Inappropriate sleep duration may influence the economic burden of health care

1. In this prevalence-based estimation study of health care costs, the estimated direct cost of insufficient sleep in Canada in 2020 was $484 million dollars, constituting 0.5% of the overall burned on illness in Canada.

2. Primary expenditures due to insufficient sleep were health care costs related to: in-hospital care, prescriptions medications, physician services, and mortality.

Evidence Rating Level: 2 (Good)

A reduction in sleep duration (i.e., less than 7 hours of sleep/night) is a health care concern in Canada. Previous literature has highlighted key adverse outcomes associated with insufficient sleep (ex. cardiovascular disease, hypertension, obesity, and type 2 diabetes) leading to a strain to the Canadian healthcare system. To date, there is no literature on the economic burden of insufficient sleep in the general population. This study aimed to estimate the extent of healthcare related costs associated with insufficient sleep.

The study used a prevalence-based approach, commonly used to estimate economic costs in disease processes. Estimates were developed using: 1) relative risk (RR) of health outcomes associated with decrease sleep duration (data obtained from meta-analyses); 2) direct and indirect costs in relation to each health outcome (data obtained from the Economic Burden of Illness in Canada); 3) prevalence of insufficient sleep duration in the Canadian population (data obtained from the 2020 Canadian Community Health Survey Rapid Response Module on Healthy Living).

Results demonstrated an increased risk of poor health outcomes in patients with insufficient sleep, ranging from a RR increase of 11% for coronary artery disease to 50% for depression. The estimated costs of insufficient sleep duration were as follows: $484 million (direct), $18 million (indirect), $502 million (total). The main contributors to these healthcare costs included prescription drugs, physician care, hospital care, and mortality. Interestingly, a 5% decrease in prevalence of insufficient sleep duration was estimated to lead to annual cost savings of $148 million. However, this study was limited due to its reliance on a prevalence-based approach (which uses several assumptions and may not reflect true costs) and including only seven health outcomes in its analysis. Nonetheless, this study was significant in being the first to assess the economic burden of insufficient sleep in a national context.

Click to read the study in Sleep Health

Image: PD

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