By Wayne Caswell, Founder of Modern Health Talk and Sleep Economist at Intelligent Sleep
What is a Sleep Economist?
I’m a sleep economist. At least that’s how I present myself when I talk about the economic impact and benefits of sleep, and the science of Intelligent Sleep. But what does that mean? Let me explain.
According to the CDC (Centers for Disease Control and Prevention), “Insufficient Sleep is a Public Health Epidemic,” and getting enough sleep is an absolute necessity, not a luxury. They also say sleep quality should be thought of as a “vital sign” of good health because of the many ways it impacts us overall.
To understand how sleep affects health requires an understanding of the underlying biology, taking things down to the cellular level where the mitochondria inside take in glucose to produce energy. In just the last few years scientists have begun to learn what actually happens during sleep, why it’s so important to our health, and what occurs when we don’t get enough of the deep restorative sleep we need. And this has resulted in a flood of published scientific studies, medical reports, and articles in the mainstream press that is awakening America to the importance of sleep. But most people still don’t know how to sleep well, and that’s why I’ve been working with the sleep experts at Intelligent Sleep, an Austin sleep fitness center.
The Health Effects
I’m in process of writing a white paper on The Economic Benefits of Population Sleep Wellness (look for it soon), but here are some of my findings so far.
Immune System – A well-functioning immune systems protects us from colds, flu, and other ailments, but when poor sleep interferes, it fails to do its job. In this study, people who slept less than six hours a night were over four times more likely to catch a cold than those who slept over 7 hours.
Obesity – Studies have linked even short-term sleep loss with a propensity to load up on bigger portions of high-card and high-calorie foods. That’s because getting fewer than 6 hours of sleep increases levels of the hunger-stimulating hormone ghrelin and decreases levels of the appetite-suppressing hormone leptin. And not only does one person getting sick keep them home from work, but it also increases the chances that they’ll pass on their illness to others.
Diabetes – Diabetes and sleep problems often go hand in hand. When your blood sugar is high, your kidneys try to get rid of it by urinating. That can mean getting up all night to use the bathroom — and not sleeping well. So yes, diabetes can cause sleep loss. But evidence also shows that not sleeping well contributes to metabolic and endocrine changes that can increase your risk of developing diabetes. When you’re sleepy, your body craves energy and finds that the fastest way to get a temporary hit is by eating foods high in carbs and sugars. That contributes to weight gain and insulin sensitivity, and diabetes.
Heart Disease – Over 800,000 Americans die each year from heart disease, which is about 1 in every 3 deaths and about the same impact as cancer. Sleep deficiency increases the risk of heart disease by 48%, according to a 2011 European Heart Journal review of 15 medical studies involving almost half a million people.
Stroke – Each year about 130,000 Americans die from a stroke, and together with heart disease, the annual cost is more than $312 billion. The one-third of working adults who sleep less than 6 hours a night are 4 times more likely to suffer a stroke, largely because of the negative effect poor sleep has on the cardiovascular system. But even with that, when the CDC listed ways to reduce your risk, they didn’t even mention sleep, even though other parts of the CDC say sleep deficiency is a public health epidemic.
Breast Cancer – Researchers in Japan found that women who slept less than 6 hours a night were 62% more likely to develop breast cancer than those who slept 7 hours. The results of several studies also suggest that women who do shift work, such as nurses, have a higher risk of developing breast cancer than those who work during the day. That’s likely because of how light and melatonin regulates circadian rhythms. Sleep can also affect recovery. One study showed a 1.5-fold increased risk of dying from breast cancer among women who slept less than 5 hours a night before diagnosis compared to those who slept 7 or more hours.
Depression – Insomnia is an early symptom of depression, and a 2007 study of over 10,000 people found that insomnia increased their chance of suffering from depression 5-fold.
