Sleep Disorders: Insomnia, Sleep Apnea, Restless Leg Syndrome, Bruxism, Narcolepsy and Sleepwalking

Sleep Disorders: Insomnia, Sleep Apnea, Restless Leg Syndrome, Bruxism, Narcolepsy and Sleepwalking published by Trimark Publications in March, 2009. This report consists of 292 pages and the price starts from US $ 3400.

Introduction

Abstract

Insomnia, sleep apnea, restless leg syndrome, bruxism, narcolepsy and sleepwalking are all serious sleep disorders that possess negative-and sometimes fatal-health consequences. Often undiagnosed and thus not treated, sleep disorders can not only take a toll on personal health but can also adverse effects on personal relationships and reduce worker productivity. In examining the troubling increase in a variety of sleep disorders, this TriMark Publications report will analyze the causes and available treatments for sleep disorder sufferers. This is a particularly interesting time in the evolution of the sleep disorders market because the blockbuster drugs that have dominated this space are coming off patent protection. There has been a strong push on the part of the major pharmaceutical companies to develop or acquire replacement sources of revenue. In order to put sleep disorders in a proper context, the study begins with an examination of key characteristics of the overall sleep disorders market. The types of disorders, causes of insomnias, parasomnias and their treatments are analyzed, with the additional review of treatments including pharmaceuticals, devices (continuous positive airway pressure or CPAP machines) and others (nutraceuticals, etc.). The report goes on to describe the primary product offerings of the major companies in this market space including major classes of prescription and over-the-counter (OTC) pharmaceuticals. Finally, a review of companies developing treatments for insomnia, sleep apnea, restless leg syndrome, bruxism, narcolepsy and sleepwalking are examined.

Methodology

The author of this report is an MD with three decades of experience as a medical products industry analyst. He has held many senior level positions in hospitals, healthcare and life sciences organizations and companies. The editor of the report has a PhD in biophysics and has worked as a research assistant professor at the University of Missouri. Company-specific information is obtained mainly from industry trade publications, academic journals, news and research articles, press releases and corporate websites, as well as annual reports for publicly-held firms. Additionally, sources of information include the non-governmental organizations (NGOs) such as the World Health Organization (WHO) and governmental entities like the U.S. Department of Health and Human Services (HHS) and U.S. federal agencies such as National Institutes of Health (NIH), Food and Drug Administration (FDA) and the Centers of Disease Control and Prevention (CDC). Where possible and practicable, the most recent data available have been used.

Some of the statistical information was taken from Biotechnology Associates' databases and from TriMark' s private data stores. The information in this study was obtained from sources that we believe to be reliable, but we do not guarantee the accuracy, adequacy or completeness of any information or omission or for the results obtained by the use of such information. Key information from the business literature was used as a basis to conduct dialogue with and obtain expert opinion from market professionals regarding commercial potential and market sizes. Senior managers from major company players were interviewed for part of the information in this report.

Primary Sources

TriMark collects information from hundreds of Database Tables and many comprehensive multi-client research projects, and Sector Snapshots that we publish annually. We extract relevant data and analytics from TriMark' s research as part of this data collection.

Secondary Sources

TriMark uses research publications, journals, magazines, newspapers, newsletters, industry reports, investment research reports, trade and industry association reports, government-affiliated trade releases and other published information as part of its secondary research materials. The information is then analyzed and translated by the Industry Research Group into a TriMark study. The Editorial Group reviews the complete package with product and market forecasts, critical industry trends, threats and opportunities, competitive strategies and market share determinations.

Table of Contents

1. Overview

• 1.1 Statement of Report
• 1.2 About This Report
• 1.3 Scope of the Report
• 1.4 Methodology
• 1.5 Executive Summary
• 1.6 U.S. Sleep Market
  • 1.6.1 Sleep Drugs Market in the U.S.
  • 1.6.2 U.S. Sleep Apnea Devices Market
  • 1.6.3 U.S. Market for Mattresses and Other Related Products
  • 1.6.4 Sleep Laboratories in the U.S.
    • 1.6.4.1 Locate Sleep Centers in the U.S.
• 1.7 Future of Sleep Drugs
  • 1.7.1 Sleep Drugs for Jet Lag and Shift Work
  • 1.7.2 Sleep Drugs for Age-related Sleep Issues
  • 1.7.3 Sleep Drugs for Those Who Cannot Sleep Through the Night
  • 1.7.4 Sleep Drugs for Restless Leg Syndrome
  • 1.7.5 Sleep Drugs for Insomnia
  • 1.7.6 Sleep Drugs for Sleep Apnea

