New Report: 14m+ Undiagnosed Sleep Disorders Damaging Health, Fuelling Dangerous Behaviour And Costing Billions

• Normalisation of sleep issues’ may be resulting in tens of millions of undiagnosed disorders as people live with issues for six years and 69% never seek support
• Sleep poverty and workplace stress are driving sleep problems, causing physical and mental health problems and driving high-risk and violent behaviours
• Postcode lottery in accessing recommended first-line sleep disorder treatments is compounded by some GPs’ lack of knowledge about available treatments
• New report calls on the government to introduce a ‘desperately needed’ National Sleep Strategy and outlines several suggested policy measures

Millions of adults are currently suffering in silence with undiagnosed sleep disorders that are having a profound and escalating impact on health, the economy and society, according to the findings of a new report published today that’s calling on the government to introduce a ‘desperately needed’ National Sleep Strategy.

Dreaming of Change: A Manifesto for Sleep, published today (Thursday 25th April) by The Sleep Charity and supported by a group of cross-party MPs, highlights the worrying scale and impact of what it describes as a ‘sleep crisis’ in the UK – with new research of 2,000 adults* revealing nine in ten are experiencing sleep problems, one in two are engaging in high-risk or dangerous behaviours when unable to sleep, and millions are living with health-damaging untreated disorders such as insomnia or sleep apnoea.

The experts behind the report cite decades of failures by successive governments to act on evidence linking sleep to serious health problems – including the current government’s failure to deliver on its 2019 commitment to improve preventative care in the 2020s by publishing guidance on sleep and best practice habits and behaviours¹. Five years later and almost half way through the decade and that guidance is still to be published.

According to the new report, such failures have created a ‘triple sleep deficit’ which encompasses:

• A ‘sleep stealing’ environment where sleep is underappreciated and misunderstood – 75% of people in work say workplace stresses have caused them sleep issues in the last six months, while one in three people are experiencing ‘sleep poverty’, where poor living conditions, noise pollution and uncomfortable sleep environments reduce sleep quality. Yet just one in twenty people are aware of the links between poor sleep and serious health problems like cancer, stroke and infertility and more than a third are unaware of best-practice sleep advice.
• A ‘normalisation of poor sleep’ that leads people to suffer in silence – 69% of people with sleep issues have yet to seek support from a healthcare professional and have instead lived with their problem for an average of more than six years. Only one in six people with insomnia symptoms have been diagnosed – meaning approximately 14m** may be suffering in silence with a disorder that could be seriously impacting their mental and physical health.
• A postcode lottery when it comes to accessing recommended first-line treatments for sleep disorders, with some GPs lacking knowledge of the treatments that exist and how to access them – NICE recommends Cognitive Behavioural Therapy for Insomnia (CBT-I) as the first-line treatment for both short and long-term insomnia. While digital CBT-I is now available, face-to-face CBT-I isn’t, with a new FOI request*** suggesting just 17 (12%) of the 132 NHS Trusts that responded offer both face-to-face and digital CBT-I. With government data showing seven million households have no internet access and four million are unable to undertake a single basic digital task², there’s a clear risk of digital exclusion – meaning thousands may be missing out on the treatment they so desperately need, further exacerbating health inequalities. The situation is compounded by the fact that healthcare professionals such as GPs typically have limited knowledge of the treatment pathways that are available and how to access them³.

With many attempting to self-manage their sleep issues, the report highlights concerns that a lack of knowledge of good sleep habits and behaviours is driving people to take misguided steps that risk exacerbating their problem and damaging their health. For example, one in ten respondents (13%) said that they’ve tried drinking alcohol to help them get a good night’s sleep, while one in twenty (5%) admitted to taking someone else’s sleep medication.

