Lack of sleep can lead to a slew of
physical and mental problems. It has been linked to heart and kidney disease, hypertension, stroke, obesity, and depression.
Sleep deprivation has risen to the level of a public health crisis in Singapore. A recent survey of 43 cities and the sleeping habits of its residents found that Singapore was the
third most sleep-deprived city. Only one in four people get more than seven hours of sleep daily and only
17 per cent of respondents sleep through the night.
Besides the health problems mentioned above, sleep deficiency can contribute to more accidents like car crashes, falls, and other dangerous mishaps.
Why aren’t Singaporeans sleeping enough?
There are many reasons that contribute to Singaporeans’ lack of sleep, such as poor pre-bedtime routines, social media and gaming, anxiety, and staying up late in an attempt to reclaim their time from obligations during the day. There is also the blurring of boundaries between work and personal time — a spillover from the COVID-19 pandemic’s work-from-home arrangement.
For students and youth, their sleep deprivation is likely due to inadequate rest to meet early start times at school. Among factors that can worsen this is the constant use of digital devices and addiction to gaming which eats into time required for revision, and peer pressure to stay up late. Adolescents who do not obtain sufficient sleep are likely to be overweight due to lack of engagement in daily physical activity, suffer from depressive symptoms and engage in risky behaviours like drinking, smoking tobacco, or using illicit drugs. They may also underperform in school. A study by Duke-NUS Medical School showed that among undergraduates, early morning classes were linked to lower grades and attendance.
For the elderly, although they generally need less sleep, many suffer from sleep problems like insomnia, whether due to anxiety and depression, pain from arthritis or obstructive sleep apnea, which becomes more common in older people.
Setting the right policies
What policies can improve sleep hygiene in Singapore?
At the school level, delaying the school start times can help. According to Lawrence Jin, Assistant Professor at the Lee Kuan Yew School of Public Policy, “Studies have found that delaying the start time of schools can improve sleep and academic performance among students.”
In Singapore, there are already voices calling for later school start times. According to the Ministry of Education, one out of 10 secondary schools and most Junior Colleges start at 8 am or later on at least three days per week.
At the community level, providing parents with more information about the importance of sleep for their children, and the kinds of effects it can have on growth and development can empower them to become part of the solution.
In 2022, Singapore rolled out a set of integrated 24-hour activity guidelines for children under the age of seven. The set of guidelines included advice on the importance of sleep, how much sleep is required for each age group, and methods to improve sleep quality and duration.
The recommendations, established by a workgroup led by KK Women's and Children's Hospital (KKH), are aimed at assisting parents in cultivating healthier daily routines to improve their children's long-term health and well-being. The workgroup included doctors, allied health professionals, academics, educators, and researchers.
On a wider level, Assistant Professor Tan Shin Bin of LKYSPP, says the built environment can also impact the amount and quality of sleep people get. She says reducing the noise and light pollution are two major factors to consider. However, she cautions that there is a health equity angle to consider, for example, “Who gets to live near a noisy expressway versus who gets to live near a lovely quiet park?”
In the private sector, employers should be made aware of the significance of rest for overall health and the responsibility of businesses to provide work environments and conditions that will not interfere with an employee’s right to adequate sleep.
The RAND Corporation found that the United States loses US$411 billion and 1.23 million working days each year due to insufficient sleep.
In Singapore, people with symptoms of anxiety and depression — two conditions which are brought on or exacerbated by sleep deprivation — could be costing Singapore nearly US$12 billion a year, or about 2.9 per cent of the nation’s gross domestic product. This is a result of absenteeism, reduced productivity and the use of healthcare resources.
To encourage work-life harmony, Singapore will introduce the Tripartite Guidelines on Flexible Work Arrangements by 2024, which, among other things, are aimed at encouraging employers to offer their staff more flexible working arrangements (FWA). According to the Ministry of Manpower, the new guidelines are aimed at promoting better work-life balance to achieve a more engaged and productive workforce. The guidelines will provide more support for human resources practitioners to implement flexible work arrangements.
The challenge ahead
Developing policies and solutions to address sleep hygiene faces some challenges.
Professor Jin notes that as people's sleep occurs in their private space during private times, it is often difficult to directly encourage better sleep hygiene.
He adds that it is also difficult to get a reliable measure of the quality and quantity of sleep. “This measurement issue makes it difficult to monitor and quantify how effective a policy is, and how we can make further modifications to the policy to make it more effective.”
Professor Jin says, “With the advancement of wearable technologies (e.g. smartwatches), there may be more opportunities to directly promote better sleep through gamification or incentives.” Singapore's Health Promotion Board has piloted various Sleep Challenges as part of its National Mental Health and Well-Being Strategy, but he emphasises that there is still much work to be done in this area.
Policies to tackle sleep health must also consider that not every segment of the population requires the same amount of sleep. On average, teenagers need eight to 10 hours of sleep a day. Adults require seven to nine hours of sleep, while those above 65 need at least seven hours of sleep daily.
While Singapore is taking some steps to enhance awareness of the importance of sleep health and adequate rest, the prevalence of poor sleep quality in the island nation calls for further intervention.
Poor sleep health has extensive repercussions on individuals, communities, and governments globally. The current burdens are evident, requiring action in three key areas, namely: raising awareness, conducting research, and shaping public policy. Addressing these aspects could tackle the issue of sleep deprivation and enhance the well-being of individuals.