Sleep Duration and Health Care Expenditures in the United States

Med Care. 2020 Sep;58(9):770-777. doi: 10.1097/MLR.0000000000001351.

Abstract

Objective: To estimate the average incremental health care expenditures associated with habitual long and short duration of sleep as compared with healthy/average sleep duration.

Data source: Medical Expenditure Panel Survey data (2012; N=6476) linked to the 2010-2011 National Health Interview Survey.

Study design: Annual differences in health care expenditures are estimated for habitual long and short duration sleepers as compared with average duration sleepers using 2-part logit generalized linear regression models.

Principal findings: Habitual short duration sleepers reported an additional $1400 in total unadjusted health care expenditures compared to people with average sleep duration (P<0.01). After adjusting for demographics, socioeconomic factors, and health behavior factors, this difference remained significant with an additional $1278 in total health care expenditures over average duration sleepers (P<0.05). Long duration sleepers reported even higher, $2994 additional health care expenditures over average duration sleepers. This difference in health care expenditures remained significantly high ($1500, P<0.01) in the adjusted model. Expenditure differences are more pronounced for inpatient hospitalization, office expenses, prescription expenses, and home health care expenditures.

Conclusions: Habitual short and long sleep duration is associated with higher health care expenditures, which is consistent with the association between unhealthy sleep duration and poorer health outcomes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Health Behavior
  • Health Expenditures / statistics & numerical data*
  • Health Services / economics
  • Health Services / statistics & numerical data
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Sleep / physiology*
  • Sleep Wake Disorders / economics*
  • Sleep Wake Disorders / epidemiology*
  • Socioeconomic Factors
  • United States
  • Young Adult