Cost Savings Viewed as Critical Benefit of Combating Sleep Apnea
The diagnosis and treatment of sleep apnea in U.S. workers suffering from the sleep condition is an ongoing battle. The cost of health care for those afflicted with sleep apnea is one of the main reasons why it is so difficult for those suffering to want to get tested and seek treatment. However, when looking at the healthcare costs resulting from untreated sleep apnea versus healthcare costs resulting from treated sleep apnea, the difference is apparent. The American Sleep Apnea Association (ASPA) is working with various fleet owners to seek treatment for OSA (obstructive sleep apnea) as an investment rather than a cost.
From the fleet owners’ standpoint, research shows that up to $165 billion in annual costs for the fleet company are related to sleep apnea with $5 billion to $10 billion as a result from lost productivity and $10 billion to $40 billion spent on traffic accidents related to fatigue. Additionally, as much as $45 billion to $80 billion are spent on “hidden” health care costs resulting from undiagnosed sleep apnea, such as hospitalization. On the other hand, only $2 billion to $10 billion in costs are spent on the diagnoses and treatment for OSA. When comparing this amount compared to the overarching $165 billion in potential costs of untreated sleep apnea, the numbers speak for themselves.
The treatment of sleep apnea not only benefits the fleet owner financially, it also provides healthy and happy drivers. Undiagnosed sleep apnea is connected with a variety of other chronic disorders such as hypertension, obesity, and diabetes. Treatment allows for the drivers to maintain a better quality of life and for the fleet owners to save costs on a variety of different healthcare conditions connected with sleep apnea.
Since 2010, awareness about OSA has been on the rise throughout the trucking industry, however now, medical officers are insisting to broaden the message and awareness of the impact of sleep apnea to other transportation sectors and the U.S. working community as a whole. The trucking industries exposer to OSA and its treatment, although viewed by truck drivers in a negative light, is in reality putting the trucking industry ahead of the curve regarding preventative health and cutting healthcare costs.
In a study done by Schneider National, it was reported that out of the 19,371 drivers tested, 79.7% suffered from some degree of sleep apnea, 31% of the total suffering from severe sleep apnea. The gold standard for treatment for OSA is a continuous positive airway pressure (CPAP) device. Utilizing this treatment would result in significantly lower apnea symptoms, reduction in health care costs, and most importantly, a decrease in the risk of crashes caused by fatigue.
Another study compared those diagnosed with OSA and were being treated versus those diagnosed with OSA not receiving treatment. The results indicated that there was a 40.6% decline in missed workdays in the group that was undergoing treatment, as well as a 47.8% decline in disability claim rates, with a total of $6,341 in savings in annual health care expenses. A similar study found a 73% reduction in preventable accidents for treated OSA drivers.
In either scenario, funds will have to be set aside to finance the ongoing battle of healthcare costs, but in regards to OSA and its treatment, the research all points to diagnosing and treating sleep apnea as the cheaper and all around more advantageous path to take. AllTrans Medical understands the lengths it takes for fleet owners to diagnose and treat OSA for its drivers and plan to work with the fleet, providing a program that takes care of screening for sleep apnea to treatment. With our cost effective and comprehensive program, fleet owners can feel confident that their drivers are being taken care of.
Sleep Apnea: What Every Trucking Company Needs to Know
Sleep apnea has shown to be a prevalent and recurring diagnosis in the fleet trucking industry. By definition, sleep apnea is a temporary cessation of breathing while you are asleep. It can occur over 100 times each hour in some severe cases. It is a disorder that is treatable, however it also worsens with age and weight gain. If sleep apnea remains untreated, it can lead to serious health conditions such as high blood pressure, anxiety, stroke, heart disease, diabetes, depression, respiratory disorders, and heartburn. Untreated sleep apnea also makes the driver at 2 to 7 times more likely to get into a motor vehicle accident. In addition, drivers who remain untreated for sleep apnea tend to revert to less effective habits to stay awake and alert, including smoking cigarettes and drinking caffeine; these habits just perpetuate the unhealthy and detrimental lifestyles of these drivers. On the other hand, sleep apnea that is treated results in reduced healthcare costs for both the driver and the employer. Treated sleep apnea allows the drivers to increase their productivity immensely and go through their work day with an alert and active mind. As a fleet owner, becoming proactive and investing in a program to advise all of your drivers to get tested and/or treated for sleep apnea can be a very constructive decision, yielding higher retention of your drivers, loads being delivered on time since treated drivers will no longer have to pull over to nap during the workday, and self-assurance that your drivers are not adding danger to the roads.
