Managed care considerations.

Managed care issues arising from excessive daytime sleepiness (EDS), which impacts as many as 37% of adults, are widespread. In the United States, insomnia is among the 3 most common complaints. Often it is younger people who have difficulty falling asleep, whereas their elders report more difficulty remaining asleep. Currently, people in the United States sleep 25% fewer hours than they did 100 years ago. Chronic sleep deprivation may be a choice driven by economic or social factors. Industrialized countries engage about 20% of the work force in shifts, and people working night shifts are thought to average 8 fewer hours of sleep each week than day workers. Falling asleep behind the wheel is the single most imminent risk associated with excessive sleepiness.