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A news story from the BBC mentioned today that a truck driver has been acquitted of killing the driver of another vehicle because the truck driver had been diagnosed with sleep apnea. In the aftermath of the trial, the victim’s father is calling for Great Britain to test all truckers for sleep apnea.
This is an understandable reaction. And the concept of testing is not without merit. In fact, we certainly support the testing of over the road truckers, bus drivers, pilots, air traffic controllers … anyone, in fact, who demonstrates certain risk factors of sleep apnea.
That’s important. “Blanket” testing of everybody, as some have called for, is not reasonable. But it certainly is reasonable to find a way to identify people who are at risk and, if their employment requires them to have the safety of others in their hands, get them tested for sleep apnea.
Certain factors that should be considered collectively are body mass index, neck circumference measurement, and signs of poor sleep … excessive daytime tiredness, frequent headaches, tendency to doze off even briefly at inappropriate times.
What do you think?
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.
Here’s good news for all those who use CPAP therapy for sleep apnea and would like some tips on making things easier.
Mark Stoiber, President of the Sleep Wellness Institute, has published a book entitled “How to Guarantee Your Experience with CPAP is a Happy One.” Mark has 21 years of experience in the sleep disorders field and has seen literally thousands of people turn their lives around from the misery of terrible sleep to the joy and relief of refreshing, restorative sleep through CPAP therapy.
You can download Mark’s book for $3.75 through clicking here. You can also order a paperback copy for $7.97. If you buy the paperback version, $1.00 will automatically be donated to the Reggie White Sleep Disorders Research & Education Foundation.
The Sleep Wellness Institute will open CPAP2GO, a retail store specializing in continuous positive airway pressure (CPAP) machines, masks and supplies that are used to help many people with obstructive sleep apnea, on July 8. It will be the only store of its kind in Wisconsin operated by a sleep disorders center.
The store, at 7017 S. 27th Street, Franklin, will be open Monday through Saturday, with evening hours Monday through Friday. It will be staffed by specially trained employees, most of whom are on CPAP therapy, themselves, and will feature the “30/30 Advantage” – an in-stock supply of more than 30 masks and a free 30 night comfort and fit guarantee. Much of the equipment will be covered by most health insurance.
According to Sleep Wellness Institute President Mark Stoiber, the store is a natural development given the success of the Institute’s professional CPAP services. “Our approach to working with people on CPAP has yielded more than an 85% compliance rate with treatment, as opposed to about 55% nationwide,” he explained. “We believe we can successfully grow our business while helping more people by having a store located in a convenient, high traffic retail business area.”
People with sleep apnea are aroused briefly several times per hour every night as the tissues around their airway collapse and prevent them from breathing. Complications can include cardiovascular disease, stroke, diabetes, depression, and even death. The CPAP equipment provides a continuous, gentle positive air flow that keeps the patient’s airway open and eliminates snoring. It is considered the “gold standard” in treatment for obstructive sleep apnea.
“Expert knowledge, wide selection and an unmatched dedication to customer service will be the hallmarks of CPAP2GO,” Stoiber said. “All too often we encounter people who have purchased CPAP equipment elsewhere, including from the internet, and then have been unable to get the follow-up service they need, at the times they need it. We intend to make a difference for those people.”
Stoiber said the store will offer the same CPAP products and service that are provided at the Sleep Wellness Institute, but in a second location that offers excellent freeway access and foot traffic. It is located in front of a Lowe’s Home Improvement center, he noted.
The store will be managed by Cody Glorioso, who is the director of the Sleep Wellness Institute’s durable medical equipment department. The store’s telephone number will be 414-761-CPAP (2727). A website, http://www.cpap2go.net provides more information.
NOTE: A second store has opened in Waukesha. See our blog post “New CPAP2GO Store Opens Today.”
The Sleep Wellness Institute is Wisconsin’s largest independent sleep disorders treatment center. It is fully accredited to diagnose and treat sleep disorders among adults and children by the American Academy of Sleep Medicine.
When former football superstar Reggie White passed away suddenly and prematurely at age 43, due in part to obstructive sleep apnea, we all knew that we had lost a special man, humanitarian, and dedicated family man.
His legacy lives on through the many good works pursued by his wife, Sara, and their children, Jeremy and Jecolia. So I, as executive director of the Reggie White Sleep Disorders Research and Education Foundation, was not all surprised when Sara offered us the opportunity to raise money for the Foundation in a special way.
