Volume 3, June 2009
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insomnia in the news
Insomnia is a sleep disorder marked by difficulty falling and/or staying asleep. Sleep specialists divide insomnia into two groups: acute and chronic. Acute insomnia, which can last up to one month, usually results from a temporary situation — such as the loss of a job. Chronic insomnia, which extends beyond this one month period, is typically associated with a physical or psychological condition.
According to the National Institutes of Health, insomnia affects more than 70 million Americans. If untreated, the disorder can lead to a host of negative consequences, including adverse health effects, reduced cognitive abilities, and decreased job performance.
Until recently, insomnia was dismissed as a symptom of other disorders. New evidence suggests, however, that insomnia may not only be a symptom of a condition, but an actual disorder in and of itself.
Today, health care professionals are paying closer attention to this under-recognized and under-treated disorder, as research indicates that insomnia has become a significant and costly public health problem with serious consequences for both individuals and society.
According to a 2007 study published in Sleep (Sleep, Vol. 30, No. 3, 2007), it costs far less to treat insomnia than to ignore it. The study, which focuses on untreated insomnia in adults in the United States, concluded that the direct and indirect cost burden of untreated insomnia was significantly high — with medical expenditures for the typical insomnia patient during the six month period before treatment began — amounting to $924 to $1,143 more per year, depending on the age of the patient. This study also highlights the enormous implications of the disorder for employers, health plans, and individuals alike.
In a similar cost burden study published in the January 1, 2009 issue of Sleep (Sleep, Vol. 32, No. 1, 2009), the total annual cost of insomnia in the province of Quebec was estimated at $6.5 billion (Cdn$). The largest proportion of this expense, i.e., at 76 percent, was attributable to indirect costs associated with lost hours of productivity. Data analysis from the 2009 study shows that annual indirect costs associated with insomnia-related absenteeism were estimated at $970.6 million — with insomnia -related productivity losses estimated at $5.0 billion.
“It’s not surprising that the largest toll is in indirect costs,” said Todd Arnedt, Ph.D., C.B.S.M., Assistant Professor of Psychiatry and Neurology, and Director of the Behavioral Sleep Medicine Program at the University of Michigan. “Insomnia is a very costly disorder. It has significant implications with regard to an individual’s ability to work effectively. If you don’t get sufficient sleep at night, work productivity is going to suffer.”
Moreover, data analysis from the 2009 study indicates that direct costs associated with insomnia are broken down, as follows:
According to the 2009 study, the largest of the direct costs associated with insomnia was alcohol used as a sleep aid. “Individuals with insomnia symptoms, rather than insomnia syndrome, used the most alcohol,” said Dr. Arnedt. “If an individual just has insomnia symptoms, he or she is usually less inclined to go to a doctor for treatment. Instead, that person might use something more readily available, such as alcohol. In contrast, individuals with more severe insomnia, or insomnia syndrome, seem to prefer prescription medications over alcohol.”
Innovative and scalable interventions such as web-based digital coaching programs can offer alternatives to medication and alcohol for treating insomnia. HealthMedia, Inc, offers an on-line digital coaching solution to help tackle insomnia. “We’ve been seeing very positive outcomes from our Overcoming Insomnia program for some time, but it’s especially gratifying to see those results replicated independently in a randomized controlled trial,” says Dr. Richard Bedrosian, Director of Behavioral Health at HealthMedia. HealthMedia’s program uses evidenced based techniques to help individuals recover from insomnia. Individuals who have participated in this innovative online intervention have experienced positive results, including:
The 2009 study also shows that the average annual per-person costs (direct and indirect combined) were $50l0 for individuals with insomnia syndrome; $1431 for individuals presenting with symptoms; and $422 for good sleepers.
Moreover, insomnia is associated with many other conditions, both physical and mental health conditions. “We don’t take sleep seriously enough,” said Dr. Arnedt. “We need to understand it better, since it plays an important role in the co-morbidity of a host of other disorders, such as cardiovascular disease and diabetes. It is very likely that insomnia is driving up health care costs for these conditions.”