The association between insomnia severity and healthcare and productivity costs in a health plan sample (original) (raw)
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Yearbook of Anesthesiology and Pain Management, 2010
Background and purpose: Insomnia is a highly prevalent problem that is associated with increased use of health care services and products, as well as functional impairments. This study estimated from a societal perspective the direct and indirect costs of insomnia. Participants and methods: A randomly selected sample of 948 adults (mean age = 43.7 years old; 60% female) from the province of Québec, Canada completed questionnaires on sleep, health, use of health-care services and products, accidents, work absences and reduced productivity. Data were also obtained from the Quebec government administered health insurance board regarding consultations and hospitalisations. Participants were categorized as having insomnia syndrome, insomnia symptoms or as being good sleepers using a standard algorithm. Frequencies of target cost variables were obtained and multiplied by unit costs to generate estimates of total costs for the adult population of the province of Quebec.
Insomnia and the Performance of US Workers: Results from the America Insomnia Survey
Sleep, 2011
Although such large effects might justify the implementation of workplace insomnia screening and intervention programs, accurate estimates of the workplace costs of insomnia would be needed to justify such programs. Estimates of this sort currently do not exist, as most available studies are based either on medical/ pharmacy claims databases that only study treated insomnia 10,11 or on consumer panels that have very low response rates and suboptimal measures of insomnia. 12 Samples that define insomnia based on treatment risk particularly strong sample bias given epidemiologic evidence that only a small minority of Americans with chronic insomnia symptoms seek formal medical attention 13 and that few insomniacs receive prescription hypnotics 14 or formal diagnoses due to prominent comorbid conditions. 15 We address the limitations of currently available estimates of the workplace costs of insomnia in the current report by using survey data collected in the America Insomnia Survey (AIS), 1 a national survey of employed subscribers to a very large US national health plan (over 34 million members) who were selected using probability methods that did not oversample subscribers with a diagnosis of or treatment for insomnia. We estimate the associations of insomnia with work performance controlling for a wide range of comorbid conditions. Insomnia was assessed with a clinically validated fully structured diagnostic screening scale. 16 Work performance was assessed with a validated questionnaire that has INTRODUCTION The societal burden of insomnia in the United States is substantial, with an estimated one-third of all US adults experiencing weekly difficulties with nighttime sleep 1 and an estimated 50-70 million people complaining of nighttime sleep loss associated with daytime impairment. 2 As experimental studies increasingly link insomnia with a range of negative effects on functioning, from increased sleepiness and fatigue 3 to reduced psychomotor performance, 4 memory consolidation, 5 and affect regulation, 6 it is unsurprising that insomnia has been associated with significant workplace deficits. Indeed, adverse effects on work performance are consistently ranked among the most prominent components of the overall societal burden of insomnia, 7,8 with estimates of annual insomnia-related workplace costs due to excess sickness absence, reduced work productivity, and workplace accidents
The direct and indirect costs of untreated insomnia in adults in the United States
Sleep, 2007
Objectives: To estimate the direct and indirect cost burden of untreated insomnia among younger adults (age 18 -64), and to estimate the direct costs of untreated insomnia for elderly patients (age 65 and over). Design: A retrospective, observational study comparing insomnia patients to matched samples without insomnia. Settings: Self-insured, employer sponsored health insurance plans in the U.S. Patients or Participants: 138,820 younger adults and 75,558 elderly patients with insomnia, plus equal-sized, matched comparison groups. Interventions: NA Measurements and Results: Direct costs included inpatient, outpatient, pharmacy, and emergency room costs for all diseases, for six months before an index date. The index date for insomnia patients was the date of diagnosis with or the onset of prescription treatment for insomnia, sometime during July 1, 1999 -June 30, 2003. Non-insomnia patients were assigned the same index dates as the insomnia patients to whom they were matched. Indirect costs included costs related to absenteeism from work and the use of short-term disability programs. Propensity score matching was used to find insomnia and non-insomnia patients who had similar demographics, location, health plan type, comorbidities, and drug use patterns. Regression analyses controlled for factors that were different even after matching was completed. We found that average direct and indirect costs for younger adults with insomnia were about 1,253greaterthanforpatientswithoutinsomnia.Amongtheelderly,directcostswereabout1,253 greater than for patients without insomnia. Among the elderly, direct costs were about 1,253greaterthanforpatientswithoutinsomnia.Amongtheelderly,directcostswereabout1,143 greater for insomnia patients. Conclusions: Insomnia is associated with a significant economic burden for younger and older patients. Citation: Ozminkowski RJ; Wang S; Walsh JK. The direct and indirect costs of untreated insomnia in adults in the united states. SLEEP 2007;30(3):263-273.
