It Pays to Treat Sleep Apnea
- By Jerry Laws
- Sep 01, 2008
Treating commercial truck drivers
who have sleep apnea significantly
lowers their health care costs, lowers
their preventable accident rate, and
reduces their turnover.While the Federal
Motor Carrier Safety Administration
revised the hours of
service rule in this decade to
reduce fatigue-related commercial
motor vehicle crashes,
the evidence in two recent
studies is an even more compelling
reason for trucking
companies to address sleep
apnea. But it is more than that.
Every safety manager now has a reason.
One of the studies was presented June
11 at the SLEEP 2008 conference in Baltimore.
Sleep researcher Dr. Najib Ayas, assistant
professor of medicine at the University
of British Columbia in Vancouver,
and colleagues reported they did not find
obstructive sleep apnea (OSA) was a significant
factor in the occupational injuries
suffered by 706 patients who were referred
to the university hospital’s sleep lab from
May 2003 to April 2006. But when they
considered only falls and motor vehicle
crashes, they found rates of those incidents
were 5.1 times higher in OSA patients
than in non-OSA patients, and the
effect of OSA persisted even after controlling
for age, gender, alcohol use, and bluecollar
occupation. (Remember, falls and
vehicle crashes are leading causes of U.S.
workplace fatalities.)
“A lot of patients without sleep apnea
may be sleepy for other reasons. Our study
is probably an understatement,”Ayas told
me. Indeed, workers may not self-report
OSA because they fear being fired. Another
sleep researcher, Dr. Allan Pack, professor
of medicine and director of the Center
for Sleep and Respiratory Neurobiology at
the University of Pennsylvania School of
Medicine, said commercial drivers stopped
self-reporting their snoring during required
biennial physicals
when they realized the admission
could lead to a sleep
apnea diagnosis.
“In commercial drivers’
major crashes, the driver
falling asleep is probably involved
in more than half of
them,” said Pack, who served
on an FMCSA expert panel
that recommended an OSA screening policy
to the agency early this year. Give truckers
with a body mass index of 33 or above
one month to be diagnosed and start CPAP
treatment if necessary, the panel said, then
check their adherence to therapy at three
months. Pack said FMCSA’s medical advisory
board dropped the recommendation
to a BMI of 30 or higher, but the policy
hasn’t been issued. (About 40 percent of the
nation’s more than 6 million truck and bus
drivers are at 30 or higher, he said.)
The second study proved truckers will
use CPAP machines, need much less health
care after treatment begins, and stay with
that employer longer.A company that employs
1,000 drivers can expect to save more
than $500,000 in health costs annually, according
to this study, which involved
Schneider National Inc. drivers who received
CPAP treatment.
This article originally appeared in the September 2008 issue of Occupational Health & Safety.
About the Author
Jerry Laws is Editor of Occupational Health & Safety magazine, which is owned by 1105 Media Inc.