Screen for sleep apnoea in the workplace, researchers suggest

Workplaces should screen employees for obstructive sleep apnoea (OSA), researchers have suggested.

A programme could be trialled for roles where daytime sleepiness carries more risks, such as driving.

It comes as analysis estimated that the common sleep condition could be causing an annual productivity loss of up to £4.22 billion in the UK.

OSA happens with the walls of the throat relax and narrow or close while sleeping – with symptoms including choking noises, loud snoring and waking up a lot.

It is thought to impact about eight million people in the UK.

Those with the condition may feel very tired during the day, as well as having mood swings and trouble concentrating.

The study, by experts in the UK and US, explored the impact of the sleep condition on the economies of both countries using data from the 2021 census.

Economic losses among working-age adults, aged between 18 and 64, were calculated by analysing how much they had missed work or were less productive at work.

Some 7% of working-age people included in the UK data met the criteria for OSA, with estimated productivity losses of up to £4.22 billion, or £1,840 per worker every year.

Researchers said: “Given the significant yet often-overlooked burden of OSA syndrome and its economic impact, we urge policymakers to allocate resources towards developing an effective screening strategy and implementing targeted public health campaigns and policies.”

They added that early identification and treatment of the condition could lead to “substantial savings”.

The study highlights that National Institute for Health and Care Excellence guidance for OSA suggests people who are drivers, train drivers, pilots and surgeons should be rapidly assessed for the condition.

However, researchers said that there is “limited data about occupational consequences of OSA” in these roles.

They also highlight that about 85% of people with OSA in the UK are undiagnosed.

The first-line treatment for OSA is continuous positive airway pressure (Cpap) machines, which involve patients wearing a mask that blows pressurised air into the nose and throat while they sleep.

However, they can be uncomfortable.

The GLP-1 receptor agonist tirzepatide, also known as Mounjaro, was also recently approved in the US for obese people with moderate to severe OSA.

Researchers said: “Sleep apnoea can now be easily identified and recently described tools can identify high-risk occupations.

“Importantly, treatment options for individuals with OSA are also improving with better Cpap adherence interventions on the horizon and new non-Cpap therapies, notably GLP-1 agonism.

“We suggest the time is now approaching for a trial of workplace screening in an exemplar high-risk occupational group.”

The team acknowledged that some workers may fear being penalised if they cannot tolerate treatment and suggest any successful screening programme should offer some form of employment guarantee.

They added: “Ultimately, the way to test whether workplace screening would be a worthwhile strategy would be to select an occupation in which OSA is prevalent and has severe consequences, such as professional driving, and see whether relevant outcomes such as road traffic accidents and absenteeism are clinically and statistically significantly different in a screened group compared with a standard care group.”

Reacting to the findings, the Sleep Apnoea Trust said: “It is very important that workplaces support their employees by not penalising them if they come forward, and that employers make the necessary adjustments while employees go through the process of clinical diagnosis and treatment.

“The trust welcomes consideration of screening programmes, and this raises the challenge to boost funding of existing and emerging treatments to meet the increased demands on services from screening.”

Adrian Jones, national officer at workers’ union Unite, said: “Professional drivers often hide issues of sleep apnoea out of fear of losing their jobs.

“Before introducing screening, employers must be fully educated that sleep apnoea can be effectively managed.

“Workers must have the confidence that they will be supported not dismissed if a problem is identified.”