South Africa’s formal employment sector could be losing more than R408bn per year due to employees’ sleep deprivation.
This stark warning comes from Dr Michael Breus, widely known as “The Sleep Doctor” – a renowned clinical psychologist, sleep specialist and best-selling author from California.
Drawing on international research, Breus explained that the average loss due to insufficient sleep is about $2,300 (R38,706) per employee per year in the US. Speaking to Business Day after this year’s Singularity South Africa Summit, he said these losses stem from absenteeism, presenteeism, workplace mistakes and safety incidents.
With 10.55-million employees in South Africa’s formal sector, according to Stats SA’s latest Quarterly Employment Survey, the local economy could be bleeding well over R400bn annually due to fatigue-related productivity losses — a cost that businesses can scarcely afford in a slow-growth environment.
“When you’re well-slept, you’re more accurate,” said Breus. “If your job has to do with finances and numbers, then you’re not making those numerical mistakes. But let’s say you’ve got a warehouse and you’ve got a forklift driver, and they fall asleep while they’re on the forklift … that’s very problematic. So sleep is actually very big inside of business.”
He added that the consequences of sleep deprivation extended beyond physically risky sectors such as manufacturing and construction, where safety concerns are pronounced.
“There’s also sleep concerns in more of the intellectual pursuits, and that’s where people are making mistakes. But then there’s also the interaction. When you’re sleep-deprived, you don’t really want to hang out and be nice, right? Your sales aren’t going to be very good. You’re not going to be able to relate to your client in the ways you want to.”
Nowhere is the risk more critical than in healthcare. “When you’re sleep-deprived in health care, people die. You’re a surgeon; you make a mistake because you’re sleep-deprived, and, God forbid, somebody dies on your table.”
Disease burden
Global research supports these concerns. Three international studies reviewed by Business Day show sleep deprivation costs national economies billions each year. In Australia, the total cost of inadequate sleep in 2016/17 was estimated at $45.21bn, with $17.88bn in direct financial costs and $27.33bn in nonfinancial costs linked to reduced well-being. This accounted for 1.55% of GDP and 4.6% of the national disease burden.
In Canada, the cost of insufficient sleep in 2020 was pegged at $502m, linked to both direct and indirect costs. According to the study, the two most expensive chronic conditions related to poor sleep were depression, at $219m, and type 2 diabetes, at $92m. In Argentina, researchers have estimated that achieving the recommended sleep duration could increase GDP by 1.27%.
Cross-country analyses confirm that these losses are consistent in all industrialised nations, with costs typically ranging from 0.5% to over 1.5% of GDP.
Breus pointed to a primary driver behind this trend: stress. “Seventy-five percent of sleep problems are stress-induced — 75% — so it’s almost like you can’t get away from it,” he said. “That’s cross-cultural. I have yet to come across a culture where stress doesn’t affect sleep at all.”
Crime and stress
In South Africa, however, this stress has a specific and deeply entrenched form. The crime levels are causing environmental stress, he said.
“That’s very similar to what I see when I work with combat veterans. It’s called hypervigilance. That pops in your head every night when the light goes off. You get concerned, and that’s for survival.”
He likens the experience of many South Africans living in high-crime areas to those of patients with post-traumatic stress disorder (PTSD), particularly military veterans. “They have nightmares, they can’t sleep well, they’re constantly worried or anxious. A lot of the different things that we do with them are ways to try to control safety. Maybe you have an animal, maybe you have an alarm system. Maybe you need to move into an area that has less crime.”
For millions of people in South Africa, relocating is not an option. That leaves them exposed to persistent, unmanaged stress — a reality that filters directly into their ability to sleep and, by extension, to work.
“If you’re living in a constantly stressful environment, the quality of your sleep is always going to be terrible. So we have to remove the stress from the environment. Now, that may or may not mean physically moving, but trying to figure that out, and then you getting more comfortable with the environment that you’re in becomes important,” Breus said.
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