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Economic burden of insomnia symptoms in Canada

Published:October 29, 2022DOI:https://doi.org/10.1016/j.sleh.2022.09.010

      Abstract

      Objective

      To estimate health care and productivity costs associated with insomnia symptoms in Canadian adults.

      Methods

      Three pieces of information were needed to calculate estimates based on a prevalence-based approach: (1) the pooled relative risk estimates of health outcomes consistently associated with insomnia symptoms obtained from recent meta-analyses of prospective cohort studies; (2) the direct (health care) and indirect (lost productivity due to premature mortality) costs of these health outcomes using the Economic Burden of Illness in Canada information; and (3) the prevalence of insomnia symptoms in Canadian men (18.1%) and women (29.5%) obtained from a nationally-representative survey.

      Results

      The direct, indirect, and total costs of insomnia symptoms in Canada in 2021 were $1.9 billion, $12.6 million, and $1.9 billion, respectively. This value represents 1.9% of the overall burden of illness costs for 2021 in Canada. The 2 most expensive chronic diseases attributable to insomnia symptoms were type 2 diabetes ($754 million) and depression ($706 million). The main contributor to the costs for type 2 diabetes and depression was prescription drugs. A 5% decrease in insomnia symptoms (from 23.8% to 18.8%) would result in an estimated $353 million in avoided costs while a 5% increase in insomnia symptoms (from 23.8% to 28.8%) would result in an estimated $333 million in additional expenditures yearly.

      Conclusions

      Insomnia symptoms greatly contribute to the economic burden of illness in Canada. Reducing the prevalence of insomnia symptoms would reduce its societal burden.

      Keywords

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      References

        • Morin CM
        • Jarrin DC.
        Epidemiology of insomnia: prevalence, course, risk factors, and public health burden.
        Sleep Med Clin. 2022; 17: 173-191
        • Chaput JP
        • Yau J
        • Rao DP
        • Morin CM.
        Prevalence of insomnia for Canadians aged 6 to 79.
        Health Rep. 2018; 29: 16-20
        • Taddei-Allen P.
        Economic burden and managed care considerations for the treatment of insomnia.
        Am J Manag Care. 2020; 26: S91-S96
        • Hillman D
        • Mitchell S
        • Streatfeild J
        • Burns C
        • Bruck D
        • Pezzullo L.
        The economic cost of inadequate sleep.
        Sleep. 2018; 41: zsy083
        • Streatfeild J
        • Smith J
        • Mansfield D
        • Pezzullo L
        • Hillman D.
        The social and economic cost of sleep disorders.
        Sleep. 2021; 44: zsab132
        • Daley M
        • Morin CM
        • LeBlanc M
        • Grégoire JP
        • Savard J.
        The economic burden of insomnia: direct and indirect costs for individuals with insomnia syndrome, insomnia symptoms, and good sleepers.
        Sleep. 2009; 32: 55-64
        • Katzmarzyk PT
        • Janssen I.
        The economic costs associated with physical inactivity and obesity in Canada: an update.
        Can J Appl Physiol. 2004; 29: 90-115
        • Janssen I.
        Health care costs of physical inactivity in Canadian adults.
        Appl Physiol Nutr Metab. 2012; 37: 803-806
        • Chaput JP
        • Carrier J
        • Bastien C
        • Gariépy G
        • Janssen I.
        Economic burden of insufficient sleep duration in Canadian adults.
        Sleep Health. 2022; 8: 298-302
        • Sofi F
        • Cesari F
        • Casini A
        • Macchi C
        • Abbate R
        • Gensini GF.
        Insomnia and risk of cardiovascular disease: a meta-analysis.
        Eur J Prev Cardiol. 2014; 21: 57-64
        • Li L
        • Gan Y
        • Zhou X
        • et al.
        Insomnia and the risk of hypertension: a meta-analysis of prospective cohort studies.
        Sleep Med Rev. 2021; 56101403
        • Johnson KA
        • Gordon CJ
        • Chapman JL
        • et al.
        The association of insomnia disorder characterised by objective short sleep duration with hypertension, diabetes and body mass index: a systematic review and meta-analysis.
        Sleep Med Rev. 2021; 59101456
        • Li L
        • Wu C
        • Gan Y
        • Qu X
        • Lu Z.
        Insomnia and the risk of depression: a meta-analysis of prospective cohort studies.
        BMC Psychiatry. 2016; 16: 375
        • Xu W
        • Tan CC
        • Zou JJ
        • Cao XP
        • Tan L.
        Sleep problems and risk of all-cause cognitive decline or dementia: an updated systematic review and meta-analysis.
        J Neurol Neurosurg Psychiatry. 2020; 91: 236-244
        • Morin CM
        • Altena E
        • Ivers H
        • et al.
        Insomnia, hypnotic use, and road collisions: a population-based, 5-year cohort study.
        Sleep. 2020; 43: zsaa032
        • Erren TC
        • Morfeld P
        • Foster RG
        • Reiter RJ
        • Groß JV
        • Westermann IK.
        Sleep and cancer: synthesis of experimental data and meta-analyses of cancer incidence among some 1,500,000 study individuals in 13 countries.
        Chronobiol Int. 2016; 33: 325-350
        • Chan WS
        • Levsen MP
        • McCrae CS.
        A meta-analysis of associations between obesity and insomnia diagnosis and symptoms.
        Sleep Med Rev. 2018; 40: 170-182
        • Diabetes inCanada
        Highlights from the Canadian Chronic Disease Surveillance System. Public Health Agency of Canada.
        Can be found at. 2017;
      1. Pearson C, Janz T, Ali J. Mental and substance use disorders in Canada. Statistics Canada, Catalogue no.82-624-X, Health at a Glance, 2013.

      2. Statistics Canada. Table 18-10-0006-01. Consumer price index, monthly, seasonally adjusted. DOI: https://doi.org/10.25318/1810000601-eng

      3. Statistics Canada. Table 17-10-0005-01. Population estimates on July 1st, by age and sex. DOI: https://doi.org/10.25318/1710000501-eng

      4. Statistics Canada. Table 14-10-0064-01. Employee wages by industry, annual (x 1,000). DOI: https://doi.org/10.25318/1410006401-eng

        • Wickwire EM
        • Tom SE
        • Scharf SM
        • Vadlamani A
        • Bulatao IG
        • Albrecht JS.
        Untreated insomnia increases all-cause health care utilization and costs among Medicare beneficiaries.
        Sleep. 2019; 42: zsz007
        • Robillard R
        • Dion K
        • Pennestri MH
        • et al.
        Profiles of sleep changes during the COVID-19 pandemic: demographic, behavioural and psychological factors.
        J Sleep Res. 2021; 30: e13231
        • Morin CM
        • Bjorvatn B
        • Chung F
        • et al.
        Insomnia, anxiety, and depression during the COVID-19 pandemic: an international collaborative study.
        Sleep Med. 2021; 87: 38-45
        • Morin CM
        • Vézina-Im LA
        • Ivers H
        • et al.
        Prevalent, incident, and persistent insomnia in a population-based cohort tested before (2018) and during the first-wave of COVID-19 pandemic (2020).
        Sleep. 2022; 45: zsab258