Appl Health Econ Health Policy. 2025 Sep 16. doi: 10.1007/s40258-025-00997-2. Online ahead of print.
ABSTRACT
OBJECTIVE: Insomnia and hypersomnia are sleep conditions associated with significant costs to the healthcare system and society. This study aimed to review the cost-effectiveness evidence of interventions for insomnia and hypersomnia, including psychotherapy, pharmacotherapy, and complementary and alternative medicine (CAM), across the age spectrum.
METHODS: A systematic search (from inception to 18th February 2025) was conducted in electronic databases (Medline, PsycINFO, CINAHL, Econlit and Embase) and Health Technology Assessment websites. Full economic evaluations and return-on-investment analyses were included if they focused on treatments targeting insomnia or hypersomnia in people aged ≥12 years. The Drummond checklist was used to evaluate the quality of eligible studies. Narrative synthesis was applied to extract study characteristics and economic evaluation outcomes.
RESULTS: Twenty-eight studies met the pre-defined criteria, including 26 for adults and older adults with insomnia, two for adolescents with insomnia, and no studies were found for hypersomnia treatment. Cognitive behavioural therapy for insomnia (CBT-I) and pharmacotherapy were likely to be cost-effective interventions for insomnia compared to inactive controls. Digital CBT-I was found to generate healthcare and societal cost savings when compared to face-to-face CBT-I or pharmacotherapy. The cost-effectiveness of CAM interventions is under-researched and remains unclear.
CONCLUSION: Among insomnia interventions, CBT-I has the strongest cost-effectiveness credentials. Future studies should focus on hypersomnia, adolescent insomnia, and comorbid insomnia and related conditions.
PROSPERO REGISTRATION NUMBER: CRD42022343067.
PMID:40956569 | DOI:10.1007/s40258-025-00997-2
