Insomnia and absenteeism at work. Who pays the cost?
OBJECTIVE
To estimate the costs of insomnia-associated work absenteeism and to analyze how these costs are shared between the different payers: the national health insurance system, employers, and employees.


METHODS
Retrospective cohort study over a 2-year period.


METHODS
The Paris Ile de France region.


METHODS
Two matched groups of employees: 369 insomniacs and 369 good sleepers.


METHODS
The costs of absenteeism at work associated with insomnia were estimated by comparing the 2 matched groups in terms of the number and duration of work absences. We considered that work absences incurred costs relating to salary replacement and loss of productivity: these were given a monetary value on the basis of the added value per hour worked.


RESULTS
The percentage of employees with at least 1 work absence are 50% and 34% for insomniacs and good sleepers, respectively. The work absenteeism (expressed in days, per employee, per year +/- confidence intervals [CI]) differed significantly between insomniacs and good sleepers: 5.8 (+/- 1.1 ) and 2.4 (+/- 0.5), respectively (p < .001). The extra cost (+/- CI) to the national health insurance system of insomnia-associated absenteeism was estimated at euro 77 (+/- euro 39) per employee, per year. The extra cost (+/- CI) to employers was estimated at euro 233 (+/- euro 101) for salary replacement and euro 1062 (+/- euro 386) for loss of productivity. Finally, employees themselves bore a cost (+ CI) of euro 100 (euro 54).


CONCLUSIONS
Employees who suffered from insomnia had a significantly higher rate of absenteeism at work than those who slept well. This absence represents a cost for society: in France, 88% of this amount is shouldered by employers.
INSERM U 537, Centre for Health Economics and Administration Research, Le Kremlin-Bicêtre, France.
Virginie
V
Godet-Cayré
Nathalie
N
Pelletier-Fleury
Marc
M
Le Vaillant
Jérôme
J
Dinet
Marie-Anne
MA
Massuel
Damien
D
Léger
D000041:Absenteeism; D000328:Adult; D015331:Cohort Studies; D017049:Employer Health Costs; D004651:Employment / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D016272:Occupational Health; D010297:Paris / Q000453:epidemiology; D012189:Retrospective Studies; D007319:Sleep Initiation and Maintenance Disorders / Q000191:economics* / Q000453:epidemiology