- Mass Eye and Ear’s Neil Bhattacharyya, MD, MA, FACS, and Phillip A. Huyett, MD, used national databases to examine the increased health care utilization and expenditures associated with sleep disorders
- Findings from their study revealed that individuals with sleep disorders had eight additional office visits, 18 additional prescriptions and $7,000 greater total costs per year when compared to similar patients without sleep disorders
- Overall, their study estimated that the direct health care costs of sleep disorders in the U.S. were $94.9 billion
Approximately 30%-40% of adults in the Unites States have at least one sleep disorder and the direct health care costs of these disorders have long been left untallied.
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Mass Eye and Ear researchers Neil Bhattacharyya, MD, MA, FACS, and Phillip Huyett, MD, found that sleep disorders are associated with significantly higher rates of health care utilization, conservatively placing an additional $94.9 billion in costs each year to the United States health care system.
In a study published in the Journal of Clinical Sleep Medicine, the researchers found that the number of medical visits and prescriptions filled were nearly doubled in people with sleep disorders such as sleep apnea and insomnia, compared to similar people without. Affected patients were also more likely to visit the emergency department and have more comorbid medical conditions.
Costly Medical Care for Sleep Disorder Patients
The researchers sought to determine how expensive these conditions were to the health care system using methodology previously applied to several other chronic disorders. They examined differences in health expenditures in similar patients with and without a sleep disorder diagnosis, as determined by their ICD-10 diagnosis code. The study included data from a nationally-representative survey of more than 22,000 Americans called the Medical Expenditure Panel Survey, which is administered by the Department of Health and Human Services’ Agency for Healthcare Research and Quality.
They found 5.6% of respondents had at least one sleep disorder, which translated to an estimated 13.6 million U.S. adults. This likely represents a significant underestimate, according to the authors, as insomnia alone is felt to conservatively affect 10%-20% of the population. These individuals accumulated approximately $7,000 more in overall health care expenses per year compared to those without a sleep disorder—about 60% more in annual costs. This equates to a conservative estimate of $94.9 billion in health care costs per year attributable to sleep disorders, far more than other common conditions such as hypertension, asthma and heart failure.
The analysis revealed that patients with sleep disorders attended more than 16 office visits and nearly 40 medication prescriptions per year, compared to nearly nine visits and 22 prescriptions for those without a sleep disorder. The study did not quantify non-health care related costs, but the authors noted it can be assumed that more doctor appointments mean more time off from work, school or other social obligations, decreased productivity, increased risk of motor vehicle and workplace accidents which only exacerbate the costs to society.
Sleep Disorders Raise Risk for Other Conditions
Sleep disorders can take a toll on health and quality of life in numerous ways. Obstructive sleep apnea is one of the most common sleep disorders and if untreated, can increase risk for neurocognitive issues, such as difficulty concentrating and mood disorders, as well as cardiovascular conditions including heart attacks, strokes, high blood pressure and irregular heart rhythms.
The costs captured in this study reflect both the expenses of treating sleep disorders themselves but also the other medical conditions influenced by certain sleep disorders. For example, a patient with obstructive sleep apnea on positive airway pressure therapy has the costs and visits associated with CPAP management. The same patient may also be on several blood pressure medications for hypertension related to the sleep apnea resulting in a further increase in visits, prescriptions and costs.
Getting a proper diagnosis at the sign of asleep problem can lead to an effective treatment for a sleep disorder.
“Fortunately, studies have demonstrated that treating certain sleep disorders effectively reduces health care utilization and costs. Therefore, sleep issues should not be ignored. Greater recognition of sleep disorders and an early referral to a sleep specialist are essential,” said Dr. Huyett. “Your sleep is important, and if there’s an issue with your sleep, seek help for it.”
Drs. Bhattacharyya and Huyett were recently featured on the American Academy of Sleep Medicine’s podcast Talking Sleep to discuss this paper: Talking Sleep - An AASM Podcast
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