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 lie 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 [Cl]) 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 E 77 ( E 39) per employee, per year. The extra cost ( CI) to employers was estimated at E 233 ( E 101) for salary replacement and E 1062 ( E 386) for loss of productivity. Finally, employees themselves bore a cost (+/- CI) of 100 EURO (+/- 54 EURO). 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.