2. Introduction to Sleep Disorders

• 2.1 Sleep Disorders Overview
  • 2.1.1 Sleep Facts from the U.S.
  • 2.1.2 Consequences of Sleep Disorder Problems
• 2.2 Physiology of Sleep
  • 2.2.1 Sleep Stages
  • 2.2.2 Neutral Control of Sleep
• 2.3 Current Understanding of Sleep Disorders
  • 2.3.1 Hypersomnia
    • 2.3.1.1 Causes of Hypersomnia
    • 2.3.1.2 Demographics of Hypersomnia
    • 2.3.1.3 Treatment for Hypersomnia
• 2.4 Obstructive Sleep Apnea (OSA)
  • 2.4.1 Causes of Sleep Apnea
  • 2.4.2 Symptoms of Sleep Apnea
  • 2.4.3 Demographics of Sleep Apnea
  • 2.4.4 Diagnosis of Sleep Apnea
  • 2.4.5 Treatments
    • 2.4.5.1 Positional Therapy
    • 2.4.5.2 Behavioral Therapy-Weight Loss
    • 2.4.5.3 Oral Appliances
    • 2.4.5.4 Surgery for Sleep Apnea
    • 2.4.5.5 Nasal Continuous Positive Airway Pressure (CPAP) Therapy
    • 2.4.5.6 Medications for Sleep Apnea
  • 2.4.6 The National Ambulatory Medical Care Survey on Sleep Apnea
    • 2.4.6.1 Age and Sleep Apnea in Men
• 2.5 Narcolepsy
  • 2.5.1 Demographics of Narcolepsy
  • 2.5.2 Causes of Narcolepsy
  • 2.5.3 Symptoms of Narcolepsy
  • 2.5.4 Diagnosis of Narcolepsy
  • 2.5.5 Treatment for Narcolepsy
• 2.6 Insomnia
  • 2.6.1 Causes of Insomnia
  • 2.6.2 Symptoms of Insomnia
  • 2.6.3 Demographics of Insomnia
  • 2.6.4 Diagnosis of Insomnia
  • 2.6.5 Insomnia and Obesity
  • 2.6.6 Treatments for Insomnia
    • 2.6.6.1 Behavioral Treatment for Insomnia
    • 2.6.6.2 Treating Insomnia with Medications
    • 2.6.6.3 Alternative Remedies for Insomnia
  • 2.6.7 Insomnia Market
  • 2.6.8 National Sleep Foundations' "Sleep In America Poll"
    • 2.6.8.1 Benzodiazepines
    • 2.6.8.2 The Short-term Gold Standard
    • 2.6.8.3 Emerging Players
    • 2.6.8.4 Insomnia Market Indicators
    • 2.6.8.5 Newer Sedative Drugs for Insomnia in 2008
• 2.7 Restless Legs Syndrome
  • 2.7.1 Demographics of RLS
  • 2.7.2 Causes of RLS
  • 2.7.3 Symptoms of RLS
  • 2.7.4 Diagnosis of RLS
  • 2.7.5 Treatments for RLS
    • 2.7.5.1 Lifestyle Changes and RLS
    • 2.7.5.2 Treating RLS with Pharmaceuticals
• 2.8 Circadian Rhythm Disorders
  • 2.8.1 Causes of Circadian Rhythm Disorders
  • 2.8.2 Symptoms
  • 2.8.3 Demographics of Circadian Rhythm Disorders
  • 2.8.4 Diagnosis of Circadian Rhythm Disorders
  • 2.8.5 Treatments for Circadian Rhythm Disorders
• 2.9 Parasomnias
  • 2.9.1 Nightmare Disorder
  • 2.9.2 Sleep Terror Disorder
  • 2.9.3 Sleep Walking Disorder
  • 2.9.4 Demographics of Parasomnias
  • 2.9.5 Causes and Symptoms of Parasomnias
  • 2.9.6 Diagnosis
  • 2.9.7 Treatment for Parasomnias

3. Drugs Used for Sleep Disorders

• 3.1 Estazolam
• 3.2 Flurazepam (Dalmane)
• 3.3 Temazepam
• 3.4 Triazolam
• 3.5 Zopiclone (Inovane)
• 3.6 Nonbenzodiazepine Hypnotics
  • 3.6.1 Eszopiclone (Lunesta)
  • 3.6.2 Zaleplon (Sonata)
  • 3.6.3 Zolpidem (Ambien, Ambien CR)
• 3.7 Pineal Gland Hormones
  • 3.7.1 Melatonin
  • 3.7.2 Ramelteon (Rozerem)
• 3.8 Antihistamines
  • 3.8.1 Benadryl (Diphenhydramine)
  • 3.8.2 Doxylamine
• 3.9 Antidepressants
  • 3.9.1 Amitriptyline (Elavil)
  • 3.9.2 Nortriptyline (Pamelor)
  • 3.9.3 Nefazodone (Serzone)
  • 3.9.4 Trazodone (Desyrel)
  • 3.9.5 Indiplon
  • 3.9.6 Gaboxadol
  • 3.9.7 Silenor
• 3.10 Other Substances
  • 3.10.1 Lavender
  • 3.10.2 Passion Flower
  • 3.10.3 Ashwagandha
  • 3.10.4 Catnip
  • 3.10.5 Kava (Piper methysticum)
  • 3.10.6 Valerian
• 3.11 Aromatherapy
• 3.12 Some OTC Sleep Gadgets in the Market
  • 3.12.1 Dreamate™
  • 3.12.2 Anti-snoring Pillow
  • 3.12.3 Nasal Dialators
  • 3.12.4 Nasal Strips
  • 3.12.5 Snore Stopper
  • 3.12.6 SleepMate
  • 3.12.7 Antisnor Therapeutic Ring
  • 3.12.8 Ayurvedic Treatment for Insomnia
  • 3.12.9 Yoga for Sleep Disorders
  • 3.12.10 Meditation for Sleep Disorders
  • 3.12.11 Hypnosis for Sleep Disorders
• 3.13 Homeopathic Treatment for Sleep Disorders
  • 3.13.1 Belladonna
  • 3.13.2 Nux vomica
  • 3.13.3 Chamomilla
  • 3.13.4 Gelsemium
  • 3.13.5 Cannabis Indica