Increasing Standards for Sleepy Truck Drivers
In the recent months, the Federal Motor Carrier Safety Administration (FMCSA) has proposed stricter standards for commercial driver sleep apnea. These proposals recommend medical examiners to thoroughly evaluate and rule out sleep apnea as a condition for these drivers. The recommendations have been presented from the medical community, an advisory panel from the trucking industry, and various advocacy interests including labor and safety.
Specifically, it was recommended that any driver with the body mass index of 35 or greater should be evaluated for sleep apnea by the medical examiner. The regulation of 35 was determined to be a decisive indicator of sleep apnea. Those who have a higher body mass index, have a stronger likelihood of being diagnosed with sleep apnea. Although it is a request at the moment, the FMCSA and panels believe that in the near future, this screening process will be mandated for all drivers.
Once tested and compliant in undergoing treatment, the driver will be qualified to drive again. By taking these drivers off the road temporarily, the risk of a driver falling asleep or having decreased job performance due to fatigue will be lessened, thus making the roads safer for all drivers. Driving while fatigued due to sleep apnea can result in a driver having a slower reaction time and having larger lapses of attention. Charles Czeisler, a professor of sleep medicine at Harvard Medical School, stated that “The crash risk for a person with sleep apnea is 242% greater than a person without the disorder.”
Private Trucking Fleet Safety
Starting a sleep program in a private fleet may put your company far ahead of other companies in the transportation industry with regards to the to the FMSCA guidelines about sleep apnea. Implementing an OSA program can help fleet companies and the public combat the number of accidents that were caused by fatigue associated with a sleep apnea. A key driving factor of an OSA program is the reduced healthcare costs and may help in driver recruitment and retention. Up to 28% of commercial drivers have some level of sleep apnea. The largest contributing factor of sleep apnea is having a body mass index (BMI) of 35 or greater. DOT examiners are looking for the following risk indicators as well: High Blood Pressure, Neck Size – 17 inches (male), Neck Size – 16 inches (female), and Tobacco and Alcohol Use
The Federal Motor Carrier Safety Administration (FMCSA) continues to review the following guideline – The medical examiner may, but is not required to, accept the recommendations. Section 390.3(d) of the FMCSRs allows employers to have more stringent medical requirements.
Respiratory Dysfunction 391.41(b)(5)
A person is physically qualified to drive a commercial motor vehicle if that person:
Has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with the ability to control and drive a commercial motor vehicle safely.
Since a driver must be alert at all times, any change in his or her mental state is in direct conflict with highway safety. Even the slightest impairment in respiratory function under emergency conditions (when greater oxygen supply is necessary for performance) may be detrimental to safe driving.
There are many conditions that interfere with oxygen exchange and may result in incapacitation, including emphysema, chronic asthma, carcinoma, tuberculosis, chronic bronchitis and sleep apnea. If the medical examiner detects a respiratory dysfunction, that in any way is likely to interfere with the driver’s ability to safely control and drive a commercial motor vehicle, the driver must be referred to a specialist for further evaluation and therapy.
Lawyers are using this type of information against truck drivers who have an untreated sleep disorder and are involved accidents that have resulted in a fatality. It’s documented that there have been lawsuits that resulted with multi-million dollar settlements against the trucking companies that employed the truck driver with the untreated sleep disorder. Implementing an OSA program can reduce your exposure to litigation and improve your existing fleet safety program. AllTrans Fleet Services offers state-of-the-art remote testing and treatment technology to the transportation industry with the convenience of full program implementation and support, DOT compliance reporting with little if any down time.
Occupational Sleep Education
The National Institutes of Health have stated that there are 50 to 70 million Americans that are affected by sleep disorders that are chronic, or intermittent which can result in compromised safety in the workplace. 18 million of the above mentioned Americans have sleep apnea. If you are a part of this statistic, it is extremely important to be educated on occupational sleep and the importance of these sleep related conditions.
