Chilcott L A, Shapiro C M
University of Toronto, Canada.
Pharmacoeconomics. 1996;10 Suppl 1:1-14. doi: 10.2165/00019053-199600101-00003.
Insomnia is an extremely common symptom both de novo and in the context of other medical and psychiatric disorders. The impact of insomnia is often ignored both by the individual and by society in terms of its clinical and socioeconomic ramifications. Insomnia is therefore under-appreciated and almost certainly under-treated, thus making it a serious health concern. It is estimated that more than 60 million Americans suffer from insomnia annually, and this figure is expected to grow to 100 million by the middle of the 21st century. Whether it be difficulty initiating or maintaining sleep, the disruption of nocturnal sleep will invariably impact on daytime activities and often results in daytime fatigue, performance deficits (including memory and other cognitive deficits), an increase in the number of sick days taken by an individual and accidents (some catastrophic). This review examines the costs directly related to insomnia in various sectors of healthcare, the indirect costs associated with accidents, sick days and decreased work productivity, and related costs resulting from insomnia but which meet neither the criteria of direct nor indirect cost categories. The total direct, indirect and related costs of insomnia are conservatively estimated at $US30 to 35 billion annually in the US (1994 dollars). Economic gains can be made by treating patients on an outpatient basis in sleep centres.
失眠是一种极为常见的症状，无论是原发性的，还是在其他医学和精神疾病背景下出现的。就其临床和社会经济影响而言，失眠的影响往往被个人和社会所忽视。因此，失眠未得到充分重视，而且几乎肯定未得到充分治疗，这使其成为一个严重的健康问题。据估计，每年有超过6000万美国人患有失眠症，预计到21世纪中叶，这一数字将增至1亿。无论是入睡困难还是维持睡眠困难，夜间睡眠中断都会对白天的活动产生影响，通常会导致白天疲劳、功能缺陷（包括记忆和其他认知缺陷）、个人病假天数增加以及事故（有些是灾难性的）。本综述探讨了医疗保健各领域中与失眠直接相关的成本、与事故、病假和工作效率下降相关的间接成本，以及由失眠导致但不符合直接或间接成本类别标准的相关成本。在美国，失眠的直接、间接和相关成本总计保守估计每年为300亿至350亿美元（1994年美元）。在睡眠中心对患者进行门诊治疗可实现经济收益。
