The Sleeping Giant

You’ve probably heard the saying ‘Early to bed, early to rise, makes one healthy, wealthy and wise’. While this is somewhat true it’s not just the length of time we spend in bed, but the quality of our sleep. Think about it, don’t you feel so much better after 7 hours of deep uninterrupted sleep than after 9 hours of broken sleep? Sure you do.

Obstructive Sleep Apnea (OSA) is highly prevalent in Australia and is likely to be costing Australian companies millions. OSA is characterized by a narrowing of the airway during sleep that leads to events called Apneas (stopping the flow of air into the lungs) and/or Hypopneas (limiting the flow of air into the lungs). These events are associated with a significant decrease in blood oxygen levels.

 The stats;

·         One in 20 adults are at risk of moderate to severe OSA. (2,3)
·         Over 25% of all adults may need investigation for OSA. (1,2)
·         OSA prevalence is likely to rise even further due to Australia’s high obesity rates and aging population. (1)
·         Approximately 80% of Australians with OSA remain undiagnosed. (7)

But wait there’s more;

•       Untreated OSA sufferers are 7 times more likely to suffer a stroke. (5)
•       A person with sleep apnea is 7 times more likely to have a motor vehicle accident. (6)
•       People with sleep apnea are 3 times more likely to suffer a work-related injury or fatality. (6)
•       The odds for developing depression are increased by two fold in people with OSA. (9)
•       Deloitte Access Economics have estimated that OSA alone cost the Australian economy more than $21     Billion in 2010. (3)

Australian Companies Unaware
Australian companies are aware of the issues and associated costs around poor Nutrition and lack of Physical Activity, and are actively implementing programs to educate and support behaviour change Sleep Apnea however, really is the Sleeping Giant, with most companies oblivious to the risk and associated costs. The majority of companies do not have an effective sleep solution.

Some sectors are taking action – OSA risk management
The National Standard for Health Assessment of Rail Safety Workers contains set criteria for the assessment of sleep disorders, including Sleep Apnea, that do not rely solely on employee self-assessment (because let’s face it employees will not always tell the entire truth), but rather on both demonstrated sleepiness and clinical risk factors. Clinical factors that impact sleep include high BMI, high Blood Pressure requiring medication and Type 2 Diabetes. Great to see rail taking such proactive measures.

Does your organisation have a way of identifying sleep issues and providing effective solutions?
One way to identify how big the sleep issue is within your organisation is to follow rail’s lead and use the next round of general health checks to identify the sleep risk factors (high BMI, BP and Type 2 Diabetes). You’re provider will also need to include a sleep survey like the Epsworth Sleepiness Scale. Using the survey results and clinical risk factors your organisation will be able to identify employees with potential sleep disorders. Employees will need to give their consent for their health data to be shared with their employer if the employer will be funding further investigation and treatment. If the employee will be funding further testing and treatment your provider can refer employees for a sleep study.

There are a few companies in Australia to offer sleep studies and solutions for people with sleep disorders. Healthy Sleep Solutions in my opinion is one of the besthttp://www.healthysleep.net.au/

1. Professor Robert Adams, Professor of Medicine, University of Adelaide; Australian Health Review 2012; 36:424-29
2. Medical Services Advisory Committee, Public Summary Document, Application No. 1130 – Unattended Sleep Studies in the Diagnosis and Reassessment of Obstructive Sleep Apnoea March 2010
3. Re-awakening Australia: The economic cost of sleep disorders in Australia, 2010. A report for the Sleep Health Foundation by Deloitte Access Economics © 2011 Deloitte Access Economics Pty Ltd
4. Al-Delaimy WK, Manson JE, Willett WC, et al. Snoring as a risk factor for type II diabetes mellitus: a prospective study. Am J Epidemiol 2002;155:387–93.
5. Bassetti et al. Sleep apnea in acute cerebrovascular diseases: final report on 128 patients. Sleep 1999;22:217-223
6. Naughton M, Pierce R. Sleep apnoea’s contribution to the road toll. Aust N Z J Med. 1991 Dec;21(6):833–834.[PubMed] 7. Fatigue and Transport Working Party (Ad hoc sub-committee of the Australasian Sleep Association 03-04)
8. Young et al. Sleep-Disordered Breathing and Mortality: Eighteen-Year Follow-Up of the Wisconsin Sleep Cohort. Sleep, August 1, 2008
9. Longitudinal Association of Sleep-Related Breathing Disorder and Depression. Paul E. Peppard, PhD; Mariana Szklo-Coxe, PhD; K. Mae Hla, MD; Terry Young, PhD. Arch Intern Med. 2006;166(16):1709-1715. doi:10.1001/archinte.166.16.1709

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