Jan. 2, 2009 -- TUESDAY, Dec. 30 (HealthDay News) -- Sleepless nights are costing the small Canadian province of Quebec, population 7 million-plus, more than $6.5 billion annually, new research shows.
No doubt, sleepless nights from Seattle to Tampa are costing the United States, population 300 million-plus, much more.
Susan Zafarlotfi, clinical director of the Institute for Sleep and Wake Disorders at the Hackensack University Medical Center, said that the costs detailed in the Canadian study likely underestimate the costs of insomnia in the United States by a wide margin.
"One of the issues that exists in our society, unlike European and Canadian societies, is that we do not have the habit of talking about anything that happens in the privacy of the bedroom including insomnia," she said.
Insomnia becomes a secondary diagnosis, discovered only while physicians treat other, related disorders such as anxiety and depression. And that means many costs aren't being factored into current estimates.
Also, the "insomnia syndrome" that the Canadian researchers mention does not actually exist in the U.S. medical lexicon, which is related to the fact that insomnia in the United States is not a primary diagnosis and is not recognized by many insurance companies, Zafarlotfi explained.
The lion's share of the costs in the Canadian study -- $5 billion, or 76 percent of the total -- come from insomnia-related work absences and reduced productivity. The report was published in the Jan. 1 issue of Sleep.
The information is not necessarily new or surprising but quantifying the problem does highlight its magnitude, said Dr. Donald Greenblatt, director of the Strong Sleep Disorders Center at the University of Rochester Medical Center, in New York.
According to background information in the study, some 6 percent to 10 percent of the population have "insomnia syndrome," while about one-third experience symptoms of insomnia at some point.
And the study authors, from Universite Laval in Quebec City, noted that insomnia remains largely an untreated problem.
These investigators analyzed information from questionnaires filled out by 948 adults in Quebec, as well as health data from the Quebec government.
The total annual direct and indirect costs of insomnia in the province came to an estimated $6.6 billion in Canadian dollars.
Direct costs included $191.2 million for doctors' visits, $36.6 million for transportation to and from these visits, $16.5 million for prescription drugs, $1.8 million for over-the-counter remedies, and a whopping $339.8 million for alcohol used as a sleep aid.
Eight percent of individuals in the study, average age almost 44 and 60 percent female, reported having used alcohol to fall asleep, including 28 percent of those with insomnia symptoms or syndrome.
Loss of productivity amounted to $5 billion, or 27.6 days per year, for people with insomnia syndrome and 6.2 days a year for those with symptoms.
Job absenteeism racked up $970.6 million in indirect costs, or 4.36 days missed per year, for people with insomnia syndrome.
Absenteeism and lost productivity totaled almost $6 billion and represented 91 percent of all costs.
The average per-person cost including both direct and indirect losses were $5,010 for people with insomnia syndrome and $1,431 for those with symptoms of insomnia and $421 for "good sleepers."
"Sleep should be considered part of the big triangle of life, with diet and exercise," Greenblatt.
How much is enough sleep? While most people end up in the seven-to-nine-hour range, said Greenblatt, rumor has it that Thomas Edison got by with three or four hours a night, while Albert Einstein "got by" with 10 or 11.
"There seems to be an optimum sleep requirement for each person. To say we all need eight hours of sleep is the same as saying we all need size-11 shoes," Greenblatt said. "We need to figure out what our own sleep requirements are."
The National Sleep Foundation has tips on how to help you sleep better.
SOURCES: Susan Zafarlotfi, Ph.D., clinical director, Institute for Sleep and Wake Disorders, Hackensack University Medical Center, N.J.; Donald Greenblatt, M.D., director, Strong Sleep Disorders Center, University of Rochester Medical Center, New York; Jan. 1, 2009, Sleep