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Can't Sleep? Clinics, Pills Offer Hope of Sweet Dreams: Helping People Get a Night's Rest is Big Business

Posted on: Monday, 1 May 2006, 12:01 CDT

By Suzanne Hoholik, The Columbus Dispatch, Ohio

May 01--David Kivimaki's sleep has been out of whack for a year. He sleeps no more than five hours, is up at least twice a night and is tired all day. "When I'm driving, I almost feel like I could pull over on the side of the road and take a catnap," said Kivimaki, a 36-year-old salesman from Lewis Center.

He tried over-the-counter medications before going to his doctor, who thought he might have sleep apnea -- brief breathing lapses that wake the sleeper and can be dangerous.

Recently, Kivimaki spent a Wednesday night and most of Thursday in the Sleep Disorder Center at University Hospitals East, where experts watched him during the night.

It's not cheap. Ohio State charges about $2,700 for a study.

Helping people get a good night's rest is big business.

The number of sleep centers in the United States has nearly tripled in the past decade, and prescriptions for sleep aids have increased by 60 percent since 2000, says IMS Health, a research tracking company.

In all, 42 million sleep-aid prescriptions were filled last year.

Experts say more people probably are suffering from sleep problems these days, in part because of in- creased stress and health issues, including obesity.

On average, adults should get about seven hours of sleep a night, but surveys show that about 40 percent get less.

Inability to sleep has only recently been recognized as a medical issue. A report by the Institute of Medicine issued last month called lack of sleep a public-health problem. The report said as many as 70 million Americans suffer with chronic sleep disorders that increase their risk of hypertension, diabetes, depression, heart attack and stroke.

"If you don't sleep, your appetite goes up and you eat more and consume more, leading to obesity and to diabetes," said Dr. Thomas Boat, a professor of pediatrics at the University of Cincinnati who was involved in the report.

"It's a problem that has always been there, but there hasn't been good data."

Drug companies have seen the light. Prescription sales of sleep aids jumped from $1.1 billion in 2001 to $2.7 billion last year, said IMS Health.

A big part of the boom is a result of direct-to-consumer advertising, making Lunesta and Ambien household names.

There's more to come. At least four other companies have sleep aids awaiting approval, and 10 more medications are in development, said Pharmaceutical Research and Manufacturers of America, the industry trade group.

"That kind of tells me that pharmaceutical companies are aware of the huge untapped market and are working diligently to create newer and better medications in this area," said Rajesh Balkrishnan, Merrell Dow professor at the OSU College of Pharmacy.

Most health-insurance companies, Balkrishnan said, require pre-approval and consider the newer sleep aids tier-three drugs, meaning a month's supply can cost $300.

But, "Less than 2 percent of these prior authorizations are rejected by managed care," he said.

Insurance companies are paying for sleep studies, too.

Children's Hospital, OSU, OhioHealth and Mount Carmel all have sleep centers. There are also several private centers in central Ohio; most have weeks-long waiting lists.

"We have 10 beds and typically we have a backlog of about four weeks," said Dr. Ulysses Magalang, medical director of OSU's sleep center.

"Some of our patients travel hours to get here."

Employers are interested in making sure their workers get their sleep.

A 2005 study by the American Academy of Sleep Medicine said that annual costs associated with lost productivity, missed days and medical bills because of insomnia can reach $107 billion.

Kivimaki, who won't know the results of his sleep study for several days, said he's willing to take prescription medications if it means feeling rested.

"At this point in my life, I would be open to feeling better during the day," he said.

shoholik@dispatch.com

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Copyright (c) 2006, The Columbus Dispatch, Ohio

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Source: The Columbus Dispatch, Ohio

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