Alzheimer’s – Several new research studies have linked poor sleep to the buildup of beta amyloid plaque, loss of brain tissue, Alzheimer’s disease, and other dementia and neurological disorders, but it’s not yet clear just how much impact poor sleep actually has, although it clearly has some. Over 5 million Americans have Alzheimer’s, with 200,000 of them are under age 65; and the numbers are growing, with estimates of 7.1M by 2025.
Each of the medical conditions described above is more likely to occur with sleep deficiency, and in some cases far more likely. So multiply the odds, however right you think they are, times the cost of delivering care, and you’ll see that we’re paying a very high cost for not sleeping well, but how high?
The cost of treating cardiovascular disease in 2010 – including Heart conditions, stroke, peripheral artery disease, and high blood pressure – was about $444 billion. But that’s just the medical cost.
Cancer is another expensive disease, with the annual cost of cost of treating breast cancer alone expected to exceed $158 billion in 2020.
And then there’s Alzheimer’s disease, with an estimated cost to society of $226 billion, half of that coming from Medicare.
The economic impact is not just the medical care provided during and after the event, but it also includes the lost wages and dampened or terminated careers, which for stroke alone is projected to exceed $50 billion in 2030. Collectively, I believe the national cost of sleep deficiency is several hundred billion dollars per year and approaching $1 trillion.
The Economic Value of a Good Night’s Sleep
As a sleep economist, my first attempt at quantifying the value of sleep came with an article I published here four years ago. I searched the literature and found a 2011 Harvard study of corporate workplace “presenteeism” that estimated at $63.2 billion/year cost to the economy, but I felt the cost might extend well beyond that when all of the trickle-down costs are considered. I also wanted to find a way to describe the health impact of poor sleep, and the economic benefits of good sleep, to individuals. What is poor sleep costing you, and what benefits can good restorative sleep provide over a lifetime?
Because I didn’t find any study of that, and no expert projections, I developed a simple computer model in Microsoft Excel so I could test various assumptions. I was surprised by the lifetime results even with very conservative assumptions. The model started with a new college graduate entering the workforce with a Bachelor’s degree and a $50K/year salary. It then projected how their career might advance with no change in sleep habits (the base case), with great sleep, and with poor sleep.
With good sleep, careers and salaries advanced more quickly and to higher levels (more than double the peak income) because of improved alertness, attention, concentration, creativity, decision-making, endurance & energy, mood, etc. The model also suggested that careers extended longer by avoiding the health conditions listed above, meaning less medical care was needed and income continued for more than a decade longer. Average longevity was also extended, and with greater income came more physical and investment assets.
The model probably needs to be refined based on new information, since the assumptions were probably way too conservative. Ideally, I’d do a version that starts not with college graduation but at infancy to show the performance impact sleep has on brain development, IQ, and school grades, and how it can determine college acceptance, scholarship qualification, career options, and starting salary, which could easily be well above my $50K assumption and then progress faster.
Population Sleep Wellness
The next step in my journey as a sleep economist is to promote a vision of population sleep wellness and the various ways our nation can work to develop a healthy, skilled and productive workforce for greater incomes, corporate profits, GDP, and global competitiveness. In my white paper on this topic I’ll look beyond the health impact to also include safety and performance – at school, work and in sports. And I’ll be making several proposals for public & private sector organizations.
I’m convinced that the economic value of population sleep wellness, if widely applied with my various proposals, would be well more than $1 trillion/year. That money could then be applied in all sorts of ways to help society, including cutting taxes, paying down the debt, or investing in education, research, healthcare, and infrastructure.
About the Author
Wayne Caswell is a retired IBM technologist, market strategist, consumer advocate, and founder and senior editor of Modern Health Talk (www.mhealthtalk.com), where he writes about health reform, the future of healthcare, and solutions for independent living. It’s with that perspective that Wayne became interested in the important impact that good or bad sleep can have on our health, safety and performance, and it’s why he is now helping to launch the Intelligent Sleep wellness center as Sleep Economist with a focus on population sleep wellness. Wayne has already published several dozen original and byline articles on Sleep.
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