Obstructive Sleep Apnea: The Present

Obstructive Sleep Apnea (OSA) is characterized by repeated closures of the airway at night. A good analogy is to remember that last time you tried to drink a thick shake through a straw. Each time you sucked on the straw it would collapse. Now imagine that the straw is your airway and the thick shake is your neck. With OSA, every time you try to breathe during sleep the tissue around your neck collapses on your airway causing it to close. When your airway closes you do not receive air (sometimes up to 60 seconds), when you do not receive air you do not receive oxygen, your heart slows down and the brain wakes you into a lighter stage of sleep (sort of like getting nudged in the shoulder) to open up your airway and get you breathing again. This process repeats itself over and over throughout the night (sometimes hundreds of times per hour). The results are a very poor night’s sleep every night and feeling exhausted during the day. People suffering from OSA are more at risk for high blood pressure, diabetes, depression, weight gain, cardiovascular disease and even death.

Obstructive Sleep Apnea: The Past

When you compare OSA to other medical disorders it is in its infancy. It wasn’t until the mid 70’s that physicians developed a test (what was to be called the polysomnogram) that could diagnose the disease. In 1981 am Australian physician, Colin Sullivan, developed a device called, “Continuous Positive Airway Pressure,” or CPAP, to treat OSA but it wasn’t until the mid 80’s before it was universally accepted as the preferred treatment for OSA.

CPAP is a device about the size of a toaster that delivers “positive air pressure” through an attached hose to a nasal mask worn by the patient. The “positive pressure” fights against the “negative pressure” caused by OSA that is closing the patient’s airway at night. By keeping the patient’s airway open they begin to breathe normally, their oxygen levels improve, the quality of their sleep improves and they wake up with more energy.

Obstructive Sleep Apnea: The Future

OSA is a serious disorder that affects more than 18 million Americans. It is as prevalent as diabetes, asthma and depression. To date, we have only diagnosed a fraction of this population (two to three million). Early research studies have shown that patients who have been diagnosed with OSA have been shown to utilize a higher degree of healthcare.1 One study indicated that patients suffering from OSA spend on average twice the amount on healthcare when compared to patients that have no OSA.2

Research studies regarding CPAP have shown that patients who have been successfully treated for OSA show a reduction in hospitalizations for cardiovascular and pulmonary disease.3

Schneider National Inc., in Green Bay, Wis., the largest privately owned trucking and logistics company, showed that they could actually reduce their health care expenses with their employees diagnosed with OSA and compliant with their CPAP therapy.4 Schneider allowed 348 of their employees to participate in a study that shows CPAP intervention reduced 47.8% of per member per group healthcare spending in drivers with OSA.

The Sleep Wellness Institute: Its Impact

The Sleep Wellness Institute understands the potential positive impact treating OSA can have on the lives of their patients. We also realize that by treating large groups of people who suffer from OSA, we have the potential to dramatically reduce future healthcare costs. Our goal is to provide first definitive study to examine the link between treatment for OSA and healthcare costs. (Please see the blog post, “Research to study the effects of Sleep Apnea on health care costs.”)

1. Ronald J., Delaive K., Roos L., Manfreda J., & Kryger M. (1998). Obstructive Sleep Apnea Patients Use More Health Care Resources Ten Years Prior to Diagnosis. Sleep Research Online 1(1), 71-74.

2. Tarasiuk A., Greenberg-Dotan S., Brin S., Simon, T., Tal A., & Reuveni H. (2005). Determinants Affecting Health-Care Utilization in Obstructive Sleep Apnea Syndrome Patients. Chest Vol. 128 (3), 1310-1314

 

3. Peker Y., Hedner J., Johansson A., & Bende M. (1997) Reduced Hospitalization with Cardiovascular and Pulmonary Disease in Obstructive Sleep Apnea Patients on Nasal CPAP Treatment. Sleep, 20(8), 645-653

4. Berger M., Sullivan W., Owen R., & Wu C. (2005, November). A corporate Driven Sleep Apnea Detection and Treatment Program: results and Challenges. Proceedings from the 2005 International Truck & Bus Safety & Security Symposium, Alexandria, Virginia.

Mark Stoiber, President

 

Advertisements