A tired trucker at the wheel.

Eyes Wide Shut

It’s time to wake up to the dangers of sleep apnea—including workplace injuries, disability claims, burnout and absenteeism.
By Boyd Goodson
May 15, 2023

Fatigue among workers remains an underreported and growing problem in many industries, but in construction, it poses a more immediate risk, having been shown to be as harmful as drunk driving. Loss of situational awareness, underestimation of risk, hindered visual perception and reduced reaction times are all symptomatic of both drunkenness and extreme fatigue.

Experiencing these symptoms every day can be an indicator of obstructive sleep apnea, which is estimated to affect 10% of the workforce. One of the fastest-growing chronic conditions in the United States, sleep apnea occurs at a higher rate in men than women—nearly twice the rate—and because construction is predominantly male, the condition is far more prevalent in the industry than in the general workforce. Sleep apnea is causally linked to a host of medical conditions, including memory loss, diabetes, depression, hypertension, obesity and cardiovascular disease. Studies have found that people with sleep apnea are nearly twice as likely to be injured at work; in addition, untreated sleep apnea significantly increases the odds of a workplace disability claim and leads to low job satisfaction and high levels of burnout. Its financial impact on employers is estimated at $150 billion.

Given the risk to themselves and their colleagues, addressing sleep apnea among construction workers isn’t just important—it’s imperative. Fortunately, this is a problem with comprehensive solutions that an increasing number of companies are investing in directly. Here are some suggestions for getting started:

Be proactive. Research has found that companies choosing to target sleep apnea in the workplace saw a 40% reduction in workplace absences, significant cost savings and an increase in productivity—to say nothing of fewer safety incidents. In other words, proactive companies save lives and money.

Currently, continuous and positive airway pressure (CPAP) therapy, which delivers compressed air that prevents airway closure during sleep, is the most reliable and effective treatment for sleep apnea. This therapy is readily available, and improvements in technology mean CPAP devices have never been so compact, effective or affordable. Employers that take a more proactive role in making this treatment available to workers go a long way toward reducing safety incidents and improving levels of employee wellbeing, absenteeism and retention.

Protect worker wellbeing. Take charge and organize screening and treatment. Offer educational programs around symptoms of sleep apnea. Offer simple tools to self-assess, such as easy online surveys. Clear the path to help. It sounds simple, and it actually is, especially because all of this can be done when companies explore alternative employee health-care solutions to target specific conditions, including the option of direct primary-care providers.

Be direct. Current best-in-class solutions include developing direct partnerships and support for workers from employers. For specific conditions, employees can receive quick onsite or at-home testing, diagnosis and treatment options. Many larger companies are adopting new models in population health management that reward preventive care and are investing in sleep-apnea diagnosis and treatment programs. This direct-care model is growing fast and paying off. Newer tools such as telehealth, predictive analytics and personalized medicine are helping the alternative health-management model succeed by reducing costs and at the same time leading to much faster diagnosis, movement to treatment and ongoing support in the form of coaching that is improving outcomes for patients.

By contrast, typical employer-sponsored health-insurance plans experienced the highest annual increase in per-employee costs since 2010 last year, at 6.3%. Similar increases are anticipated this year. For companies across industries, health care remains the second-highest operating cost after payroll.

Looks to other sectors. Construction could take some cues from companies in the transportation industry, where more holistic patient-care models are already proving successful. Among other strategies, transportation organizations are directly addressing the lack of medical-screening requirements for sleep apnea and other sleep disorders for employees in safety-sensitive positions. Given the very real public-health and economic impacts of sleep-apnea-related transportation incidents on society, positive change has been made by acting ahead of any federal-level action.

Talk about it. Address the stigma that surrounds symptoms such as snoring and treatments that involve mask use. Have management lead the way. Get tested, and talk about your own sleep-apnea experiences. Change the conversation around sleep health and workplace wellbeing.

Because patients often struggle to maintain CPAP treatment over time on their own, encourage or provide ongoing support in the form of sleep coaches or other forms of check-in. This is where specialist sleep companies come into their own—making the change stick. Offer incentives. Promote use, and invite speakers like footballers, mountaineers and weightlifters. All ages and all body types experience sleep apnea. Chances are, you, or someone you know, has sleep apnea. Tell a story. Be forthright. Encourage action.

Whatever you decide, starting a conversation about sleep apnea is smart—both personally and for the workplace.

by Boyd Goodson

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