Sleep apnea wake-up callNews added by Benefits Pro on July 21, 2014

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By Scott Wooldridge

Is sleep apnea the next poster child for the wellness revolution?

Traditionally, employee wellness programs concentrate on two areas: exercise and nutrition. But there is a movement to add a “third pillar” to the wellness equation—a new awareness of sleep, or more precisely, the lack of sleep, as a major health and productivity issue.

A significant percentage of sleep problems for workers is linked to obstructive sleep apnea, a breathing disorder that interferes with sleep by restricting oxygen flow to the brain. OSA happens when airwaves are blocked during sleep, causing people to snore and even stop breathing briefly. People with this condition can have their sleep disturbed as many as 80 times an hour, as the brain wakes up just enough to restart the breathing pattern.

According to the American Sleep Apnea Association, sleep apnea can put “enormous stress on an individual’s cardiovascular and metabolic systems,” which has been tied to chronic medical problems, including heart conditions, insulin-resistant diabetes, and high blood pressure .

The lack of sleep cause by OSA can leave workers groggy, less-productive, and even dangerously inattentive at work.

“A lack of sleep can create dangerous workplaces,” wrote Dr. Christopher Barnes, assistant professor of management at the University of Washington, in a 2013 article for the Huffington Post. “Regardless of training, equipment, or procedures, if employees work while short on sleep, their odds of making dangerous mistakes will increase.”

The condition can be treated successfully with a variety of therapies, and some industries, especially in the area of transportation, have begun screening employees and referring them for treatment of OSA.

Trucking industry focuses on OSA and safety

Those who study sleep issues and the effect of sleep deprivation on workers say the trucking industry, along with other transportation areas, is among the leaders in taking a close look at sleep apnea as a workplace issue.

The dangers created by sleep-deprived drivers are obvious. The ASAA says untreated OSA increases the risk of motor vehicle crashes by 2 to 7 times. The group also notes that the Federal Motor Carrier Safety Administration released a statement in 2008 saying, “Drivers should be disqualified until the diagnosis of sleep apnea has been ruled out or has been treated successfully.”

A 2013 study sponsored by the National Institutes of Health screened commercial drivers for OSA, and found that as many as 21 percent of drivers showed signs of the condition. The NIH study used an online screening tool to identify high-risk drivers, who were then referred for clinical testing.

According to Tracy Nasca, executive director of ASAA, employers and employees both can benefit from sleep apnea screening.

“Screening is a very simple process, and if sleep apnea is indicated as a possible problem, then an overnight sleep study or even home testing can be very easily performed,” she said. “And the treatment options are very reasonable and effective.”
Although the condition can be treated, Nasca and other experts note that there can be complications in industries such as commercial trucking, where some workers may not be insured, or may have plans with high deductibles. In some cases, the research shows workers simply feel they can’t afford treatment.

“There is no shame in having sleep apnea,” Nasca said. “The shame lies in knowing you have it, but not treating it or not being able to afford treatment through no fault of your own.”

Health and productivity

Beyond safety concerns, sleep-deprived employees can underperform, or have difficulties with co-workers, or just generally fail to be at the top of their game. Barnes even noted in the Harvard Business Review blog that his research has linked lack of sleep to ethical lapses, as well.

But a bigger concern to employers and HR departments could be the chronic health conditions that have come to be associated with OSA and other causes of sleep deprivation. Cary Shames, DO, medical director for the Americas at ResMed Corp., estimates that while it costs employers $2 billion to $10 billion annually to diagnose and treat OSA, the hidden medical costs could be closer to $45 billion to $85 billion.

ResMed, a San Diego-based medical device manufacturer that markets a range of sleep apnea therapies, is a sponsor of the Institute for Health and Productivity Management, a group that provides productivity and health resources to organizations throughout the world.

According to Liesl Cooper, vice president of market access for ResMed Americas, her company has supported a number of studies to help educate employers and the public on the health problems that sleep apnea can cause.

“The cost of health care is something all employers are concerned about, as are employees. We can help them with understanding how costs are impacted by improving sleep,” she said.

Technology and OSA

With the recent explosion in popularity of wearable devices such as Fitbits, organizations that are studying sleep problems says such devices can be an important tool in tracking sleep and finding signs of sleep disorders. Although the devices can’t give a medical diagnosis, they may raise red flags that cause employees to seek a clinical opinion on sleep apnea. And a further diagnosis can be done at home, if medical guidelines are followed.

“There are home sleep testing devices,” Cooper said. “Much of the testing now is being moved into the home, because it is safe and it is effective.”

Cooper added that more companies are likely to incorporate sleep issues as part of their wellness programs in the future, but that it has to be approached carefully.

“It’s something that’s being looked at now,” she said. “The trouble is you really have to have a full, front-to-back-end solution. You have to have a good partner; someone who knows how to put all the pieces together—screening, diagnosis, an appropriate treatment plan, and following up the plan to make sure the person with sleep apnea is compliant with the therapy and can tolerate the therapy.”

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