4. A Guide to Better Sleep

• 4.1 The Normally Required Sleep
• 4.2 Sleep and Driving
• 4.3 Tips to Avoid Drowsy Driving
• 4.4 Tips to Find whether One has Sleep Disorders
• 4.5 A Good Night' s Sleep

5. Sleep Laboratories

6. Profiles of Companies and Their Product Offering

• 6.1 Device Companies (CPAP and Other)
  • 6.1.1 AEIOmed, Inc. and Product Offerings
  • 6.1.2 Chad Therapeutics, Inc. and Product Offerings
  • 6.1.3 Compumedics Ltd. and Product Offerings
  • 6.1.4 Puritan Bennett (Covidien) and Product Offerings
  • 6.1.5 ResMed Corporation and Product Offerings
  • 6.1.6 Respironics, Inc. (Philips)
  • 6.1.7 CleveMed and Product Offerings
  • 6.1.8 SomnoMed Ltd. and Product Offerings
• 6.2 Pharmaceutical (Prescription and OTC) Companies
  • 6.2.1 Acadia Pharmaceuticals, Inc.
    • 6.2.1.1 Pimavanserin for the Treatment of Parkinson' s Disease Psychosis
    • 6.2.1.2 Pimavanserin as a Co-therapy for Schizophrenia
    • 6.2.1.3 ACP-104 for the Treatment of Schizophrenia
    • 6.2.1.4 Pimavanserin for the Treatment of Sleep Maintenance Insomnia
    • 6.2.1.5 Neuropathic Pain
    • 6.2.1.6 Glaucoma
  • 6.2.2 Actelion Ltd.
    • 6.2.2.1 Actelion' s TracleerR
    • 6.2.2.2 Tracleer in Digital Ulcers
    • 6.2.2.3 Actelion' s VentavisR
    • 6.2.2.4 Actelion' s ZavescaR
    • 6.2.2.5 Actelion' s Focus on Sleep and Sleep Disorders
    • 6.2.2.6 The Orexin System
    • 6.2.2.7 Almorexant in Clinical Development
  • 6.2.3 Arena Pharmaceuticals, Inc.
    • 6.2.3.1 Arena' s R&D Programs
    • 6.2.3.2 Arena Pharmaceuticals' Development Pipeline
    • 6.2.3.3 Locaserin Hydrochloride for Obesity
    • 6.2.3.4 APD125 for Insopmnia
  • 6.2.4 Cephalon, Inc.
  • 6.2.5 Eli Lilly and Company
    • 6.2.5.1 Eli Lilly' s Product Acquisitions, 2007
  • 6.2.6 GlaxoSmithKline Plc
  • 6.2.7 King Pharmaceuticals, Inc. and Product Offerings
    • 6.2.7.1 King Pharmaceutical' s R&D
    • 6.2.7.2 King Pharmaceutical' s Manufacturing
    • 6.2.7.3 King Pharmaceutical' s Financial Highlights
  • 6.2.8 Neurogen Corporation
    • 6.2.8.1 Neurogen' s Insomnia Products
    • 6.2.8.2 Positive Results in Phase IIb Studies in Chronic Insomnia
    • 6.2.8.3 Positive Results in Phase IIb Studies with Adipiplon
    • 6.2.8.4 Study 202-Primary Endpoint Sleep Maintenance
    • 6.2.8.5 Study 203-Primary Endpoint Sleep Onset
    • 6.2.8.6 Transient Insomnia
    • 6.2.8.7 Study Results
    • 6.2.8.8 Study Design
  • 6.2.9 Neurocrine Biosciences, Inc.
    • 6.2.9.1 Neurocrine' s Pipeline-GnRH Antagonists
    • 6.2.9.2 Corticotropin Releasing Factor (CRF1) Receptor Antagonists
    • 6.2.9.3 Urocortin 2 for Congestive Heart Failure (CHF)
    • 6.2.9.4 Neurocrine' s Research Programs
    • 6.2.9.5 Indiplon
  • 6.2.10 Pfizer, Inc. and Product Offerings
    • 6.2.10.1 Lipitor
    • 6.2.10.2 Norvasc
    • 6.2.10.3 Celebrex
    • 6.2.10.4 Lyrica
    • 6.2.10.5 Viagra
    • 6.2.10.6 Xalatan/Xalacom
    • 6.2.10.7 Zyrtec/Zyrtec D
    • 6.2.10.8 Detrol/Detrol LA
    • 6.2.10.9 Camptosar
    • 6.2.10.10 Zyvox
    • 6.2.10.11 Chantix/Champix
    • 6.2.10.12 Geodon/Zeldox
    • 6.2.10.13 Genotropin
    • 6.2.10.14 Vfend
    • 6.2.10.15 Sutent
    • 6.2.10.16 Caudet
    • 6.2.10.17 Zoloft
    • 6.2.10.18 Zithromax/Zmax
    • 6.2.10.19 Aricept
    • 6.2.10.20 Replax
    • 6.2.10.21 Revatio
    • 6.2.10.22 Aromasin
    • 6.2.10.23 Eraxis/Ecalta
    • 6.2.10.24 Indiplon
    • 6.2.10.25 Halcion (Triazolam)
  • 6.2.11 Sanofi Aventis
    • 6.2.11.1 Sanofi' s Pharmaceutical Business in 2007
    • 6.2.11.2 Sanofi' s Human Vaccine Business in 2007
    • 6.2.11.3 Ambien CR
    • 6.2.11.4 Ambien
  • 6.2.12 Schering-Plough Corporation
  • 6.2.13 Sepracor, Inc.
  • 6.2.14 SleepMed, Inc.
    • 6.2.14.1 Home Sleep Disorders Sleep Laboratory Partnership Services
    • 6.2.14.2 SleepMed' s Self-test for Sleep Disorders
    • 6.2.14.3 Sleepiness Scale
  • 6.2.15 Somaxon Pharmaceuticals, Inc.
    • 6.2.15.1 Silenor (Doxepin HCl Tablets)-A Successful Clinical Development Program
  • 6.2.16 Takeda Pharmaceutical Company Ltd.
  • 6.2.17 Takeda Pharmaceuticals North America, Inc.
    • 6.2.17.1 Rozerem
  • 6.2.18 Vanda Pharmaceuticals, Inc.
  • 6.2.19 Wyeth
  • 6.2.20 Valeant Pharmaceuticals, Inc.

