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Insomnia takes a $20-billion bite out of the Canadian economy each year, most of it due to lost productivity and absenteeism among the sleep deprived, according to new Canadian research.

"The costs are staggering but that's because there are a staggering number of people suffering from insomnia," Meagan Daley, a professor of psychology at CÉGEP Champlain-St. Lawrence in Sainte-Foy, Que., and lead author of the study, said in an interview.

About 15 per cent of adults suffer from insomnia syndrome, meaning they have trouble sleeping at least three nights a week. Another 32 per cent suffer from insomnia occasionally, meaning at least once a month. The balance, 52 per cent, are classified as good sleepers.

Those with insomnia syndrome lose the equivalent of 27.6 days a year of work due to fatigue-related lost productivity, according to the research. They also miss 4.4 days of work annually because of sleep problems.

Those with insomnia symptoms, for their part, account for the equivalent of 6.2 days annually in lost productivity and an extra 1.6 sick days on average.

All told, productivity losses add up to $15-billion and absenteeism another $2.9-billion, according to the research, published in the medical journal Sleep.

By contrast, the health-care costs associated with the treatment of insomnia are minimal - $256-million for consultations with health-care professionals (ranging from physicians to acupuncturists) and another $110-million for transportation to those visits. Those with insomnia also spend $49.5-million a year on prescription medications and $5.6-million on over-the-counter products like antihistamines and herbal teas.

"People are reluctant to get help," said Dr. Daley, who is also a psychologist with a private practice. "There is stigma on an individual and societal level about insomnia because people don't want to admit they have trouble with something as basic as sleeping."

Dr. Daley said people wait, on average, 10 to 12 years before seeking medical help for insomnia. When they do, most physicians tend to prescribe sleeping pills.

Many of these medications are generics and relatively cheap, but many people fear getting hooked on pills. Dr. Daley said people also fear the pills' side effects, principally weight gain.

In fact, the study shows that most people suffering from insomnia tend to self-medicate and their drug of choice is, overwhelmingly, alcohol.

According to the research, Canadians spend just over $1-billion a year on alcoholic beverages consumed specifically as sleep aides.

They do so even though alcohol costs more than sleeping pills, a paradox Dr. Daley believes is explained easily enough: "Alcohol is readily available, it doesn't require a prescription and, above all, it doesn't require an admission that you have problems sleeping," she said.

The research was part of a larger study on insomnia that involved 948 adults in Quebec, whose average age was 44. Participants filled out detailed questionnaires on sleep, health, work absences, lost productivity and use of health-care services.

In Quebec, insomnia cost the economy $6.5-billion, according to the article in Sleep. The Canada-wide numbers cited above were extrapolated from the provincial data, but a larger cross-Canada study is now under way.

Researchers said they believe their findings provide an accurate assessment of the direct and indirect costs of insomnia. But they noted the research has two important limitations: It relies on self-reporting and it is believed people overestimate their sleep difficulties; and the methodology used to estimate productivity losses has not been validated.

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