Chronically Poor Sleep: The Global Epidemic

Chronically Poor Sleep: The Global Epidemic
In the landscape of healthcare, sleep disorders often remain undiagnosed and untreated, particularly among underserved communities grappling with socioeconomic challenges. This article sheds light on the pervasive issue of sleep disorders in the United States, where one-third of Americans endure chronically poor sleep, exacerbated by barriers to accessing sleep testing and treatment. Despite the prevalence of sleep disorders, only a fraction of sufferers receive proper diagnosis and care, underscoring the urgent need for innovative solutions to bridge these gaps and improve sleep health outcomes.

One such solution is Wesper, a revolutionary home sleep testing platform that offers an accessible, accurate, and comfortable alternative to traditional in-lab sleep studies. By partnering with a nonprofit crisis center serving a diverse, low-socioeconomic community, Wesper embarked on a groundbreaking study to assess the impact of stressful work environments and irregular shifts on sleep health. The findings revealed alarming rates of untreated chronic insomnia and sleep apnea among participants, highlighting the urgent need for intervention and comprehensive sleep care strategies in underserved populations.

Through this study, Wesper not only provided valuable insights into the sleep challenges faced by crisis center employees but also paved the way for targeted interventions and organizational reforms. Medical interventions were initiated for participants with identified sleep disorders, while the crisis center management team embarked on initiatives to optimize shift scheduling practices and implement wellness programs focused on sleep hygiene and stress management. This collaborative endeavor underscores the transformative potential of leveraging innovative sleep technologies to address disparities in sleep healthcare and enhance the well-being of underserved communities.

One-third of Americans report chronically poor sleep, and the CDC estimates that approximately 70 million Americans have at least one sleep disorder. The two most common sleep disorders are insomnia and sleep apnea, affecting 26-30% of the population. Yet, only 10% of sufferers are diagnosed and treated. Chronically poor sleep reduces quality of life and is a significant risk factor for many life-threatening conditions such as cardiovascular disease, stroke, diabetes, cancer, dementia, and mental health disorders. 


Barriers to Sleep Testing

Several factors contribute to low rates of sleep testing in the United States. Access to sleep clinics is limited, especially in rural areas and low-socioeconomic communities. Testing wait times are long due to increased demand, a shortage of healthcare professionals, and delays caused by the COVID-19 pandemic. Additionally, in-lab sleep testing is extremely expensive, especially for underinsured individuals. Finally, some individuals avoid sleep testing due to time constraints and comfort concerns.

The introduction of new sleep technologies has eliminated factors that typically inhibit patients from accessing sleep studies. One such technology is Wesper, an accurate, affordable, accessible, and comfortable FDA-approved home sleep test and long-term sleep monitoring platform. Wesper allows patients to easily conduct multiple nightly tests with physician guidance and diagnostics, detailed sleep reports, and the ability to view sleep data over time. Unlike sleep labs and other home sleep technologies, Wesper can also be used like a consumer sleep tracker, allowing long-term data collection and providing the most accurate patient sleep assessment.


Sleep Testing for Underserved Communities: The Crisis Center Project 

Recently, Wesper partnered with a nonprofit, Texas-based, crisis center in a diverse, low-socioeconomic area. The crisis support team provides 24/7 around the year support for individuals suffering from poor mental health and suicidal ideation. Due to working on a rotating schedule, which often includes overnight shifts, along with the emotionally charged nature of their environment, the crisis support team is at high risk for poor sleep, stress, and reduced wellbeing. 

High stress and chronic sleep deprivation, and other health challenges, has lead to low attendance and high turnover, resulting in chronic staffing shortages. Further, the crisis center management team recognized that their employees and volunteers were at a high risk for the same metal health challenges that their organization was trying to address in the greater community. 

Many of the employees and volunteers at the crisis center are under the poverty line and come from backgrounds with low economic resources, resulting in social disadvantage, poor education, poor working conditions, housing insecurity, and residence in unsafe neighborhoods. Thus, access to quality healthcare is limited. 

The goal of the partnership study with Wesper was to identify how a stressful work environment and rotating shifts affected the sleep of employees who do not have quality access to sleep testing centers. Further, the information collected would be used to screen employees for common sleep disorders and provide medical intervention. Additionally, the management team aimed to use the collected sleep data to reassess their shift scheduling practices, and implement company-wide educational and wellness programs.

Study Overview

The participants were asked to test with Wesper for a period of 8 weeks. Various data collection methods were utilized to gather enough information to understand the participants’ sleep struggles and sleep habits.

First, information about the participants’ lifestyle habits was assessed to determine factors that may be contributing to poor sleep. Before starting a Wesper sleep test, the app encouraged participants to complete questions about factors during the 12 hours before testing that may impact their sleep. Examples include, but aren’t limited to, questions about caffeine intake, exercise, light exposure, medications, and stress.

After completing each test, the Wesper app prompted the participants to answer questions about their subjective sleep quality, such as how well they perceived they slept, if there were any sleep disturbances, and how many times they got up to use the bathroom. Additionally, the app asked if they experienced any common symptoms of sleep disorders, such as snoring, frequent awakenings, or breathing difficulties.

The participants were also asked to fill out a sleep diary in the app, where they could list additional information not included in the questionnaires. Finally, the sleep schedule was evaluated by tracking nightly bedtime and wake time.

Second, various objective sleep and respiratory measures were collected to assess sleep quality and identify if participants were at risk for insomnia or sleep apnea. These metrics included standard indices such as sleep latency (SL), sleep efficiency (SE), total sleep time (TST), number of awakenings (#W), total awake time after sleep onset WASO, and sleep stage percentages. A novel measure of assessing sleep introduced by Wesper includes the Sleep Quality Index (SQI), which considers sleep time, number of wakes, and a deep sleep time to provide an overall sleep quality percentage score.

Standard respiratory metrics were also collected to assess if a participant had sleep apnea. These metrics include the Apnea/Hypopnea Index (AHI), Central Apnea Index (CAI), Oxygen desaturation Index (ODI), SPO2 (oxygen saturation), and snoring. Novel measures of assessing respiratory metrics not previously used by a home sleep test include Hypoxic Burden (HB), Respiratory Effort Related Arousal Index (RERA I), and Respiratory Disturbance Index (RDI).

Finally, Wesper collected a wide range of additional data to provide a comprehensive overview of sleep and health, including heart rate, sleeping position, ambient noise, and body temperature. 


Study Outcome

The crisis center study objectively revealed the extent of the participants’ sleep issues over time. The majority of the participants qualified as having untreated chronic insomnia, and 30% (4) qualified as having untreated sleep apnea. All participants had poor sleep quality and bad sleep habits.

On average, the participants had a sleep quality index of 65%, considered very poor. The average nightly total sleep time was 5.8 hours, which is 1.2 hours less than the recommended minimum for adults. The average number of awakenings after sleep onset was 6.6, 4.6 times higher than normal, demonstrating highly disturbed sleep. When evaluating sleep schedule consistency, Wesper showed that 12 out of 13 participants had a highly irregular bedtime and wake time, which varied by over 60 minutes.

Interestingly, the subjective data found that participants rated their sleep quality better than the objective data indicated, demonstrating that they were bad at assessing the extent and severity of their sleep issues.




The findings of this study resulted in medical intervention for several participants, especially those found to be positive for sleep apnea and severe insomnia. Based on the findings, the crisis center management team is currently in the process of overhauling their scheduling rosters to prevent employees from having dramatic shift changes, thus reducing the risk of further disrupting their sleep. Additionally, new company-wide wellness and educational programs are planned to focus on better sleep habits and stress management. 

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