scholarly journals The Social And Economic Cost Of Sleep Disorders

SLEEP ◽  
2021 ◽  
Author(s):  
Jared Streatfeild ◽  
Jackson Smith ◽  
Darren Mansfield ◽  
Lynne Pezzullo ◽  
David Hillman
Keyword(s):  
Health System ◽  
Sleep Disorders ◽  
Informal Care ◽  
Economic Cost ◽  
Well Being ◽  
Cost Component ◽  
Productivity Losses ◽  
Financial Costs ◽  
Obstructive Sleep ◽  
Medical Accident

Abstract Study Objectives To estimate economic cost of common sleep disorders in Australia for 2019–2020. Methods Costs were estimated for obstructive sleep apnea (OSA), insomnia, and restless legs syndrome (RLS) using prevalence, financial, and nonfinancial data from national databases. These included: (1) financial costs associated with health care, informal care, productivity losses, non-medical accident costs, deadweight loss from taxation/welfare inefficiencies; and (2) nonfinancial costs associated with loss of well-being. They were expressed in US dollars ($). Results Estimated overall cost of sleep disorders in Australia in 2019–2020 (population: 25.5 million) was $35.4 billion (OSA $13.1 billion; insomnia $13.3 billion, RLS $9.0 billion). Of this, the financial cost component was $10.0 billion, comprised of: health system costs $0.7 billion; productivity losses $7.7 billion; informal care $0.2 billion; other, mainly non-medical accident costs, $0.4 billion; and deadweight losses $1.0 billion. For moderate to severe OSA syndrome, insomnia unrelated to other conditions and RLS, financial costs represented $16,717, $21,982, and $16,624 per adult with the condition for the year, respectively. The nonfinancial cost was $25.4 billion. Conclusions The economic costs associated with sleep disorders are substantial. The financial component of $10.0 billion is equivalent to 0.73% of Australian gross domestic product. The nonfinancial cost of $25.4 billion represents 3.2% of total Australian burden of disease for the year. Health system costs of these disorders are low relative to those associated with their consequences, suggesting greater expenditure on detection, treatment and prevention is warranted.

Integrative Sleep Medicine

2021 ◽  
Keyword(s):  
Circadian Rhythm ◽  
Sleep Disorders ◽  
Health Care Providers ◽  
Sleep Disturbances ◽  
Well Being ◽  
Sleep Medicine ◽  
Whole Body ◽  
Care Providers ◽  
Obstructive Sleep ◽  
The Many

Sleep is one of the key underpinnings of human health, yet sleep disturbances and impaired sleep are rampant in modern life. Healthy sleep is a whole-body process impacted by circadian rhythm, daily activities, and emotional well-being, among others. When properly aligned, these work in concert to produce restorative and refreshing sleep. When not in balance, however, sleep disorders result. Yet too often, the approach to treatment of sleep disorders is compartmentalized, failing to recognize all of the complex interactions that are involved. This text offers a comprehensive approach to sleep and sleep disorders by delineating the many factors that interplay into healthy sleep. Health care providers can learn how to better manage their patients with sleep disorders by integrating complementary and conventional approaches. Using an evidence-based approach throughout, this book describes the basics of normal sleep then delves into the foundations of integrative sleep medicine, including the circadian rhythm, mind/body-sleep connection, light, dreaming, the gastrointestinal system, and botanicals/supplements. Specific sleep issues and disorders are then addressed from an integrative perspective, including insomnia, obstructive sleep apnea, sleep related movement disorders, and parasomnias.

Contemporary Concepts in the Diagnosis and Management of Obstructive Sleep Apnea

2021 ◽  
pp. 1-17
Author(s):  
Rajasekar Arumugam
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Wide Spectrum ◽  
Well Being ◽  
Comprehensive Overview ◽  
Sleep Related Breathing Disorders ◽  
Surgical Interventions ◽  
Obstructive Sleep

Optimal sleep is an inseparable component of both physical and psychological well-being. With the widespread increase in the prevalence of sleep disorders, there has been an immense interest among the global researchers in exploring the molecular biology of sleep and innovative modalities for diagnosing and treating sleep disorders. Notably, sleep disorders encompass a wide spectrum of sleep disturbances with potential multisystem complications. Polysomnography is an overnight sleep study that is widely considered as the gold standard objective diagnostic method for diagnosing obstructive sleep apnea (OSA) and provision of continuous positive airway pressure (CPAP), which maintains airway patency during sleep remains the cornerstone therapy for OSA. Although CPAP remains the mainstay of therapy for OSA, various oral appliances and surgical interventions have widely been considered for OSA. This chapter provides a comprehensive overview of contemporary diagnostic and therapeutic approaches available in clinical practice for sleep-related breathing disorders with particular emphasis on OSA.

