OBJECTIVES: Insomnia prevalence has increased globally, imposing a great burden on patients’ lives and triggering social and economic problems. We aim to assess productivity losses, use of healthcare resources and costs (direct and indirect) associated with chronic insomnia in Spain.

METHODS: Cross-sectional observational study based on an online electronic questionnaire targeted at the general population who meet chronic insomnia criteria (have problems initiating/maintaining/conciliating sleep at least 3 times/week during the last 3 months, unrelated to another medical condition/circumstance). Sociodemographic, productivity and healthcare-resource use data were collected. A descriptive analysis was performed (STATA v.14).

RESULTS: A total of 1,504 individuals responded to the questionnaire, of whom 700 (46.5%) meet chronic insomnia criteria (55.4% female; mean (SD) age 44.0 (13.4) years; 75.0% employed/self-employed). Only 4.9% had a diagnosis of chronic insomnia.

During last year, 33.0% of workers (n=172) required medical leave; a mean (SD) of 7.7 (32.8) insomnia-related days off work; 12.3% had to change or quit their job/studies due to insomnia. Absenteeism, presenteeism, work impairment and disability due to insomnia according to Work Productivity and Activity Impairment Questionnaire reached 6.4%, 41.1%, 44.1% and 44.2%, respectively.

In the past 12 months, 51.9% required public and 23.9% private healthcare services: primary care (40.0%; 13.9%), psychology (9.6%; 6.6%), nurse (5.6%; 2.3%), psychiatry (5.3%; 2.0%), emergency room (6.0%; 1.7%) and sleep specialist (4.3%: 2.3%). To treat insomnia 47.9% used non-pharmacological and 41.6% pharmacological treatment.

The mean of the total annual cost of insomnia population that require healthcare resources use (n=363) reached €1719.51/patient [€501.50/patient direct (n=363; 8.54% with insomnia diagnosis), €686.91/patient out-of-pocket (n=335; 7.16% with insomnia diagnosis), €531.10/patient indirect cost (n=172; 9.30% with insomnia diagnosis).

CONCLUSIONS: Insomnia is under-diagnosed, and leads to work productivity loss, mainly associated with presenteeism, and out-of-pocket costs. Proper diagnosis and treatment would contribute to reducing the economic impact of insomnia.