• Kelly Akemi Kikuti-Koyama, Ítalo Ribeiro Lemes, Luana Carolina de Morais, Henrique Luiz Monteiro, Bruna Camilo Turi-Lynch, Rômulo Araújo Fernandes, and Jamile Sanches Codogno.
• Student, Department of Physical Education, Laboratory of InVestigation in Exercise (LIVE), Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil.
• Sao Paulo Med J. 2024 Jan 1; 142 (6): e2023241e2023241.

BackgroundThe magnitude of economic losses attributed to sleep problems and insufficient physical activity (PA) remains unclear. This study aimed to investigate the association between insufficient PA, sleep problems, and direct healthcare costs.ObjectiveTo investigate the association between insufficient physical activity (PA), sleep problems, and direct healthcare costs among adults.Design And SettingAdults aged ≥ 50 years attended by the Brazilian National Health Service were tracked from 2010 to 2014.MethodsDirect healthcare costs were assessed using medical records and expressed in US$. Insufficient PA and sleep problems were assessed through face-to-face interviews. Differences were identified using the analysis of covariance and variance for repeated measures.ResultsIn total, 454 women and 166 men were enrolled. Sleep problems were reported by 28.9% (95%CI: 25.2% to 32.4%) of the sample, while insufficient PA was reported by 84.8% (95%CI: 82.1% to 87.6%). The combination of sleep problems and insufficient PA explained 2.3% of all healthcare costs spent on these patients from 2010 to 2014, which directly accounts for approximately US$ 4,765.01.ConclusionThe combination of sleep problems and insufficient PA plays an important role in increasing direct healthcare costs in adults. Public health stakeholders, policymakers, and health professionals can use these results to reinforce the need for strategies to improve sleep quality and increase PA, especially in nations that finance their National Health Systems.

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