Insomnia Research Paper Assignment

Running head: INSOMNIA 1 Abstract Sleep disorders are common, and they affect many people in the world. People with sleep disorders can either sleep for long durations or sleep for short durations. Insomnia is an example of a sleep disorder whereby people sleep for a short period. Insomnia is a result of stressful situations, and people with insomnia have reduced productivity. Insomnia can last weeks or months, but it can be treated by changing lifestyles. This paper explores the causes of insomnia and its economic costs. The economic costs of insomnia result from the healthcare costs of treating insomnia-related diseases, nonmedical costs accrued due to accidents, and lost productivity. This paper seeks to establish the monetary costs of insomnia in the top economies of the world. INSOMNIA 2 Insomnia Insomnia is an example of sleep issues that affect many people in the world. Inadequate sleep is a challenge that many people are experiencing in the world today. An ideal sleep takes between 7-8 hours. A sleeping duration that is less than 7 hours is considered inadequate, and Lombardero et al. (2019) claim that 35% of Americans have an inadequate sleep. Even though inadequate sleep is sometimes self-induced, sometimes it is a result of the difficulty in initiating and maintaining sleep. Insomnia Research Paper Assignment

Insomnia, according to Kalmbach, Pillai & Drake (2018), is a result of an inability to cope with stressful situations, and it can cause depression. Given the negative impacts of insomnia on the health of a person, it is vital to determine and treat the disorder early before it becomes severe and leads a person to depression. The aim of this study is to uncover the causes of insomnia and its economic impacts. INSOMNIA 3 Level 1: Scientific Perspective of Insomnia Even though people have different sleeping durations, there is a minimum number of hours that are good for the health of a person. The recommended minimum time for adults is 7 hours. Insomnia arises when a person spends less time sleeping. Adults can have acute or chronic insomnia. Acute insomnia lasts a few days or weeks, and it is a result of stressful or traumatic events, while chronic insomnia can last for more than a month. Insomnia is a common yet neglected condition. According to Bhaskar, Hemavathy & Prasad (2016), insomnia is prevalent worldwide at 10-30%, and it is common among adults. Insomnia is characterized by irritability, daytime sleepiness, waking up early or late, difficulty sleeping, increased accidents, and difficulties in remembering things. There are different factors responsible for insomnia. One factor responsible for insomnia is stress. At one point in their lives, people experience stress that can be due to issues with job or family. Stress makes people spend most of their time thinking about the stressor, and they find it hard to sleep or wake up during the night and fail to get sleep again. Morales et al. (2019) say that work-related stress is the leading cause of insomnia for healthcare personnel. Healthcare personnel works in a stressful environment whereby there are high expectations, time pressure, and low tolerance of mistakes. There are also long working hours, and these work-related stress and pressure can make a person develop insomnia. Lifestyle choices also cause insomnia. Using bright screens before going to bed is one factor that contributes to insufficient sleep. Studies indicate that using digital devices before going to bed suppresses melatonin. When melatonin is suppressed, the body fails to produce cells that indicate it is time INSOMNIA 4 to wake up, instead of sleeping. Another lifestyle choice is using caffeine before bedtime. Caffeine increases alertness, and this drives away the urge to sleep. One of the body systems that is affected by insomnia is the central nervous system. The central nervous system acts as the information highway of the body. Information is sent from neurons to other brain cells, and when a person fails to sleep, the brain becomes exhausted and cannot function optimally.

This leads to delays in sending signals, a decrease in coordination, and increased risks of accidents. The immune system is also affected by insomnia. During sleep, when a person is sleeping, the immune system produces substances that protect the body from foreign invaders. Inadequate sleep hinders the production of the protective substances and therefore predisposes the body to attacks by foreign invaders. The cardiovascular system is also affected by inadequate sleep. Sleep plays a crucial role in the regulation of blood pressure and inflammation levels. Without sleep, a person can easily get cardiovascular diseases. The endocrine system is also affected by insomnia. Production of hormones, especially testosterone, is dependent on quality sleep. The minimum uninterrupted sleep for the production of testosterone is three hours. Insufficient sleep affects the production of this hormone and hence hinders sex drive. Researchers have found a similarity between genes causing insomnia with anxiety and depression. According to Jansen et al. (2019), the genes causing insomnia have the same composition as those causing psychiatric disorders. Scientists have linked the genetic Gammaaminobutyric acid (GABA) chemical to insomnia. The chemical acts regulate the transmission of nerve impulses. For people with insomnia, GABA levels are low, and this creates an INSOMNIA 5 imbalance since the chemical is not effective in regulating signals. GABA is, therefore, an essential chemical since it influences and regulates the transmission of signal transmission. Level 2: Analytical Perspective of Insomnia Insufficient sleep affects the health of an individual and their overall productivity. Insomnia is caused by individual-level factors, for instance, lifestyle choices like alcohol consumption and work-related issues like the psychosocial environment. Hillman et al. (2018) say that more than “one in three adults” lack adequate sleep. Insomnia Research Paper Assignment

