In May, the UK’s drug advisory body, NICE, recommended the first ever digital therapy for use in the National Health Service.
The Sleepio app, which offers CBT via a smartphone, has been shown by a series of randomized controlled trials to be more effective against insomnia than maintaining a regular sleep environment and routine, or taking sleeping pills.
Although CBT has long been known as the treatment of choice for insomnia, this is the first time it is available in a clinically proven virtual environment.
The move highlights the growing awareness of the importance of sleep, especially at a time when life has been disrupted by Covid-19, and hybrid work has blurred the lines between home and office.
Some studies early in the epidemic showed an increase in sleep for some groups, but this gradually increased the problems.
“Although we first realized that we have more hours to sleep and more flexibility, as commute time has evaporated and school times for children have become flexible, as the pandemic continues, we have lost our vital biological signals, such as exposure to light during the day , ” said Abhinav Singh, medical director of the Indiana Sleep Center, meal times, social rhythm and exercise times.
According to research by Gallup, lost sleep costs the American economy more than $44 billion in lost productivity annually.
One group that benefited from the shutdown was America’s older “high school students,” millions of whom also work, said Indira Guruphagavatula, an assistant professor in the Department of Sleep Medicine at the University of Pennsylvania. “Teen workers are some of the most sleep-deprived in the workforce and the people most at risk of falling asleep in a car accident,” she explains.
“When schools went virtual and opened after an hour or so, kids had a work schedule that was more in tune with their natural circadian rhythms. They all got a few extra minutes of sleep a day, which led to a significant increase in their self-reported sleep satisfaction.”
On the other hand, frontline health workers were working at full capacity in hospitals that were often understaffed. This group experienced increased insomnia, nightmares and anxiety – and were more likely to turn to sleeping pills.
Working from home brought a new set of problems, says Dmitriy Gavrilov, a clinical psychologist and sleep medicine specialist at Oxford University and a consultant to Big Health, the company that made Sleepio.
He explains that one of the main theories, from a psychological perspective, is stimulus control, the way we develop pairwise associations between particular contexts and the things we do. This can be a serious problem for those who are forced to work from their bedrooms, for example.
“The bedroom is associated with quality sleep with a place of calm, rest and relaxation,” says Gavrilov. “Sleep is not associated with stress, existential angst, frustration and the to-do list.”
Companies are starting to internalize the idea that a well-rested workforce is a more productive workforce.
The solution starts at the top, says James Wilson, a British sleep expert who advises companies on how to get the best out of their employees by encouraging better sleep. “We need to encourage management not to see the workplace in terms of what they work for.”.
CEOs are often men in their 50s and 60s, who fit the nine-to-five schedule, but that model doesn’t work for everyone, Wilson says. Only about 10 percent of people are “birds,” 30 percent are “owls,” and the other 60 percent are somewhere in between.
Business leaders have also been blamed in the past for lacking the sleep they need — a point researchers say is not only unhelpful, but harmful to health.
At the same time, Wilson argues, corporate “mindfulness” programs are of little use unless more fundamental problems are addressed. “If anxiety is your problem, you’ll interact with mindfulness. If your mattress is the problem, you can meditate and count the sheep.”
This view is shared by Colin Espy, professor of sleep medicine at the University of Oxford and head of the international IQOS project which studies how sleep is affected by the pandemic – and he is also the designer of Sleepio.
Espy claims that much of the digital “health and wellness” market — expected to be worth $82.5 billion worldwide this year, according to research firm Statista — is pseudoscience and marketing. “We won’t pay attention to the tips and tricks to beat cancer, so why should we put him to sleep?”
He adds that longer rest periods cannot compensate for a lack of sleep. “Cells don’t recreate during rest – they only regenerate during sleep. This idea that a good rest is like sleep is not true.”
Everyone agrees that some independence for employees to work when they are most productive can be a huge boost to the business. “If you’re leading a team, you need to know how your team sleeps. That’s the key to understanding them,” says Wilson.
Experts seem to be united in the need to get rid of the idea that less sleep is the hallmark of success. According to Wilson, “Lack of sleep is not a sign of hard work. It’s actually detrimental to work culture.”