Insomnia and the Performance of US Workers
1161 The Effects of Insomnia on Work Performance—Kessler et al injuries in the US civilian workforce ranging between 15billionand15 billion and 15billionand92 billion. 9,10 Although such large effects might justify the implementation of workplace insomnia screening and intervention programs, accurate estimates of the workplace costs of insomnia would be needed to justify such programs. Estimates of this sort currently do not exist, as most available studies are based either on medical/ pharmacy claims databases that only study treated insomnia 10,11 or on consumer panels that have very low response rates and suboptimal measures of insomnia. 12 Samples that define insomnia based on treatment risk particularly strong sample bias given epidemiologic evidence that only a small minority of Americans with chronic insomnia symptoms seek formal medical attention 13 and that few insomniacs receive prescription hypnotics 14 or formal diagnoses due to prominent comorbid conditions. 15 We address the limitations of currently available estimates of the workplace costs of insomnia in the current report by using survey data collected in the America Insomnia Survey (AIS), 1 a national survey of employed subscribers to a very large US national health plan (over 34 million members) who were selected using probability methods that did not oversample subscribers with a diagnosis of or treatment for insomnia. We estimate the associations of insomnia with work performance controlling for a wide range of comorbid conditions. Insomnia was assessed with a clinically validated fully structured diagnostic screening scale. 16 Work performance was assessed with a validated questionnaire that has
Insomnia risks and costs: health, safety, and quality of life
The American journal of managed care, 2010
The effect of insomnia on next-day functioning, health, safety, and quality of life results in a substantial societal burden and economic cost. The annual direct cost of insomnia has been estimated in the billions of US dollars and is attributed to the association of insomnia with the increased risk of certain psychiatric and medical comorbidities that result in increased healthcare service utilization. It is well known that psychiatric conditions, anxiety and depression in particular, are comorbid with insomnia. However, emerging data have shown links with several common and costly medical conditions such as heart disease and diabetes. Furthermore, studies show that patients who have insomnia have more emergency department and physician visits, laboratory tests, and prescription drug use than those who do not have insomnia, increasing direct and indirect consumption of healthcare resources. Insomnia also has been shown to negatively affect daytime functioning, including workplace p...
Sleep, 2012
Recent experimental and epidemiologic literature associates insomnia with multiple daytime symptoms, including sleepiness and fatigue, 2,3 psychomotor performance deficits, 4,5 cognitive impairments, 6,7 and mood dysregulation; 8,9 leading to broader impairments in daytime role functioning 1,10-13 and increased risk of injuries. 14-16 The annual cost of sleep-related workplace injuries in the US civilian workforce is estimated to exceed $100 billion (2004 US dollars) using conservative assumptions about sleep disorder prevalence. 17 Self-reported sleep problems, 14,16,18,19 short time asleep, 20 fatigue, 21 and daytime sleepiness 22 have also been INSOMNIA, COMORBIDITY, AND RISK OF INJURY
Sleep Medicine, 2010
Background: Insomnia is commonly associated with one or more comorbid illnesses. Data on the relationship between insomnia severity and comorbid disorders are still limited, especially with regard to the use of well-validated measures of insomnia severity. Methods: A total of 2086 health plan enrollees, over-sampling for those with insomnia based on health claims, completed a telephone survey between April and June of 2006. Participants were categorized using four insomnia severity categories and compared on their administrative health claims' psychiatric and medical comorbidities. Results: Controlling for age and gender, the odds ratio for having at least one psychiatric diagnosis was 5.04 (CI = 3.24-7.84) for severe insomnia, 2.63 (CI = 1.97-3.51) for moderate insomnia, and 1.7 (CI = 1.30-2.23) for subthreshold insomnia compared with those with no insomnia. Similarly, the odds ratio for having treatment for at least one chronic disease was 2.83 (CI = 1.84-4.35) for severe insomnia, 2.34 (CI = 1.83-2.99) for moderate insomnia, and 1.55 (CI = 1.25-1.92) for subthreshold insomnia compared with the no insomnia group. Conclusions: Increasing insomnia severity is associated with increased chronic medical and psychiatric illnesses. Further research is needed to better understand associations between insomnia severity and individual psychiatric and chronic medical comorbidities.
Association of insomnia with quality of life, work productivity, and activity impairment
Quality of Life Research, 2009
Purpose To assess the association of insomnia with health-related quality of life (HRQOL), work productivity, and activity impairment. Methods Data were obtained from the 2005 US National Health and Wellness Survey. Subjects were assigned to the insomnia group (diagnosed insomnia experienced at least a few times a month) or the noninsomnia group (no insomnia or sleep symptoms). HRQOL was assessed using the short form 8 (SF-8) (mental and physical scores). The work productivity and activity impairment questionnaire (WPAI) assessed absenteeism (work time missed), presenteeism (impairment at work), work productivity loss (overall work impairment), and activity impairment. Linear regression models were used to control for potential confounders. Results A total of 19,711 adults were evaluated (5,161 insomnia, 14,550 noninsomnia). Subjects in the insomnia group had significantly lower SF-8 physical (-5.40) and mental (-4.39) scores and greater activity impairment scores (?18.04) than subjects in the noninsomnia group (P \ 0.01 for all). Employed subjects in the insomnia group had greater absenteeism (?6.27), presenteeism (?13.20), and work productivity loss (?10.33) scores than those in the noninsomnia group (P \ 0.01 for all). Conclusions Insomnia is significantly associated with poorer physical and mental quality of life and work productivity loss and activity impairment.