Insomnia and absenteeism at work. Who pays the cost?

STUDY 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. DESIGN Retrospective cohort study over a 2-year period. SETTING The Paris Ile de France region. PATIENTS Two matched groups of employees: 369 insomniacs and 369 good sleepers. MEASUREMENTS 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.