• Appendix 1.1: Sleep and Smoking
• Appendix 1.2: Sleep and Alcohol Use
• Appendix 1.3: Sleep and Physical Inactivity
• Appendix 1.4: Sleep and Obesity

• Appendix 3.1: Tests Performed in the Sleep Laboratories

• Appendix 4.1: U.S. Obesity Trends, 2007
• Appendix 4.2: Economic Consequences of Obesity
• Appendix 4.3: Childhood Overweight and Obesity
• Appendix 4.4: Prevalence of Overweight and Obesity in a U.S. Pediatric Surgical Population

• Appendix 5.1: Sleep Physiology
• Appendix 5.2: Two Types of Sleep
• Appendix 5.3: NREM and REM Sleep Cycles
• Appendix 5.4: Four Stages of NREM Sleep
• Appendix 5.5: Stage I Sleep
• Appendix 5.6: Stage II Sleep
• Appendix 5.7: Stages III and IV-Slow Wave Sleep
• Appendix 5.8: REKM Sleep
• Appendix 5.9: Sleep-Wake Regulation
• Appendix 5.10: Sleep-generating System in the Brain Stem
• Appendix 5.11: Wake-generating System in the Brain Stem
• Appendix 5.12: Circadian Rythms
• Appendix 5.13: Change of Sleep Patterns with Age
• Appendix 5.14: Sleep Architecture in Young Children
• Appendix 5.15: Sleep Architecture in Adolescents
• Appendix 5.16: Sleep Architecture in Adults
• Appendix 5.17: Gender Difference and Sleep Architecture
• Appendix 5.18: Sleep Architecture in Elderly People

• Appendix 6.1: Clinical Trials
• Appendix 6.2: Risks in Clinical Trials
• Appendix 6.3: Ideas for Clinical Trials
• Appendix 6.4: Sponsors of Clinical Trials
• Appendix 6.5: Placebo
• Appendix 6.6: Control Group
• Appendix 6.7: Different Phases of Clinical Trials

• Appendix 7.1: Biology of Human Sleep and Sleepiness
• Appendix 7.2: Crash Characteristics
• Appendix 7.3: Countermeasures
• Appendix 7.4: Panel Recommendations
• Appendix 7.5: Sleepiness Impairs Performance
• Appendix 7.6: Causes of Sleepiness/Drowsy Driving
• Appendix 7.7: Sleep Restriction or Loss
• Appendix 7.8: Job-related Sleep Restrictions
• Appendix 7.9: Personal Demands and Lifestyle Choices
• Appendix 7.10: Sleep Fragmentation
• Appendix 7.11: Characteristics of Drowsy-driving Crashes
• Appendix 7.12: The Problem Occurs during Late Night Hours
• Appendix 7.13: Crashes Occur on a High-speed Road
• Appendix 7.14: More Single Occupant Crashes
• Appendix 7.15: Consumption of Alcohol Increases Drowsiness
• Appendix 7.16: Population Groups at Highest Risk of Road Crashes

• Appendix 8.1: American Sleep Apnea Association
• Appendix 8.2: The American Sleep Association
• Appendix 8.3: National Sleep Foundation
• Appendix 8.4: National Center on Sleep Disorders Research (NCSDR)
• Appendix 8.4.1: Research
• Appendix 8.4.2: Training
• Appendix 8.4.3: Technology Transfer
• Appendix 8.4.4: Coordination
• Appendix 8.5: American Academy of Sleep Medicines
• Appendix 8.6: International Restless Leg Syndrome Study Group
• Appendix 8.7: The Movement Disorder Society