Vitamin D and Sleep Regulation: Is there a Role for Vitamin D?

2020 ◽  
Vol 26 (21) ◽  
pp. 2492-2496 ◽  
Author(s):  
Fiammetta Romano ◽  
Giovanna Muscogiuri ◽  
Elea Di Benedetto ◽  
Volha V. Zhukouskaya ◽  
Luigi Barrea ◽  
...  
Keyword(s):  
Vitamin D ◽  
Sleep Disorders ◽  
Vitamin D Deficiency ◽  
Sleep Apnea Syndrome ◽  
Regulatory Mechanisms ◽  
Sleep Regulation ◽  
Vitamin D Receptors ◽  
Obstructive Sleep ◽  
The Impact

Background: Vitamin D exerts multiple pleiotropic effects beyond its role in calcium-phosphate metabolism. Growing evidence suggests an association between hypovitaminosis D and sleep disorders, thus increasing the interest in the role of this vitamin in the regulatory mechanisms of the sleep-wake cycle. Objective: The study aimed to explore and summarize the current knowledge about the role of vitamin D in sleep regulation and the impact of vitamin D deficiency on sleep disorders. Methods: The main regulatory mechanisms of vitamin D on sleep are explained in this study. The literature was scanned to identify clinical trials and correlation studies showing an association between vitamin D deficiency and sleep disorders. Results: Vitamin D receptors and the enzymes that control their activation and degradation are expressed in several areas of the brain involved in sleep regulation. Vitamin D is also involved in the pathways of production of Melatonin, the hormone involved in the regulation of human circadian rhythms and sleep. Furthermore, vitamin D can affect sleep indirectly through non-specific pain disorders, correlated with alterations in sleep quality, such as restless legs syndrome and obstructive sleep apnea syndrome. Conclusions: : Vitamin D has both a direct and an indirect role in the regulation of sleep. Although vitamin D deficiency has been associated to sleep disorders, there is still scant evidence to concretely support the role of vitamin D supplementation in the prevention or treatment of sleep disturbances; indeed, more intervention studies are needed to better clarify these aspects.

scholarly journals The role of iron and zinc in cognitive development of children

2017 ◽  
Vol 3 (2) ◽  
pp. 145-151
Author(s):  
Md Abdullah Al Mamun ◽  
Ruhina Binta A Ghani
Keyword(s):  
Health Care Services ◽  
Economic Cost ◽  
Well Being ◽  
Deficiency Anemia ◽  
Micronutrient Deficiencies ◽  
Dietary Practices ◽  
Risk Of Death ◽  
Care Services ◽  
Iron And Zinc ◽  
Frequent Consumption

The effects of iron and zinc on cognitive, motor and behavioral development are on children is scientifically accepted and concentrates on the more recent work, some previous work and areas of controversy. There are well established associations with poor development and iron and zinc deficiency in food source but the deficiencies usually occur in disadvantaged circumstances and establishing causal relationships is not easy. The health and well being of children depend upon the interaction between their genetic potential and exogenous factors like adequacy of nutrition, safety of the environment, social interaction and other childhood activity. Both proteins-energy malnutrition and micronutrient deficiencies increase the risk of death from common diseases such as acute gastroenteritis, pneumonia and measles. Iron deficiency anemia, for example, is estimated to affect almost 25% of the world’s population resulting in high economic cost by adding to the burden on health care services, affecting learning in school. Dietary practices frequently seen in children from both developed and developing countries, leading to frequent consumption of nutrient poor foods, may also put them at risk of micronutrient deficiencies.Asian J. Med. Biol. Res. June 2017, 3(2): 145-151

scholarly journals Informal carer in Portugal: moving towards political recognition in Portugal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
I Fronteira ◽  
J Simoes ◽  
G Augusto
Keyword(s):  
Informal Care ◽  
Long Term Care ◽  
Well Being ◽  
Oecd Countries ◽  
Low Fertility ◽  
Informal Carer ◽  
Term Care ◽  
System Perspective ◽  
Informal Carers

Abstract Informal care represents around 80% of all long term care provided in EU countries. Nevertheless, the needs for this type of care are expected to increase in the coming years in all OECD countries. Portugal is among the OECD countries with the highest ageing index (21.5% of the population was older than 65 years in 2017) due to high life expectancy and low fertility rates. As this demographic trend establishes, Portugal is expected to have more than 40% of the population over 65 years in 2037, and the expected prevalence of dementia is 3%, in 2050. In 2015 there were 2.1% of people over 65 receiving long-term care, representing 52% of all long-term care users. Around 38% were receiving care at home. It is estimated that 287,000 people in Portugal depend on informal carers. The agenda towards the official recognition of informal cares has been push forward in the country. Since 2015, several recommendations have been issued by the Parliament as well as legislative initiatives and a proposal for a Status of the Informal Carer is currently under discussion. We analyse the process of formulation of this policy in terms of sectors and stakeholders involved, definition and scope of informal carer, rights and obligations, role of the person being cared for, formal protection (e.g., labor, social, financial, training) and implementation. Recognition of the informal carer is a sector wide approach. One of the main features is the economic, social and labor protection mainly through reconciliation between work life and caring activities and promotion of the carer’s well being. Notwithstanding, and from a health system perspective, community health teams are to be the focal point for informal carers, supporting and providing specific training whenever needed. Despite its relevance, informal care should not be professionalized and responsibility of care should not be shifted from health services to informal carers. Key messages Needs for informal care are expected to increase in the coming years in OECD countries. Recognition of the informal carer is a sector wide approach.

