The burden of untreated insomnia disorder in a sample of 1 million adults: a cohort study
Abstract Background Insomnia disorder is a highly prevalent, significant public health concern associated with substantial and growing health burden. There are limited real-world data assessing the burden of insomnia disorder on daytime functioning and its association with comorbidities. The objecti...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-08-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-023-16329-9 |
| _version_ | 1827632807360331776 |
|---|---|
| author | Michael Grandner Antonio Olivieri Ajay Ahuja Alexander Büsser Moritz Freidank William V. McCall |
| author_facet | Michael Grandner Antonio Olivieri Ajay Ahuja Alexander Büsser Moritz Freidank William V. McCall |
| author_sort | Michael Grandner |
| collection | DOAJ |
| description | Abstract Background Insomnia disorder is a highly prevalent, significant public health concern associated with substantial and growing health burden. There are limited real-world data assessing the burden of insomnia disorder on daytime functioning and its association with comorbidities. The objective of this study was to leverage large-scale, real-world data to assess the burden of untreated insomnia disorder in terms of daytime impairment and clinical outcomes. Methods This United States medical claims database study compares patients diagnosed with insomnia disorder but not receiving treatment (‘untreated insomnia’ cohort) to patients without an insomnia disorder diagnosis and without treatment (‘non-insomnia’ cohort). International Classification of Disease, Tenth Revision codes were used as a proxy to represent the three symptom domains (Sleepiness, Alert/Cognition, Mood) of the Insomnia Daytime Symptoms and Impacts Questionnaire (IDSIQ), a newly developed and validated tool used in clinical studies to assess daytime functioning in insomnia disorder. Chronic Fatigue (R53.83) and Other Fatigue (R53.83), Somnolence (R40.0) and Disorientation (R41.0) were selected as categories representing one or more IDSIQ domains. Clinical outcomes included cardiovascular events, psychiatric disorders, cognitive impairment and metabolic disorders. Results Approximately 1 million patients were included (untreated insomnia: n = 139,959; non-insomnia: n = 836,975). Compared with the ‘non-insomnia’ cohort, the ‘untreated insomnia’ cohort was more likely to experience daytime impairments, with mean differences in occurrences per 100 patient-years for: (a) fatigue, at 27.35 (95% confidence interval [CI] 26.81, 27.77, p < 0.01); (b) dizziness, at 4.66 (95% CI 4.40, 4.90, p < 0.01); (c) somnolence, at 4.18 (95% CI 3.94, 4.43, p < 0.01); and (d) disorientation, at 0.92 (95% CI 0.77, 1.06, p < 0.01). During the 1-year look-back period, patients in the ‘untreated insomnia’ cohort were also more likely to have been diagnosed with arterial hypertension (40.9% vs. 26.3%), psychiatric comorbidities (40.1% vs. 13.2%), anxiety (29.2% vs. 8.5%), depression (26.1% vs. 8.1%) or obesity (21.3% vs. 11.1%) compared with those in the ‘non-insomnia’ cohort. Conclusions This large-scale study confirms the substantial burden of insomnia disorder on patients in a real-world setting, with significant daytime impairment and numerous comorbidities. This reinforces the need for timely insomnia disorder diagnosis and treatments that improve both sleep, as well as daytime functioning. |
| first_indexed | 2024-03-09T14:50:46Z |
| format | Article |
| id | doaj.art-dc83988de5cf4a97a1cb55986f5a8503 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-09T14:50:46Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-dc83988de5cf4a97a1cb55986f5a85032023-11-26T14:29:49ZengBMCBMC Public Health1471-24582023-08-0123111410.1186/s12889-023-16329-9The burden of untreated insomnia disorder in a sample of 1 million adults: a cohort studyMichael Grandner0Antonio Olivieri1Ajay Ahuja2Alexander Büsser3Moritz Freidank4William V. McCall5Department of Psychiatry, University of Arizona College of MedicineIdorsia Pharmaceuticals LtdIdorsia Pharmaceuticals US IncIdorsia Pharmaceuticals LtdVisium SADepartment of Psychiatry and Health Behavior, Medical College of Georgia at Augusta UniversityAbstract Background Insomnia disorder is a highly prevalent, significant public health concern associated with substantial and growing health burden. There are limited real-world data assessing the burden of insomnia disorder on daytime functioning and its association with comorbidities. The objective of this study was to leverage large-scale, real-world data to assess the burden