Paul F. Schmook, RPSGT
Obstructive Sleep Apnea, or OSA, is clinically defined as a cessation of breath for periods of 10 seconds or longer during sleep.
Imagine holding your breath because you’re swimming or trying to get rid of your hiccups. You’re anxious to gain that next breath again. When you’re sleeping, you’ve lost that natural ability to breath on demand. During an OSA event, your respiratory center sends a message to the hypothalamus part of the brain which creates an urgency to breath.
The result, either a full blown awakening or a micro-awakening. Full blown awakenings are normally associated with heavy breathing, gasping, choking or coughing.
Micro-awakenings often go unnoticed and the person may just roll over into another position. Many people with severe OSA have over 100 micro-awakenings per hour and not even realize this.
Any type of awakening kicks you out of deep or restorative sleep stages.
Furthermore, when you stop breathing:
When you start breathing after the awakening both the oxygen level in your bloodstream and heart rate spike, leading to what’s called Heart Rate Variability.
Excessive Daytime Sleepiness
Obesity or Abnormal Body Mass Index
Apnea Witnessed by Bed Partner
Congestive Heart Failure
Screen all employees across the board
Set up sleep screening clinics at terminals
Rely on internal medical departments to screen employees
Per the Federal Motor Carrier Safety Administration guidelines which were published on August 26, 2016, people who qualify for sleep testing will demonstrate a:
BMI > 40 Kg
Self-reported sleepiness during major wake periods or a fatigued related crash
BMI >33 and <40
Plus three of the following:
Ideally, it’s nice to ship home testing sleep equipment directly to the terminal
The terminal manager will be assigned to dispensing the equipment to the employee, and then attach a “Chain of Custody” bracelet to the employee’s wrist
If shipping to the terminal is not possible, then ship:
If shipped to the employees residence,
Sleep testing kits shipped to terminal managers or directly to employees will contain:
The employee will be contacted by one of our Sleep Coaches to ensure that the sleep testing device is assembled properly and that the “Start” button has been activated
Our operation runs 24 hours per day and every day of the year. Employees who experience complications will always have the ability to contact our call center for assistance.
In the morning directly after the study:
The employee will remove the testing equipment and place the device and paperwork into the shipping box, seal this and then affix the pre-paid label. Employees can then return the box to the terminal for shipping or stop by a local post office for delivery.
In the event your employee tests positive for OSA:
CPAP (Continuous Positive Airway Pressure) is a fixed pressure setting
APAP (Automatic Positive Airway Pressure) adjusts pressures automatically on a breath to breath basis.
For the first two weeks of APAP use is critical for the outcome of success.
For unsuccessful trials:
Employees who are currently using APAP should make arrangements to report compliance on a regular basis.
APAP units are connected to the Cloud which allows us to monitor compliance and troubleshoot if the need arises, regardless of where the employee resides or vacations.
The minimal goal on APAP is 4 hours per night, 70% of the time. This meets the FMCSA guidelines.
Traditional Insurance Billing
Re-Supply: Every 180 days, APAP users should receive new supplies.
Clinic: $1,000.00 per day per practitioner
Sleep testing device with the ancillary supplies
Pre-paid shipping label
Chain of Custody bracelet
The complete program should cost about $250.00 per employee.
The APAP device should come with masks, tubing, heated humidity chambers and the rest of the supplies.
Complete Sleep Program: $1,000.00
Costs of including a sleep apnea program is the number one question people ask me.
APAP compliance monitoring
Chain of Custody bracelet
Education in advance