The economic burden of insomnia: Direct and indirect costs for individuals with insomnia syndrome, insomnia symptoms, and good sleepers

Ecole de psychologie, Université Laval, Québec, Canada.
Sleep (Impact Factor: 4.59). 02/2009; 32(1):55-64.
Source: PubMed


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.
A randomly selected sample of 948 adults (mean age = 43.7 years old; 60% female) from the province of Quebec, 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 hospitalizations. 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.
The total annual cost of insomnia in the province of Quebec was estimated at $6.6 billion (Cdn$). This includes direct costs associated with insomnia-motivated health-care consultations ($191.2 million) and transportation for these consultations ($36.6 million), prescription medications ($16.5 million), over the-counter products ($1.8 million) and alcohol used as a sleep aid ($339.8 million). Annual indirect costs associated with insomnia-related absenteeism were estimated at $970.6 million, with insomnia-related productivity losses estimated at $5.0 billion. The average annual per-person costs (direct and indirect combined) were $5,010 for individuals with insomnia syndrome, $1431 for individuals presenting with symptoms, and $421 for good sleepers.
This study suggests that the economic burden of insomnia is very high, with the largest proportion of all expenses (76%) attributable to insomnia-related work absences and reduced productivity. As the economic burden of untreated insomnia is much higher than that of treating insomnia, future clinical trials should evaluate the cost-benefits, cost-utility, and cost-effectiveness of insomnia therapies.

Download full-text


Available from: Jean-Pierre Grégoire, Oct 05, 2015
44 Reads
  • Source
    • "From an economic perspective, insomnia places a tremendous burden on individuals and society. A study showed that the direct and indirect cost of insomnia in Canada in the year 2007 was estimated at $6.6 billion and $975.6 billion, respectively, equivalent to an average annual perperson cost of $5010 for individuals with insomnia syndrome [4]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Self-help cognitive-behavioral therapy (CBT) is an increasingly popular treatment option for insomnia. The objective of this meta-analysis was to compile an up-to-date evaluation on the efficacy, adherence, acceptability and dropout rate of self-help CBT for insomnia. We systematically searched six key electronic databases up until May 2013. Two researchers independently selected relevant publications, extracted data, and evaluated methodological quality according to the Cochrane criteria. Twenty randomized controlled trials were included; 10 of which were published after the last review up until January 2007. Meta-analysis of self-help CBT vs. waiting-list, routine care or no treatment was performed. Results showed that self-help CBT improved sleep, sleep-related cognitions and anxiety and depressive symptoms. Effect sizes for sleep-diary-derived sleep efficiency, sleep onset latency, and wake after sleep onset at immediate posttreatment were 0.80, 0.66, and 0.55, respectively. The average dropout rate of self-help CBT at immediate posttreatment was 14.5%, which was not significantly different from the 16.7% in therapist-administered CBT. Subgroup analyses supported the added benefit of telephone consultation. In conclusion, self-help CBT is efficacious and acceptable as an entry level of a stepped-care model for insomnia. In places where face-to-face treatments are unavailable or too costly, self-help CBT can be considered as a compromise.
    Sleep Medicine Reviews 12/2014; 19. DOI:10.1016/j.smrv.2014.06.010 · 8.51 Impact Factor
  • Source
    • "Its clinical features include inadequate quality or quantity of sleep which is further associated with negative impact on health and function.[3] It carries a huge burden on the economy in terms of cost of management, higher chances of depression and functional limitations.[45678910] Despite of all these problems, insomnia still goes highly untreated or managed by over-the-counter medications.[2] Early and correct diagnosis is a key to reducing the health costs. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background:Pittsburgh insomnia rating scale is a 65 item self administered open source questionnaire. The scale is widely used in clinical practice but its psychometric properties are not well established. Therefore keeping in mind this lacuna the current study was designed for university population of poor sleepers in India.Aims:The purpose of this study was to establish the Pittsburgh sleep Quality Index test- retest reliability, validity and internal consistency of Pittsburgh insomnia rating scale.Materials and Methods:Twenty five subjects were randomly chosen from the screened population of poor sleepers. Pittsburgh insomnia rating scale, Pittsburgh sleep quality index and Insomnia severity index were administered on test day. Retest was administered after one week.Results:Eight males and seventeen females with mean age 24 + 7.04 were recruited. The test retest reliability for Pittsburgh insomnia rating scale total score showed excellent reliability (ICC2,1-0.93). The results also show that the total score is moderately correlated with Pittsburgh sleep Quality Index (r-0.31) and moderately correlated with Insomnia severity index (r-0.49). Internal consistency for the test was excellent (Cronbach's alpha- 0.930)Conclusion:The study findings suggest that Pittsburgh insomnia rating scale has excellent internal consistency, test-retest reliability and good validity for university population of poor sleepers in India. It is an important first line of assessment scale for screening of sleep problems.
    North American Journal of Medical Sciences 04/2014; 6(4):161-7. DOI:10.4103/1947-2714.131238
  • Source
    • "Insomnia in elderly people results in deterioration of social and/or physical functioning.3 From previous studies in Canada, it has been shown that in addition to affecting the lives of individuals, insomnia may prove to be indirectly detrimental to the economy, costing the province of Quebec 6.6 billion CD each year due to missed work days.4 While the exact cause of insomnia is debatable, there appear to be numerous factors that may lead to insomnia. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Insomnia is one of the most common complaints faced by primary care practitioners after pain. Non-pharmacological management of Insomnia that is noninvasive is gaining interest among patients with insomnia. To determine the feasibility of recruiting and retaining participants in a clinical trial on shirodhara, Ayurvedic oil dripping therapy, for insomnia in the United States and also to investigate the therapeutic usefulness of Shirodhara for insomnia using standardized outcome measures. Case series. Shirodhara with Brahmi oil was done for 45 minutes on each participant for 5 consecutive days. Insomnia Severity Index (ISI) was used to evaluate the severity of insomnia as well as to determine the response to Shirodhara therapy. Data were collected at baseline, end of the treatment (day 5) and 1 week after the treatment ended (follow-up). Two males and eight females with a mean age of 40 years (range 23 to 72), SD ± 14.2, were enrolled in the study. One dropped out of the study, but all remaining nine participants experienced improvement at the end of treatment. The percentage of improvement range varied from 3.85% to 69.57%. At follow-up, most participants continued to improve. Comparison of means between baseline and day 5 indicated an overall significant improvement (P < .005), but in a comparison of baseline vs 1 week posttreatment the improvement was not significant (P < .089). No adverse events were reported during the study. Shirodhara with Brahmi oil may be beneficial for moderate to severe insomnia. It is feasible to recruit and retain participants for such therapies in the United States. It is important to validate these findings and investigate the mechanism of action using a larger sample and rigorous research design.
    01/2014; 3(1):75-80. DOI:10.7453/gahmj.2012.086
Show more