If you have insomnia, you know that a night of endless tossing and turning can cause a sleep deficit. However, lack of sleep can also create another debt - one that hits you in the wallet.

A recent study found that people who fail to promptly treat their insomnia often run up a bill of several hundred dollars or more in the six months before treatment begins. The study was conducted by researchers from Sleep Medicine and Research Center in Missouri. The study was published in the March issue of SLEEP.

Insomnia is the inability to sleep for a reasonable amount of time to maintain adequate restfulness. It is not defined by the total number of hours slept because this number varies from person to person. Symptoms of insomnia may include:

• Difficulty falling asleep


• Waking up frequently during the night


• Waking up too early and having difficulty returning to sleep


• Daytime drowsiness


• Irritability

Insomnia is the most common type of sleep disorder. About one in three American adults experience insomnia in a given year, according to the National Center on Sleep Disorders Research. About one in 10 American adults experience insomnia that is chronic or severe. Insomnia is more common among women (especially after menopause) and elderly people. About half of people over age 65 have frequent sleep problems.

The study on the effects of delaying insomnia treatment examined the impact of untreated insomnia in more than 210,000 patients. Many of those who did not seek help for their insomnia incurred medical expenses that ran into the hundreds of dollars in the six months prior to beginning treatment.

The researchers identified both direct and indirect costs associated with untreated insomnia. Direct costs include inpatient, outpatient, pharmacy and emergency-room expenditures. Indirect costs are associated with absenteeism from work and employee use of short-term disability programs.

The study's authors found that average indirect and direct medical costs were $1,253 greater in young adults with insomnia than for patients without insomnia. In addition, direct costs were about $1,143 greater in elderly adults with insomnia than in those without this problem.

Insomnia also takes a bite out of an employer's bottom line. The employer's share of the employee's health expenditures prior to treatment coupled with lower worker productivity costs the employer an average of $1,059 in the six months before treatment begins, the study found.

By contrast, insomnia usually is not very expensive to treat, the authors conclude. Several approaches may be used to treat insomnia, depending on its cause. A physician will ask the patient for details about medication use and lifestyle that may help pinpoint the cause.

Patients may also be evaluated for psychiatric conditions or asked to keep a sleep diary to document sleep patterns and behaviors. In some cases, patients may be referred to a sleep center where sleep is analyzed by sleep disorder professionals.

Lifestyle changes, such as increased exercise or elimination of alcohol or caffeine, may be used to treat insomnia. Sedative medications may also be prescribed. Some forms of therapy, such as relaxation therapy, may help some patients.

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