The societal, economic burden of insomnia is high

The largest proportions of all insomnia-related expenses are attributed to lost job productivity, absences from work and alcohol used as a sleep aid.
A study in the Jan. 1 issue of the journal Sleep indicates that the indirect costs of untreated insomnia are significantly greater than the direct costs associated with its treatment. The study estimates that the total annual cost of insomnia in the province of Quebec is 6.5 billion Canadian dollars, representing about one percent of the province's $228.5 billion in gross domestic product for 2002.
Annual indirect costs of insomnia related to lost hours of productivity are estimated to be $5 billion, representing the largest proportion (76 percent) of all insomnia costs. The annual estimate of insomnia-related lost productivity is 27.6 days per year for individuals with insomnia syndrome, and 6.2 days per year for people with insomnia symptoms. The second-highest cost of insomnia is attributed to job absenteeism, with $970.6 million – 14.7 percent of the total economic burden of insomnia - estimated to be lost annually due to insomnia-related absences. Individuals with insomnia syndrome are absent from work an estimated 4.36 days per year because of insomnia.
Lead author of the study, Meagan Daley, PhD, professor of psychology and business, in Quebec City, Canada stated that costs associated with the use of alcohol as a sleep aid exceed those associated with consultations and the use of medications and over-the-counter products.
The total estimated annual cost of alcohol used for promoting sleep is $339.8 million, which is the highest direct cost, representing 60 percent of all direct costs and five percent of all insomnia-related costs. The annual cost of insomnia-related consultations with a health-care professional is estimated to be $85.3 million (32.6 percent of all direct costs and 2.9 percent of overall costs), and an estimated $16.5 million is spent annually on prescription medications for insomnia (only 2.8 percent of direct costs and less than one percent of overall costs). According to the authors the centralization of the health-care system in Quebec keeps salaries and capital costs relatively low, and most medications prescribed for sleep in Canada are inexpensive generic drugs.
Daley said, "This study demonstrated that it is not the costs associated with seeking out treatment (for insomnia), such as consulting health-care professionals or purchasing medications or over-the-counter products that constitute anywhere near the largest proportion of expenditures. Rather, indirect costs constitute the greatest proportion of all insomnia costs, with about ¾ of overall costs being due to lost work productivity."
This study was a part of a larger epidemiological study documenting the natural history of insomnia. A total of 948 randomly selected adults were chosen from the province of Quebec, Canada, to participate. The mean age of participants was 43.7 years. Sixty percent of participants were female. Volunteers completed questionnaires on sleep, health, use of health-care services and products, accidents, work absences and reduced productivity in the previous three months. Data were also obtained from the government-administered health-insurance board in Quebec regarding consultations and hospitalizations.

Have Insomnia? Try Aerobic Exercise

Older adults who have insomnia may sleep better if they eliminate the sleeping pills and take up aerobic exercise such as walking or bicycling, according to a new study. Researchers from Northwestern University are the first to evaluate the impact of aerobic exercise on middle-aged and older adults who suffer with insomnia.

Insomnia in America

About 30 to 40 percent of adults have symptoms of insomnia, which is an inability to fall asleep or stay asleep, and waking up not feeling refreshed. Up to 15 percent of adults have chronic insomnia, which is defined as experiencing these symptoms for a month or longer. Insomnia is more prevalent among women than men, and about half of all middle-aged and older adults suffer with this sleep disorder.
Medications called hypnotics are the most common treatment for insomnia, but they are associated with side effects such as memory problems, morning sedation, headaches, and sleepwalking. Relaxation techniques such as yoga, meditation, and exercise, as well as behavioral therapies have all been found to be helpful in varying degrees, depending on the cause of insomnia and consistently an individual uses them.
New Insomnia and Exercise Study
The study included 23 sedentary adults age 55 and older, mostly women, who had symptoms of chronic insomnia. One group was assigned to aerobic exercise for two 20-minutes sessions four times weekly or one 30-to-40 minute session four times weekly, both for 16 weeks. The participants chose at least two activities such as walking, using a stationary bike, or treadmill.
The control group engaged in a recreational or educational activity, such as a lecture or cooking class, which met for 45 minutes three to five times a week for 16 weeks. Subjects in both groups were given information about good sleep habits.
People in the exercise group reported better quality sleep, fewer symptoms of depression, more energy, and less sleepiness during the day. These improvements raised their status from a poor sleeper to good sleeper.
“This is relevant to a huge portion of the population,” according to Phyllis Zee, MD, director of the Sleep Disorders Center at Northwestern Medicine and senior author of the study. “Exercise is good for metabolism, weight management and cardiovascular health and now it’s good for sleep.”
Sleep quality has a critical impact on both physical and mental health. Because insomnia increases as people age, this population is at greater risk of health problems, which are also already more common in older adults. Therefore, “It is essential that we identify behavioral ways to improve sleep,” says Zee. “Now we have promising results showing aerobic exercise is a simple strategy to help people sleep better.”