Sleep & Mental Health at Work: Am I just Tired, or could I be Suffering from Burnout?

This year the theme for World Mental Health Day on 10th October 2024 is “It is Time to Prioritise Mental Health in the Workplace”.

Work that we enjoy can have a hugely positive impact on mental wellbeing. The right job and work environment has the potential to provide a sense of purpose, financial security, opportunities for growth, friendships and social support. However, negative workplace experiences can also be a source of stress, worry, short and disrupted sleep.

In this article we explain the relationship between sleep and mental health at work, including the increasingly common condition of burnout.

What has sleep got to do with mental health at work? A close, two-way relationship

Sleep is a restorative process for both physical and mental health. Consistent, good quality sleep gives us energy, repairs damaged cells, and enables learning, memory and concentration the next day. Sleep also helps us to process emotional experiences, so that we wake up feeling more positive, and less anxious (Palmer et al 2023).

How does mental health at work impact sleep?

Feeling stressed, or anxious, can put the brain and body into a state of tension, or arousal, which makes it harder to fall asleep, or stay asleep, or can make us wake up feeling unrefreshed. Many studies have shown that people who describe their work as stressful (for example, a combination of high demands and low control over their work), are more likely to report insomnia, or fragmented sleep (Halonen et al 2017, Yang et al 2018). In contrast, those who feel fairly rewarded for their work, or have high levels of social support, are more likely to recover from insomnia than those who do not (Ota et al 2009).

How does sleep loss impact mental health at work?

When we don’t get enough sleep, our brains are more likely to interpret challenging situations the next day as threatening, or stressful. In other words, if your boss gives you a new project after a good night’s sleep you might feel grateful for the challenge, whereas after a poor night’s sleep, you’re more likely to feel overwhelmed, and worry that you aren’t up to the task.

If we are sleep deprived at work, research shows that we are less productive, less creative, less patient with colleagues, less engaged and more likely to struggle to make effective leadership decisions (Barnes & Watson 2019). Long working hours, short sleep, insomnia and disrupted sleep patterns due to shift work have all been linked to increased risks of work-related stress (Baek et al 2023).

Lack of sleep can also reduce our ability to cope with stress at work since, when we’re tired, we are less likely to engage in healthy coping behaviours such as asking for help, taking breaks to relax, or regular exercise. If we’re fatigued, we’re also more likely to resort to drinking excess caffeine or alcohol, or eating late night convenience foods, which can further worsen sleep. This can lead to a vicious cycle of work stress, unhealthy lifestyle behaviours, poor sleep and poor mental health.

Can better sleep improve mental health?

Positively, the relationship between sleep and mental health goes both ways; improving poor sleep has been linked to an increase in workplace engagement and job satisfaction, as well as a reduction in mental health disorders (Barnes et al 2017, Scott et al 2021).

During the COVID-19 pandemic, healthcare workers who had good quality sleep were less likely to develop anxiety or depression, supporting the idea that sleep could be an important factor in protecting us against the effects of work stress (Liu et al 2022).

Am I tired, or suffering from burnout?

In recent years, there has been growing concern about burnout, defined by WHO in 2019 as a state of physical, mental and emotional exhaustion. This is usually caused by chronic stress at work, but can also be caused by other long term stressors such as caregiving, or living with a chronic illness.

The American Psychological Association (APA) suggests that burnout has its origins from “performing at a high level until stress and tension, especially from extreme and prolonged physical or mental exertion or an overburdening workload, take their toll.”

In other words, burnout happens when we get to the point where we feel so depleted by ongoing stress that there is little emotional reactivity left. People often report feeling numb, or not caring, even when their job used to feel meaningful, rewarding or exciting.

The three crucial signs of burnout include:

1. Feeling tired, or exhausted: lack of energy which is not relieved easily by sleep. Signs of physical depletion include getting colds or flu, aches, headaches, loss of appetite, or insomnia.
2. Low performance: an inability to perform effectively at work, marked by procrastination, withdrawal from others, increased irritability, sometimes turning to food, alcohol or drugs to cope.
3. Emotional burnout: feeling hopeless, defeated, cynical, incapable and isolated - those in caring roles cease to be able to care for others.

Burnout is more than just feeling fatigued. Even when well rested, the weariness does not go away. Burnout has many similarities to depression - usually the feelings of depletion are directed towards the source of stress (such as your job) whereas depression can be more universal.

Both depression and burnout often involve sleep disruption. For some people this means excess sleep, or ‘hypersomnia’, whereas for others, sleep becomes lighter and less restorative - or there may be a combination of the two. Studies have found a close relationship between sleep problems, depression and burnout (Roth et al 2022).

What can you do if you feel stressed at work, or worried about burnout?

Crucially, burnout is unlikely to resolve itself on its own. If you suspect you may be moving towards burnout, it’s important to take action to protect your wellbeing.

1. Seek help: When we’re stressed, our minds often make us feel as though the situation is catastrophic and that there is nothing we can do. Burnout can make us feel hopeless. Talking the situation over with a trusted friend or colleague, can often give a sense of perspective. If workload is the problem, discuss it with your line manager and ask for help in prioritising what is important, or negotiating realistic deadlines. If you find it hard to talk to your manager, consider approaching occupational health, or another manager. You may need to speak to your GP, or medical professional, if you’re worried about your ability to cope. Many companies offer an EAP (Employee Assistance Programme) where you can speak to a trained counsellor or therapist for advice.
2. Prioritise sleep: Stress can interfere with sleep quality so we may need to work harder at sleep hygiene to have a restorative night’s sleep. Here are 3 core behaviours to focus on, which will help with a more restful night:
   1. Consistency - aim to get out of bed at the same time, to within an hour, 7 days a week. This will help to keep your circadian rhythms (or body clocks) coordinated, which means you will wake up feeling alert, and start to naturally feel sleepy at bedtime.
   2. Protect 7+ hours - working adults are recommended to get at least 7 hours of sleep every 24 hours. This is time spent sleeping.. not scrolling on your phone in bed! Work back from your wake time, and try to switch out the light at least 7.5 hours before that.. To allow for time spent falling asleep, or waking up at night.
   3. Plenty of natural light - sunlight helps us to feel energised during the day, and can improve mood and sleep quality by keeping your body clocks aligned. When you feel overwhelmed, it can feel as though you don’t have time for breaks. Try to structure several breaks outside during the day, and sit by a window. 
3. Try mind-body relaxation practices: One recent study combined the results of 23 trials which looked at the effects of mind-body practices on work stress in healthcare workers (Zhang et al 2024). They compared mindfulness-related therapies, muscle relaxation, biofeedback and yoga. Yoga had the strongest effect on improving mental health, followed by muscle relaxation.