The survey also found that nearly half (48%) are engaging in unhealthy, high-risk and sometimes dangerous behaviours when they’re unable to sleep, including being violent or physically aggressive with those around them (4% or 1 in 25 adults), being emotionally aggressive with others (10%) or going for a drive when they’re tired (5% or 1 in 20 adults), which is a common cause of road traffic accidents⁴. One in five (21%) people reported experiencing paranoid, anxious and depressive thoughts when struggling to sleep, while almost a quarter (24%) reported eating more unhealthy food.

The report calls for a National Sleep Strategy to include three measures:

1. Embed sleep hygiene and sleep support advice as a central feature in all public health campaigns – the charity says that the government should prioritise delivering on its 2019 commitment¹ to publish new standardised sleep hygiene advice and then work with NHS England to launch public health programmes to educate the public on sleep, including a standalone sleep campaign and embedding sleep advice more prominently into future physical and mental health campaigns.
2. Use existing health conversation frameworks to deliver advice on sleep through millions of routine health interactions – the charity says that the government and NHS England already have the Making Every Contact Count (MECC)⁵ commitment to support the opportunistic delivery of consistent and concise health information and so, with tiredness and fatigue a key complaint in 10-20% of GP appointments, the MECC Framework and training should be updated to include sleep hygiene advice. Currently, information is offered on healthy eating, exercise, reducing alcohol and stopping smoking.
3. Make NICE-approved treatments for insomnia and sleep apnoea available in every NHS Trust and ensure GPs and other health professionals are equipped with knowledge of these and how to access them – the charity says that all patients with symptoms of insomnia should be offered NICE-approved CBT-I as a first-line treatment, and presented with a choice of face-to-face or digital treatment options with a real therapist. In addition, GPs and other health professionals should be provided with a clear training pathway to equip them with knowledge of the treatment pathways available for various sleep disorders and how to access these. The report also suggests that practical cost-effective support should be given to people experiencing sleep poverty or bed poverty, for example by prescribing eye masks or ear plugs for people unable to sleep due to light pollution or noise pollution.

Lisa Artis, Deputy CEO of The Sleep Charity, said: “While public health campaigns around healthy eating and physical activity have been ongoing for decades, sleep has been left in the ‘solutions box’ despite evidence showing poor sleep increases mortality by 13%⁶ and is linked with major physical and mental health conditions⁷. We believe it’s high time this changed.

“At a time when the government has never been more focused on preventative measures to tackle ill-health, our report clearly demonstrates that sleep can play an oversized role in supporting this ambition and positively impacting on all six of the major health conditions in the UK, including cancer, cardiovascular diseases, dementia, and mental ill health.

“Its impact extends far beyond our health too, with sleep issues estimated to cost the UK billions of pounds every year in lost productivity⁸. Moreover, these issues exacerbate existing societal disparities, including bed poverty which disproportionately impacts the economically disadvantaged.

“There’s no doubt that the management of sleep issues is complex and multifaceted, and that’s precisely why a National Sleep Strategy is desperately needed. We believe that this government and the next has a golden opportunity to lay the foundations for a better system of education and support which would make a seismic difference to the lives of the millions of people in the UK who are struggling with sleep.”

One such person is Jenny Benjamin, 48, from Northampton who has struggled with insomnia for 30 years. She said: “Suffering from insomnia has had a huge impact on my life. I feel stressed, irritable and constantly worn out.

“I had a good career in banking, but my insomnia caused me to underperform and was a major source of stress, becoming so bad that I ultimately decided to quit my job and career to focus on battling my condition. It’s really impacted on my family and social life too. For example, I’ve reorganised family holidays just to make sure I can get some sleep and I don’t stay over at friends’ houses or drive to see people as I worry about sleeping properly and being too tired to drive safely.

“In my experience, there’s a real lack of support and treatment available for sleep issues. GPs often don’t seem able to provide the right support and help and, from talking to other people with insomnia, it’s a postcode lottery when it comes to accessing recommended first-line treatments such as CBT-I.”

While there are courses available to educate GPs on sleep architecture, sleep disorders and CBT-I, there is no established training pathway, resulting in many GPs having a limited understanding of sleep disorders and the treatment pathways available³.

