title: Chronic insomnia, quality-of-life, and utility scores: comparison with good sleepers in a cross-sectional international survey.
abstract: BACKGROUND
  Chronic insomnia has a recognized impact on health-related quality-of-life (HRQoL) but data on utility scores across countries are lacking. The objective of the present study was to assess health related quality of life (HRQoL) and utility scores in individuals from three different countries (USA, France, and Japan), comparing sufferers of chronic insomnia to good sleepers.
  
  
  METHODS
  A cross-sectional survey (SLEEPI-i) of 4067 persons in the US (n=1298; 478 good sleepers and 820 patients with insomnia), France (n=1858; 998 good sleepers and 860 patients with insomnia) and Japan (n=911; 506 good sleepers and 405 patients with insomnia). Enrollment and data collection using consumer panels were web-based in the US and France, and gathered via a postal survey in Japan. People with chronic insomnia (>6 months) were selected based on Insomnia Severity Index scores (ISI). Severity of insomnia was assessed using the ISI score and HRQoL was assessed using the self-administered Short-Form SF-36 Health Survey. Utility scores were derived using the algorithm developed by Brazier et al. Multivariate analyses were used to adjust for potential confounding factors.
  
  
  RESULTS
  In all countries, people with chronic insomnia (40% treated) reported lower SF-36 scores in each of eight domains compared with good sleepers (P<.0001). Chronic insomnia was associated with significantly lower utility scores compared with good sleepers (mean scores 0.63 versus 0.72 in the US, 0.57 versus 0.67 in France, and 0.67 versus 0.77 in Japan, P<.0001).
  
  
  CONCLUSIONS
  This survey suggests that chronic insomnia is associated with significant impairment of HRQoL and decreased utilities across the different geographical regions studied.
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, APHP, Hôtel Dieu de Paris, Centre du Sommeil et de la Vigilance, Paris, France. damien.leger@htd.aphp.fr
authors.forename: Damien
authors.initials: D
authors.lastname: Léger
authors.forename: Charles M
authors.initials: CM
authors.lastname: Morin
authors.forename: Makoto
authors.initials: M
authors.lastname: Uchiyama
authors.forename: Zalmaï
authors.initials: Z
authors.lastname: Hakimi
authors.forename: Sandrine
authors.initials: S
authors.lastname: Cure
authors.forename: James K
authors.initials: JK
authors.lastname: Walsh
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life / Q000523:psychology*; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology