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Direct and Indirect Costs of Sleep Disturbances and Residual Symptoms in Patients Treated for Depression: Analysis of a Nationwide Cross Sectional Survey

Gupta, Shaloo MS; Goren, Amir PhD; Kim, Edward MD; Gabriel, Susan MSc; Dupclay, Leon PharmD

Journal of Occupational and Environmental Medicine: July 2012 - Volume 54 - Issue 7 - p 881–888
doi: 10.1097/JOM.0b013e31825107da
Original Articles

Objective: To assess the relationship between inadequate response to depression treatment and sleep disturbances, work productivity loss, and resource utilization.

Methods: 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.

Results: 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.

Conclusions: 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.

From the Kantar Health (Ms Gupta and Dr Goren), Princeton, NJ; and Novartis Pharmaceutical Corporation (Dr Kim, Ms Gabriel, and Dr Dupclay), East Hanover, NJ.

Address correspondence to: Shaloo Gupta, MS, Health Sciences Practice, Kantar Health, 1 Independence Way, Suite 220, Princeton, NJ 08540 (

The National Health and Wellness Survey (NHWS) is conducted by Kantar Health, Princeton, NJ.

Novartis Pharmaceutical Corporation, East Hanover, NJ licensed access to NHWS and funded the analysis and preparation of this paper.

©2012The American College of Occupational and Environmental Medicine