scholarly journals Veterans Health Administration’s Whole Health System of Care: Supporting the Health, Well-Being, and Resiliency of Employees

2021 ◽  
Vol 10 ◽  
pp. 216495612110226
Author(s):  
Kavitha P Reddy ◽  
Tamara M Schult ◽  
Alison M Whitehead ◽  
Barbara G Bokhour
Keyword(s):  
Health System ◽  
Care Delivery ◽  
Health Planning ◽  
Well Being ◽  
Employee Health ◽  
Veterans Health ◽  
Health Administration ◽  
Patient Centered ◽  
Foundational Work ◽  
Health And Well Being

The Veterans Health Administration (VHA) is implementing a Whole Health System (WHS) of care that empowers and equips Veterans to take charge of their health and well-being and live their lives to the fullest, and increasingly leaders recognize the need and value in implementing a similar approach to support the health and well-being of employees. The purpose of this paper is to do the following: 1) provide an overview of the WHS of care in VHA and applicability in addressing employee resiliency; 2) provide a brief history of employee well-being efforts in VHA to date; 3) share new priorities from VHA leadership as they relate to Employee Whole Health strategy and implementation; and 4) provide a summary of the impacts of WHS of care delivery on employees. The WHS of care utilizes all therapeutic, evidence-based approaches to support self-care goals and personal health planning. Extending these approaches to employees builds upon 10 years of foundational work supporting employee health and well-being in VHA. In 2017, one facility in each of the 18 Veterans Integrated Service Networks (VISNs) in VHA was selected to participate in piloting the WHS of care with subsequent evaluation by VA’s Center for Evaluating Patient-Centered Care (EPCC). Early outcomes, from an employee perspective, suggest involvement in the delivery of the WHS of care and personal use of the whole health approach have a meaningful impact on the well-being of employees and how they experience the workplace. During the COVID-19 pandemic, VHA has continued to support employees through virtual resources to support well-being and resiliency. VHA's shift to this patient-centered model is supporting not only Veteran care but also employee health and well-being at a time when increased support is needed.

611 Sleep Disorders in a Longitudinal Community Cohort of Children with Down Syndrome

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A240-A240
Author(s):  
Nisha Patel ◽  
Timothy Morgenthaler ◽  
Julie Baughn
Keyword(s):  
Down Syndrome ◽  
Sleep Disorders ◽  
Screening Tools ◽  
Treatment Needs ◽  
Cross Sectional Survey ◽  
Periodic Limb Movement Disorder ◽  
Cross Sectional ◽  
Children With Down Syndrome ◽  
Obstructive Sleep ◽  
Respiratory Sleep Disorders

Abstract Introduction Obstructive sleep apnea (OSA) affects 50–79% of children with Down Syndrome (CDS) prompting the development of guidelines to increase early detection of OSA. Cross-sectional survey based data shows that CDS have higher rates of bedtime resistance, sleep anxiety, night waking and parasomnias, which are also under-recognized. However, due to increased survival of CDS it may be that OSA treated in childhood returns or worsens, or that CDS may develop other sleep disorders as their life experience and exposure to comorbidities expands. Little is known about sleep disorders across the life span of CDS and screening guidelines leave a gap beyond early childhood. We determined to enhance understanding of respiratory and non-respiratory sleep disorders in a community population of CDS. Methods A retrospective population based observational study of CDS born between 1995–2011 was performed using the Rochester Epidemiology Project database. Medical records from all encounters through July 2020 were reviewed to identify sleep disorders. Sleep diagnoses, sleep test results, and treatments aimed at sleep disorders were recorded. Results 94 CDS were identified with 85 providing consent for research. 54 out of 85 individuals were diagnosed with OSA with 26 diagnosed prior to age 4 and 25 undergoing polysomnography prior to treatment. 26 individuals underwent polysomnography following surgery of which 16 continued to have clinically significant OSA requiring further treatment with secondary surgery, CPAP or anti-inflammatory therapy. Other sleep disorders observed included insomnia (n=16), restless leg syndrome (n=7), periodic limb movement disorder (n=10), idiopathic hypersomnia (n=1), nightmares (n=1), nocturnal enuresis (n=1), bruxism (n=1) and delayed sleep phase disorder (n=1). Most non-OSA sleep disorders were diagnosed during OSA evaluation by sleep medicine providers. However, many children were on melatonin without a formal sleep disorder diagnosis. Conclusion Both OSA and other sleep disorders remain under-diagnosed in CDS. This may be due to lack of validated screening tools that can be administered at the primary care level. Screening recommendations should consider the longitudinal nature of OSA in CDS and the presence of non-respiratory sleep disorders. Adenotonsillectomy is not as effective in CDS and postsurgical polysomnography is warranted along with long term follow-up to assess for further treatment needs. Support (if any):