INDEX OF FIGURES

• Figure 1.1: Total Market for Leading Sleep Drugs, 2007
• Figure 1.2: Sleep Product' s Market Share, 2007
• Figure 1.3: Percent Market Share of Leading CPAP Devices, 2008
• Figure 1.4: U.S. Rx and OTC Sleeping Pills Market, 2003-2007
• Figure 1.5: U.S. CPAP Sleep Apnea Devices Market, 2003-2007
• Figure 1.6: U.S. Mattresses and Foundations Retail Market, 2003-2007
• Figure 1.7: U.S. Sleep Lab Revenues, 2003-2007
• Figure 1.8: Number of Accredited Sleep Labs in the U.S., 2003-2007
• Figure 1.9: U.S. Growth of Sleep Center Beds, 2007-2009
• Figure 1.10: Circadin' s Effect on the Improvement in Quality of Sleep
• Figure 2.1: Hours of Sleep in a Sample U.S. Population, 2008
• Figure 2.2: Treatment Effects on Patients with Hypersomnia
• Figure 2.3: Adults with Sleep Apnea Symptoms who Sought Medical Care in the U.S., 2006
• Figure 2.4: Sleep Apnea Percentage by Medical Specialty as Reported by NAMCS
• Figure 2.5: NAMCS Ages of Sleep Apnea Patients
• Figure 2.6: Age-specific Prevalence of Obstructive Sleep Apnea Diagnosed
• Figure 2.7: Prevalence of Sleep Aid Use by Age Group in the U.S., 1998-2006
• Figure 2.8: Percentage of Sleep Aid Users Younger than 45 Years Old in the U.S., 1998-2006
• Figure 2.9: Prevalence of Mental Health Diagnoses Made in First Sleep Aid Users by Provider Type
• Figure 2.10: Common Symptoms of Insomnia
• Figure 2.11: Insomnia Patient Population, 2007
• Figure 2.12: Obesity Prevalence by Age and Sex in the U.S., 2005-2006
• Figure 2.13: Prevalence of Obesity in U.S. Women by Age and Race/Ethnicity, 2005-2006
• Figure 2.14: The Globally Growing Market for Insomnia, 2001-2006
• Figure 2.15: Global Prescription for Insomnia Products, 2001-2006
• Figure 2.16: Global Sales of Insomnia Drugs, 2007
• Figure 2.17: Global Insomnia Market, 2005-2009
• Figure 2.18: Frequency of Insomnia Symptoms in the U.S. Adult Population
• Figure 2.19: U.S. Sleep Market-Under-Penetrated
• Figure 2.20: U.S. Sleep Market Growth, 2009
• Figure 2.21: Time to Sleep for RLS Sufferers
• Figure 2.22: Times RLS Sufferers Woken at Night
• Figure 2.23: RLS Sufferers Referred to Specialist by Country
• Figure 3.1: Dalmane' s Market, 2005-2007
• Figure 3.2: Global Market for Lunesta, 2005-2007
• Figure 3.3: Sonata' s (Zaleplon) Sales, 2005-2007
• Figure 3.4: Total Sales for Four Leading Brands of Sleeping Pills, 2007
• Figure 3.5: WASO
• Figure 5.1: Number of Accredited Sleep Labs in the U.S., 2003-2007
• Figure 5.2: Sleep Monitoring Revenue Distribution by Provider Type in the U.S., 2006
• Figure 5.3: U.S. Sleep Lab Revenues, 2003-2007
• Figure 6.1: Chad' s Business for the Six months ended September, 2006 and 2007
• Figure 6.2: Chad' s R&D Expenditure for the Six Months Ended September, 2006 and 2007
• Figure 6.3: Chad' s Business in Geographic Region/Country for Six Months Ended September, 2007
• Figure 6.4: Compumedics' Revenue, 2003-2008
• Figure 6.5: Compumedics' R&D Expenditure, 2007 and 2008
• Figure 6.6: Compumedics' Business Revenue from the U.S., 2003-2008
• Figure 6.7: Compumedics' Global Sleep Diagnostic Market, 2008
• Figure 6.8: Compumedics' Global Brain Research Market, 2008
• Figure 6.9: Compumedics' Global Neurodiagnostics Market, 2008
• Figure 6.10: Compumedics' Global Neuromedical Supplies Market, 2008
• Figure 6.11: Compumedics' Global Doppler Ultrsound Market, 2008
• Figure 6.12: Covidien' s Medical Device Business Sales, 2005-2007
• Figure 6.13: Covidien' s Pharmaceutical Products Business Sales, 2005-2007
• Figure 6.14: Covidien' s Imaging Solutions Business Sales, 2005-2007
• Figure 6.15: Covidien' s Medical Supplies Business Sales, 2005-2007
• Figure 6.16: Covidien' s Retail Products Business Sales, 2005-2007
• Figure 6.17: Covidien' s Net Sales by Geographic Area, 2005-2007
• Figure 6.18: Covidien' s R&D Expenditure, 2005-2007
• Figure 6.19: ResMed' s Percent Net Revenue from North and Latin America, 2006-2008
• Figure 6.20: ResMed' s Percent Net Revenue from Europe, 2006-2008
