title: Sleep problems, psychiatric hospitalization, and emergency department use among psychiatric patients with Medicaid.
abstract: OBJECTIVE
  This study examined the prevalence of sleep problems and their association with the use of inpatient and emergency department services by Medicaid recipients with serious mental illness.
  
  
  METHODS
  The sample consisted of 1,560 psychiatric patients with Medicaid coverage who were identified in a ten-state random survey of psychiatrists. Sleep problems were assessed by clinician ratings.
  
  
  RESULTS
  Over 75% of the patients experienced a sleep problem, and approximately 50% of these patients had problems that were moderate to severe. Greater sleep problem severity was associated with an increased risk of psychiatric hospitalization and emergency department visits for mental health reasons.
  
  
  CONCLUSIONS
  Sleep problems were highly prevalent among Medicaid patients with serious mental illness and were associated with greater inpatient and emergency mental health service use. More careful monitoring and management of sleep problems in this patient population could address a common clinical need and might help to reduce costly service use.
authors: Johns Hopkins Bloomberg School of Public Health–Mental Health, Hampton House, 624 North Broadway, 8th Floor, Baltimore, MD 21205, USA. ckaufmann@jhsph.edu
authors: Christopher N
authors: CN
authors: Kaufmann
authors: Adam P
authors: AP
authors: Spira
authors: Donald S
authors: DS
authors: Rae
authors: Joyce C
authors: JC
authors: West
authors: Ramin
authors: R
authors: Mojtabai
mesh_terms: D000293:Adolescent; D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008484:Medicaid; D001523:Mental Disorders; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult