Insomnia, Health-Related Quality of Life and Healthcare Resource Consumption

Hatoum, Hind T.; Kong, Sheldon X.; Kania, Christopher M.; Wong, Jiahui; Mendelson, Wallace B.

doi:10.2165/00019053-199814060-00004

Cited by 163 publications

(109 citation statements)

References 7 publications

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“…In addition, these symptoms cannot be accounted for by another medical or psychiatric condition. Studies have begun to document a high degree of morbidity associated with insomnia including reductions in quality of life that are comparable to other chronic illnesses such as congestive heart failure and depression [5,6].…”

Section: Introductionmentioning

confidence: 99%

Stress-related sleep disturbance and polysomnographic response to caffeine

et al. 2006

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Background and purpose-To determine the sleep response to caffeine in individuals vulnerable to stress-related sleep disturbance as measured by polysomnography.Patients and methods-Eleven healthy individuals without insomnia scoring low (4 women, mean age=32.64 ± 15.46 years) and 10 healthy individuals also without insomnia scoring high (6 women, mean age=34.20 ± 13.73 years) on a measure of vulnerability to stress-related sleep disturbance were studied in a laboratory protocol. A moderate-low dose of caffeine (3 mg/kg) was administered 1 h prior to lights-out and compared to a counterbalanced control night with each condition separated by 1 week. Standard polysomnographic measures were assessed (i.e. total sleep time, sleep efficiency, latency to persistent sleep, and sleep stage percentages) for both control and caffeine nights.Results-There were no between-group differences in sleep on the control night. Importantly, individuals reporting vulnerability to stress-related sleep disturbance had significantly prolonged latency to persistent sleep in response to the caffeine challenge (interaction; P <0.05).Conclusion-Normal sleepers with an identified vulnerability to stress-induced sleep disturbance exhibited greater objectively verifiable sleep-reactivity in response to a caffeine challenge compared to non-vulnerable individuals. These results suggest that the construct of individual differences in vulnerability to sleep disturbance applies to a pharmacological 'stressor' (i.e. caffeine) as well as to previously assessed stressors such as a first-night effect. This finding provides further support for generalized trait vulnerability by demonstrating a sleep disturbance to a wake-promoting pharmacological challenge in specific a priori identified individuals.

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Section: Introductionmentioning

confidence: 99%

Stress-related sleep disturbance and polysomnographic response to caffeine

et al. 2006

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“…Individuals who experience insomnia have been reported to have higher resource utilization, including emergency room visits, hospitalizations, and physician visits, when compared to those who do not experience insomnia. 9,13 The annual direct cost of insomnia is estimated to be approximately $14 billion in the United States.…”

Section: Population Health Managementmentioning

confidence: 99%

“…7 One study found that both mental health status and emotional dimensions of quality of life were lower among severe and mild insomniacs compared to those with no insomnia. 7 In a study of managed care enrollees by Hatoum et al, 9 those with insomnia reported significantly lower health-related quality 1 Consumer Health Sciences, Princeton, New Jersey (at time of writing). 2 Sanofi-Aventis, Bridgewater, New Jersey (at time of writing).…”

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confidence: 99%

Burden of Chronic Sleep Maintenance Insomnia Characterized by Nighttime Awakenings

Bolge

Joish

Balkrishnan

et al. 2010

Population Health Management

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The objective of this study was to evaluate the economic and humanistic burden of chronic sleep maintenance insomnia characterized by nighttime awakenings (CINA). A database analysis of National Health and Wellness Survey, an annual cross-sectional study of health status and outcomes of US adults, was performed. CINA was defined as experiencing nighttime awakenings at least twice per week for more than 1 month that have moderate to severe impact on daily life and not experiencing difficulty falling asleep. No insomnia was defined as not selfreporting insomnia, sleep difficulties, or sleep symptoms. Outcomes included resource utilization in the past 6 months, the Work Productivity and Activity Impairment questionnaire, and the SF-8. Linear regression models were developed to assess the independent effects of CINA on outcomes while controlling for demographics and comorbidity.In all, 1523 respondents met the criteria for CINA and 24,106 met the criteria for no insomnia. Controlling for demographics and comorbidity, CINA sufferers had greater resource utilization (0.1 [P < 0.001] more emergency room visits, 0.2 [P ¼ 0.001] more days hospitalized, and 2.5 [P < 0.001] more provider visits), 22.4% (P < 0.001) greater activity impairment, and SF-8 physical and mental summary scores that were 6.2 (P < 0.001) and 6.8 (P < 0.001) points lower than those with no insomnia, respectively. Among those employed full time, CINA sufferers had greater work productivity impairment (4.0% due to absenteeism, 17.6% due to presenteeism, and 15.6% greater overall productivity impairment) than those with no insomnia (P < 0.001 for all).CINA in relative isolation was associated with a significant negative impact on health care utilization and its associated costs, health-related quality of life, and work productivity. (Population Health Management 2010;13:15-20)

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“…If a primary care provider poses this question, there is roughly a 40% probability that the answer will be "not good" and will necessitate additional time-consuming exploration. 46 The process of taking a sleep history is often vexing because of night-by-night variability in sleep and because of one quality inherent to the sleep state-unconsciousness. In this era of increased pressure for productivity, the primary care provider may not have time to flesh out the subtleties of sleep behavior.…”

Section: What Are the Barriers To Screening For Insufficient Sleep/slmentioning

confidence: 99%

How is Your Sleep: A Neglected Topic for Health Care Screening

Sorscher¹

2008

The Journal of the American Board of Family Medicine

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Purpose: Inadequate sleep, whether it is caused by voluntary sleep curtailment or specific sleep disorders, is highly prevalent, has wide-ranging negative consequences for human health and well-being, and is greatly under-diagnosed. The objective of this study was to determine the frequency of inquiry by family medicine clinics about unhealthy sleep patterns and symptoms in their health history database questionnaires.Methods: This study surveyed health history database forms used by family medicine clinics in the 7-county Minneapolis/St. Paul metropolitan area for questions related to sleep disorders. Fourteen distinct database batteries that are used in 121 primary care clinics and employ 935 family medicine doctors (roughly 75% of physicians practicing in this region) were analyzed.Results: Direct questions about sleep health are often not included in health history questionnaires. Eight of 14 (57%) database batteries reviewed in this study featured no sleep-related questions. Other lifestyle issues were screened with much greater frequency. For example, questions about healthy eating patterns and regular physical activity were present in 13 and 12 of the 14 batteries (93% and 86%), respectively.Conclusions: Despite the significant burden that sleep disorders place on human health, this study found that family medicine clinics do not screen for them as frequently as they do for other lifestyle/ behavioral issues when they establish a health history database for new patients.

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Insomnia, Health-Related Quality of Life and Healthcare Resource Consumption

Abstract: Insomnia is significantly associated with reduced HR-QOL and increased healthcare resource use in enrollees of managed-care organisations.

Cited by 163 publications

References 7 publications

Stress-related sleep disturbance and polysomnographic response to caffeine

Stress-related sleep disturbance and polysomnographic response to caffeine

Burden of Chronic Sleep Maintenance Insomnia Characterized by Nighttime Awakenings

How is Your Sleep: A Neglected Topic for Health Care Screening

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