Economic burden of comorbid insomnia in 5 common medical disease subgroups

Wickwire, Emerson M.; Juday, Timothy; Kelkar, Mona; Heo, Jihaeng; Margiotta, Caroline; Frech, Feride

doi:10.5664/jcsm.10592

Journal of Clinical Sleep Medicine

2023

DOI: 10.5664/jcsm.10592

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Economic burden of comorbid insomnia in 5 common medical disease subgroups

Emerson M. Wickwire

Timothy Juday

Mona Kelkar³

et al.

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2024

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Cited by 3 publications

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Clinical and financial significance of insomnia within a large payor-provider health system

Karlin,

Anderson,

Rung

et al. 2024

Sleep Advances

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Study Objectives Insomnia has profound negative effects on behavioral health, physical health, and functional domains. Leveraging claims data from one of the nation’s largest payor-provider systems, the current study examined real-world prevalence of insomnia, comorbidity of insomnia with behavioral health and other sleep disorders, and the impact of insomnia on total health care costs. Methods Prevalence and costs associated with insomnia were assessed by examining claims data on approximately 3 million insured members during the year 2022. Using propensity score matching, total health care expenditures were calculated and compared for members with insomnia relative to matched cohorts without insomnia. Generalized linear modeling tested for differences between the cohorts. Results Nine percent of members were identified as having insomnia; 64% of those also had a depression, anxiety, and/or substance use disorder. Median total health care costs among individuals with insomnia were 4-6 times greater than among those without insomnia. A disproportionate amount (21.1%) of total claims spend came from members with insomnia. Conclusions Findings demonstrate a high degree of clinical need and behavioral health comorbidity associated with insomnia within a large insured cohort. Beyond the clinical significance, the current results demonstrate substantial financial need and opportunity for adequately treating insomnia. This is especially the case for the high proportion of members with insomnia and co-occurring depression, anxiety, and/or substance use disorders. Overall, the findings point to the important role payors and providers may have in promoting greater attention to sleep and insomnia.

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Clinical and financial significance of insomnia within a large payor-provider health system

Karlin,

Anderson,

Rung

et al. 2024

Sleep Advances

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The effectiveness of exercise interventions targeting sleep in older adults with cognitive impairment or Alzheimer's disease and related dementias (AD/ADRD): A systematic review and meta‐analysis

Páez,

Frimpong,

Mograss

et al. 2024

Journal of Sleep Research

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SummarySleep loss is associated with reduced health and quality of life, and increased risk of Alzheimer's disease and related dementias. Up to 66% of persons with Alzheimer's disease and related dementias experience poor sleep, which can predict or accelerate the progression of cognitive decline. Exercise is a widely accessible intervention for poor sleep that can protect against functional and cognitive decline. No previous systematic reviews have investigated the effectiveness of exercise for sleep in older adults with mild cognitive impairment or Alzheimer's disease and related dementias. We systematically reviewed controlled interventional studies of exercise targeting subjectively or objectively (polysomnography/actigraphy) assessed sleep in persons with mild cognitive impairment or Alzheimer's disease and related dementias. We conducted searches in PubMed, Embase, Scopus and Cochrane‐Library (n = 6745). Nineteen randomised and one non‐randomised controlled interventional trials were included, representing the experiences of 3278 persons with mild cognitive impairment or Alzheimer's disease and related dementias. Ten had low‐risk, nine moderate‐risk, and one high‐risk of bias. Six studies with subjective and eight with objective sleep outcomes were meta‐analysed (random‐effects model). We found moderate‐ to high‐quality evidence for the beneficial effects of exercise on self‐reported and objectively‐measured sleep outcomes in persons with mild cognitive impairment or Alzheimer's disease and related dementias. However, no studies examined key potential moderators of these effects, such as sex, napping or medication use. Our results have important implications for clinical practice. Sleep may be one of the most important modifiable risk factors for a range of health conditions, including cognitive decline and the progression of Alzheimer's disease and related dementias. Given our findings, clinicians may consider adding exercise as an effective intervention or adjuvant strategy for improving sleep in older persons with mild cognitive impairment or Alzheimer's disease and related dementias.

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From trenches to technology: a narrative review of sleep medicine in the military

Thomas,

Carr,

Yang

et al. 2024

Journal of Clinical Sleep Medicine

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Economic burden of comorbid insomnia in 5 common medical disease subgroups

Cited by 3 publications

References 35 publications

Clinical and financial significance of insomnia within a large payor-provider health system

Clinical and financial significance of insomnia within a large payor-provider health system

The effectiveness of exercise interventions targeting sleep in older adults with cognitive impairment or Alzheimer's disease and related dementias (AD/ADRD): A systematic review and meta‐analysis

From trenches to technology: a narrative review of sleep medicine in the military

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