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, according to a new study from researchers at Mass Eye and Ear, a member hospital of Mass General Brigham.
In their new analysis, published in the Journal of Clinical Sleep Medicine, the researchers found 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.
“Our estimates are likely low, considering we know there are a large number of patients not yet diagnosed with a disorder like sleep apnea, restless legs syndrome and insomnia,” said senior study author Neil Bhattacharyya, MD, FACS, an ear, nose and throat doctor at Mass Eye and Ear and Professor of Otolaryngology-Head and Neck Surgery at Harvard Medical School. “If we as a country continue this pattern, this huge burden to the health care system will grow and affect patient care for everyone.”
Costly medical care for sleep disorder patients
The researchers sought out to determine the true diagnostic prevalence of sleep disorders and how expensive these conditions were to the health care system. 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 2018 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 per cent 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 to 20 per cent 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 per cent more in annual costs. This equates to a conservative estimate of $94.9 billion in health care costs per year attributable to sleep disorders.
The analysis revealed that patients with sleep disorders attended more than 16 office visits and nearly 40 medication prescriptions per year, compared to nearly 9 visits and 22 prescriptions for those without a sleep disorder. The study did not quantify non-healthcare related costs, but the authors noted it can be assumed that more doctors’ appointments mean more time off from work, school or other social obligations, not to mention decreased productivity associated with symptoms, only exacerbating costs to society.
“The degree to which sleep disorders increased costs and visits and prescriptions was somewhat surprising and suggest that sleep disorders and the effects of poor sleep quality may be underappreciated,” said lead study author Phillip A. Huyett, MD, Director of Sleep Surgery at Mass Eye and Ear. “The importance of high-quality sleep is strongly associated with daytime function and long-term health issues, and as our study shows there are financial ramifications as well.”
Sleep disorders raise the risk for other conditions
Sleep disorders can take a toll on health and quality of life in numerous ways. Individuals with certain sleep disorders experience decrease daytime functionality related to sleepiness, mental fog and an increased risk of motor vehicle accidents, for instance. Obstructive sleep apnea is one of the most common sleep disorders and if untreated, can increase the 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.
Getting a proper diagnosis at the sign of an 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.”
About Mass Eye and Ear
Massachusetts Eye and Ear, founded in 1824, is an international centre for treatment and research and a teaching hospital of Harvard Medical School. A member of Mass General Brigham, Mass Eye and Ear specialize in ophthalmology (eye care) and otolaryngology–head and neck surgery (ear, nose and throat care). Mass Eye and Ear clinicians provide care ranging from the routine to the very complex. Also, home to the world’s largest community of hearing and vision researchers, Mass Eye and Ear scientists are driven by a mission to discover the basic biology underlying conditions affecting the eyes, ears, nose, throat, head and neck and to develop new treatments and cures. In the 2020–2021 “Best Hospitals Survey,” U.S. News & World Report ranked Mass Eye and Ear fourth in the nation for eye care and sixth for ear, nose and throat care.
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