Sleep apnea can occur in all age groups and both genders, however there are certain factors that increase your risk in being diagnosed, including large neck size, small upper airway or large tongue, overweight or obesity, small jaw, recessed chin, smoking and alcohol, age, and ethnicity. OSA has also shown signs to run in some families, providing speculation to the to idea of the disorder to have some genetic indications as well. Lifestyle is also an indicator of sleep apnea. People who work the second or third shift in the day may also be at an increased risk of developing sleep apnea. These workers should insist on becoming educated about occupational sleep and should consider getting screened or tested for sleep apnea. AllTrans Medical is a great source for any sleep apnea disorder information and solutions. By providing screening, testing, diagnosing, treatment, and monitoring, AllTrans is a full-service solution to your potential sleep apnea problems.
Lack of Sleep Has Negative Effects on Your Work
A shocking 40% of Americans do not get a sufficient amount of sleep at night. Knowing that a percentage of this 40% probably drive a motor operated vehicle daily, and some of them even work for Trucking Fleets as a profession, this alarming statistic would definitely cause alarm. Within the transportation industry alone, undiagnosed sleep apnea is a major cause of lack of sleep. Drivers are reported to feel fatigued and tired during the middle of the work day to the point where their job performance is affected. The Federal Motor Carrier Safety Administration has worked to decrease these reports by not only acknowledging the importance of sleep apnea screening, but also recommending more thorough screening for truck driver sleep apnea based on a selected criteria.
Obstructive sleep apnea is a sleep-breathing disorder. An apnea event occurs throughout the night when the individual’s airway to the lungs becomes obstructed due to relaxation of muscles, resulting in snoring, or the individual to stop breathing temporarily. This event causes the individual to awake from their deep sleep to be able to breath again. If many of these events occur during the night, the individual will not feel well rested and refreshed.
Trucking companies are all looking for the overall safety of their drivers and the civilians on the road, and thus are looking to be extra careful when hiring new drivers by being sure to rule out sleep apnea and ensuring a sufficient amount of rest time before the driver is on the road.
Liability in the Trucking Industry has a Major Contributor – Sleep Disorders
The trucking industry has a major contributor when it comes to health care and liability costs, its sleep disorders. There are well documented and easy to spot losses that are incurred daily but not recognized. Sleep disorders that go untreated are linked to heart disease, obesity, high blood pressure, diabetes and many other medical conditions. We are trying to be proactive before the disease catches the patient.
AllTrans Fleet Services Program provides a Turnkey Obstructive Sleep Apnea (OSA) Program that offers state-of-the-art remote testing and treatment technology to the transportation industry with the convenience of full program implementation and support, superior compliance reporting with little if any down time. The program is easy to follow and affordable for commercial truck drivers and keeps them on the road. Many Fleet managers are meeting the sleep apnea problem head on and reaping the rewards of lowering health-care costs and reducing the amount of accidents for their drivers. Treating sleep apnea will continue to lower costs in the long run by lowering liability premiums.
Keep Your Health Care Costs Down
For employers in every industry, health care costs are continuing to grow with no signs of stopping in the recent future. It is nearly impossible to find a decent coverage policy at a low cost to the company. One particular instance causing health care costs to increase is accidents. Accidents, although affect every industry to an extent, is extremely evident particularly in the trucking industry.
If a driver is fatigued due to undiagnosed or untreated sleep apnea, the risk for them to get into an accident is increased. A fatigued driver has a decreased ability to remain alert and concentrate, affecting their safety while on the road as well as safety of other drivers. Sleep apnea almost guarantees a driver to have an inadequate amount of sleep causing them to be fatigued during the work day.
Not only do they increase accident risk, untreated sleep apnea in truck drivers increases risk of other health issues. This included heart attack, strokes, high blood pressure, diabetes, immune problems, and more that are at a higher risk of occurring with the presence of untreated sleep apnea. Adding these conditions to the list would increase the company’s cost in health care immensely. Diagnosing and treating sleep apnea will, in the long run, decrease a company’s potential increase in health care due to the additional costs. Costs for health care associated with sleep apnea can be reduced by up to 50% for each driver who is diagnosed and treated with sleep apnea.