Reggie was inducted into the Pro Football Hall of Fame posthumously in 2006. As is true of all inductees, a special limited edition cap was produced in honor of the event. In Reggie’s case, however, the design was not created by a cap company, but by Sara. And, of course, once they’re gone, they are gone forever.
Thanks to Sara, the Foundation now has a limited number of these special caps to sell as a fundraiser. You can see and order the cap by visiting the Foundation’s site and clicking on “Support Us.”
Your help will contribute to the Foundation’s efforts to help people with sleep apnea whose socio-economic status would prevent them from getting the healthcare services they need. That’s our Mission. And we’re proud to carry it out in Reggie’s memory.
The CBS program “60 Minutes” took an interesting look at “The Science of Sleep” last night. If you missed it, click here to visit the 60 Minutes website where you can view the entire segment.
One point that 60 Minutes missed, however: when showing a young man whose sleep was being disrupted by beeping noises in a research study, reporter Lesley Stahl, who did an otherwise excellent job, failed to mention that the waking caused by those beeps is not at all dissimilar to what occurs for a patient with obstructive sleep apnea.
Mark Stoiber, President
West Allis, Wis. March 11, 2008 — The Sleep Wellness Institute, the state’s largest sleep disorders diagnosis and treatment center, will now offer an inexpensive sleep apnea screening tool for use in the home.
The SleepStrip® costs $25 and allows people who suspect that they may have sleep apnea, a potentially lethal disorder, an easy way to screen themselves for indications of the disease. According to Sleep Wellness Institute President Mark Stoiber, the new tool is the “first step” for people who may be reluctant to undergo full testing initially.
“Sleep apnea can only be diagnosed by a sleep study, and unattended ambulatory studies are considered somewhat less reliable, as shown by Medicare’s recent decision not to provide coverage for them,” he explained. “But for those people who are concerned that they might have sleep apnea and are reluctant to be evaluated, the SleepStrips offer them a way to screen themselves, in effect, and then contribute to a determination with a sleep center if a full sleep study is necessary.”
Stoiber acknowledged that the strip will allow some people to allay their fears by screening out those people who have no apnea present.
Manufactured by Sleep Sense®, a division of Scientific Laboratory Products, the strips are worn under the nose overnight. They contain sensors that track breathing and monitor apnea events. Events are displayed in a one digit number from 0 to 3 that the patient reports to the Sleep Wellness Institute. The reading, combined with information about the patient’s sleep and health history, can be used to make a determination of whether additional testing is necessary. If so, the patient will be invited to consult with a Sleep Wellness Institute sleep specialist.
“We believe that offering the SleepStrip will increase awareness and help to identify people who need treatment for sleep apnea,” Stoiber said. He noted that approximately 16 million Americans are believed to have undiagnosed sleep apnea, roughly the same number of people with diabetes, depression, and asthma.
He stressed that while the new strips should be used for screening purposes only, they could help prevent added expense for some people who will learn that they do not need an overnight study in a sleep center. They are not a replacement for a physician’s diagnosis, he stressed. The strips are approved for use by the FDA, he said.
We’re pleased to announce the launching this morning of the official Reggie White Sleep Disorders Research & Education Foundation website. Please take a look to learn more about the work being done by this non-profit organization that was co-founded by Reggie’s wife, Sara, and the Sleep Wellness Institute.
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
Sleep apnea is not just a condition that affects men; it affects people of all ages, shapes and sizes, including women. Four percent of middle-aged men and two percent of middle-aged women experience sleep apnea, and the rate of sleep apnea increases significantly in women after menopause.
“Classic” symptoms of obstructive sleep apnea include:
- Witnessed gasping, pauses in breathing
- Excessive daytime sleepiness
Although these symptoms occur in women, sometimes they may be more vague or suggestive of other illnesses:
- Insomnia or frequent nighttime awakenings
- Waking up in a sweat or with heart palpitations
- Feeling unrefreshed in the morning
- Changes in mood, such as increased feelings of anxiety, depression or irritability
In this situation, a diagnosis of obstructive sleep apnea may be overlooked. Instead, emphasis is often placed on treating underlying thyroid disease, diabetes, depression or anxiety. It is important for women to talk with their health care providers about any concerns they have with sleep or daytime sleepiness.