Chronic Insomnia and Health Care Utilization in Young Adults

Bramoweth, Adam D.; Taylor, Daniel J.

doi:10.1080/15402002.2011.587067

Cited by 31 publications

(26 citation statements)

References 52 publications

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“…46 Individuals with chronic insomnia and a comorbid medical or psychiatric condition have greater health care costs than those with chronic insomnia alone. 11 The current study demonstrated that bCBTi can significantly decrease HCU in patients who complete and respond to treatment. Given our means of data collection, we were not able to measure change in indirect costs, but it is plausible that indirect costs, which are often greater than direct costs, would have been reduced as well.…”

Section: Discussionmentioning

confidence: 93%

“…However, this reporting of HCU data is consistent with other studies of insomnia and costs. 11,12,14,50 Additionally, while significant differences in costs pre-and post-treatment were identified, effect sizes were small. The study was not adequately powered to find meaningful change in HCU, and effect size was influenced by the high variability (i.e., large standard deviations) of the cost data.…”

Section: Discussionmentioning

confidence: 99%

“…10 A recent study by Bramoweth and colleagues provides support for increased costs related to comorbid insomnia. 11 Specifically, they found significantly greater estimated health care costs for young adults with insomnia comorbid with a medical or psychiatric disorder compared to those with insomnia alone and good sleepers. 11 Two other recent studies also found evidence for increased costs linked to insomnia among comorbid samples.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

“…11 Specifically, they found significantly greater estimated health care costs for young adults with insomnia comorbid with a medical or psychiatric disorder compared to those with insomnia alone and good sleepers. 11 Two other recent studies also found evidence for increased costs linked to insomnia among comorbid samples. Sarsour et al found people with insomnia (per the Insomnia Severity Index) and a psychiatric diagnosis had the highest health care costs.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

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Impact of Brief Cognitive Behavioral Treatment for Insomnia on Health Care Utilization and Costs

McCrae

Bramoweth

Williams

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objectives: To examine health care utilization (HCU) and costs following brief cognitive behavioral treatment for insomnia (bCBTi). Methods: Reviewed medical records of 84 outpatients [mean age = 54.25 years (19.08); 58% women] treated in a behavioral sleep medicine clinic (2005)(2006)(2007)(2008)(2009)(2010) based in an accredited sleep disorders center. Six indicators of HCU and costs were obtained: estimated total and outpatient costs, estimated primary care visits, CPT costs, number of office visits, and number of medications. All patients completed ≥ 1 session of bCBTi. Those who attended ≥ 3 sessions were considered completers (n = 37), and completers with significant sleep improvements were considered responders (n = 32). Results: For completers and responders, all HCU and cost variables, except number of medications, signifi cantly decreased (ps < 0.05) or trended towards decrease at posttreatment. Completers had average decreases in CPT costs of $200 and estimated total costs of $75. Responders had average decreases in CPT costs of $210. No signifi cant decreases occurred for non-completers. Conclusions: bCBTi can reduce HCU and costs. Response to bCBTi resulted in greater reduction of HCU and costs. While limited by small sample size and non-normal data distribution, the fi ndings highlight the need for greater dissemination of bCBTi for several reasons: a high percentage of completers responded to treatment, as few as 3 sessions can result in signifi cant improvements in insomnia severity, bCBTi can be delivered by novice clinicians, and health care costs can reduce following treatment. Insomnia remains an undertreated disorder, and brief behavioral treatments can help to increase access to care and reduce the burden of insomnia. Keywords: Insomnia, health care utilization, costs, brief cognitive behavioral treatment, physician visits, medication Citation: McCrae CS; Bramoweth AD; Williams J; Roth A; Mosti C. Impact of brief cognitive behavioral treatment for insomnia on health care utilization and costs. J Clin Sleep Med 2014;10(2):127-135.http://dx.doi.org/10.5664/jcsm.3436 S C I E N T I F I C I N V E S T I G A T I O N SC hronic insomnia impacts approximately 8% to 10% of adults in the United States population 1 and carries substantial economic burden. Direct costs (i.e., costs directly related to treatment) have been estimated at $13.9 billion annually in the United States, with total treatment costs estimated at $77 to $92 billion. 2 When indirect costs (i.e., lost productivity, insomniarelated accidents, increased medical problems) are included, annual costs exceed $100 billion. 3 Evidence from outside the U.S. reveals a similar pattern. Specifi cally, a study in Quebec, Canada, found that the combined direct and indirect per-person costs of insomnia syndrome (insomnia complaint ≥ 3 nights/ week with > 1 month duration, dissatisfaction with sleep, and daytime impairment; prescription sleep medication ≥ 3 nights/ week) was approximately $5,010; with $293 attributed to direct costs and $4,717...

