316 Comorbidities among medically diagnosed insomnia patients: A MarketScan database study

Abstract Introduction A large proportion of patients with insomnia frequently suffer from comorbid medical conditions. Literature on the relationship between insomnia and associated comorbidities is severely limited due to challenges of generalizability, focus on a specific comorbidity and concerns of information biases. We conducted a comprehensive secondary database analysis to describe comorbidities among medically diagnosed insomnia patients. Methods All patients in the MarketScan database in 2018 with a full year of enrollment were included. Insomnia patients were identified using ICD-10-CM diagnosis codes (at least 2 outpatient claims or 1 inpatient claim of insomnia in 2018), along with their comorbidities recorded in that year. The frequencies of comorbidities among patients with insomnia were estimated. For comorbidities with prevalence > 1%, we further grouped them when appropriate to reduce the number of comorbidities. Results Among 20,209,292 enrollees, 259,035 (1.3%) had insomnia in 2018. Patients with insomnia had a median of 2 (IQR: 1–3) insomnia claims. The mean age of these insomnia patients was 49.3 years (std: 15.7), most of them were female (62.5%). About 172 comorbidities with >1% were found in this patient population, and 35 comorbidities had a frequency greater than 10%. The common comorbidities among these insomnia patients included 1): common physical disorders among middle aged and older adults: hyperlipidemia (39%), hypertension (39%), skin diseases (37%), back pain 35%; 2):common mental health disorders such as anxiety disorder (41%), depression (28%); and 3): other diseases such as GERD and thyroid diseases also had high frequencies among insomnia patients (18% and 18.7%, respectively). Conclusion Using claims data, we provided a quantitative assessment of comorbidities among patients with medically diagnosed insomnia. These results could help clinicians become aware of the most frequently occurring comorbidities and assist in integrating management of the insomnia. Support (if any):