AllTrans Fleet works to screen, test, prescribe, and treat all drivers in your fleet. By monitoring the treatment of each diagnosed driver, we ensure that the treatment is successfully allowing your drivers to improve their lifestyles, while simultaneously preventing your health care costs from increasing.
Home Sleep Testing for Sleep Apnea
There is a strong surge for home sleep testing and there is and will continue to be some confusion regarding the results for home sleep testing. This document will highlight the use of home sleep testing.
As always each individual should be pre-screened for any signs of sleep apnea before they are issued a home sleep test. The tool for which we do this needs to be a validated screening tool and the Berlin Questionnaire is the most used screening tool. However, the questionnaire is not easy to score or use. There is a questionnaire that is easy to use and is simple to score. The Stop-Bang questionnaire can zero on a patients rick for sleep apnea if they answer yes to any 3 of the questions. (Stop-Bang questionnaire attached)
Any person that answers yes to 3 of the questions is considered high risk for sleep apnea and should use a home sleep test. Our Home sleep test (HST) produce results accepted throughout the medical field. If the results indicates a sleep disordered breathing condition other than OSA, (e.g. Central Sleep Apnea), our interpreting physician may refer the patient to another sleep health care provider for a polysomnography (PSG) or laboratory sleep test.
The most common method to treat sleep apnea is continuous positive airway pressure (CPAP). There are two common types of CPAP machines: the traditional fixed pressure CPAP machines and automatically-adjusting positive airway pressure APAP machines. Both have been proven in treatment for obstructive sleep apnea (OSA) by the American Academy of Sleep Medicine.
The two types of sleep testing are significantly differently in the cost and to the convenience of the patient. Home sleep testing costs are around $400.00 compared to in-lab testing that runs around $1,500.00 per night for two nights. The sheer convenience of having the patient use the HST in their own sleep environment adds to the comfort of the patient
Please contact us if you would like to be screened, tested and treated for sleep apnea.
AllTrans Fleet Services
21432 Provincial Blvd.
Katy, TX 77450
Tel: 281.945.4080
Fax: 281.945.4085
The National Transportation Safety Board (NTSB) says that a Fatal Bus Crash Underscores the Need for Fatigue Management Programs.
The National Transportation Safety Board has urged the Federal Motor Carrier Safety Administration to be more aggressive in monitoring fatigue management programs due to a fatal bus crash in last year.
On May 31, 2011 at 4:55am an incident occurred because the driver fell asleep, the Board found. A Sky Express bus that was headed northbound on I-95 in Virginia flipped over after it drifted across the roadway and struck a cable barrier. Unfortunately, four passengers were killed and fourteen others were seriously injured.
After the investigation was completed, the Board found that the bus driver had been suffering from sleep loss, poor sleep quality and interruption of his heart rhythm.
“Sky Express’s failure to exercise even minimal oversight of its drivers’ rest and sleep activities enabled the drivers to drive while dangerously fatigued,” the Board said.
The Board would like for the FMSCA to implement a program to monitor and improve the safety management programs to address fatigue. This is a direct follow up on a previous recommendation that all carriers have a fatigue management program.
The Board also wants new-entrant safety audits to include a review of a structured safety management process so the new carriers will know how to identify safety risks and maintain a safety assurance program.
Sky Express passed the Federal Motor Carrier Safety Administration new entrant safety assurance audit despite safety shortcomings in its operation, which indicates the new entrant audit process is not always keeping unsafe carriers from entering the motor carrier industry,” the Board said.
Fatigue Management Program for North American
The Board has urged the agency to incorporate fatigue management strategies, in addition to the hours of service rules for bus drivers who work at night.
The Board has also recommended a joint FMCSA-Transport Canada project to develop a fatigue management program.
The North American Fatigue Management Program, as it is called, aims to provide carriers with a manual that would have a best-practices reference for implementing a fatigue management program in their operations.
Rebecca Brewster, president and COO of the American Transportation Research Institute stated that It has been in the works for several years and now is nearing completion. The American Trucking Associations is on the project’s steering committee.
Brewster said the project expects to launch a website by November that will provide program materials at no charge. Training and materials for drivers, dispatchers, and management, have been developed and tested by carriers in the U.S. and Canada.
