Insomniacs often had increases in health utilization. Léger117 cited work from Weyerer and Dilling in 1991,118 who had reported that insomniacs had about twice as many outpatient physician visits as good sleepers (12.9 vs. 5.2) in one year. Insomniacs were also more likely to have been hospitalized compared with good sleepers (21.9% vs. 12.2%). Insomnia also generates a loss of productivity. In 1991, Leigh119 surveyed 1308 workers in a cross-sectional study for workers employed for at least 20 hours weekly. The number of self-reported absences during the last 14 days were examined. The author analyzed 37 variables, and found that insomnia was the most predictive of absenteeism at work. Adults who were described as having seven or more nights of poor sleep per month missed 5.2 days of work per year more than persons who slept well in 1992. Stoller120 estimated the loss of productivity to be $41.1 billion in 1998. Hopefully, more investigations into the various deleterious effects of insomnia will further clarify its health and economic consequences.