Technological advances have made people increase their wakeful hours to accomplish more work. Hillman et al. (2018) further assert that the number of people with sleep challenges is increasing in western countries. Since sleep disorders have adverse health outcomes such as reduced motivation and memory lapse, it reduces the productivity of a worker. The healthcare costs of insomnia arise from the disorder and the conditions associated with inadequate sleep like workplace injuries. Hillman et al. (2017) say that in Australia, healthcare costs in the 2016-2017 year were $1.24 billion. This amount can be broken down to $158.3 million due to sleep disorders, $9.1million for congestive cardiac failure, and $77.8 million for corona artery diseases, $238.9 million for motor vehicle accidents, $423.3 million for workplace accidents, $271.8 million for depression and $ 12.1 million for type 2 diabetes. Informal care costs are another measurement of economic costs related to insomnia. According to Hillman et al. (2018), these are costs that arise from caring for people with insomniarelated illnesses outside the healthcare sector. The time used by carers or relatives to care for people with insomnia-related illnesses could have been spent on other productive activities. Hillman et al. INSOMNIA 6 (2018) say that the informal costs for inadequate sleep are $ 413.2 million. Another measure of economic costs is the nonmedical costs of accidents due to insomnia. Workplace injuries and motor vehicle accidents are the primary forms of accidents due to insomnia. During 2016-2017, the nonmedical costs due to workplace injuries amounted to $290.4 million, while the nonmedical costs due to motor vehicle accidents were $2.19 billion. The total nonmedical costs were $2.48 billion (Hillman et al., 2018). Productivity cost is another measure of the economic costs of insomnia. People who have an inadequate sleep have high chances of dying, and this reduces the workforce. Also, people with illnesses related to inadequate sleep are likely to be absent from work, and when they are present, their performance does not match that of people who had an adequate sleep. Hafner et al. (2016) assert that workers who sleep less than 6 hours a day have higher productivity loss as a result of absenteeism when compared to workers who have more than 7 hours of sleep. Hafner et al. (2016) further claim that the US loses about 9.9 million “working hours” a year due to inadequate sleep. In other developed countries, Japan, Germany lose 4.8 and 1.65 million working hours annually. Insomnia Research Paper Assignment

Hillman et al. (2018) say that Australia lost $12.9 billion due to productivity issues like reduced employment, premature death, absenteeism, and presenteeism. Insomnia is complicated condition since it has no specific treatment. Apart from the use of medications to treat insomnia, other cost-effective methods target behavioral change exist. One economical approach to treating insomnia is stimulus control. This approach involves taking away things that affect sleep. This approach can succeed if the patient is willing to break the old sleeping habits and adopt new ones. ANOVA is the statistical process that can be used to gain an INSOMNIA 7 understanding of insomnia. ANOVA is used to determine the statistical significance when assessing the hypothesis. To conclude, insomnia is a condition characterized by a lack of sleep. Many people in the world have insomnia. Ideally, people are advised to sleep for at least 7 hours. Ideally, adults are recommended to have at least 7 hours of sleep. Technological advances have enabled people to work from their homes, and this has led to a reduction in hours people sleep. The research questions for this research were; what are the causes of insomnia? What are the economic impacts of insomnia? From the research, the causes of insomnia are stress, work-related factors, and lifestyle choices. Stress causes insomnia in that it keeps a person awake for long hours and hence can fail to sleep. Work-related factors such as pressure and intolerance to mistakes can prevent a person from getting adequate sleep. Lifestyle choices like drinking caffeine before bedtime reduces the chances of getting asleep. The economic costs of insomnia include the costs of treating a person suffering from insomnia-related illnesses, nonmedical costs due to accidents, and productivity costs due to mortality, absenteeism, and presenteeism. References Bhaskar, S., Hemavathy, D., & Prasad, S. (2016). Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. Journal of family medicine and primary care, 5(4), 780–784. https://doi.org/10.4103/2249-4863.201153 Hafner, M., Stepanek, M., Taylor, J., Troxel, W. M, & Van Stolk, C. (2016). Why sleep mattersthe economic costs of insufficient sleep: cross-county comparative analysis. Rand health quarterly, 6(4). INSOMNIA 8 Hillman, D., Mitchell, S., Streatfeild, J., Burns, C., Bruck, D., & Pezzullo, L. (2018). Insomnia Research Paper Assignment

