A new goal is being proposed in the ongoing battle to focus on ways to diagnose and treat U.S. workers suffering from sleep apnea: near- and long-term cost savings from reduced health care expenditures coupled to vastly improved quality of life metrics for those afflicted with sleep apnea.
“The economics around sleep apnea are just huge,” Edward Grandi, executive director of the American Sleep Apnea Association (ASPA), told Fleet Owner during the group’s third annual conference in Baltimore designed to address the impact of this disease in the workplace.
“What we’re trying to do now is get companies to look at treating OSA [obstructive sleep apnea] as an investment rather than a cost, because research indicates it costs far more in health care expenditures and lost productivity for starters to leave OSA untreated,” Grandi explained.
Dr. Cary Shames, medical directors for the Americas at ResMed Corp., provided the keynote address at ASPA’s conference – entitled The Economic and Clinical Impact of Sleep Apnea – and described the costs associated with untreated OSA.
“Research indicates there are $67 billion to $165 billion in annual costs related to sleep apnea,” he said. “Some $5 billion to $10 billion of that result from lost productivity, another $10 billion to $40 billion from traffic accidents related to fatigue, with $45 billion to $80 billion resulting from ‘hidden’ health care costs such as extra hospitalization, etc. Only $2 billion to $10 billion revolve around the cost to diagnose and treat OSA: a very small amount by comparison.”
Shames also pointed out that it’s important to understand the “high prevalence” of sleep apnea in connection with other chronic health issues such as diabetes, hypertension and especially obesity.
“The data points tell us a very disturbing story, especially as obesity rates continue to climb in this country,” he stressed. “That’s why it’s all about cost at the end of the day when we’re talking about sleep apnea, because there are very few areas left in healthcare where you can help people attain a better quality of life and save money.”
Dr. Michael Coppola, ASPA’s president and chief medical officer, emphasized that while the ASPA’s initial conference in 2010 focused on the prevalence of OSA in the trucking industry and how this chronic affliction impacts highway safety, the group is trying to broaden its message not only to other transportation sectors but to the broaden U.S. workplace as well.
“This year in particular we’re focused specifically on the broader economic and employment impact of sleep apnea – not just how it affects the transportation alone,” he said.
Yet truckers and other transportation providers should really see themselves as the “forward thinkers” in the OSA field, added ASPA’s Grandi, especially in terms of cost savings.
“There’s this idea that we’ve been ‘picking on’ truckers about sleep apnea, but we really don’t see it that way,” he explained. “We’re concerned about their welfare but also want to draw their attention to the cost ramifications of sleep apnea – especially where accidents are concerned, as crashes are six- and seven-figure events in trucking.”
Dr. Indira Gurubhagavatula from the University of Pennsylvania, addressed the sleep apnea/truck crash connection in her presentation, noting that – according the research by the Federal Motor Carrier Safety Administration (FMCSA) – non-fatal crashes involving a tractor-trailer average $91,112 in costs, whereas a fatal crash averages $3.6 million in costs.
Gurubhagavatula pointed to a recent study conducted by Schneider National that highlights the prevalence of sleep apnea in trucking and why her research indicates 30% of all truck crashes are related to fatigue. She said Schneider screened 19,371 of its drivers and found that 31% suffered from severe sleep apnea, while 79.7% suffered from some degree of apnea.
However, Gurubhagavatula stressed that use of continuous positive airway pressure or “CPAP” devices to alleviate the physical causes of sleep apnea can significantly improve not only quality of life but reduce health care costs and – importantly – crash risk.
She said one study that compared diagnosed suffers of OSA treated with CPAP machines to OSA suffers that received no treatment found that those receiving CPAP therapy recorded a 40.6% decline in missed workdays, a 47.8% decline in disability claim rates, and saved $6,341 in total annual health care expenses.
Gurubhagavatula also referenced another study by Schneider back in 2006 that found of 225 drivers using CPAP machines to treat sleep apnea, they’d recorded a 73% reduction in preventable accidents and 2.29 times improvement in their retention rate.
Kevin Potts, chief operating office for the Union Pacific Health System – the health care provider for 20,000 active workers with the Union Pacific (UP) railroad, as well as 12,000 Medicare retirees – pointed to the $4.9 million savings generated by effort begun seven years ago to combat sleep apnea within UP’s ranks.
Potts revealed at the conference that a confidential screening of UP’s workers determined that 10.8% of them suffered from some form of sleep disordered breathing (SDB) issue. Shouldering the cost of conducting sleep studies and CPAP machines, Potts said spent over $579,730 in the first year of its “Complete Sleep Program.”
“If the board had reviewed our efforts after just one year, they most likely would have cancelled it,” he quipped.
However, in the program’s second year, UP’s health care arm saved $422,652 – in large part due to declining hospital admission rates, which would eventually drop by 28% over the four-year effort. In year three, the company saved $1.7 million, followed by $3.04 million in savings by year four of the effort.
“We all know that ‘win/win’ is a trite phrase now, but it really applies to efforts [such as UP’s] to deal with sleep apnea,” added ASPA’s Grandi. “We just hope such programs are not limited to the transportation sector; that we can get everyone to adopt such efforts in the business world.”