Plan members living with insomnia or sleep problems could benefit from sleep-specific cognitive behavioural therapy programs accessible through their benefits plans.
“One of the key things I’m going to say is benefits plans should offer some sort of online cognitive therapy for sleep,” said Atul Khullar, medical director of the Northern Alberta Sleep Clinic, in a session during Benefits Canada‘s 2020 Plan Sponsor Week earlier this month. “This would help me as a sleep specialist because if [patients have] done this [and found little or no relief], I can be a little more aggressive with medications.”
While 30 to 40 per cent of adults experience insomnia symptoms, only nine to 13 per cent meet the diagnostic criteria for an actual disorder, he noted. Even so, sleep issues among plan members — which can be linked to mental-health issues, chronic pain or medical conditions — are a large productivity cost to plan sponsors.
“Good sleepers are much less of an economic burden than people with insomnia disorders and even individuals with a little bit of insomnia symptoms. So even if you have some insomnia symptoms, some early intervention, I think, would be warranted.”
He pointed to a Canadian study that found people with insomnia disorders were absent an average of 10 days per year, while those with insomnia symptoms were absent an average of seven days annually, compared to just three for good sleepers. People with an insomnia disorder experienced an average of 45 days per year of productivity impairment, compared to 16 for those with insomnia symptoms and 10 for good sleepers. “If you can stop the symptoms from becoming the disorder . . . you will get a lot of productivity improvement, as well as some absenteeism improvement.”
A Norwegian study also found a connection between insomnia and disability leave, where people with insomnia are three to four times more likely than good sleepers to eventually go on permanent disability, noted Khullar.
These disorders also present increased risks of depression, anxiety and alcohol dependence; heightened health risks for stroke, hypertension and other conditions; and an increased risk of accidents, he said.
Sleep training can be delivered online very easily without face-to-face time like therapy sessions for mental-health issues such as depression and anxiety. He cited data from online sleep clinic Haleo on online sleep therapy for plan members that found 80 per cent of employees agreed to be contacted by one of the company’s therapists and 90 per cent of them reported an improvement in their sleep quality. In addition, 50 per cent said they felt a reduction in their psychological distress and 70 per cent saw an improvement in their working life.
However, without addressing any underlying issues such as depression, anxiety or chronic pain, sleep-specific therapy may be like “sticking a finger in a firehose,” said Khullar. “Getting treatment for sleep that is not successful is a good barometer that more needs to be done.”
All of the 2020 Plan Sponsor Week sessions are available on-demand at benefitscanada.com/webinars.