People who have irregular sleep patterns and get less than seven hours of shut-eye a night face a 22% higher mortality risk than the general population, according to research by SA’s biggest health and life insurer, Discovery.
Discovery led the market in designing incentive programmes to encourage medical scheme members to lead healthier lives and lodge fewer claims, and then expanded its rewards schemes to prompt better driving and financial management among its insurance and banking clients.
It is now turning its sights on sleep and plans to launch a personalised programme next year to encourage Discovery Health Medical Scheme (DHMS) members to improve their sleep and reduce their healthcare bills.
“People have a lot of choice and agency around their sleep,” said Ron Whelan, CEO of medical scheme administrator Discovery Health, which counts DHMS among its clients. The regularity of a person’s bedtime, their sleeping environment, exposure to stimulating blue light from screens and consumption of stimulants such as caffeine and alcohol are all within their control, he said.
Three years of sleep data insights
The new programme is built on insights gleaned from the anonymised sleep records, exercise activity and health claims of 105,000 DHMS members who had signed up to Discovery's incentive scheme Vitality. The analysis drew on 47-million nights of sleep, recorded by wearable devices, over a three-year period.
It analysed three components of sleep: how long a person slept, the regularity of their sleep and wake times and the quality of the sleep they got.
Sleep and health by the numbers
- 22% higher mortality risk for people sleeping less than seven hours per night
- 105,000 DHMS members whose anonymised sleep, activity, and claims data were analysed
- 47-million nights of sleep recorded over three years
- Less than 6 hours/night increases health risks:
- 1.7× higher risk of diabetes
- 1.3× higher risk of ischaemic heart disease
- 1.2× higher risk of moderate to severe depression
- 24% mortality risk reduction with improved sleep
- 7% potential reduction in annual in-hospital claims if sleep habits improve
It found people who slept less than six hours per night were 1.7 times more likely to develop diabetes, 1.3 times more likely to develop ischaemic heart disease and 1.2 times more likely to have symptoms of moderate to severe depression. These findings are broadly in line with international research on the links between sleep and health.
Cumulative effects of poor sleep
The longer poor sleep persisted, the worse the effects were, said Discovery Health’s chief actuary Emile Stipp.
“If you have poor sleep on one [night], it affects your risk of having a car accident the following day. If you have bad sleep for a week it increases your hunger hormones — that means your risk of gaining weight (increases).
“After a month, it increases your blood glucose levels, your blood pressure, anxiety and depression. After six months, you have impaired immunity, memory, focus and increased hypertension, and after two years, you have an increased risk of cancer, diabetes and heart disease,” he said.
Better sleep cuts risks and bills
While poor sleep increased health risks and hospital admissions, the converse was also true, said Whelan.
Improving sleep reduced mortality risk by 24%, according to Discovery’s research.
And improving the sleep habits of DHMS members, including sleep duration, regularity and the amount of deep and REM sleep could potentially reduce annual in-hospital claims by 7%, said Stipp.
Vitality offers a personalised programme called personal health pathways that incentives members to take a steps to improve their health, such as exercising more and getting regular check ups if they have chronic diseases.
Next year it plans to add sleep to the programme, offering rewards as people achieve their sleep goals. It will expand the sleep-tracking options available to members by incorporating this function into its app, and will add a smart ring to the wearable devices it currently supports.
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