• Figure 6.21: ResMed' s Percent Net Revenue from Asia Pacific, 2006-2008
• Figure 6.22: Number of Employees in ResMed and its Subsidiaries, 2008
• Figure 6.23: ResMed' s Consolidated Statement of Income Data, 2004-2008
• Figure 6.24: ResMed' s R&D Expenditure, 2004-2008
• Figure 6.25: Respironics' Business, 2006 and 2007
• Figure 6.26: SomnoMed' s OSA Global Market Size Projection, 2007 and 2008
• Figure 6.27: Growth Projection for SomnoMed MAS, 2005-2010
• Figure 6.28: Acadia' s Revenue, 2003-2007
• Figure 6.29: Acadia' s R&D Expenses, 2003-2007
• Figure 6.30: Actelion' s Sales Revenue from Three of its Brands, 2007
• Figure 6.31: Actelion' s Revenue, 2007-2008
• Figure 6.32: Actelion' s Net Revenues and Net Income, 2006 and 2007
• Figure 6.33: Actelion' s Sales Revenue, 2006-2008
• Figure 6.34: Arena' s Research Expenditure, 2005-2007
• Figure 6.35: Arena' s Revenue, 2003-2007
• Figure 6.36: Arena' s Revenue from Partnered Programs, 2005-2007
• Figure 6.37: Provigil Sales Revenue, 2007
• Figure 6.38: Cephalon' s Percent Net Sales of Provigil, Fentora and Actiq, 2007
• Figure 6.39: Cephalon' s Consolidated Total Revenue, 2003-2007
• Figure 6.40: Cephalon' s R&D Expenditure, 2006-2007
• Figure 6.41: Cephalon' s Total Sales Revenue of Products by Segment, 2007
• Figure 6.42: Eli Lilly' s Products Launched this Decade Contributed $6.0 Billion, 2007
• Figure 6.43: Eli Lilly' s Six Products Exceeded $1.0 Billion in Net Sales, 2007
• Figure 6.44: Eli Lilly' s Growth Across Therapeutic Areas, 2007
• Figure 6.45: Eli Lilly' s Gross Margin, 2003-2007
• Figure 6.46: Eli Lilly' s Increased R&D Investment, 2003-2007
• Figure 6.47: GSK' s Top Five Consumer Healthcare Products by Turnover, 2007
• Figure 6.48: GSK' s Employee Numbers by Region, 2007
• Figure 6.49: GSK' s Respiratory Products' Turnover, 2007
• Figure 6.50: GSK' s Central Nervous System Products' Turnover, 2007
• Figure 6.51: GSK' s HIV Products' Turnover, 2007
• Figure 6.52: GSK' s Herpes Products' Turnover, 2007
• Figure 6.53: GSK' s Metabolic Products' Turnover, 2007
• Figure 6.54: GSK' s Vaccines' Turnover, 2007
• Figure 6.55: GSK' s Cardiovascular and Urogenital Products' Turnover, 2007
• Figure 6.56: GSK' s Oncology and Emesis Products' Turnover, 2007
• Figure 6.57: GSK' s Pharmaceutical Turnover from the U.S. and Europe, 2007
• Figure 6.58: GSK' s Pharmaceuticals Turnover in the International Market, 2007
• Figure 6.59: GSK' s Total Turnover of Pharmaceuticals and Consumer Healthcare, 2005-2007
• Figure 6.60: GSK' s R&D Expenditure, 2005-2007
• Figure 6.61: King' s Net Sales of Neuroscience Products, 2007
• Figure 6.62: King' s Net Sales of Hospital Products, 2007
• Figure 6.63: King' s Net Sales of Acute Care Products, 2007
• Figure 6.64: King' s Net Sales of Cardiovascular/Metabolic Products, 2007
• Figure 6.65: King' s Research Expenditure, 2005-2007
• Figure 6.66: Neurogen' s R&D Expenditure, 2005-2007
• Figure 6.67: Funding by Neurogen' s Collaborative Partners in R&D, 2005-2007
• Figure 6.68: Neurogen' s Business, 2003-2007
• Figure 6.69: Mean LPS in Minutes for Each Arm of the Study
• Figure 6.70: Neurocrine' s Total Revenue, 2002-2006
• Figure 6.71: Neurocrine' s R&D Expenditure, 2002-2006
• Figure 6.72: Pfizer' s Revenue, 2005-2007
• Figure 6.73: Pfizer' s R&D Expenditure, 2005-2007
• Figure 6.74: Pfizer' s Sales Revenues from its Pharmaceutical Medicines, 2007
• Figure 6.75: Pfizer' s Revenue from Pharmaceutical Medicines, 2007
• Figure 6.76: Pfizer' s Sales Revenue from its Pharmaceutical Products, 2007
• Figure 6.77: Pfizer' s Sales Revenue from its Pharmaceutical Products, 2007
• Figure 6.78: Pfizer' s Sales Revenue from its Pharmaceutical Products, 2007
• Figure 6.79: Global Market for Pharmaceutical Medicines by Disease Segment, 2012
• Figure 6.80: Pfizer' s Revenue by Business Segments, 2005-2007
• Figure 6.81: Pfizer' s Revenue by Segment, 2007
