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The economic cost of inadequate sleep
Open accessAbstract
Study Objectives: To estimate the economic cost (financial and nonfinancial) of inadequate sleep in Australia for the 2016-2017 financial year and relate this to likely costs in similar economies. Methods: Analysis was undertaken using prevalence, financial, and nonfinancial cost data derived from national surveys and databases. Costs considered included the following: (1) financial costs associated with health care, informal care provided outside healthcare sector, productivity losses, nonmedical work and vehicle accident costs, deadweight loss through inefficiencies relating to lost taxation revenue and welfare payments; and (2) nonfinancial costs of loss of well-being. They were expressed in US dollars ($). Results: The estimated overall cost of inadequate sleep in Australia in 2016-2017 (population: 24.8 million) was $45.21 billion. The financial cost component was $17.88 billion, comprised of as follows: direct health costs of $160 million for sleep disorders and $1.08 billion for associated conditions; productivity losses of $12.19 billion ($5.22 billion reduced employment, $0.61 billion premature death, $1.73 billion absenteeism, and $4.63 billion presenteeism); nonmedical accident costs of $2.48 billion; informal care costs of $0.41 billion; and deadweight loss of $1.56 billion. The nonfinancial cost of reduced well-being was $27.33 billion. Conclusions: The financial and nonfinancial costs associated with inadequate sleep are substantial. The estimated total financial cost of $17.88 billion represents 1.55 per cent of Australian gross domestic product. The estimated nonfinancial cost of $27.33 billion represents 4.6 per cent of the total Australian burden of disease for the year. These costs warrant substantial investment in preventive health measures to address the issue through education and regulation.
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BackgroundThe Physical Work Environment and Sleep
Magee, C., Gopaldasani, V., Bakand, S., & Coman, R. L. (2019) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001725 · Cited by 20
Lai, V., Tong, B., Tran, C., Ricciardiello, A., Donegan, M., Murray, N., Carberry, J. C., & Eckert, D. J. (2019) · SLEEP · doi:10.1093/sleep/zsz119 · Cited by 20
Effectiveness of Auricular Acupuncture for Insomnia: An Overview of Systematic Reviews
Huang, J., Shen, M., Qin, X., & Huang, Y. (2020) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2020/6920902 · Cited by 19
“Worldwide, around 15% to 30% of adults and 10% to 23% of adolescents have different degrees of insomnia [2].”
BackgroundAccuracy of a Smartphone Application Measuring Snoring in Adults—How Smart Is It Actually?
Klaus, K., Stummer, A.-L., & Ruf, S. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147326 · Cited by 19
Greissl, S., Mergl, R., Sander, C., Hensch, T., Engel, C., & Hegerl, U. (2021) · Journal of Sleep Research · doi:10.1111/jsr.13516 · Cited by 21
Corrigan, J., Tsai, W. H., Ip-Buting, A., Ng, C., Ogah, I., Peller, P., Sharpe, H. M., Laratta, C. R., & Pendharkar, S. R. (2021) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.9776 · Cited by 19
“3,4 However, our results suggest that once a diagnosis is made with appropriate specialist involvement, treatment outcomes are similar.”
Chaput, J., Gariépy, G., Pendharkar, S. R., Ayas, N., Samuels, C. H., Vallières, A., Davidson, J. R., Morin, C. M., Simonelli, G., Bourguinat, C., et al. (2022) · Sleep Health · doi:10.1016/j.sleh.2022.06.005 · Cited by 20
Adult obstructive sleep apnoea: Pathogenesis, importance, diagnosis and imaging
Whyte, A., & Gibson, D. J. (2019) · Journal of Medical Imaging and Radiation Oncology · doi:10.1111/1754-9485.12978 · Cited by 19
“21 billion.(9) The causes of OSA can be divided into anatomical and non-anatomical factors.”
BackgroundBinks, H., Vincent, G. E., Irwin, C. G., Heidke, P., Vandelanotte, C., Williams, S. L., & Khalesi, S. (2020) · Collegian Journal of the Royal College of Nursing Australia · doi:10.1016/j.colegn.2020.02.013 · Cited by 22
Self-Applied Home Sleep Recordings
Korkalainen, H., Nikkonen, S., Kainulainen, S., Dwivedi, A. K., Myllymaa, S., Leppänen, T., & Töyräs, J. (2021) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2021.07.003 · Cited by 18
Chapagai, S., & Martyn-Nemeth, P. A. (2022) · Journal of Transcultural Nursing · doi:10.1177/10436596211072884 · Cited by 24
“21 billion (Hillman et al., 2018), which translates to US$585 billion for the population of the United States (Virani et al.”
