Sleepless in Chennai: The Consequences of Increasing Sleep Among the Urban Poor?

Co-sponsored by Asia Health Policy Program (AHPP) and Center for South Asia (CSA).

One-third of our time is dedicated to sleep, yet little is known about the levels and consequences of sleep deprivation, especially in the developing world. To begin to address this gap, we randomized treatments to increase sleep among 452 adults in urban India for a month each, measured their sleep objectively, and gathered fine-grained data on multiple outcomes.  We present five sets of results. First, individuals sleep little -- only 5.6 hours per night, despite spending 8 hours in bed -- and poorly. Second, sleep can be improved; providing devices, encouragement, (and for some) financial incentives, increased night sleep by over 30 minutes. Short naps in the afternoon also increased daily sleep significantly. Third, contrary to the expert predictions, increased night sleep did not increase earnings: while productivity did increase, especially due to naps, countervailing reductions in labor supply counterbalanced the productivity increases. Fourth, increased night sleep had no impacts on cognition, well-being, physical health, or decision-making. In contrast, naps had only suggestive on physical health but significantly improved elements of cognition and well-being. Finally, naps altered decision-making in meaningful ways, increasing savings by up to 14 percent, enhancing attention to non-salient incentives, and reducing present-bias. Taken together, we find strikingly low levels of sleep in an urban population in India and little evidence of increased night sleep impacting short-run economic outcomes but more noticeable short run economic impacts of naps. The results provide a possible explanation for the persistence of widespread sleep deprivation and the relatively high prevalence of afternoon naps in many developing countries.

Dr. Heather Schofield is an Assistant Professor in the Perelman School of Medicine and The Wharton School. Dr. Schofield is an economist studying development, health, and behavioral economics. Two primary ongoing areas of research include the role of health human capital (nutrition, pain management, adequate sleep) in economic productivity, cognitive function, and decision-making and the role of financial and social incentives in promoting healthy behaviors. Dr. Schofield completed her Ph.D. in Business Economics, MS in Global Health and Population, and BA in Economics at Harvard University.