Sleep Deprivation: An Economic Catastrophe

Sleep deprivation has now been classified by Medsleep–a network of Canadian clinics–as an “emerging global epidemic” (“Sleep Deprivation”). In the past fifty years, our average sleep duration has decreased by nearly two hours (“Sleep Deprivation”). In the United States, the average sleep duration has dropped below the recommended seven hours of sleep with one in three American adults experiencing sleep deprivation (“1 in 3”).

One demographic that is significantly impacted by this issue and yet is often overlooked is teenagers. The National Heart, Lung, and Blood Institute recommends that teenagers should be getting between nine to ten hours of sleep per night (Carroll), but Research and Development Corporation (RAND) researchers Wendy Troxel and Marco Hafner reveal that only about forty percent of teens fulfill this need (“Shifting School Start Times”). Though people are aware of the short-term effects of sleep deprivation such as basic cognitive difficulties, few are aware of the long-term effects of chronic (ongoing) sleep deprivation and the economic repercussions (“Teenagers and Sleep”). Teen sleep habits persist throughout adulthood and lead to more serious diseases such as diabetes, cardiovascular disease, and even premature death (Krueger and Friedman). These unnecessary health effects cost our nation through medical expenses and by inhibiting our productivity and safety (Amadeo). Sleep deprivation, developed during our critical teenage years, leads to various costly economic outcomes.

Sleep is an essential function to our health and allows time to restore the brain and body. During sleep, the cerebral cortex (the brain’s outer layer which controls learning, thoughts, and actions) slows down and replenishes nerve cells in the frontal lobe (Brynie). If these nerves aren’t replenished, numerous health effects can emerge, impacting both the mind and body (Brynie). Ironically, teenagers are one of the most at risk populations for sleep deprivation, but are also the ones who need it most. During adolescence, the brain’s prefrontal cortex is still developing making teenagers more susceptible to the effects of sleep deprivation including impacts on the efficiency of attention span, memory, decision-making, emotional-regulation, and learning (Breus). The question remains: why aren’t teens getting enough sleep? Biologically, teen sleep-wake cycles, or their “biological clocks,” are set later in the day because their melatonin is released one to two hours after adults (“Teenagers and Sleep”). Both the American Academy of Pediatrics and the American Medical Association advise that schools do not begin until 8:30 a.m. to ensure that students get enough sleep (Breus), but the Center for Disease Control and Prevention (CDC) estimates that over eighty-two percent of U.S. middle and high schools currently aren’t fulfilling this need (“Shifting School Start Times”). Other causes of teen sleep deprivation include overscheduling, social attitudes towards sleep, and technology use; but for whatever reason sleep deprivation occurs, it’s undeniably a prevalent issue in modern day society (“Teenagers and Sleep”).

Neurological effects of sleep deprivation such as concentration difficulties, shortened attention span, and memory impairment all directly impact teen academic performance (“Teenagers and Sleep”). In a study evaluating the effect of sleep on students’ standardized test scores, Finley Edwards, Clinical Assistant Professor of Economics at Baylor University, found that found that a one-hour delay resulted in students’ math and reading scores increasing by two to three percentile points (“Do Schools Begin”). In this same study, Edwards found that this delay also reduced school absences by twenty-five percent (“Do Schools Begin”). Allowing students an additional hour of sleep not only improved their testing skills, but also their attendance rates. Furthermore, one additional hour of sleep has been correlated to a 13.3 percent increase in high school graduation rates, and a 9.6 percent increase in college attendance rates (“Shifting School Start Times”). Higher education, depending on the amount, can augment lifetime earnings anywhere between 0.25 to 2.35 million dollars, suggesting that sleep can significantly impact individual contributions to the economy (Burnsed).

The effects insufficient sleep has on the brain’s cognitive abilities such as decreased attention spans, concentration difficulties, poor decision making, and slower physical reflexes can affect one’s well-being more directly by inhibiting their ability to drive (“Teenagers and Sleep”). The AAA Foundation for Traffic Safety found that people who sleep six to seven hours a night are twice as likely to be involved in a car crash than those who sleep eight hours or more hours a night (“Facts and Stats”). This is especially dangerous among teens because of their driving inexperience coupled with their heightened risk of sleep deprivation. Troxel writes that ten percent of all car crashes are a result of drowsy driving, and teens are involved in about fifty percent of these (“Teens Are Driving”). These higher crash rates have many costly consequences and according to the National Highway Traffic Safety Administration, approximately 100,000 of annual car crashes are directly correlated to driver fatigue resulting in over 12.5 billion dollars of yearly monetary losses (“Facts and Stats”). Sleep deprivation significantly increases the risk of car crashes which, in turn, creates various preventable economic expenses.

The long-term effects of sleep deprivation emerge in various ways, affecting both mental and physical health as well as creating unnecessary medical expenses. A shortened sleep duration is commonly associated with obesity, depression, and other health issues, the leading two being an increased risk of diabetes and cardiovascular disease (Krueger and Friedman). In a clinical study conducted by the University of Chicago Clinical Resource Center, the insulin levels of seven healthy adults were measured after spending four days with either 4.5 or 8.5 hours of sleep (Broussard). Sleep restriction lowered insulin concentrations by thirty percent and reduced insulin sensitivity (Broussard). This indicates that sleep is an important factor in the production of insulin, and the regulation of energy metabolism which puts sleep-deprived individuals at a greater risk for pre-diabetes as well as type-2 diabetes (Broussard).

Another study conducted by the Lahey Clinic Medical Center in Boston, Massachusetts measured the effect of sleep on high-sensitivity C-Reactive Protein (CRP) levels–a predictor of cardiovascular morbidity (Meier-Ewert). In the experiment, ten adults slept either 8.2 or 4.2 hours for ten consecutive days with hourly samples of CRP taken throughout the night (Meier-Ewert). The CRP concentrations and heart rates increased for those getting 4.2 hours of sleep but remained stable for those getting 8.2 hours of sleep which suggests that continuous sleep deprivation can lead to cardiovascular disease and if left untreated, cardiovascular morbidity (Meier-Ewert). The health repercussions of chronic sleep deprivation are fueling our nation’s health epidemic by causing our health care rates to soar. According to economic analyst and graduate from the Sloan School of Business at M.I.T., Kimberly Amadeo, “health care costs have risen faster than the average annual income” due to health care costing only $27.2 billion in 1960 which quickly rose to $3.5 trillion in 2017 (“The Rising Cost”). Amadeo identifies one of the leading causes for rising healthcare costs as “an epidemic of preventable diseases” in which diabetes and heart disease which are responsible for eighty-five percent of U.S. health care costs (“The Rising Cost”). Healthcare costs will continue to escalate if we don’t regulate these preventable diseases. Many of these diseases could be easily avoided if people were educated on the topic of sleep deprivation, therefore stopping the problem before it begins.

Chronic sleep deprivation among teens creates a habit that follows them throughout their lives, causing a multitude of costly health effects. These preventable health costs are contributing to U.S. rising health care rates, all of which could be easily avoided if we track these health issues back to their origin–teen sleep deprivation. The question remains, how do we break this toxic cycle? Recent policy changes to adjust school start times to be better aligned with school start times have proven beneficial to student health, or even simply educating the public (both teens and adults) on the correlation between insufficient sleep and costly diseases could all help diminish this problem. We must address this issue before it gets any worse because we are fueling an epidemic that our nation can’t afford.