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Over the last two years, the Sleep Wellness Institute has partnered with Kleen Test Products (KTP) to study the effect of screening, testing and treatment of Obstructive Sleep Apnea (OSA) on a volunteer segment of their employee population. Through numerous benefits programs, Kleen Test rewards employees for healthy lifestyles and offers many programs to improve the well-being of all who work for them. This study offered a unique opportunity to learn about OSA, provide treatment to those employees affected and determine if OSA increased employee/employer healthcare costs.

KTP has a workforce of 585 employees. Our original recruitment target was to get sixty volunteer employees to come forward – with 20 in each group. After recruitment we were able to start with 65 employees (representing 11% of the company’s workforce.)
To cost-effectively determine which employees had OSA, we initially used an at-home portable ApneaLink screening device for one night. Those employees who showed potential OSA from the results of the ApneaLink screening were given an overnight sleep study. The results of each sleep study were interpreted by a board certified sleep physician to confirm if the employee had OSA. The results of the sleep studies demonstrated that 33 of the KTP employees showed no evidence of OSA, 27 showed evidence of OSA, and 5 subjects withdrew from the project.

We are still in the process of collecting data regarding healthcare usage during the 12 months each employee was in the study. Our targeted completion date is October 8, 2009. Once all data have been collected we will be able to make assertions and findings that are statistically significant. However, of the 65 employee volunteers there are 11 employees diagnosed with OSA using their CPAP devices for 4 or more hours per night, preliminary data shows a trend of reduction in healthcare spending. (To date, the reduction in spending in this group of employees is down from an average of approximately $3,900 per employee to $205 per employee.) The premise of the trial does appear to be valid – patients suffering from Obstructive Sleep Apnea use more healthcare than non-OSA sufferers. During the next year, we will continue to collect compliance and healthcare spending data to determine what effects CPAP set-up and screening have on healthcare costs of OSA patients.

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The Sleep Wellness Institute is currently conducting a research project entitled  Reducing Employer Healthcare Costs:  A Two-Year Study on Screening, Testing and Treatment of Obstructive Sleep Apnea.

To date, the Sleep Wellness Institute has completed recruitment for this research trial.  65 subjects were sampled from the manufacturing company Kleen Test Products, headquartered in Port Washington, Wis.  Kleen Test Products is very proactive about their employees’ health.  These two companies have been an excellent match working on this trial.

Obstructive Sleep Apnea (OSA) has long  been linked to many co-mobid conditions (Pagel 2007).  More recently, a relationship between healthcare cost and OSA has been suggested ( Ronald, Delaive, Roos, Manfreda & Kryger 1998; Kapur et al., 1999; Berger et al, 2006; Tarasiuk et al., 2005).  The goal of this trial was to reinforce these findings using a control group and the latest technology.  Previous studies have had some concerns … for example, by using a pre/post test design and relying on self reporting to monitor compliance to treatment.  This trial’s hope is to build upon the prior works and showing an even greater likelihood that OSA sufferers do utilize more healthcare services, and that once treated , that utilization is reduced.

The preliminary findings, taken from the 65 subjects, do show an increase in healthcare utilization prior to screening or treatment when compared to the control group (P=0.039).  The control group’s mean healthcare spending for 12 months prior to screening equals $1,194.68 per member.  The OSA group’s mean healthcare spending for the year prior to treatment is $2,579.13 per member.

Currently, the premise of our trial appears to be valid, that OSA sufferers utilize more healthcare than controls.  For the next year, compliance to treatment and healthcare spending data will continue to be collected to determine what effects the treatment of OSA has on healthcare costs.

 

We’ve spent a lot of time here in the Milwaukee area over the past year or so talking about how complications of sleep apnea kill 38,000 Americans each year. At first, people didn’t want to believe it.

But now Dr. Terry Young, professor of epidemiology at the University of Wisconsin-Madison, and his colleagues have published the results of the Wisconsin Sleep Cohort Study in an article entitled “Sleep-Disordered Breathing and Mortality: Eighteen-year Follow Up of the Wisconsin Sleep Cohort” in the Journal SLEEP.

Almost as important as the results of the study … essentially that those people with untreated sleep apnea are at a greater risk of death from causes such as cardiovascular disease and stroke … was Dr. Young’s comment that “I was surprised by how much the risks increased when we excluded people (from the study) who reported treatment with CPAP (continuous positive airway pressure).” Dr. Young said the findings suggest that people diagnosed with sleep apnea should be treated, “And if CPAP is the prescribed treatment, regular use may prevent premature death.”

Dr. Young and his colleagues have done a great service to those with undiagnosed sleep apnea. And now it is up to medical professionals and the public to take the next step … get checked for sleep apnea. If you snore at night and are exhausted during the day, take the time to find out. It could save your life.

Steve Gardner

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