and circadian alignment: Implications for health and psychological well-being Mohammad Ali Salehineiad et al EXCLI Journal, 19, 1297-1308. https://doi.org/10.17179/excli2020-2831
[17] Impact of Covid-19 Pandemic on Quality of Sleep Among Nepalese Residents, Avinash Chandra et alhttps://www.researchgate.net/publication/341924236_Impact_of_Covid-19_Pandemic_on_Quality_of_Sleep_Among_Nepalese_Residents
[18] Sleep and circadian problems during the coronavirus disease 2019 (COVID‐19) pandemic: the International COVID‐19 Sleep Study (ICOSS) Markku Partinen et al, Journal of Sleep Research, Vol 30, Issue 1 https://onlinelibrary.wiley.com/doi/10.1111/jsr.13206
[19] Family, health, money, home, friends and lifestyle habits are all immensely capable of disturbing our sleep patterns. The 2018 Great British Sleeps Survey for Chemist 4 found that ‘children’ was the lowest ranked factor given by respondents as keeping them awake at night. ‘Stress’ was by far the most common, cited by one respondent in four. https://www.chemist-4-u.com/sleep-study/#div10
[20] Sleep and Recovery: a toolkit for employers, Business in the Community and Public Health England https://www.bitc.org.uk/wp-content/uploads/2019/10/bitc-wellbeing-toolkit-sleeprecovery- jan2018.pdf Also helpful may be the BSB’s 8 factors that affect employee wellbeing in the workplace https://bankingstandardsboard.org.uk/wp-content/uploads/2019/03/BSB-wellbeing-paper.pdf
[21] A 2018 Gallup Survey of the factors correlated with employee burnout placed ‘unfair treatment at work’ at the top of the list Employee Burnout, Part 1; the 5 Main Causes, Ben Wigert and Sangeeta Agrawal https://www.gallup.com/workplace/237059/employee-burnout-part-main-causes.aspx while a longitudinal study of civil servants found that the survey question most closely linked to subsequent poor health, was ‘Do you ever get criticised unfairly?’ Organisational justice and change in justice as predictors of employee health: The Whitehall II study Mika Kivimäki et al, Journal of Epidemiol Community Health 2004;58:931–937. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1732612/pdf/v058p00931.pdf
[22] For personal/ lifestyle advice on sleep, the NHS offers tips at https://www.nhs.uk/live-well/sleep-and-tiredness/how-to-get-to-sleep/, and the website for World Sleep Day 2021 provides a downloadable toolkit https://worldsleepday.org/toolkit
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