Incremental health care utilization and expenditures for sleep disorders in the United States.

STUDY OBJECTIVES: To determine the incremental increases in healthcare utilization and expenditures associated with sleep disorders.

METHODS: Adults with a diagnosis of a sleep disorder (ICD-10 code G47.x) within the medical conditions file of the 2018 Medical Expenditure Panel Survey medical conditions file were identified. This dataset was then linked to the consolidated expenditures file and comparisons in healthcare utilization and expenditures were made between those with and without sleep disorders. Multivariate analyses, adjusted for demographics and co-morbidities, were conducted for these comparisons.

RESULTS: Overall, 5.6±0.2% of the study population had been diagnosed with a sleep disorder, representing approximately 13.6±0.6 million adults in the U.S. Those with sleep disorders were more likely to be non-Hispanic, white and female, with a higher proportion with public insurance and higher Charlson Comorbidity Scores. Adults with sleep disorders were found to have increased utilization of office visits (16.3±0.8 vs 8.7±0.3, p<0.001), emergency room visits (0.52±0.03 vs 0.37±0.02, p<0.001) and prescriptions (39.7±1.2 vs 21.9±0.4, p<0.001) versus those without sleep disorders. The additional incremental healthcare expenses for those with sleep disorders were increased in all examined measures: total healthcare expense ($6975±800, p<0.001), total office-based expenditures ($1694±277, p<0.001), total prescription expenditures ($2574±364, p<0.001) and total self-expenditures for prescriptions ($195±32, p<0.001).

CONCLUSION: Sleep disorders are associated with significantly higher rates of healthcare utilization and expenditures. Using the conservative prevalence estimate found in this study, the overall incremental health care costs of sleep disorders in the US represents approximately $94.9 billion.