Costs of sleep disorders
There are several aspects of the costs of sleep disorders to society.
1 Development of other diseases which could have been avoided if the sleep disorder had been recognized and treated earlier. An example is the occurrence of strokes or myocardial infarctions associated with untreated obstructive sleep apnoeas.
2 Reduction in the quality of life [24]. Excessive daytime sleepiness leads to irritability and difficulties in interpersonal relationships, which not only impair social activity, but also reduce productivity at work.
Studies of those with obstructive sleep apnoeas before and after using continuous positive airway pressure treatment have shown a considerable reduction in quality of life which improves with treatment. The same has been demonstrated for those with narcolepsy before and after receiving treatment with modafinil.
3 Financial consequences of sleep-related accidents.
Excessive daytime sleepiness impairs efficiency at work and leads to accidents which may have considerable financial consequences. The duration of sick leave is increased in those with excessive daytime sleepiness and insomnia.
Nature of Sleep and its Disorders
These costs could largely be avoided with better awareness of sleep disorders and availability of advice and treatment for them. The cost of providing care for sleep disorders and education about good sleep hygiene practice has to be offset against these potential savings. Sleep laboratories are expensive, and investigations such as polysomnography are costly and require trained staff.
These resources should be used in a cost-effective manner in order to provide the best value for money. The simplest effective test should be used rather than proceeding directly to polysomnography unless the additional information that this provides is required.
Most drugs used to treat sleep disorders are cheap, particularly benzodiazepines and other hypnotics and antidepressants, but some drugs and equipment such as continuous positive airway pressure systems and light therapy are more expensive. The cost of ongoing medical or paramedical supervision of the patient also has to be balanced against the benefit that it provides.