Lack of Sleep Costs Companies Cash

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Sleep apnea, a neurological sleeping disorder, combined with other sleep disorers is costing the business world up to $150 billion a year in productivity losses, according to a study released by the National Commission on Sleep Disorders Research in Washington, D.C.

It’s as common as diabetes with more than 12 million people suffering from it nationwide, yet sleep apnea remains unfamiliar to most people, including many it afflicts. The disorder results in heavy losses in profit and productivity and can increase company health care costs greatly, according to the study.

Sleep apnea occurs when the soft tissue in the rear of the throat collapses, blocking the airway. This forces those with the disorder to stop breathing repeatedly during sleep, as many as 100 times an hour. They wake up for a second or two in order to gain muscle tone in the airway before falling asleep again. Many times they are unaware that they have woken up but will complain of excessive fatigue and sleepiness the next day.

Although there are several ways to treat the disorder, David Brown, a neurologist at Neurological Associates in Fayetteville, said the most prevalent and best treatment is “nasal continuous positive airway pressure.” Approved by the FDA, the CPAP requires patients to wear a mask that fits over the nose or nose and mouth and is hooked via a tube to a machine that blows air through the nose during sleep.

An air stent is placed in the airway so that when the patient sleeps, the airway won’t collapse.

Most insurance providers require patients to visit a sleep lab to receive a diagnosis of sleep apnea and get prescribed pressure settings. The treatment costs about $3,000, with hospitals spending as much as $80,000 to run the testing equipment.

“Many people won’t recognize that they’re that sleepy, because it’s something that has come on over the years. They will frequently say things like ‘I’m tired of being tired,'” Brown said.

Although typical patients tend be overweight males older than 40, the disorder affects physically active men and women across the age spectrum. Factors increasing the risk of sleep apnea include smoking, alcohol use, obesity and abnormalities of the structure of the upper airway. Individuals with a family history of sleep apnea are two-four times more likely to suffer from it.

Profit loss

The disorder results in lessened productivity, decreased profits and increased costs for employers who must deal with job-related accidents caused by loss of sleep.

A report submitted to Congress by the National Commission on Sleep Disorders Research found that 89 percent of untreated sleep apneics suffered from impaired concentration, memory and problem solving ability. It estimated a $189.5 billion annual loss in the United States from workplace sleepiness, with $10.3 billion lost due to workplace accidents, $29.2 billion lost because of motor vehicle accidents and $150 billion lost in productivity.

The largest sector affected by sleep disorders is the trucking industry. Instances of sleep apnea, which can increase accident rates, are considerably higher among truck drivers. The study attributes that to the fact that drivers are typically male and often overweight because their job promotes a sedentary lifestyle.

One study found almost 80 percent of longhaul truckers showed repeated drops in oxygen levels during sleep, which is consistent with sleep apnea. According to the Columbus Community Health Regional Sleep Disorders Center in Ohio, sleep apnea has been associated with an “up to nine-fold increased incidence of motor vehicle accidents.”

Sleep apnea affects every industry, decreasing workers’ awareness and response time as well as motivation. Individuals who have a monotonous type of job, such as watching a video monitor, are especially susceptible to making costly errors, Brown said.

“If someone is sleepy, blanking out or spending so much energy trying to stay awake, they can’t concentrate on what they’re doing,” he said.

In fact, sleepiness among workers was cited as a primary factor that contributed to the nuclear disasters at Chernobyl and Three Mile Island, according to an article released by the Columbus Community Health Regional Sleep Disorders Center.

Fortunately, sleep apnea can be successfully treated, and it’s covered by most insurance providers.

Changing times

When sleep apnea became recognized as a disorder in the early 1980s, many insurance companies refused to cover medical costs. Now there are only a handful of companies that don’t cover sleep apnea and even fewer that limit how much they will cover, Brown said.

Brown attributes this to the fact that it is cheaper for a company to buy insurance that covers sleep apnea than lose money due to decreased productivity by apneic employees. And medical costs aren’t the only consideration, he said. Industrial and car accidents can cause losses in machine productivity as well.

According to its Web site, Arkansas Blue and Cross Blue Shield’s policy covers CPAP treatments and “independently adjusted inspiratory and expiatory positive airway pressure instrumentation” when there is evidence that CPAP therapy has failed.

Brown said getting the CPAP treatment for sleep apnea has a tremendous impact on those afflicted and is one that has immediate results.

“People feel dramatically better. It changes the quality of life in an individual tremendously,” Brown said.

Christin Engelhardt, executive director of the American Sleep Apnea Association in Washington, D.C., said she thinks awareness and education concerning sleep apnea has changed significantly during the past 10 years.

Since 1990, when the ASAA was founded, Engelhardt said the organization has made great strides in fulfilling its mission of seeing that all people with sleep apnea are diagnosed and treated properly. She credits the National Center on Sleep Disorders with advancing that cause.