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Sleep Apnoea: An Occupational Health and Safety Factor

Many people have sleep apnoea (also spelt sleep apnea), but may not even know it. In fact, sleep apnea affects more than 3 in 10 men and nearly 1 in 5 women1. A large number of those diagnosed have full time employment and are actively working.

Because of this, sleep apnoea may not only pose a risk to the person who has it, but also to their community and workplace.

According to a 2010 study2, sleeping disorders are often associated with reduced work performance and lead to an increased risk of accidents in the workplace, especially in jobs that involve driving5. This is largely due to excessive daytime sleepiness, a common symptom of sleep apnea known to impair performance, slow response times and decrease memory.

Some examples:

Case 1 – A 40-year-old shipmate fell asleep while watch keeping.

His tugboat was towing a barge full of oil. The collision resulted in half a million dollars in damage to the tugboat but no resultant oil leaks or injuries to the workers on board. The worker had admittedly fallen asleep during his watch keeping duties and was not able to pilot the ship as required.

Since the incident the mate has been diagnosed with severe obstructive sleep apnea and has begun continuous positive airway pressure (CPAP) treatment. This patient has a history of being extremely compliant and has used CPAP downloads for monitoring.

Case 2 – Two airline pilots fell asleep while cruising over Hawaii.

They flew past their destination toward open ocean for 18 minutes before waking up and returning for a safe landing. During this time air traffic controllers were frantically radioing the flight from Honolulu to Hilo for 18 minutes but receiving no response from the pilots. Since this incident the airline captain has been diagnosed with severe obstructive sleep apnea.

Case 3 – Sleep apnoea affects around 28% of truck drivers3

This is a group that is at greater risk when it comes to sleep apnea and occupational health. One trucking company in the US ran a program to diagnose and treat sleep apnea among its employees. They reported a 56% reduction in medical expenses for their treated drivers, resulting in savings of over $7,000 USD per driver per year. They also reported a 50% reduction in preventable accidents4.

Another report drew the following conclusions6:

Among 348 drivers diagnosed with sleep disordered breathing (SDB) and who were treated, medical costs accrued were slashed in half per month. There was a 73% reduction in preventable driving accidents among a group of 225 SDB-diagnosed drivers treated with continuous positive airway pressure (CPAP) devices, which are essentially breathing masks that use air pressure to ensure airways remain open during sleep. The driver retention rate of CPAP-treated individuals was 2.29 times greater than the total company driver population in 2004

Obstructive sleep apnoea is the cause of excessive daytime sleepiness

These three case studies are real-life occurrences of obstructive sleep apnoea (OSA) in mission-critical positions in the workplace. OSA is the most common medical disorder to cause excessive daytime sleepiness. It is also a risk factor for both drowsy driving and motor vehicle collisions associated with drivers falling asleep.

Other causes for excessive daytime sleepiness include narcolepsy, central sleep apnea, alcohol use, severe restrictive lung disease, insufficient sleep time, neuromuscular disease, medication and drug use, periodic leg movement disorder, shift work, chronic pain, and neurological disease. Insufficient sleep time is an extremely common problem and it can be addressed, but the challenge is to change patients’ sleep-related behaviour over the long term.

The clinical manifestations of OSA are commonly daytime sleepiness and snoring. Additional symptoms and signs can include restless sleep periods, fatigue, poor concentration, morning headaches, and awakening with a choking sensation. Physical exam findings can be normal or can include obesity (body mass index greater than 30 kg per m2), elevated blood pressure, a narrow airway, a large neck circumference (for men, a collar size greater than 43 cm; for women, a collar size greater than 40 cm), and signs of pulmonary hypertension.

Medical consequences of sleep apnoea include a three- to sixfold increased risk of all causes of mortality: hypertension, pulmonary hypertension, stroke, coronary artery disease, cardiac arrhythmias, and depression.

Does your organisation need any help?

Contact EdenSleep to discuss sleep testing for your organisation.

We are happy to come and visit and explain sleep apnoea and how we can easily detect and treat this condition.

References:

  1. Peppard PE et al. Increased Prevalence of Sleep-Disordered Breathing in Adults.Am J Epidemiol. 2013 (5.17)
  2. Saunders.
  3. Pack et al. Am J Respir Crit Care Med. 2006
  4. Harbenbaum et al. J Occup Environ Med 2006
  5. Proietti et al. Clin Ter. 2010
  6. Schneider: sleep apnea treatment pays off http://fleetowner.com/management/news/sleep_apnea_treatment

Contact EdenSleep to discuss sleep testing for your organisation