Sleepless in America: A $32.4 Billion Business
Life + Money

Sleepless in America: A $32.4 Billion Business

Reuters/The Fiscal Times

The exhortation we’ve heard all our lives sounds so simple and doable: “Get a good night’s sleep.”

But judging by the numbers, a multitude of Americans don’t get enough shut eye and need the array of specialists, services and products that exist today. Even a “natural” water enhanced with melatonin, GABA and 5-HTP tryptophan is on the market to help sleep-desperate consumers achieve the slumber they so badly crave. Welcome to the sleep economy.

IMS Health, a marketing analytics firm based in Parsippany, N.J., projects the sleep industry could reach an astounding $32.4 billion this year in the U.S. That number represents an 8.8 percent year-over-year increase since 2008 and includes everything from pills, products and medical devices to “sleep consultants” who farm themselves out to hospitals, labs, and sleep centers, to luxe mattresses made with tension-relieving foams.

RELATED:  The High Cost of a Good Night’s Sleep

Sleep hotels and “pods” catering to weary travelers have popped in many major cities around the world, while advocacy groups like the International Sleep Products Association – founded in 1915 to represent a few dozen mattress manufacturers – now represents nearly 700 mattress makers and bedding supply companies in over 50 countries.

If all of this sounds like a lot of pillow talk, consider the new “Got Sleep?” specialty stores launched by Sleep Train, an employee-owned mattress retailer on the West Coast. The “Got Sleep?” boutiques have sprung up in California malls and offer everything from noise canceling machines to slippers, scented candles, and sheets. Sleep Train had a record year last year, with sales at about $370 million, representing an 18 percent increase from 2010. 

According to a report in April from the Centers for Disease Control and Prevention, nearly a third of working Americans – or nearly 41 million people – are sleep deprived. Most adults need 7 to 9 hours of shut eye a night but we’re not getting close to that. Analyzing data from the 2010 National Health Interview Survey to compare sleep duration by age, race and ethnicity, sex, marital status, education and employment characteristics, the CDC found that 30 percent of civilian-employed U.S. adults reported sleeping an average of less than six hours a night.

Sleep deprivation can lead to poor health, lower levels of workplace safety, impaired public safety, and decreased job and school performance – all of which can raise costs for employers, consumers and communities. Sleep deprivation can also affect the immune system as stress. Researchers in the U.K. and in The Netherlands found that a loss of sleep actually triggers the production of white blood cell counts at night.

Dr. Stanley Wang, M.D., a clinical cardiologist and director of the Sleep Disorders Center at the Heart Hospital of Austin, Texas, told KXAN in Austin that sleep deprivation itself can lead to high blood pressure, which leads to heart problems. “But if you also have a sleep disorder on top of that, such as sleep apnea, that causes even worse problems,” he said.  

As Max Hirschkowitz, PhD, an internationally recognized sleep expert and a diplomate of the American Board of Sleep Medicine, has written, “If you don’t get the sleep you need, you don’t restore and refresh your brain and body. You’re basically running on empty… When a car runs out of gas, it stops running. That’s an apt analogy. Sleep is the gas that fuels your brain, and when you don’t get enough you may end up on the side of the road, literally or figuratively.”

The National Sleep Foundation says that more than 50 million Americans will suffer from a sleep disorder at some point in their lives. Those who experience sleep apnea stop breathing for short periods of time – which can strain the body and the heart. Sleep problems are also common in older people: A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health found that fragmented or interrupted sleep could predict future placement in a nursing home or assisted living facility.

Right now the U.S. accounts for a major share of the global sleep apnea market, making the opportunity ripe for manufacturers and distributors of such treatments as CPAP – or continuous positive airway pressure – in which a face mask, worn at night, is attached to an air pressurizer to help keep airways open. The total over-the-counter market for sleep aids alone reached $604 million in 2008, an increase of 9 percent over 2007, according to Packaged Facts, a division of Rockville, Md.-based Market Research Group.

Not surprisingly, the so-called consumer sleep market is positively brimming with pillows, humidifiers, clothing, sleeping bags and much more. The popular retailer Bed Bath & Beyond, for example, lists more than 600 products under the sleep category, including the Brookstone Tranquil Moments Advanced Sleep Sounds system (for about $170); the Sleep for Success down-alternative pillow with an “exclusive tri-chamber design” and “temperature management” (for about $50); and even a DogPedic Sleep System bed with memory foam that “warms and soothes” the “aching joints, pressure points and hip dysplasia” of pooches lucky enough (or sleep-deprived enough) to need one (for about $40).

The business of diagnosing and treating sleep disorders, and helping people sleep better overall, has become a growing field for physicians, psychologists and other medical professionals. The American Academy of Sleep Medicine (AASM), the only professional society dedicated to the subspeciality of sleep medicine, has a membership of some 10,000 physicians, researchers and health care professionals and considers itself “the leader is setting standards and promoting excellence in sleep medicine health care, education and research.” (A TedMed conference earlier this year classified sleep as one of the most important subjects worthy of increased medical attention.)

