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

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