A wide variety of health professionals would cross paths with patients with sleep disorders regularly in practice. But how prevalent are sleep disorders, and what are the economic costs involved?

Prevalence – Australian Adults

Insomnia:

• Around 13% to 33% of the Australian adult population having regular difficulty either getting to sleep or staying asleep (Cunnington et al., 2013)

Obstructive Sleep Apnea, Insomnia, and Restless Legs:

• Diagnosed sleep apnea is reported by 8% of Australian adults, significant insomnia by 20% and restless legs by 18%

Prevalence – Australian Adolescents

We should also be aware that Australian adolescents are also at risk of poor sleep patterns. Short et al. (2013) found that on average, 13-18 year olds obtained inadequate sleep across the school week, and commonly reported difficulty falling asleep, not feeling refreshed after sleep, and subjective feelings of restless legs.

Costs

Streatfeild et al. (2021) estimated that the economic cost of common sleep disorders in Australia for 2019-2020 was $35.4 billion USD. Disorders included in the study were obstructive sleep apnea ($13.1 billion), insomnia ($13.3 billion) and restless legs syndrome ($9.0 billion). They divided the costs into:

• Financial ($10 billion) – those associated with healthcare, other care (informal), loss of productivity, non-medical accident costs, and losses from taxation/welfare inefficiencies; and
• Nonfinancial ($25.4 billion) – those associated with a loss of wellbeing

Streatfeild et al. (2021) concluded that greater expenditure on detection, treatment and prevention is warranted because the health system costs of these disorders are low relative to those associated with their consequences.

Treatments

Treatments for sleep apnea include a sleep apnea mouth guard worn overnight during sleep, continuous positive airway pressure, and surgery. Treatments for insomnia include cognitive behavioural therapy and pharmacological agents. Treatment for restless legs can include management of any related mental health conditions and pharmacological agents.

Conclusion

In light of the prevalence and economic cost of sleep disorders, it is important that clinicians are aware of these and ensure that patients are able to access appropriate treatment.

References

Adams, Robert J., MBBS, MD, Appleton, Sarah L., BSc, PhD, Taylor, Anne W., MPH, PhD, Gill, Tiffany K., MPH, PhD, Lang, Carol, MPH, PhD, McEvoy, R. Douglas, MPH, PhD, & Antic, Nick A., MPH, PhD. (2016). Sleep health of Australian adults in 2016: results of the 2016 Sleep Health Foundation national survey. Sleep Health, 3(1), 35–42. https://doi.org/10.1016/j.sleh.2016.11.005

Bjornsdottir, E., Lindberg, E., Benediktsdottir, B., Gislason, T., Garcia Larsen, V., Franklin, K., Jarvis, D., Demoly, P., Perret, J. L., Garcia Aymerich, J., Arenas, S. D., Heinrich, J., Torén, K., Jögi, R., & Janson, C. (2020). Are symptoms of insomnia related to respiratory symptoms? Cross-sectional results from 10 European countries and Australia. BMJ Open, 10(4), e032511. https://doi.org/10.1136/bmjopen-2019-032511

Cunnington, D., Junge, M. F., & Fernando, A. T. (2013). Insomnia: prevalence, consequences and effective treatment. Medical Journal of Australia, 199(8), S36–S40. https://doi.org/10.5694/mja13.10718

Short, M. A., Gradisar, M., Lack, L. C., Wright, H. R., & Dohnt, H. (2013). The sleep patterns and well-being of Australian adolescents. Journal of Adolescence (London, England.), 36(1), 103–110. https://doi.org/10.1016/j.adolescence.2012.09.008

Streatfeild, J., Smith, J., Mansfield, D., Pezzullo, L., & Hillman, D. (2021). The social and economic cost of sleep disorders. Sleep (New York, N.Y.), 44(11), 1. https://doi.org/10.1093/sleep/zsab132