Insomnia and Performance of Us Workers

1161 The Effects of Insomnia on Work Performance—Kessler et al injuries in the US civilian workforce ranging between $15 billion and $92 billion.9,10 Although such large effects might justify the implementation of workplace insomnia screening and intervention programs, accurate estimates of the workplace costs of insomnia would be needed to justify such programs. Estimates of this sort currently do not exist, as most available studies are based either on medical/ pharmacy claims databases that only study treated insomnia10,11 or on consumer panels that have very low response rates and suboptimal measures of insomnia.12 Samples that define insomnia based on treatment risk particularly strong sample bias given epidemiologic evidence that only a small minority of Americans with chronic insomnia symptoms seek formal medical attention13 and that few insomniacs receive prescription hypnotics14 or formal diagnoses due to prominent comorbid conditions.15 We address the limitations of currently available estimates of the workplace costs of insomnia in the current report by using survey data collected in the America Insomnia Survey (AIS),1 a national survey of employed subscribers to a very large US national health plan (over 34 million members) who were selected using probability methods that did not oversample subscribers with a diagnosis of or treatment for insomnia. We estimate the associations of insomnia with work performance controlling for a wide range of comorbid conditions. Insomnia was assessed with a clinically validated fully structured diagnostic screening scale.16 Work performance was assessed with a validated questionnaire that has INTRODUCTION The societal burden of insomnia in the United States is substantial, with an estimated one-third of all US adults experiencing weekly difficulties with nighttime sleep1 and an estimated 50-70 million people complaining of nighttime sleep loss associated with daytime impairment.2 As experimental studies increasingly link insomnia with a range of negative effects on functioning, from increased sleepiness and fatigue3 to reduced psychomotor performance,4 memory consolidation,5 and affect regulation,6 it is unsurprising that insomnia has been associated with significant workplace deficits. Indeed, adverse effects on work performance are consistently ranked among the most prominent components of the overall societal burden of insomnia,7,8 with estimates of annual insomnia-related workplace costs due to excess sickness absence, reduced work productivity, and workplace accidentsINSOMNIA AND PERFORMANCE OF US WORKERS