By Dr Alison Bentley, Restonic Sleep Expert
While burnout is mainly caused by work stress, difficulty with getting enough good quality sleep worsens the problem in all three phases of burnout:
Studies show that thinking about work during off hours is significantly linked to the development of burnout, and this worrying about work would also increase the risk of insomnia.
The presence of poor sleep during extreme work stress has been linked to the development of burnout. The poor sleep can be of poor quality or reduced quantity.
Crucially, the poor sleep may be blamed on the work stress, but may be due to organic sleep disorders such as insomnia or obstructive sleep apnoea. Daytime fatigue from any sleep disorder can be mistaken for early burnout. With 40% of adults predicted to have some form of apnoea and 10% of adults with chronic insomnia, these are important disorders to find and treat.
One of the main causes of insomnia is insomnia disorder, where the insomnia occurs without any particular cause, and which keeps itself going due to hyperarousal of thoughts and anxiety before bed.
Studies show that thinking about work during off hours is significantly linked to the development of burnout, and this worrying about work would also increase the risk of insomnia. Many people also work at night and try to go to sleep immediately after closing their laptops, which often leads to a delay in falling asleep and fewer hours of sleep at night as a result.
The lack of restoration at night that usually occurs during sleep will inevitably lead to sufferers feeling run down and fatigued during the day, independently of any burnout symptoms. As fatigue is one of the main symptoms of burnout, the cause may be tricky to identify.
Once burnout begins, the sleep of people with symptoms of burnout is worse than those without burnout. They experience increased numbers of arousals during sleep, causing fragmentation and poor quality, less of the deeper stages of sleep and more light sleep – which all lead to reduced restoration during sleep.
It appears to be vitally important that sleep is better during the recovery phase of burnout. Poor sleep has been linked to slower recovery and an increased risk of not working up to two years after burnout. Those people who sleep better during treatment get back to work faster. Thus during recovery from burnout, a deliberate attempt should be made to find and treat any independent sleep disorder.
In a situation of work stress where sleep is becoming a problem, it is important to work on your sleep. If poor sleep quality came before the burnout, check whether you have sleep apnoea (complete the STOP BANG questionnaire to check whether you have a high risk). If you had insomnia first, then get that assessed to see whether it needs specific treatment.
In a situation where you are working late into the night, try to get a good night’s sleep. Make sure that you have at least one hour after working to get your brain into the right state for falling asleep. Close the laptop and let your work thoughts swirl around for a while, then distract yourself with reading a novel or watching a short programme on TV.
Get ready for bed 30 minutes before bedtime – keep it slow – go to the bathroom, put on pyjamas, brush teeth, etc. Get into bed and find a deliberate distraction to keep your mind off work, to allow the sleepiness to develop. Once you feel sleepy, you will find it much easier to fall asleep. A good sleep will result in better performance during the day and less work stress than if you were underperforming due to poor sleep as well.
If you have sleep difficulties not solved by that technique and you are worried about getting sufficient good quality sleep, please speak to your doctor.
Dr. Bentley is a medical doctor with 30 years of experience treating sleep problems in both adults and children. She has a PhD in restless leg syndrome and has worked in private practice, research including academia. She was the founding chair of the Sleep Society of South Africa and has presented at local and international medical and sleep conferences, and in her spare time, she volunteers to build nursery school classrooms. Dr. Bentley believes sleep remains under-researched and aims to improve sleep research and training for doctors. From 2023, Dr. Bentley will be partnering with Restonic SA to share her knowledge and expertise on sleep
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