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Cited by 527Sleep and related disordersSleep and Work-Related FatigueWorkplace Health and Well-being

Insomnia and the Performance of US Workers: Results from the America Insomnia Survey

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Kessler, Ronald C., Berglund, Patricia A., Coulouvrat, Catherine, Hajak, Goeran, Roth, Thomas, Shahly, Victoria, Shillington, Alicia C., Stephenson, Judith J. +1 more·2011·Sleep
DOI 10.5665/sleep.1230PMC PMC3157657
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Abstract

STUDY OBJECTIVES: To estimate the prevalence and associations of broadly defined (i.e., meeting full ICD-10, DSM-IV, or RDC/ICSD-2 inclusion criteria) insomnia with work performance net of comorbid conditions in the America Insomnia Survey (AIS). DESIGN/SETTING: Cross-sectional telephone survey. PARTICIPANTS: National sample of 7,428 employed health plan subscribers (ages 18+). INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Broadly defined insomnia was assessed with the Brief Insomnia Questionnaire (BIQ). Work absenteeism and presenteeism (low on-the-job work performance defined in the metric of lost workday equivalents) were assessed with the WHO Health and Work Performance Questionnaire (HPQ). Regression analysis examined associations between insomnia and HPQ scores controlling 26 comorbid conditions based on self-report and medical/pharmacy claims records. The estimated prevalence of insomnia was 23.2%. Insomnia was significantly associated with lost work performance due to presenteeism (χ² (1) = 39.5, P < 0.001) but not absenteeism (χ² (1) = 3.2, P = 0.07), with an annualized individual-level association of insomnia with presenteeism equivalent to 11.3 days of lost work performance. This estimate decreased to 7.8 days when controls were introduced for comorbid conditions. The individual-level human capital value of this net estimate was $2,280. If we provisionally assume these estimates generalize to the total US workforce, they are equivalent to annualized population-level estimates of 252.7 days and $63.2 billion. CONCLUSIONS: Insomnia is associated with substantial workplace costs. Although experimental studies suggest some of these costs could be recovered with insomnia disease management programs, effectiveness trials are needed to obtain precise estimates of return-on-investment of such interventions from the employer perspective.

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  • Women, military veterans, and those with comorbid medical and psychiatric conditions are disproportionately impacted by insomnia.

    “women, military veterans, and those with comorbid medical and psychiatric conditions are disproportionally impacted by insomnia”

    From Novel Treatment Based on Acceptance and Commitment Therapy Versus Cognitive Behavioral Therapy for Insomnia: A Randomized Comparative Effectiveness Trial in Women Veterans (2023) · cites this paper as Kessler et al., 2011

    The Results (page not specified) report higher insomnia prevalence among employed women than men. The Methods (page not specified) identify medical and emotional disorders associated with elevated rates of insomnia. The cited paper does not establish the claim about military veterans, and its prevalence finding concerns employed respondents rather than the population generally. (LLM, conf=0.88)

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Authors
Kessler, R. C., Berglund, P. A., Coulouvrat, C., Hajak, G., Roth, T., Shahly, V., Shillington, A. C., Stephenson, J. J., & Walsh, J. K.
Affiliations
  • Harvard University (US)
  • University of Michigan (US)
  • Sanofi (France) (FR)
  • University of Regensburg (DE)
  • Henry Ford Health (US)
  • Epi-Q (United States) (US)
  • Carelon Research (United States) (US)
  • St. Luke's Hospital (US)
Corresponding author
Kessler, Ronald C.
ORCID
Venue
Sleep
Publisher
Oxford University Press (OUP)
Published
2011-09
Volume
34
Issue
9
Pages
1161-1171
ISSN
  • 0161-8105 (ISSN-L)
  • 1550-9109
DOI
10.5665/sleep.1230
PMC
PMC3157657
OpenAlex
W2111203770
Cited by
527
References
13
Citations by year
2026: 24 · 2025: 33 · 2024: 25 · 2023: 43 · 2022: 53 · 2021: 57 · 2020: 63 · 2019: 35 · 2018: 26 · 2017: 30 · 2016: 32 · 2015: 29 · 2014: 25 · 2013: 29 · 2012: 16
FWCI
29.68
Type
journal article
Language
en
Open access
Locations
  • SLEEP (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • University of Regensburg Publication Server (University of Regensburg) (acceptedVersion)
Funders
Sanofi
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
Keywords
insomnia, employee performance, presenteeism, absenteeism, comorbidities, human capital, insomnia prevalence, employer perceptions
MeSH terms
Absenteeism, Adult, Cross-Sectional Studies, Employee Performance Appraisal, Employment, Female, Health Surveys, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, United States, Cost of Illness, Young Adult

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