Sleep consultants, for their part, typically provide a range of services, from individual coaching to course instruction in corporate wellness programs. Patty Tucker, a physician’s assistant for nearly 25 years in the Napa Valley, says she transitioned full time into sleep specialization about two years ago. In the past decade, she says she’s seen “the business of sleep grow in an amazing way,” she told The Fiscal Times. “I found I could focus on the sleep disorders, the sleep apnea, the restless legs, the narcolepsy, and provide proper treatments. In a conventional medical setting that didn’t guarantee my patients would turn into champion sleepers.” As the population ages, most medical experts say that the problems may get worse, not better. The effects of not sleeping well and of not breathing well over time become far more evident. And then, of course, there’s the obesity epidemic, “which also has a strong sleep link,” adds Tucker. 

RELATED: The Obesity Epidemic: Another $550B in Costs by 2030

Sleep testing, one of the most expensive options, is also a lucrative business. Just one night at a hospital-based sleep lab can run a patient $1,900; the cost is usually covered by health insurance. The number of accredited sleep labs that test for sleep apnea and other disorders has quadrupled, according to AASM, and insurer spending on the procedure has skyrocketed. Medicare payments for sleep testing rose from $62 million in 2001, to $235 million in 2009, according to the Office of the Inspector General.

Not incidentally, ResMed, one of the leading developers and manufacturers of products for the diagnosis and treatment of sleep-disordered breathing, runs a sleep market “panel” to help businesses achieve better performance and understand today’s market trends, given the “rapidly growing and dynamic market” for sleep needs in America. Total revenue for all of ResMed's sleep products in fiscal year 2011 was $1.2 billion, a company spokesman told The Fiscal Times; that number's expected to grow to about $1.34 billion this year.

Dr. Fred Holt, an expert on fraud and abuse and the medical director of Blue Cross Blue Shield in North Carolina, told Kaiser Health News, however, that some patients aren’t having baseline exams first and are being prescribed expensive tests they don’t really need. Not everyone who snores, for example, has a chronic disorder. In other cases, labs may prescribe pricey CPAP machines without first suggesting common-sense strategies like losing weight or sleeping on one’s side, which may also reduce apnea.

On top of legitimate health and medical issues related to lack of sleep, in today’s trying economy many Americans are sacrificing their sleep health by working longer and longer hours, according to the National Sleep Foundation. A recent survey found that roughly 41 percent of people reported problems with tossing and turning at least a few nights a week – while nearly 24 percent said that the movement of their partner disturbs their sleep at least a few nights a week.

David Lekach, 32, co-founder of Dream Water, knows all about insomnia issues. It’s the reason he and a partner, Vincent Porpiglia, both Miami natives, created their “all-natural” water, which contains GABA (for relaxation), melatonin (to help induce sleep), and tryptophan (to help improve sleep quality). They launched the drink in 2009, right after “the worst economic collapse of my lifetime,” Lekach told The Fiscal Times. “We live in an increasingly stressful world and at least one in four Americans has some type of sleep issue. It’s only exacerbated by economic stress and turmoil. It was a perfect moment for us to launch.”

Lekach calls his product the “anti-Red Bull.” “I thought, there must be other people like me who can’t sleep who can use this. It’s not a medicine; it’s not a pill. We’re a mainstream product.” The cost of a 2.5-ounce shot of the zero-calorie liquid is about $3, depending on the retailer. Lekach has seen sales “shoot up”  this year (his company is privately owned so he won’t share figures). Today the product is sold in 30,000 stores including Duane Reade, Walmart and others, as well as in 1,000 airports. 

Valley Sleep Center of Phoenix, with multiple locations throughout Arizona, has also seen its business grow – by 800 percent since 2004. Accredited by the American Academy of Sleep Medicine (not all sleep centers are), the business offers diagnostic sleep studies in a “home-like atmosphere.” Rooms feature plush bedding, flat screen TVs, and private baths and showers. Board-certified sleep medicine specialists treat insomnia, sleep apnea, snoring, excessive daytime sleepiness, hypertension, sleepwalking and pediatric sleep problems. 

Wendy Kenney of Valley Sleep Center notes that recent cuts by Medicare and insurance companies have forced the center to watch every penny even as it expands its locations. “One reason for our growth in Phoenix has been the demise of other sleep clinics that couldn’t survive the cuts,” she told The Fiscal Times

Either way, a multitude of services and products are clearly turning America’s problems with ZZZs into very big $$$. That’s likely to continue as the population continues to age. As sleep consultant Tucker says, “It’s a myth that we need less sleep as we get older. We need every bit as much sleep at age 65 as we did at 35. It’s just harder to come by, for a variety of reasons.” No wonder that everything from sleep boutiques to sleep spas, retreats and even vacations, once just a dream, are now very much a reality.  

Katya Johns of The Fiscal Times contributed reporting to this article.