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Epidemiology and Economic Burden of Sleep Disorders in Europe
University Grenoble Alpes - Grenoble Institut des Neurosciences (GIN); INSERM, U1216; Centre Hospitalier Universitaire de Grenoble (CHU Grenoble Alpes), Service de Neurologie
Background: Sleep and sleep disorders (SD) have a major impact on brain (neurological and psychiatric), body and societal health. The epidemiology of SD and its related economic burden has not been comprehensively studied in Europe. This study investigates the epidemiology and economic burden of SD across 47 European countries and identifies knowledge gaps in the literature.
Methods: Systematic literature reviews on PubMed (between 01/2010 and 04/2023) and expert communications identified relevant epidemiological and cost-of-illness (COI) studies on five major SD: insomnia, obstructive sleep apnoea (OSA), narcolepsy, restless legs syndrome (RLS), and REM sleep behaviour disorder (RBD). Four epidemiological parameters, including prevalence, were investigated. Economic analyses stratified direct, indirect, and informal care costs, and employed an imputation procedure accounting for several country-specific economic factors. Costs were expressed in purchasing power parity (PPP)-adjusted in 2019 Euros.
Findings: Eleven COI and six epidemiological studies were identified. Estimated prevalence for OSA, insomnia, RLS, RBD, and narcolepsy were 18%, 10%, 3%, 0·03%, and 0·009%, respectively. Economic data were exclusively available for high-income Europe. OSA was the most costly sleep disorder (€184 billion), followed by insomnia (€158 billion), RLS (€79 billion), narcolepsy (€905 million), and RBD (€436 million). Direct and indirect costs contributed 48% and 52%, respectively, with no available data on informal care costs.
Interpretation: The unexpected high prevalence and substantial economic burden associated with SD contrast with the universally neglected role of sleep health and SD in public health strategies. More research on the burden of SD is needed.
Keywords: burden of disease, cost of illness, Epidemiology, Insomnia, narcolepsy, obstructive sleep apnoea, REM sleep behaviour disorder, restless legs syndrome, sleep disorders
Bassetti, Claudio Lino Alberto and Welter, Luisa Sophie and Montes Martínez, Mateo and Mühlberger, Nikolai and Boon, Paul and Berger, Thomas and Deuschl, Günther and Arvandi, Marjan and Konti, Maria and Lolich, Maria and Pajediene, Evelina and Fronczek, Rolf and Moro, Elena and Siebert, Uwe and Dodel, Richard, Epidemiology and Economic Burden of Sleep Disorders in Europe. Available at SSRN: https://ssrn.com/abstract=5220665 or http://dx.doi.org/10.2139/ssrn.5220665
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