BackgroundInfluentialVillarreal‐Zegarra, D., Torres-Puente, R., Otazú-Alfaro, S., Al‐kassab‐Córdova, A., de Castro, J. R., & Mezones‐Holguín, E. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.110759 · Cited by 21
The human circadian clock from health to economics
Koritala, B. S. C., & Çakmaklı, S. (2018) · PsyCh Journal · doi:10.1002/pchj.252 · Cited by 16
Adolescent Sleep Problems and Susceptibility to Peer Influence
Semenza, D. C., Jackson, D. B., Testa, A. M., & Meldrum, R. C. (2020) · Youth & Society · doi:10.1177/0044118x20969024 · Cited by 18
“Estimates show that negative adolescent behaviors that result from increased susceptibility to peer influence such as delinquency (Cohen & Piquero, 2009; McCollister et al., 2010) as well as inadequate sleep (Colten & Altevogt, 2006; Hillman et al., 2018) impose large economic costs upon society.”
BackgroundSleep Capital: Linking Brain Health to Wellbeing and Economic Productivity Across the Lifespan
Golombek, D. A., Eyre, H. A., Spiousas, I., Casiraghi, L. P., Hartikainen, K. M., Partonen, T., Pyykko, M., Reynolds, C. F., Hynes, W. M., Bassetti, C. L., et al. (2024) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2024.07.011 · Cited by 18
Management of insomnia in primary care
Ng, L., & Cunnington, D. (2021) · Australian Prescriber · doi:10.18773/austprescr.2021.027 · Cited by 17
Tuckwell, G. A., Vincent, G. E., Gupta, C. C., & Ferguson, S. A. (2022) · Industrial Health · doi:10.2486/indhealth.2021-0174 · Cited by 18
Factors associated with sleep quality in university students
Maciel, F. V., Wendt, A. T., Demenech, L. M., & Dumith, S. C. (2023) · Ciência & Saúde Coletiva · doi:10.1590/1413-81232023284.14132022en · Cited by 17
“Inadequate sleep can increase oxidative stress 9 , cardiovascular disease 10 and obesity 11 , compromise cognitive and learning performance 4,12,13 and harm mental health 14 .”
BackgroundRusanen, M., Korkalainen, H., Grétarsdóttir, H., Siilak, T., Olafsdottir, K. A., Töyräs, J., Myllymaa, S., Arnardóttir, E. S., Leppänen, T., & Kainulainen, S. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13977 · Cited by 17
“…health consequences (Jose et al., 2005; Luyster et al., 2014; Zinchuk et al., 2018) and economic burden (AASM, 2016; Benjafield et al., 2019; Hillman et al., 2018; Mattila et al., 2022) originating from sleep-disordered breathing (SDB), including obstructive sleep apnea (OSA), is globally…”
BackgroundThe Cost-Effectiveness of Sleep Apnea Management
Pendharkar, S. R., Kaambwa, B., & Kapur, V. K. (2024) · CHEST Journal · doi:10.1016/j.chest.2024.04.024 · Cited by 17
Pitkänen, H., Duce, B., Leppänen, T., Kainulainen, S., Kulkas, A., Myllymaa, S., Töyräs, J., & Korkalainen, H. (2021) · IEEE Transactions on Biomedical Engineering · doi:10.1109/tbme.2021.3118229 · Cited by 17
“SUFFICIENT, good quality sleep is essential for physical restoration, maintenance of physiological functions, and neurocognitive performance [1].”
BackgroundSleep: The silent hero in cardiometabolic health
Chaput, J., & Stranges, S. (2024) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2024.10.020 · Cited by 15
Sleep hygiene strategies for individuals with chronic pain: a scoping review
Gupta, C. C., Sprajcer, M. A., Johnston‐Devin, C., & Ferguson, S. A. (2023) · BMJ Open · doi:10.1136/bmjopen-2021-060401 · Cited by 16
Sleep Duration and Health Care Expenditures in the United States
Jasani, F., Seixas, A. A., Madondo, K., Li, Y., Jean‐Louis, G., & Pagán, J. A. (2020) · Medical Care · doi:10.1097/mlr.0000000000001351 · Cited by 17
Xu, B., Cai, Q., Mai, R., Liang, H., Huang, J., & Yang, Z. (2022) · Behavioral and Brain Functions · doi:10.1186/s12993-022-00188-2 · Cited by 16
Outpatient health care utilization for sleep disorders in the Cerner Health Facts database
Al-Shawwa, B. A., Glynn, E. F., Hoffman, M. A., Ehsan, Z., & Ingram, D. G. (2020) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8838 · Cited by 16
“Many of these studies showed that the increased health care utilization and cost related to sleep disorders are due primarily to indirect morbidities.(14) These findings highlight the importance of early treatment for sleep disorders to curtail associated morbidity and mortality.”
Davies, H. J., Nakamura, T., & Mandic, D. P. (2019) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2019.8856710 · Cited by 15
“With the key role of sleep in cardiovascular health [1] and consolidation of memory [2], poor sleep quality and lack of sleep place a huge burden on society in terms of both public health and economic costs [3].”
BackgroundHernández, B., Scarlett, S., Moriarty, F., Romero‐Ortuño, R., Kenny, R. A., & Reilly, R. B. (2022) · BMC Public Health · doi:10.1186/s12889-022-14108-6 · Cited by 15
Han, D., Cheng, J., Qu, J., Wen, X., Liu, X., Chen, Y., Wen, Y., Liu, Z., Liu, H., & Huang, Y. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.892453 · Cited by 15
The impact of sleep quality on mental health in working Australians: A quasi-experimental approach
Foo, J. K., & Doan, T. T. (2023) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.116039 · Cited by 15
“The direct cost of poor sleep on the Australian economy was AUD 160 million for the years 2016-2017, while the direct cost of poor mental health was AUD 43 to 70 billion for the years 2018-2019 (Hillman et al., 2018; Productivity Commission, 2020).”
BackgroundFang, L., Lyu, Z., Ai, S., Du, S., Zhou, W., Zeng, S., Luo, X., Guo, J., Zhao, Y., Li, S., et al. (2024) · SLEEP · doi:10.1093/sleep/zsae122 · Cited by 15
Bano, A., Hepsomali, P., Rabbani, F., Farooq, U., Kanwal, A., Saleem, A., Bugti, A. A., Khan, A. A., Khalid, Z., Bugti, M., et al. (2023) · Frontiers in Pharmacology · doi:10.3389/fphar.2023.1250560 · Cited by 18
“…million people, respectively (World Health Organization, 2022), causing signi fi cant disruption to everyday life, affecting performance in occupational and educational settings, and placing considerable burden (trillions of dollars) on healthcare systems (Hafner et al., 2017; Hillman et al., 2018).”
BackgroundEffectiveness and safety of acupuncture for insomnia
Zhang, M., Zhao, J., Li, X., Chen, X., Xie, J., Meng, L.-Y., & Gao, X. (2019) · Medicine · doi:10.1097/md.0000000000017842 · Cited by 14
No improvement of sleep from vitamin D supplementation: insights from a randomized controlled trial
Larsen, A. U., Hopstock, L. A., Jorde, R., & Grimnes, G. (2021) · Sleep Medicine X · doi:10.1016/j.sleepx.2021.100040 · Cited by 17
“Combined with high treatment-related costs from increased health care utilization [7], it”
BackgroundA sleep medicine medical school curriculum
Smith, A. G. (2018) · Neurology · doi:10.1212/wnl.0000000000006229 · Cited by 14
“5 billion for nonmedical accident costs.(3) In addition to primary sleep disorders, which are sufficiently common to warrant more attention in medical school curricula, disordered sleep is a risk factor for many neurologic disorders, which in turn often result in sleep disruption.”
BackgroundEpidemiology and Economic Burden of Sleep Disorders in Europe
Bassetti, C. L., Welter, L. S., Martínez, M. M., Mühlberger, N., Boon, P., Berger, T., Deuschl, G., Arvandi, M., Konti, M., Lolich, M., et al. (2026) · European Journal of Neurology · doi:10.1111/ene.70463 · Cited by 15
“Informal care costs for SD are unknown in Europe, though studies from Australia suggest they contribute less than 1% to the overall costs of OSA and insomnia [11, 35].”
Puterflam, J., Comis, J., Lan, Q., Liu, C., Lipschitz, A. J., Grunstein, R., Ferreira, P., & Gordon, C. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2022.101672 · Cited by 11
Metadata
- Authors
- Hillman, D., Mitchell, S., Streatfeild, J., Burns, C., Bruck, D., & Pezzullo, L.
- Affiliations
- The University of Western Australia (AU)
- Health Economics and Social Policy Team, Deloitte Access Economics, Canberra, Australia
- Victoria University (AU)
- Corresponding author
- Hillman, David
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-06-04
- Volume
- 41
- Issue
- 8
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W2806077392
- Cited by
- 278
- References
- 70
- Citations by year
- 2026: 17 · 2025: 34 · 2024: 38 · 2023: 46 · 2022: 37 · 2021: 36 · 2020: 35 · 2019: 24 · 2018: 11
- FWCI
- 34.69
- Type
- journal article
- Language
- en
- Open access
- green
- vuir.vu.edu.au
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- SLEEP (publishedVersion)
- PubMed (publishedVersion)
- Victoria University Research Repository (Victoria University) (submittedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Funders
- Sleep Health Foundation
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- insufficient sleep, sleep disorders, productivity loss, presenteeism, absenteeism, informal care, premature mortality, deadweight loss, disease burden, Australia
- MeSH terms
- Absenteeism, Accidents, Australia, Efficiency, Health Expenditures, Humans, Sleep Initiation and Maintenance Disorders, Male, Public Health, Sleep, Prevalence, Health Care Costs, Cost of Illness
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