The ecomomic costs of inadequate sleep. Sleep, 41(8), zsy083. Jansen, P. R., Watanabe, K., Stringer, S., Skene, N., Bryois, J., Hammerschlag, A. R., Posthuma, D. (2019). Genome-wide analysis of insomnia in 1,331,010 individuals identifies new risk loci and functional pathways. Nature Genetics, 1. https://doi.org/10.1038/s41588018-0333-3 Kalmbach, D. A., Pillai, V., & Drake, C. L. (2018). Nocturnal insomnia symtoms and stressinduced cognitive intisions in risk for depression: A 2-year prospective study. PloS on, 13(2). Lombardero, A., Hansen, C. D., Richie, A. E., Campbell, D. G., & Joyce, A. W. (2019). A narrative review of the literature on insufficient sleep, insomnia, and health correlates in american Indian/Alaska native populations. Journal of environmental and public health, 2019, 4306463. https://doi.org/10.1155/2019/4306463 Running head: LEGAL AND CULTURAL FACTORS ON INSOMNIA 1 Insomnia is a sleeping issue characterized by the inability to initiate and maintain sleep at night leading to a night of non-restorative sleep. The duration people sleep differs, meaning that there is no standard duration for sleeping. A person can sleep for eight hours and still feels drowsy while another person can sleep for five hours and does not feel sleepy during the day. Scientists are, however, recommending people to sleep for at least seven hours to reduce the chances of having insomnia. According to Lombardero et al. (2019) claims that about 35% of LEGAL AND CULTURAL FACTORS ON INSOMNIA 2 Americans have an insufficient sleep. Insomnia is a public health problem since it causes diseases that affect body systems. Cerolini, Ballesio & Lombardo (2015) say that insomnia leads to poor emotional regulation. Since sleep loss impairs how people regulate emotions, it can lead to adverse health and behavioral outcomes and, therefore, the need for laws to govern insomnia. In this study, I intend to uncover the laws that govern insomnia and cultural practices that influence it. Ethical perspective inquiry Different states have taken different approaches to insomnia. One major law on insomnia is drowsy driving laws. People with insomnia have challenges when driving since they can fall asleep while on the wheels. The risks posed by sleeping drivers have made states enact laws to combat drowsy driving. NCSL (2018) states that sleep-driving is responsible for 100,000 crashes annually, and it leads to 71,000 injuries and 1,500 deaths. These deadly effects of sleep-driving have forced legislators in the different states to formulate policies concerned with drowsy sleeping. Whereas some states have set aside days to create awareness on drowsy driving and others, have criminalized drowsy driving by classifying it as reckless driving. According to NCSL (2018), New Jersey and Arkansas are the states that punish drowsy driving while Alabama, Florida, California, and Texas have created awareness days for drivers. Doctors are against using some medications to manage insomnia for ethical reasons. Insomnia can be controlled using pharmacological and non-pharmacological means. Cunnington, Junge & Fernando (2013) say that hypnotic drugs are some of the medications used to manage insomnia. These drugs work by acting on the aminobutyric acid receptor, and studies indicate that long term usage of the drugs leads to dependence and tolerance. When patients tolerate the drugs, then their effectiveness fades, and in such a scenario, the doctor will not have achieved the LEGAL AND CULTURAL FACTORS ON INSOMNIA 3 aim of the treatment. Non-maleficence and beneficence require that the doctors do what is best for the patient. Insomnia Research Paper Assignment

