A Corporate Driven Sleep Apnea Detection and Treatment Program: Results and Challenges

Abstract: Sleep disordered breathing (SDB), including sleep apnea, is very prevalent in commercial drivers and contributes significantly to higher healthcare and liability costs. Without a mandated screening program, driver and physician recognition of this condition remains low. Our corporate supported recognition and treatment program for SDB utilizes an objective screening tool that yields a positive predictive value of 91%. Of those continuous positive airway pressure (CPAP) treated drivers successfully contacted, one month or longer treatment compliance is 91% with high subjective rating scores. In 348 SDB drivers, CPAP intervention resulted in a 47.8% (p<.0001) reduction in per member per month (PMPM) health care spending. There was a 73% reduction in preventable driving accidents in a subgroup of 225 full-time CPAP-treated drivers. The driver retention rate in CPAP treated individuals was 2.29 times greater than the 2004 global corporate driver retention rate. On-going corporate measures that facilitate testing and treatment of drivers with SDB are described. These activities are proving both clinically and financially beneficial for a major commercial carrier.