of untreated insomnia disorder in terms of daytime impairment and clinical outcomes. Methods This United States medical claims database study compares patients diagnosed with insomnia disorder but not receiving treatment (‘untreated insomnia’ cohort) to patients without an insomnia disorder diagnosis and without treatment (‘non-insomnia’ cohort). International Classification of Disease, Tenth Revision codes were used as a proxy to represent the three symptom domains (Sleepiness, Alert/Cognition, Mood) of the Insomnia Daytime Symptoms and Impacts Questionnaire (IDSIQ), a newly developed and validated tool used in clinical studies to assess daytime functioning in insomnia disorder. Chronic Fatigue (R53.83) and Other Fatigue (R53.83), Somnolence (R40.0) and Disorientation (R41.0) were selected as categories representing one or more IDSIQ domains. Clinical outcomes included cardiovascular events, psychiatric disorders, cognitive impairment and metabolic disorders. Results Approximately 1 million patients were included (untreated insomnia: n = 139,959; non-insomnia: n = 836,975). Compared with the ‘non-insomnia’ cohort, the ‘untreated insomnia’ cohort was more likely to experience daytime impairments, with mean differences in occurrences per 100 patient-years for: (a) fatigue, at 27.35 (95% confidence interval [CI] 26.81, 27.77, p < 0.01); (b) dizziness, at 4.66 (95% CI 4.40, 4.90, p < 0.01); (c) somnolence, at 4.18 (95% CI 3.94, 4.43, p < 0.01); and (d) disorientation, at 0.92 (95% CI 0.77, 1.06, p < 0.01). During the 1-year look-back period, patients in the ‘untreated insomnia’ cohort were also more likely to have been diagnosed with arterial hypertension (40.9% vs. 26.3%), psychiatric comorbidities (40.1% vs. 13.2%), anxiety (29.2% vs. 8.5%), depression (26.1% vs. 8.1%) or obesity (21.3% vs. 11.1%) compared with those in the ‘non-insomnia’ cohort. Conclusions This large-scale study confirms the substantial burden of insomnia disorder on patients in a real-world setting, with significant daytime impairment and numerous comorbidities. This reinforces the need for timely insomnia disorder diagnosis and treatments that improve both sleep, as well as daytime functioning.https://doi.org/10.1186/s12889-023-16329-9Cardiovascular diseaseCohort studyDaytime impairmentInsomnia disorderMetabolic disordersPsychiatric disorders |
| spellingShingle | Michael Grandner Antonio Olivieri Ajay Ahuja Alexander Büsser Moritz Freidank William V. McCall The burden of untreated insomnia disorder in a sample of 1 million adults: a cohort study BMC Public Health Cardiovascular disease Cohort study Daytime impairment Insomnia disorder Metabolic disorders Psychiatric disorders |
| title | The burden of untreated insomnia disorder in a sample of 1 million adults: a cohort study |
| title_full | The burden of untreated insomnia disorder in a sample of 1 million adults: a cohort study |
| title_fullStr | The burden of untreated insomnia disorder in a sample of 1 million adults: a cohort study |
| title_full_unstemmed | The burden of untreated insomnia disorder in a sample of 1 million adults: a cohort study |
| title_short | The burden of untreated insomnia disorder in a sample of 1 million adults: a cohort study |
| title_sort | burden of untreated insomnia disorder in a sample of 1 million adults a cohort study |
| topic | Cardiovascular disease Cohort study Daytime impairment Insomnia disorder Metabolic disorders Psychiatric disorders |
| url | https://doi.org/10.1186/s12889-023-16329-9 |
| work_keys_str_mv | AT michaelgrandner theburdenofuntreatedinsomniadisorderinasampleof1millionadultsacohortstudy AT antonioolivieri theburdenofuntreatedinsomniadisorderinasampleof1millionadultsacohortstudy AT ajayahuja theburdenofuntreatedinsomniadisorderinasampleof1millionadultsacohortstudy AT alexanderbusser theburdenofuntreatedinsomniadisorderinasampleof1millionadultsacohortstudy AT moritzfreidank theburdenofuntreatedinsomniadisorderinasampleof1millionadultsacohortstudy AT williamvmccall theburdenofuntreatedinsomniadisorderinasampleof1millionadultsacohortstudy AT michaelgrandner burdenofuntreatedinsomniadisorderinasampleof1millionadultsacohortstudy AT antonioolivieri burdenofuntreatedinsomniadisorderinasampleof1millionadultsacohortstudy AT ajayahuja burdenofuntreatedinsomniadisorderinasampleof1millionadultsacohortstudy AT alexanderbusser burdenofuntreatedinsomniadisorderinasampleof1millionadultsacohortstudy AT moritzfreidank burdenofuntreatedinsomniadisorderinasampleof1millionadultsacohortstudy AT williamvmccall burdenofuntreatedinsomniadisorderinasampleof1millionadultsacohortstudy |