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

See 2 more Smart Citations

Impact of Brief Cognitive Behavioral Treatment for Insomnia on Health Care Utilization and Costs

McCrae

Bramoweth

Williams

et al. 2014

Journal of Clinical Sleep Medicine

Self Cite

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show abstract

“…Insomnia affects the quality of life and the health state as well as causes a variety of physical and mental disorders in serious cases [1,2]. Studies have shown that insomnia is directly related to the increase in traffic accidents [3], the decline in the survival rate [4], and the increase in the rate of medical resource utilization [5]. In order to increase people's awareness of insomnia, the International Foundation for Mental Health and Neuroscience (IFMHN) established March 21 as 'World Sleep Day'.…”

Section: Introductionmentioning

confidence: 99%

Extraction methods and sedative–hypnotic effects of polysaccharide and total flavonoids of Cordyceps militaris

Sun

Zhang

et al. 2017

Biotechnology & Biotechnological Equipment

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Sedatives and hypnotics made from Chinese herbal medicine show great market prospects for minor side effects and zero potential addiction. In this study, the extraction conditions of Cordyceps militaris polysaccharide (CMP) and flavonoids (CMF) were, respectively, optimized by orthogonal experiments as follows: 30:1 ratio of water to plant material, three rounds of extraction at 90 C and 3 h for each extraction; 40:1 ratio of 70% ethanol to plant material, reflux extraction at 90 C for 4 h. Then, 200, 100 and 50 mg/kg of CMP and CMF were given intragastrically to mice for 30 days. The locomotor activity times of the mice were recorded on the 14th and 30th days. The effects of CMP and CMF on the sleep induced by pentobarbital sodium were observed on the 30th day. 5-Hydroxytryptamine (5-HT), acetylcholine (ACh), glutamate (Glu) and g-aminobutyric acid (GABA) levels in the mouse brains were determined by enzyme-linked immunosorbent assay on the 30th day. The results showed that different doses of CMP and CMF could reduce the number of locomotor activities in mice and lower the Glu level (p < 0.05 in the 50 mg/kg CMP group and p < 0.01 in the other groups), elevate the 5-HT level and reduce the ACh level (p < 0.01 only in the 200 mg/kg CMP and CMF groups) in the mouse brains. Therefore, the elevated 5-HT levels and decreased ACh and Glu levels in the brains may be the main mechanisms through which CMP and CMF exert their sedative and hypnotic effects.

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Bedtime repetitive negative thinking moderates the relationship between psychological stress and insomnia

Benham

2021

Stress and Health

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Research suggests that psychological stress is associated with insomnia, but there is limited research on vulnerabilities that might amplify this association, particularly in college students. Based on a sample of 507 undergraduates, the current study demonstrates that the observed positive correlation between self‐perceived stress and insomnia severity is moderated by the tendency to engage in repetitive negative thinking (RNT) at bedtime. Additionally, separate analyses of those who scored below/above the threshold for insomnia (non‐insomniacs vs. insomniacs) revealed that the interaction between stress and these negative bedtime cognitions differed qualitatively between the two groups. In insomniacs, the stress‐insomnia relationship was dampened for those with lower levels of bedtime RNT, but amplified for those with higher levels. For non‐insomniacs, the stress‐insomnia relationship was stronger for those with minimal bedtime RNT, while higher levels of bedtime RNT appeared to overshadow this association. To develop a better understanding of the contribution of stress and RNT to clinically relevant levels of insomnia, future studies should take into account the dissimilar patterns of moderation seen in non‐insomniacs and insomniacs, either through prospective screening or separate analyses. Findings from the current study suggest that insomnia treatments that can simultaneously reduce stress and address bedtime RNT may be optimal.

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Chronic Insomnia and Health Care Utilization in Young Adults

Cited by 31 publications

References 52 publications

Impact of Brief Cognitive Behavioral Treatment for Insomnia on Health Care Utilization and Costs

Impact of Brief Cognitive Behavioral Treatment for Insomnia on Health Care Utilization and Costs

Extraction methods and sedative–hypnotic effects of polysaccharide and total flavonoids of Cordyceps militaris

Bedtime repetitive negative thinking moderates the relationship between psychological stress and insomnia

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