scholarly journals Responding to unforeseen disasters in a large health system

2020 ◽  
Author(s):  
Ryan J Hannan ◽  
Margaret K Lundholm ◽  
Dennis Brierton ◽  
Noelle R M Chapman
Keyword(s):  
Supply Chain ◽  
Health System ◽  
Disaster Response ◽  
Well Being ◽  
Lessons Learned ◽  
Strategic Decision ◽  
Pharmacy Services ◽  
Efficient System ◽  
Team Members

Abstract Purpose To describe how health systems may respond to sudden changes in operations by leveraging existing resources and to share one organization’s experience responding to the coronavirus disease (COVID-19) pandemic. Summary In a health system based in Illinois and Wisconsin, pharmacy services are provided by a single, integrated department responsible for all aspects of pharmaceutical care within the organization. Hospital, retail, ambulatory care, and population health services are all managed under one leadership team. All pertinent ancillary services are also managed within the department, including informatics, supply chain, and drug policy. During the COVID-19 pandemic, the pharmacy services leadership has successfully managed volume and capacity challenges by redirecting resources to where they are needed. A disaster response framework based on Federal Emergency Management Agency guidance was put in place, and change management principles were used to rapidly operationalize change. Components of the nimble response have included quickly increasing capacity, thoughtful and timely communication to all team members, strategic decision making with available data, creating an agile pool of labor, and maintaining an efficient system supply chain. Well-being and resilience are emphasized alongside reflection on lessons learned. Some changes made in the urgent response to the pandemic are being considered for long-term implementation. Conclusion Organizations have the potential to respond to almost any situation if they are integrated and teams work together to build flexibility. The keys to success are thoughtful maximization of existing resources and strong communication.

scholarly journals Uncovering Common Sleep Disorders and Their Impacts on Occupational Performance

2017 ◽  
Vol 65 (5) ◽  
pp. 232-232
Author(s):  
Sylvia R. Judd
Keyword(s):  
Sleep Disorders ◽  
Hormonal Regulation ◽  
The Body ◽  
Screening Tools ◽  
Occupational Performance ◽  
Obstructive Sleep ◽  
Occupational Health Nurse ◽  
Inadequate Sleep ◽  
Simple Screening ◽  
Healthy Immune System

Sleep is an active process; the body undergoes restoration and regeneration. Adequate sleep is essential to health and cognitive function. Sleep is critical for cell repair, a healthy immune system, and hormonal regulation, and aids in the process of learning, memory, and emotion. Inadequate sleep can lead to multiple chronic health and mental conditions over time. The occupational health nurse can be instrumental in screening for two of the most common sleep disorders, insomnia and obstructive sleep apnea, by asking workers key questions and using simple screening tools.

scholarly journals Using Higher-Order Constructs to Estimate Health-Disease Status: The Effect of Health System Performance and Sustainability

Mathematics ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1228
Author(s):  
Alicia Ramírez-Orellana ◽  
María del Carmen Valls Martínez ◽  
Mayra Soledad Grasso
Keyword(s):  
Health System ◽  
Social Services ◽  
System Performance ◽  
Structural Equation ◽  
Disease Incidence ◽  
Disease Status ◽  
Well Being ◽  
Equation Modeling ◽  
Health System Performance ◽  
The Relationship

This article aims to provide information to public agencies and policymakers on the determinants of health systems and their relationships that influence citizens’ health–disease status. A total of 61 indicators for each of 17 Spanish autonomous communities were collected from the Spanish Ministry of Health, Social Services, and Equality between 2008 and 2017. The applied technique was partial least squares structural equation modeling (PLS-SEM). Concerning health–disease status, an influence of sustainability and performance on the health system was hypothesized. The findings revealed that health system sustainability had a negative effect on health–disease status, measured in terms of disease incidence. However, the relationship between health system performance and health–disease status is positive. Furthermore, health system performance mediates the relationship between sustainability and health–disease status. According to our study, if we consider the opposite poles that make up the definition of health–disease status (well-being and disease), this concept is defined more by the incidence of the negative aspect.

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