What A Leader Should Know About Sleep

By John Axelsson & Tina Sundelin

In this article, the authors lift the lid on the pitfalls of a lack of adequate sleep – in terms of both quality and quantity, and how leaders are hindering their productivity when sleep deprived.


Sleep is a curious phenomenon. Despite more than 50 years of research, its biological function or functions remain elusive. Most recently, sleep has been shown to support vital brain functions relating to metabolism and adaptation. We do know that the high metabolism of the waking brain is a messy and costly business, and that sleep facilitates maintenance and recuperative functions by repairing the body’s machinery and structures from the day’s wear and tear. During sleep, we refill local energy stores and effectively clean up and remove metabolic rest products and toxic protein fragments.  There is also a growing body of evidence indicating that sleep plays a crucial role in how we adapt to our environment. During sleep, the brain repeats what it has experienced during the day so that the episodes and behaviours are incorporated into the already existing neural networks. This will also allow the brain to update and fine-tune these networks every night so that they become more efficient and stable. For example, movements that we have practiced during the day, such as playing the piano or hitting a curve ball, become more fluid and efficient after a night of sleep. Sleep is also likely to be a key player in the brain’s ability to learn vast amounts during the day and subsequently forget what is not used regularly. This way, the brain is ready to learn anew after a period of sleep. In other words, sleep seems to be the price for having a nervous system that can continuously adapt to each individual’s environment.


Sleep Disturbances are Common

While most adults should sleep between 7-9 hours per night to stay healthy, almost a third of the working population sleep less than 6 hours on a regular basis. Disturbed sleep is also common. As many as 30% of the adult population report having disturbed sleep and around 10% fulfil the clinical criteria for insomnia. In addition, a growing number of people suffer from sleep apnea, the risk factors of which are overweight, drinking alcohol, smoking, being male and increased age. In addition, about 25-30% of the working population are shift workers, and about 20% of the working force report having work-related sleep disturbances. Along with the fact that disturbed sleep shows a high comorbidity with other diseases, often aggravating the symptoms, there is a large need for improved screening and interventions focusing on prevention and treatment of sleep disturbances.


Sleep Loss is a Health Risk

Chronic disturbed sleep increases the risk for developing metabolic disorders such as cardiovascular disease, type 2 diabetes, and obesity. Furthermore, it may aggravate the risk for developing depression and Alzheimer’s disease.1 But even just a few days of decreased sleep increases the risk of contracting the common cold when exposed. Prioritising your sleep is thus a good choice, both in the long and short run.


Sleepy People are Error and Accident-Prone

Sleep loss and shift work are related to an increased risk for errors and accidents, particularly at the workplace. Several reports have found that sleep-related fatigue was a contributing factor to large-scale accidents such as Three Mile Island, Chernobyl, and Exxon Valdes. Long working hours (>10 hours/day) and extended workweeks (>60 hours/week) are particularly risky. For example, the long work shifts and work weeks amongst medical residents are related to reduced sleep, attentional failures, as well as serious diagnostic and medical errors. The increased risk for diagnostic errors with these kinds of shifts was more than 400% higher as compared to a schedule that has eliminated extended work shifts.2 Driving home after a long night shift is also a particularly risky situation. Few are well suited for the monotony of driving after being awake for such a long time, and being inattentive for a few seconds can be fatal.

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About the Authors

John Axelsson is a Professor at the Stress Research Institute, Stockholm University, and affiliated at the Department of Clinical Neuroscience, Karolinska Institute. With his research he aims to increase the knowledge and awareness of how sleep in the rapidly developing 24-hour society affects health, cognitive processes and social behaviour.


Dr. Tina Sundelin has a PhD in psychology from Stockholm University, Sweden and is currently a Postdoc at Karolinska Institutet, Sweden, and New York University, USA. Dr. Sundelin studies cognitive and social effects of sleep loss.




1. Kecklund G, Axelsson J. Health consequences of shift work and insufficient sleep. BMJ. 2016;355:i5210. doi: 10.1136/bmj.i5210. PubMed PMID: 27803010.
2. Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, et al. Effect of reducing interns’ work hours on serious medical errors in intensive care units. New England Journal of Medicine. 2004;351(18):1838-48. PubMed PMID: 15509817.
3. Haack M, Mullington JM. Sustained sleep restriction reduces emotional and physical well-being. Pain. 2005;119(1-3):56-64. doi: 10.1016/j.pain.2005.09.011. PubMed PMID: 16297554.
4. Kamphuis J, Meerlo P, Koolhaas JM, Lancel M. Poor sleep as a potential causal factor in aggression and violence. Sleep Med. 2012;13(4):327-34. doi: 10.1016/j.sleep.2011.12.006. PubMed PMID: 22305407.
5. Wickens CD, Hutchins SD, Laux L, Sebok A. The Impact of Sleep Disruption on Complex Cognitive Tasks: A Meta-Analysis. Hum Factors. 2015;57(6):930-46. doi: 10.1177/0018720815571935. PubMed PMID: 25850114.
6. Lim J, Dinges DF. A meta-analysis of the impact of short-term sleep deprivation on cognitive variables. Psychol Bull. 2010;136(3):375-89. doi: 10.1037/a0018883. PubMed PMID: 20438143; PubMed Central PMCID: PMC3290659.
7. Barnes CM. I’ll sleep when I’m dead: Managing those too busy to sleep. Organizational Dynamics. 2011;(40):18-26. doi: 10.1016/j.orgdyn.2010.10.001.
8. Axelsson J, Sundelin T, Ingre M, Van Someren EJ, Olsson A, Lekander M. Beauty sleep: experimental study on the perceived health and attractiveness of sleep deprived people. BMJ. 2010;341:c6614. Epub 2010/12/16. PubMed PMID: 21156746; PubMed Central PMCID: PMC3001961.
9. Barnes CM, Guarana CL, Nauman S, Kong DT. Too tired to inspire or be inspired: Sleep deprivation and charismatic leadership. J Appl Psychol. 2016;101(8):1191-9. doi: 10.1037/apl0000123. PubMed PMID: 27159583.
10. Barnes CM, Gunia BC, Wagner DT. Sleep and moral awareness. J Sleep Res. 2015;24(2):181-8. doi: 10.1111/jsr.12231. PubMed PMID: 25159702.
11. Cho K, Barnes CM, Guanara CL. Sleepy Punishers Are Harsh Punishers. Psychol Sci. 2017;28(2):242-7. doi: 10.1177/0956797616678437. PubMed PMID: 28182529.
12. Olsen OK, Pallesen S, Torsheim T, Espevik R. The effect of sleep deprivation on leadership behaviour in military officers: an experimental study. J Sleep Res. 2016;25(6):683-9. doi: 10.1111/jsr.12431. PubMed PMID: 27231096.
13. Stothard ER, McHill AW, Depner CM, Birks BR, Moehlman TM, Ritchie HK, et al. Circadian Entrainment to the Natural Light-Dark Cycle across Seasons and the Weekend. Curr Biol. 2017. doi: 10.1016/j.cub.2016.12.041. PubMed PMID: 28162893.


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