The NHS is under significant pressure, with over 15 million people in England – more than a quarter of the population – living with long-term health conditions. These chronic conditions, while manageable with modern medical solutions, place a substantial burden on the healthcare system, with related healthcare costs reaching £50.5 billion in 2019. Reducing this burden is essential for improving patient outcomes and for achieving significant cost savings, which are crucial for safeguarding the NHS’s future.
Recent staff shortages and strikes have exacerbated the pressures facing the NHS, particularly following the COVID-19 pandemic. As the UK’s population ages, the prevalence of chronic conditions continues to rise, leading to longer waiting times and limited access to treatments.
Preventative health strategies, such as those already successfully applied to tackle obesity and smoking, demonstrate the importance of addressing the root causes of poor health. The NHS has made strides in these areas, showing that prevention not only improves population health but also reduces pressures on healthcare services.
One often overlooked factor in this crisis is the role of sleep health. By prioritising sleep as a pillar of preventative health, we could further alleviate some of this pressure, in turn improving population health and helping to restore the NHS’s capacity.
Sleep: an overlooked pillar of health
Sleep is often regarded as a luxury rather than a necessity, but recent research highlights its critical role in preventing chronic diseases. In the UK one in seven people sleep fewer than five hours a night, a habit that can have serious health consequences. In fact, ResMed’s sleep survey found that nearly 40% of respondents no more than three nights of good sleep in an average week.
The Whitehall II cohort study, led by UCL researchers, found that individuals who slept five hours or less at age 50 were 20% more likely to be diagnosed with a chronic disease and 40% more likely to develop chronic conditions over the next 25 years, compared to those who got at least seven hours of sleep. With more than half of older adults now having at least two chronic diseases, the link between sleep and long-term health is clear.
Poor sleep is linked to numerous chronic conditions, including cardiovascular disease, diabetes, and gastrointestinal disorders. Research shows that disturbed sleep can increase the risk of conditions like gastroesophageal reflux disease (GERD), one of the most common causes of hospital admissions. In fact, hospital admission rates have risen by 48.5% from 1999 to 2019, with diseases of the digestive system being a leading cause. Furthermore, chronic sleep deprivation negatively impacts brain function, metabolism, and the immune system, and disrupts the regulation of blood pressure, cholesterol, and blood sugar levels. Sleep durations of less than seven hours per night are associated with an increased risk of morbidity and mortality. Therefore, addressing sleep health is essential to mitigate the rise of chronic diseases and reduce healthcare costs and ease the strain on the NHS.
Easing the burden on NHS resources
Research has shown that sleep can improve the wellbeing of the general population and can lead to fewer hospital admissions and reduced healthcare visits – an independent evaluation from the Office of Health Economics found a 56% reduction in the use of sleep medication and a 70% drop in anxiety symptoms when sleep is properly managed, with potential NHS savings of £99 million over three years. These savings represent crucial resources that can be redirected to other areas in need, thereby reducing the overall burden on NHS services.
ResMed-backed research, presented at the ATS International Conference 2024, underscores the value of Positive Airway Pressure (PAP) therapies in reducing hospitalisation rates for patients with obstructive sleep apnoea (OSA). Dr. Holger Woehrle, German physician and sleep researcher, looked at 17,000 treatment-naïve patients in both PAP-treated and untreated cohorts and showed PAP treatment reduces hospitalization in patients with OSA over the first four years of treatment. Although these findings are based on German data, they indicate a strong correlation between effective sleep treatment and reduced use of healthcare resource usage. With the prevalence of OSA expected to rise due to an ageing population and increasing BMI trends, reliance on PAP therapy will be crucial in managing future healthcare demands.
Improving treatment through technology advancements
Advancements in sleep therapy technology are making it possible to diagnose and treat sleep disorders more quickly and effectively than before. Modern diagnostic tools, such as portable home sleep monitors, and streamlined treatment protocols enable faster patient setup for therapies like PAP. This could help NHS resource management by reducing waiting times, and enhances the overall patient experience, contributing to better health outcomes and a healthier population. By embracing these innovations, we can further ease the burden on the NHS while delivering high-quality care to patients.
Building a sleep-conscious society
Improving public health by prioritising sleep health across society begins with simple yet impactful changes at the individual level. This includes adopting a tech-free bedtime routine, sticking to a consistent sleep schedule, and creating a dark, cool, and restful environment for sleep. Encouraging healthy habits like limiting daytime naps, avoiding late-night meals, and incorporating physical activity into daily routines can also make a significant difference.
Public health campaigns should raise awareness about these easy-to-implement tips, emphasising sleep’s importance as a vital component of overall health – as we have seen already with nutrition and smoking. Policy changes are also needed to support better sleep health within communities and workplaces. For example, implementing workplace wellness programs that include sleep education and encourage healthier sleep habits can help employees manage stress and improve productivity. Community education programs should focus on the benefits of good sleep hygiene and provide resources for those struggling with sleep disorders.
Additionally, integrating sleep disorder screenings into routine healthcare visits could help identify issues early, allowing for timely intervention and management. By cultivating a sleep-conscious society through education, policy changes, and public health initiatives, we can create a culture where sleep is recognised as a fundamental pillar of health.
Prioritising sleep for a healthier future
The evidence is clear: poor sleep is closely linked to the rise of chronic diseases, and interventions like PAP therapy have demonstrated the potential to reduce hospital admissions and healthcare visits. By focusing on improving sleep health, we can achieve better patient outcomes and reduce the demand on NHS resources.
Addressing the challenges facing the NHS requires innovative and holistic approaches. Sleep health offers a crucial opportunity to help alleviate the burden of chronic diseases and improve healthcare outcomes on a broad scale.
Now is the time for healthcare leaders, policymakers, and the public to embrace this perspective. By integrating sleep health into public health strategies and everyday practice, we can improve individual well-being and contribute to a more sustainable and efficient NHS for the future. The importance of sleep in our collective health journey, and in the national interest of reducing pressure on the NHS, cannot be overstated.
By Carlos Nunez, M.D., Global Chief Medical Officer, ResMed