• Figure 6.82: Sanofi' s Business, 2004-2007
• Figure 6.83: Sanofi' s Business, 2007
• Figure 6.84: Sanofi' s Top Five Pharmaceutical' s Sales, 2007
• Figure 6.85: Sanofi' s Global Sales of Flavix, 2007
• Figure 6.86: Sanofi' s Human Vaccine Business, 2007
• Figure 6.87: Schering-Plough' s Consolidated Sales Revenue, 2005-2007
• Figure 6.88: Schering-Plough' s Human Prescription Pharmaceutical Sales, 2005-2007
• Figure 6.89: Schering-Plough' s Animal Health Product' s Revenue, 2005-2007
• Figure 6.90: Schering-Plough' s Consumer Healthcare Revenue, 2005-2007
• Figure 6.91: Schering-Plough' s R&D Expenditure, 2005-2007
• Figure 6.92: Schering-Plough' s Sales Revenue from Top Seven Human Prescription Pharmaceuticals, 2007
• Figure 6.93: Sepracor' s Total Revenues, 2003-2007
• Figure 6.94: Sepracor' s Revenue from Lunesta, 2005-2007
• Figure 6.95: Sepracor' s Revenue from Xoponex, 2005-2007
• Figure 6.96: Sepracor' s Employee Distribution, 2007
• Figure 6.97: Somaxon' s R&D Expenditure, 2004-2007
• Figure 6.98: Takeda' s Business, 2006-2008
• Figure 6.99: Takeda' s Net Sales by Region, 2006-2008
• Figure 6.100: Takeda' s R&D Expenditure, 2006-2008
• Figure 6.101: Takeda' s Performance in Europe, 2003-2007
• Figure 6.102: Net Sales of Actos, 2003-2007
• Figure 6.103: Total Global Pharmaceutical Market by Region, 2007
• Figure 6.104: Takeda' s Net Sales of International Strategic Products, 2007
• Figure 6.105: Takeda' s Net Sales by Region, 2007
• Figure 6.106: Wyeth' s Sales Revenue, 2006 and 2007
• Figure 6.107: Wyeth' s Pharmaceutical Sales Revenue, 2007
• Figure 6.108: Wyeth' s Business, 2004-2007
• Figure 6.109: Wyeth' s R&D Expenditure, 2004-2007
• Figure 6.110: Wyeth' s Revenue by Segment, 2004-2007
• Figure 6.111: Valeant Pharmaceuticals' Total Revenues, 2003-2007
• Figure 6.112: Valeant Pharmaceutical' s R&D Expenditure, 2003-2007
• Figure 6.113: Valeant Pharmaceuticals' Total Turnover in Neurology Products, 2005-2007
• Figure 6.114: Valeant Pharmaceuticals' Total Turnover for its Dermatology Products, 2005-2007
• Figure 6.115: Valeant Pharmaceuticals' Total Turnover for Infectious Diseases' Products, 2005-2007
• Figure A1.1: Age-adjusted Percentage of Hours of Sleep in a Day Among Adults in the U.S., 2006
• Figure A1.2: Age-adjusted Percentage of Adults who Currently Smoked Cigarettes and Age-adjusted Percentage who had Five or More Drinks in a Day in the U.S., 2004-2005
• Figure A1.3: Age-adjusted Percentage of Adults who were Physically Inactive and Age-adjusted Percentage who were Obese by Usual Hours of Sleep in a Day in the U.S., 2004-2006
• Figure A2.1: Mean Change from Baseline to Final Visit in Functional Outcomes of FOSQ Domain Scores by Treatment Group
• Figure A4.1: Prevalence of Obesity Among Adult Men and Women, 2005 and 2006
• Figure A4.2: Obesity Prevalence by Age and Sex in the U.S., 2006
• Figure A4.3: Trends in Obesity by Sex 20 Years and Older in the U.S., 2000-2006
• Figure A4.4: Prevalence of Obesity among Males by Age, Race/Ethnicity in the U.S., 2005-2006
• Figure A4.5: Prevalence of Obesity in Women by Age, Race/Ethnicity in the U.S., 2005-2006
• Figure A4.6: Childhood Obesity in LA County, 2001-2010
• Figure A4.7: American Society of Anesthesiologists (ASA) Classification by Weight Group
• Figure A4.8: Age Group and Gender-specific Prevalence (%) of Overweight and Obesity
• Figure A5.1: Progression of Sleep States across a Single Night in Young Adult
• Figure A5.2: Characteristic EEG Activity of Each of the Four Stages of NREM Sleep
• Figure A7.1: Time of Occurrence of Crashes for 25 Years of Age or Younger
• Figure A7.2: Time of Occurrence of Crashes for Drivers between 25 and 46 Years of Age
• Figure A7.3: Time of Occurrence of Crashes for Drivers between 45 and 66 Years of Age
• Figure A7.4: Time of Occurrence of Crashes for Drivers older than 65 Years
• Figure A7.5: Interaction between Alcohol and Sleepiness
• Figure A7.6: Percent Crashes by the Young Men

