Obstructive Sleep Apnea or OSA is a frequently seen form of sleep disorder in which the airway collapses during sleep, most commonly as the result of to much weight pressing down on the airway, effectively preventing the person from being able to reach the REM stage of sleep during which the body rejuvenates and replenishes itself resulting in the person waking from bed the next day feeling as tired as they did the night before. This is a major area of concern throughout the trucking industry regarding the safety of the truck drivers as well as the general traveling public, considering that a drowsy or fatigued driver is not capable of safely operating their vehicle with the level of awareness needed to do so. Going directly alongside this is an increased frequency in litigation being brought on to trucking companies who have had a driver involved in an accident in which the driver suffers from undiagnosed sleep apnea or driver not being properly monitored to ensure effective treatment is being administered to control their sleep apnea. The results of these cases have ranged from relatively small fines and penalties to multi-million dollar settlements as seen in the case ruled on in late 2012 in which a court determined that a company’s negligence in enforcing drivers to be tested and treated for sleep apnea resulted in an accident involving a driver that fell asleep behind the wheel with cruise control engaged, slamming into the back of stopped traffic on a highway, killing the father to a family of three children and wife. If this company had taken a more proactive approach in addressing the need for sleep disorder testing and implemented a well managed program, the likelihood of an accident as tragic as this occurring could have been significantly reduced saving the life of that father and, less important, a substantial sum of money for the company.
As mentioned in the previous paragraph, OSA is primarily the result of the airway being forced shut due to too much weight pressing down on it during sleep. With this is mind, it is easy to understand why the rate of people who suffer from OSA increases almost linearly as weight increases, with the severely obese (BMI>50) suffering from some level of sleep apnea approximately 95% of the time. The correlation between OSA and obesity is undeniable, much like the frequency in which the obese also suffer from any number or combination of chronic illnesses such as high blood pressure, Type II diabetes, and numerous heart conditions. What this equates to in the eyes of Human Resource and Safety personnel is consistently increasing overall health care costs. The longer that someone goes on with undiagnosed or untreated sleep apnea, the greater the risk of other illnesses developing which can result in more expenditures being taken on by the company in health care expenses then leading to health care providers raising rates across the board to cover the costs. Early diagnosis and effective treatment of OSA can, in some cases, greatly reduce the chance or even prevent the onset of other conditions such as high blood pressure or Type II diabetes and in the event of a late diagnosis; proper treatment can help to stabilize other illnesses that the person may already suffer from with the goal being to avoid incurring any additional health costs.
Now that you see how a well enforced sleep disorder management program can save the company significant amounts of money in avoided litigation and aiding to lower overall health care costs, let us explore how a sleep program can actually make your company money and let you see a return on your investment. The old saying, “A healthy worker is a happy worker and a happy worker is a productive worker” can not hold truer than it does when it comes to the successful management of sleep disorders. Getting a sufficient night sleep is the cornerstone to being able to perform daily tasks and job requirements to the level that is expected from your employer. Studies performed to understand the correlation between sleep and neurological capabilities have demonstrated that a person who has not slept for a period of 24 hour period has the same reaction and neurological capabilities as that of an individual with a blood alcohol level of.08% or the legal limit to still operate a vehicle. As mentioned before, untreated OSA prevents an individual from reaching the REM stage of sleep or the stage of deep sleep in which the body effectively shuts down to rejuvenate. So an individual suffering from untreated OSA, although not as severe as being awake for a 24 hour period, will still suffer in their cognitive abilities due to lack of sleep and as this goes on night after night, the problem starts compounding resulting in a less efficient and productive worker. In the case of truck drivers with untreated OSA, this means that the person behind the wheel of an 80,000 pound vehicle will be attempting to operate that truck with diminished cognitive abilities and reaction speed. Although this is not always going to result in severe crashes as previously referenced, it does lead one to think about all the other areas that it could effect. How many turns did that driver miss and what does that equate to in fuel cost and time lost OR What was missed or overlooked while doing their pre-trip inspection of the truck resulting in fines and penalties to the companies CSA score. It all boils down to the fact that a well rested worker is going to be more tentative to detail, better capable of making real time split decisions behind the wheel which could save their life and the lives of others around them, and lead to an overall increase in their productivity level.
Now, having shown all the benefits that having a proper sleep management program in place can bring to a company, it is all for nothing if the drivers are not properly using the machines and receiving the correct treatment. This is why having a compliance monitoring service in place for all drivers that are on CPAP treatment is crucial to the overall effectiveness of the program. Without compliance monitoring, the likelihood of drivers sitting the CPAP on the shelf and not using it increases greatly in which case all the negative side effects that were discussed earlier that are associated with untreated OSA will still be felt. Along with that, medical examiners who perform the DOT physicals on drivers for CDL recertification are now requiring to see compliance data for drivers that are suppose to be using CPAP and if they do not meet the minimum requirements, the examiners will not issue full certifications and in some cases require a driver to show up to 3 weeks of compliance before allowing that driver to get back into their truck. This unnecessary time spent out of the truck costs the company lost profits by not having enough drivers to meet already scheduled deliveries and hinders the company’s ability to contract new deliveries since they will be unsure as to how many drivers will be available at a given time.
The issue of sleep apnea testing has become a hot topic within the transportation industry and worrisome to management and drivers alike as to how it is going to effect their day to day operations and when the overall cost of a treatment program will be. However, what will become even more of a concern is not having a solution to the issue when it inevitably shows up. This will only cost more in the long run, where having a proactive approach to sleep apnea testing can actually bring increased profit margins and lower health care cost for a company.