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September 19, 2007 11:00 AM, EDT

Sleep Apnea Program Cuts Costs for Health Care, Schneider Says

Company Cites Improved Safety, Productivity

By Dan Leone, Staff Reporter

This story appears in the Sept. 17 print edition of Transport Topics. Click here to subscribe today.

Truckload carrier Schneider National said a sleep apnea screening and treatment program managed by an outside vendor has improved safety and driver productivity while lowering health-care costs.

“This program has been a huge success for us,” said Angela Fish, director of benefits for Schneider, Green Bay, Wis. “We reduced our health-care costs an average of 58% for our treated drivers.”

Fish also said the program has reduced the frequency of accidents attributed to fatigue by 30% and improved driver retention for Schneider.

Dr. Mark Berger, president of Precision Pulmonary Diagnostics, Houston, said his company discovered 778 cases of sleep apnea as it screened more than 11,000 drivers as part of a three-year pilot program.

“There are immense health costs involved with untreated sleep apnea,” Berger said. “Whether a commercial carrier recognizes it or not, they’re paying for it [both] in health-care costs [and] in costs related to accidents.”

Berger told Transport Topics that an analysis of Schneider’s health-care costs showed that the company was saving an average of  $578 per driver per month for every case of sleep apnea treated.

About 28% of commercial truck drivers have some form of sleep apnea, compared with about 4% of the overall population, Berger said.

Persons with sleep apnea periodically pause in their breathing while they are asleep because of blocked air passages. This pause triggers an “arousal response,” when the body will reflexively clear the blocked airways, Berger said.

Such arousal responses can take place as few as 10 times per hour or as many as 100 times per hour.

During an arousal response, “you might not wake up, but it’s like your brain wakes up for a few seconds,” Berger noted.

He said the result is a less restful sleep that can leave truck drivers fatigued upon awakening.

The condition is treated with a continuous positive airway pressure device, which provides a sleeping driver with a steady flow of air that prevents breathing passages from becoming blocked.

Wendy Sullivan, a registered nurse and Schneider’s occupational health manager, told TT the devices used to treat driver sleep apnea are small enough to fit inside a truck’s cab.

Drivers using the CPAP treatment wear a face mask while they are asleep. The face mask is connected to an air pump by a small hose. The pump can be powered by an inverter that plugs into a truck’s dashboard.

“Some drivers have strung a clothesline across their cabs to get the hose out of the way and [prevent] themselves from getting tangled while they sleep,” Sullivan said.

To get the proper benefit, drivers must use the devices for at least four hours every day, Sullivan said.

The PPD program was a good fit for Schneider, she said, because the treatment and diagnostic processes did not take drivers off the road.

Still, some were hesitant to disclose symptoms for fear that the treatment would require them to park their rigs.

“It’s a concerning question for a driver to answer,” Sullivan said. “They’re trying to be safe and do the right thing, but they are concerned about their jobs.”

Drivers who are determined to be at risk after the screening process must undergo an overnight test at a sleep laboratory before they can be diagnosed with sleep apnea and treated, PPD’s Berger said.

He pointed out that drivers who are diagnosed with the condition after spending a night in a sleep lab can be issued CPAP equipment the morning after the test and immediately be sent back to their cabs to continue along their route.

Schneider National ranks No. 8 on the Transport Topics 100 list of the largest for-hire carriers in the United States and Canada.

PPD also said that food service distributor Sysco Corp., No. 1 on the Transport Topics 100 list of the largest U.S. and Canadian private carriers, would begin using the specialized sleep-apnea program this fall.

Calls to Sysco were not returned by press time.