Screening for Sleep Disorders

Research has shown:

• Up to 40% of active duty police officers and 37% of firefighters are at risk of at least one major sleep disorder, primarily obstructive sleep apnoea (OSA), and that the risk of a sleep disorder is also associated with a higher risk of chronic disease, particularly depression and anxiety.
• Approximately 40% of truck drivers are at high risk of OSA.
• Insomnia is associated with a two-fold increase in workplace injuries, even when controlled for other comorbid conditions. Productivity is also significantly affected by insomnia in lost work performance, due to presenteeism (low on-the-job performance), with an average of around eight days of lost work performance per person. The American Insomnia Survey estimated the prevalence of insomnia at 23% of the workforce.
• Drivers with untreated OSA are up to five times more likely to have a motor vehicle crash. In Australia, heavy vehicle drivers diagnosed with OSA were more than three times more likely to crash than those without OSA and more than six times likely to crash if they had not completed fatigue management training.
• The odds of having a workplace accident is doubled in workers with OSA, and having any reported sleep problems saw an increased risk of being injured at work by 62%, with 13% of injuries attributable to sleep problems.
• About 1.5 million Australians who are shift workers are particularly vulnerable to sleepiness related accidents and injuries, with around a 30% increased risk of having an accident on a night shift compared to a day shift, increasing to 25% after four consecutive night shifts. Many high-profile workplace accidents have happened at night and illustrate the potentially catastrophic impact of occupational errors on the public.

What does it really cost?

As well as costing us our health and in some cases, our lives, the financial cost of accidents and reduced productivity to business due to sleepiness and sleep disorders is enormous. According to the Sleep Health Foundation report, Asleep on the Job, the total cost of inadequate sleep in Australia was estimated to be $66.3 billion in 2016-17, comprising $26.2 billion in financial costs and $40.1 billion in the loss of wellbeing. This equates to approximately $8,968 per person affected in both financial and wellbeing costs.

The components of financial costs were estimated to be:

• health system costs of $1.8 billion, or $246 per person with inadequate sleep;
• productivity losses of $17.9 billion, or $2,418 per person with inadequate sleep;
• informal care costs of $0.6 billion, or $82 per person with inadequate sleep; and
• other financial costs, including deadweight losses, of $5.9 billion, or $802 per person with inadequate sleep.

What can be done?

When individuals are advised to visit their doctor for assistance, it can create barriers for them in receiving treatment. As such, workplaces are ideal in helping to identify undiagnosed disorders. Programs can be conducted in the workplace in a confidential manner and arranged to account for any logistical, health insurance, or licensing concerns to ensure that workers are not penalised for participating. While each workplace will find its own best practice model, they should all address the same underlying principles – to identify workers who may be at risk of a clinical sleep disorder and referring them for formal evaluation, diagnosis and treatment. Examples and benefits of successful sleep disorder screening, referral and treatment programs are included in this section. Such programs will improve workplace alertness, safety and productivity and employee health and wellbeing.