As a result, GPs often feel under pressure to prescribe medication⁹, with NHS data published in 2023 showing a record one million people are now prescribed insomnia medication¹⁰ – with the number of children prescribed sleeping drugs tripling over the last seven years¹¹.

However, sleep experts agree that medication is often not the right treatment for those who are experiencing sleep problems – with the ineffectiveness of current medical interventions borne out by the new research which found that, of those who had consulted a healthcare professional, the biggest proportion (40%) had not noticed any change in their issue, while 10% said it had actually worsened.

Speaking on the urgent need for action, MP Jim Shannon, Chair of the All Party Parliamentary Group for Sleep and a keen activist for improving sleep in the UK, said:

“The UK has a cultural disregard for the importance of sleep that spans government, workplaces, health services and families, with sleep often relegated to a soft issue that’s trivialised, misunderstood and under-supported. However, this underestimation belies the far-reaching ripple-effects that sleep issues are having on individual and public health, as well as the economy and society in general.

“I welcome the publication of this timely and important report and strongly encourage the government to act now to create a National Sleep Strategy to tackle the problem and make a transformational difference to the lives and wellbeing of many millions of people.”

The Sleep Charity’s Dreaming of Change: A Manifesto for Sleep can be accessed at thesleepcharity.org.uk/get-involved/sleep-manifesto-2024/.

Ends 

* In November 2023, The Sleep Charity commissioned Censuswide to undertake a survey of 2,000 adults across the UK to understand the prevalence and impact of sleep issues, as well as the level of knowledge people possess on sleep and good sleeping habits.

**14m was calculated as follows:

Of the 614 respondents who experience all of the common symptoms of insomnia, only 89 have been diagnosed with insomnia specifically. This means that 525 with symptoms (26.25% of the total sample of 2,000 adults) remain undiagnosed.

If this data is extrapolated, based on a population of 54,711,707 UK adults, we calculate that there’s potentially 14,361,823 Brits experiencing symptoms of insomnia who have not been diagnosed with the disorder.

*** Between October and December 2023, The Sleep Charity made a freedom of information (FOI) request to understand the current provision of Cognitive Behavioural Therapy for Insomnia (CBT-I) across England, which is recommended by the National Institute for Health and Care Excellence (NICE) as a first-line gold standard treatment for insomnia. FOI requests were submitted to every NHS Trust in England that could, in theory, offer CBT-I – 196 in total once various NHS Ambulance Trusts and specialist centres, such as cancer facilities that quite clearly wouldn’t offer such services, had been removed. Responses were received from 132 NHS Trusts in total with the data included in the report and this news release based on these.

For more information or to set up an interview with those quoted in this press release, please contact Matt Thompson (matt.thompson@evergreenpr.co.uk / 07587 418710) or Chris Hayter (chris.hayter@evergreenpr.co.uk /07741245596

References

1. Advancing our health: prevention in the 2020s – consultation document, Department of Health and Social Care, 22nd July 2019
2. Digital exclusion, House of Lords – Communications and Digital Committee, 3rd report, 2023
3. Cognitive behavioural treatment for insomnia in primary care: a systematic review of sleep outcomes, British Journal of General Practice, 2019
4. Road Safety Factsheet, The Royal Society for the Prevention of Accidents, July 2020
5. Making Every Contact Count (MECC), NHS England
6. Why sleep matters: the economic costs of insufficient sleep, RAND Europe. 2016
7. Short and long-term health consequences of sleep disruption. Nature and Science of Sleep. 2017
8. The societal and economic burden of insomnia in adults, RAND Europe, March 2023
9. GPs’ management strategies for patients with insomnia: a survey and qualitative interview study, British Journal of General Practice, 2014
10. Before you take a sleeping pill tonight – read this, Daily Telegraph, May 2023
11. Number of children prescribed sleeping drugs has tripled in 7 years, data suggests, Independent, November 2022