Ethical issues arise when the doctor knows that the drugs for treating insomnia lead to dependence. One ethical theory that applies to insomnia is utilitarianism ethics. According to this theory, the concepts of right and wrong are dependent on the outcome of a decision. Further, the theory asserts that individuals make decisions that lead to the greatest benefits. Moral awareness enables a person to differentiate right from wrong, and according to Križan (2019), insufficient sleep degrades the moral awareness of an individual. Križan (2019) asserts that people with deprived sleep make utilitarian decisions. Križan (2019) explains that sleep-deprived people have degraded moral awareness and therefore tend to make utilitarian decisions. These are decisions that an individual cannot make when they are sober, and they conflict their individual beliefs. The decisions made by doctors who refuse to treat patients using the hypnotic is utilitarian since it relies on the perceived outcomes of the treatment, such as dependency. Therefore, utilitarian ethics applies to insomnia since it leads an individual to make decisions that are self-centered and conflict with their values and also makes doctors make decisions that prioritize the health outcomes of the patient. Power and money are related to insomnia in different ways. Worries concerning money are the primary cause of insomnia in America. According to Hill (2017), about 65% of Americans have an inadequate sleep because they worry a lot about money. People need money to buy necessities like food, clothing, and also pay for healthcare. The lack of money keeps people worried about how they can afford some essentials, and these worries lead to insomnia. Insomnia is managed pharmacologically using drugs and non-pharmacologically using cognitive-behavioral therapy. These treatment mechanisms are costly, and this can prevent LEGAL AND CULTURAL FACTORS ON INSOMNIA 4 people from seeking treatment (Rezaie, Khazaie & Yazdani, 2016). Power also leads to insomnia. People in leadership positions have many things to do daily, and the volume of the work can prevent them from having sufficient sleep. The responsibilities the individuals have can also prevent them from seeking treatment since they can be busy and lack time to seek treatment. Cultural perspective of inquiry Culture is an integral part of people’s lives, and it, therefore, affects how people sleep.

Knutson (2012) says that culture entails beliefs, attitudes, practices, and behaviors that can influence the duration of sleep. Cultural pressures override biological clocks since they dictate when an individual can sleep. From a study of sleeping durations and practices across the world, Knutson (2012) found that people from countries like Japan and Singapore had little sleep, and this is attributed to the work ethics in those countries. In these cultures, long sleep is considered a waste of time, and therefore people tend to have short sleeping durations. Arslan, Kacoglu & Durmus (2015) say that Turkish cultures encourage afternoon siesta, and this reduces the rates of insomnia among the Turkish communities. These studies indicate that cultural beliefs and practices influence the duration of people to sleep and hence contribute to insomnia. Insomnia has negative impacts on the health of an individual, their productivity, and, ultimately, the economy of a country. This has led cultures to developed specific ways of managing the condition. Even though there are methods of treating insomnia that across cultures, such as the use of medications and behavioral-based interventions, some cultures have unique methods. In Japan, companies are encouraging employees to take naps during worktime. Some companies have created napping rooms whereby employees can take naps and therefore improve their productivity. The Chinese use herbal medicines to treat insomnia. Insomnia Research Paper Assignment

Li et al. (2019) say that available drugs for treating insomnia have limitations, and therefore, Chinese traditional LEGAL AND CULTURAL FACTORS ON INSOMNIA 5 medicine are alternative drugs for managing insomnia. These are medicines that have tranquilizing effects on the heart and mind and, consequently, vital in treating insomnia. Many western cultures rely on pharmacological treatments and cognitive behavioral therapy to manage insomnia. Societies in developed countries are the most affected by insomnia. Hafner et al. (2017) assert that industrialized nations like Canada, Germany, United Kingdom, United States, and Japan sleep for fewer hours, and this is associated with the modern economy of the nations. The percentage of citizens who sleep for less than six hours varies from one country to another such that the US has 18%, the UK has 16%, Germany has 9%, Japan has 16%, and Canada has 6%. Ideally, recommended minimum hours for sleeping is seven hours, meaning that people sleeping for less than six hours have high chances of having insomnia. In these developed countries, advances in technology have enabled people to work for long hours, and they finally end up with insufficient sleep. Grunstein (2012) claims that developing countries, such as India and China, are also recording an increase in insomnia cases. This increase is a result of urban …