Only about one in five Germans naturally wakes up early, according to chronobiologist Till Roenneberg. The rest — roughly 80 percent of the population — are fighting their internal biological rhythm every time they punch in for a standard 9-to-5 shift. That mismatch, known as social jetlag, is now linked to higher risks of obesity, diabetes, and cardiovascular disease, experts warn.
The problem is compounded by climate change. Data from Climate Central shows that people around the world lose an average of 56 hours of sleep per year due to heat. In Germany, a DAK survey found that roughly one-third of respondents suffer health problems during extreme heat. Specialists are urging companies to adopt more flexible working hours that align with individual chronotypes, arguing that doing so preserves creativity and decision-making ability.
Presenteeism Remains a Stubborn Problem
While the discussion around biological rhythms gains traction, a more immediate workplace health issue persists: presenteeism. In Austria, ÖGB expert Claudia Neumayer-Stumler reports that about 65 percent of employees show up for work when they are sick. The Arbeiterkammer Oberösterreich estimates the figure may be as high as 75 percent. Trade union representatives are calling for better working conditions and warning against any deterioration in sick-pay regulations.
The situation has prompted a planned labour-law reform that would introduce a mandatory sick note from the first day of illness. Currently, employers can already request a medical certificate from day one in individual cases. Labour-law experts caution that a general rule would create logistical hurdles — particularly in areas where doctor appointments are scarce or for shift workers. The same reform package also proposes extending fixed-term contracts without cause to up to 48 months, with a maximum of six renewals.
A Prevention Offensive With Digital Tools
Against this backdrop, Federal Health Minister Nina Warken (CDU) has joined forces with the German Medical Association (Bundesärztekammer) and the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) to launch a comprehensive prevention initiative. The goal is to detect and avoid diseases earlier through targeted screening, building on the Prevention Act of 2015. A key focus is supporting small and medium-sized enterprises — which often lack the resources of large corporations — in establishing workplace health promotion. The GKV-Spitzenverband currently spends around 734 million euros on prevention services.
The plan also includes digitising invitation systems for health check-ups. Schoolchildren and adolescents will receive digital invitations for screenings, while people over 60 will get expanded preventive examinations. Closer coordination between federal, state, and local governments is also envisaged.
A new digital health check developed by SBK Siemens-Betriebskrankenkasse and the insurer BIG direkt gesund is already available. The CE-certified system captures lifestyle factors, pre-existing conditions, and family medical history, then generates personalised recommendations for mental health, cardiovascular health, and the musculoskeletal system.
International Developments in Sleep and Energy Management
Globally, the intersection of AI and health is attracting significant investment. In China, startup Jinri Yixiu — led by former Xiaomi manager Wang Teng — has secured a new round of funding from investors including CMC Capital and the Honghui Fund. The company is developing a system that uses multi-modal sensors and an AI energy assistant to optimise users’ recovery around the clock. The Chinese sleep-health market is projected to exceed one trillion yuan by 2030, according to industry forecasts.
For German policymakers and employers, the challenge is twofold: addressing the structural factors that drive presenteeism and the biological factors that erode long-term health. The prevention offensive aims to tackle both, but with a mandatory sick-note rule still under debate and a workforce increasingly out of sync with its own biology, the path forward remains complex.
