目标:睡眠不足每年给美国经济造成的损失超过4110亿美元。然而,大多数调查睡眠经济成本的研究依赖于睡眠的一次性测量,这可能容易回忆偏差,并且不能捕捉到睡眠中的变异性。为了弥补这些差距,我们研究了从每日睡眠日记中获取的睡眠指标如何预测医疗支出.
方法:参加世界贸易中心卫生计划的391名世界贸易中心响应者(平均年龄=54.97岁,89%男性)。在基线,参与者完成了14天自我报告的睡眠和压力测量.平均睡眠,睡眠的变异性,和一种新的睡眠反应性测量方法(即,人们对每日压力的睡眠变化有多大)被用来预测下一年的医疗支出,随着年龄的变化,种族/民族,性别,医学诊断,和体重指数。
结果:平均睡眠效率不能预测心理保健的利用。然而,更高的睡眠效率对压力的反应(b=191.75美元,p=0.027),睡眠持续时间对压力的反应(b=206.33美元,p=0.040),睡眠效率的变异性(b=339.33美元,p=0.002),睡眠持续时间的变异性(b=260.87美元,p=0.004),和二次平均睡眠持续时间(b=182.37美元,p=.001)都预测了更大的精神医疗支出。一起,这些睡眠变量解释了精神医疗支出中12%的独特差异.没有睡眠变量与身体保健支出显着相关。
结论:睡眠不规律的人,更多的睡眠反应,无论是短期睡眠还是长期睡眠都会参与更多的精神保健利用。解决这些人的睡眠问题对改善心理健康和降低医疗成本可能很重要。
OBJECTIVE: Insufficient sleep costs the U.S. economy over $411 billion per year. However, most studies investigating economic costs of sleep rely on one-time measures of sleep, which may be prone to recall bias and cannot capture variability in sleep. To address these gaps, we examined how sleep metrics captured from daily sleep diaries predicted medical expenditures.
METHODS: Participants were 391 World Trade Center responders enrolled in the World Trade Center Health Program (mean age = 54.97 years, 89% men). At baseline, participants completed 14 days of self-reported sleep and stress measures. Mean sleep, variability in sleep, and a novel measure of sleep reactivity (i.e., how much people\'s sleep changes in response to daily stress) were used to predict the subsequent year\'s medical expenditures, covarying for age, race/ethnicity, sex, medical diagnoses, and body mass index.
RESULTS: Mean sleep efficiency did not predict mental healthcare utilization. However, greater sleep efficiency reactivity to stress (b=$191.75, p=.027), sleep duration reactivity to stress (b=$206.33, p=.040), variability in sleep efficiency (b=$339.33, p=.002), variability in sleep duration (b=$260.87, p=.004), and quadratic mean sleep duration (b=$182.37, p=.001) all predicted greater mental healthcare expenditures. Together, these sleep variables explained 12% of the unique variance in mental healthcare expenditures. No sleep variables were significantly associated with physical healthcare expenditures.
CONCLUSIONS: People with more irregular sleep, more sleep reactivity, and either short or long sleep engage in more mental healthcare utilization. It may be important to address these individuals\' sleep problems to improve mental health and reduce healthcare costs.