INDEX OF TABLES

• Table 1.1: Sleep Center Locations in New York
• Table 2.1: Drugs of Short and Long-acting Hypnotics
• Table 2.2: Characteristics of Patients with Sleep Apnea in the NAMCS Database
• Table 2.3: Prevalence of Sleep Apnea
• Table 2.4: The Hallmark Symptoms of Insomnia
• Table 2.5: The Four New Currently Available Sleeping Pills, 2008
• Table 2.6: Cost of Newer Insomnia Drugs and Selected Older Ones, 2008
• Table 6.1: ResMed' s Product Portfolio, 2008
• Table 6.2: Acadia' s Programs, 2007
• Table 6.3: Actelion' s Products in the Market, 2007
• Table 6.4: Actelion' s Clinical Development Pipeline, 2007
• Table 6.5: Actelion' s Consolidated Financial Position, 2006 and 2007
• Table 6.6: Actelion' s Geographic Information, 2006 and 2007
• Table 6.7: Arena' s Independent and Partnered Research Programs, 2007
• Table 6.8: Cephalon' s Product Profile, 2007
• Table 6.9: Eli Lilly' s Net Sales Activity, 2007
• Table 6.10: Trade Marks of Eli Lilly' s Products, 2007
• Table 6.11: King' s Product Portfolio, 2007
• Table 6.12: King' s Summary of Net Revenues by Operating Segment, 2005-2007
• Table 6.13: King' s Branded Prescription Products
• Table 6.14: Neurogen' s Clinical Development Programs, 2007
• Table 6.15: Mean LPS in Minutes
• Table 6.16: Neurocrine' s Product Pipeline
• Table 6.17: Pfizer' s R&D Pipeline, 2008
• Table 6.18: Pfizer' s Revenue by Product, 2006 and 2007
• Table 6.19: Pfizer' s Revenue from Major Pharmaceutical Products, 2005-2007
• Table 6.20: Recent FDA Approved Products from Pfizer, 2007
• Table 6.21: Pfizer' s Pending New Drug Applications (NDAs) and Supplemental Filings in U.S., 2007
• Table 6.22: Regulatory Approvals and Filings in the E.U. and Japan
• Table 6.23: Pfizer' s Revenue by Geographic Region, 2005-2007
• Table 6.24: Pfizer' s Revenue by Therapeutic Area, 2005-2007
• Table 6.25: Sanofi' s Pharmaceutical and Human Vaccine Business, 2007
• Table 6.26: Sanofi' s R&D, 2007
• Table 6.27: Sanofi' s Vaccine Pipeline, 2007
• Table 6.28: Net Sales of Schering-Plough' s Products, 2005-2007
• Table 6.29: Sepracor' s Products and Pipeline, 2007
• Table 6.30: Sepracor' s Launch and Target Launch Dates, 1999-2014
• Table 6.31: Sepracor' s Selected Financial Data, 2003-2007
• Table 6.32: SleepMed' s Self-test Questionnaire
• Table 6.33: SleepMed' s Sleep Assessment Form
• Table 6.34: Sleepiness Scale
• Table 6.35: Silenor Clinical Program
• Table 6.36: Takeda' s Global Locations, 2008
• Table 6.37: Takeda' s Net Sales by Region, 2006-2008
• Table 6.38: Takeda' s R&D Pipeline, 2008
• Table 6.39: Takeda' s R&D Pipeline, 2007
• Table 6.40: Takeda' s In-Licensing and Alliance Activities, 2007
• Table 6.41: Number of Employees in Takeda, 2006-2008
• Table 6.42: Vanda' s Candidates in Clinical Development
• Table 6.43: Wyeth' s Pipeline of Products, 2007
• Table A1.1: Age-adjusted Percentages of Adults Engaged in Selected Health Risk Behaviors by Hours of Sleep in the U.S., 2004-2006
• Table A1.2: Age-adjusted Percentages of Adults Engaged in Selected Health Risk Behavior by Sex and Hours of Sleep in the U.S., 2004-2006
• Table A1.3: Age-adjusted Percentages of Adults Engaged in Selected Health Risk Behaviors by Age and Hours of Sleep in the U.S., 2004-2006
• Table A2.1: Most Common Adverse Events Occurring in At least Five Percent of Patients
• Table A4.1: Sample BMIs for Weight and Height Ranges
• Table A4.2: U.S. Obesity Rates, 2007
• Table A4.3: Demographic Statistics of a Pediatric Surgical Population in the U.S.
• Table A5.1: Physiological Changes during NREM and REM Sleep
• Table A5.2: Percent Sleep for Young Children
• Table A5.3: Percent Sleep for Young Adults
• Table A5.4: Percent Sleep for Elderly Adult
• Table A6.1: Current Sleep-related Clinical Trials
• Table A6.2: Just Completed and On-going Clinical Trials for Circadian Rhythm Sleep Disorders

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