Few, however, recognize or understand the equally significant cost associated with another chronic condition, Obstructive Sleep Apnea (OSA). In recent years, the healthcare industry has dedicated more resources for studies and education to help curb financial losses to employers while improving the overall health of OSA patients.
Some studies suggest that the impact of undiagnosed sleep apnea on business might exceed $1 billion. This financial burden is a result of reduced productivity due to absenteeism and fatigue, insurance and wellness costs and workplace accidents.
Sleep apnea goes hand-in-hand with conditions already on employer’s radars. Studies have shown that OSA is an independent risk factor for high blood pressure and cardiovascular disease. It is strongly linked with insulin resistance, diabetes, obesity and mood disorders such as depression.
Over 20 million Americans are afflicted with sleep apnea. An estimated 80 and 85 percent of individuals with OSA are undiagnosed. According to the American Sleep Apnea Association, people with OSA tend to be heavy users of health care resources. Studies show that these people have higher utilization rates and incur greater healthcare costs than non-OSA patients for up to 10 years prior to diagnosis. Patients with OSA incurred medication and hospital costs two to three times the norm. Studies also determined that early diagnosis of OSA can dramatically reduce the impact on healthcare costs.
Untreated OSA can cost employers far more than money spent on healthcare claims. The chronic sleepiness, loss of energy and decreased cognitive function associated with OSA can limit a worker’s ability to perform. In some circles, this situation is now being referred to as “presenteeism” – an employee is at work, but at a reduced capacity to produce.
Specific industries, such as transportation, have begun to consider the ramifications of untreated OSA in their employee populations since sleepiness, fatigue and diminished reflexes increase the risk of accidents. Studies show that untreated OSA increases motor vehicle crashes up to seven times the norm. As such, a panel of physicians specializing in sleep apnea have presented new guidelines to the Federal Motor Carrier Safety Administration (FMCSA), stating drivers should be disqualified until the diagnosis of sleep apnea has been ruled out or a patient with OSA is been successfully treated.
According to a study by the University of Pennsylvania and sponsored by FMCSA and the American Trucking Association, 28 percent of truckers have mild to serve sleep apnea. This is an alarming number, considering that there are more than three million truckers on American Highways.
What is sleep apnea? While sleeping, muscles that control the upper airway relax. When these muscles relax too much, the airway will narrow slightly. The result can be snoring – a vibration caused by the soft, floppy parts of the throat as air passes during breathing.
However, if the muscles are too relaxed, the narrowing of the air passageway is more significant and may become blocked, causing a person to stop breathing for 10 seconds or more. During these episodes, a person with sleep apnea may wake gasping for air. This pattern can be repeated over 100 times throughout the night, causing cumulative oxygen deprivation, which puts enormous stress on an individual’s cardiovascular and metabolic systems. Additionally, the repeated arousals at night, necessary to kick-start the breathing cycle, prevent people from getting the restorative sleep necessary for optimal health and daily function. Chronic daytime sleepiness and fatigue are hallmarks of untreated sleep apnea. QCBN
At Arizona Cardiac Sleep Facility (ACSF), we have created educational programs for companies of any size. This includes simple, one-page questionnaires and in-home screening devices to help determine the potential for sleep apnea. Most insurance plans cover the cost for more extensive sleep studies conducted at our facility. We are also planning seminars for both the general public and another specifically for employers and HR Directors later this year. For more information about any of these programs, please call our office at 928-441-1117.
By Stephen Stuart, M.D.