Direct and indirect costs of sleep disturbances and residual symptoms in patients treated for depression: analysis of a nationwide cross sectional survey.

Abstract

To assess the relationship between inadequate response to depression treatment and sleep disturbances, work productivity loss, and resource utilization. Adults reporting antidepressant use for more than 90 days (n = 6116) in the 2009 US National Health and Wellness Survey were categorized as non-, partial-, or complete responders to depression treatment. Multivariable analyses, adjusting for patient characteristics and comorbidities, examined the association of treatment response with sleep disturbances (including possible mediation), productivity, and resource use. Partial- and nonresponders, versus complete responders, experienced greater sleep disturbance, productivity loss, and resource use. Mediation results were consistent with the possibility that sleep disturbances predicted inadequate treatment response, which led to greater resource use. Sleep disturbances are prevalent in depression and associated with increased resource use. Appropriate management, including antidepressants that alleviate sleep disturbances, may improve functional and economic outcomes.