Employers’ dream of controlling health costs turns to workers’ sleep
Charlie Blakey had a sense he was sleeping poorly since he often would wake up tired and hear from his wife how loudly he breathed during the night.
So he jumped at the chance when his employer, Southern Co., an Atlantabased electric utility, offered to test him in 2018 for sleep apnea, a potentially serious disorder in which people repeatedly stop breathing while asleep.
After he tested positive, the utility arranged for him to have a machine that provides continuous airflow through a mask while he sleeps — at no cost to him. Within weeks, Blakey, of Augusta, Ga., noticed a difference.
“Without a doubt, it’s helped me feel more refreshed when I get up,” said Blakey, 38, a safety and health specialist at the company.
About 4,000 of Southern’s 30,000 employees have been screened for sleep apnea in the past three years, and 1,500 are being treated. Southern officials said the program is saving money on health costs — $1.2 million in 2018 alone — because it reduces medical services for dangerous conditions such as heart disease that are complicated by sleep apnea.
Sleep is the latest in an ever-growing list of wellness issues — such as weight loss, exercise and nutrition — that firms are targeting to improve workers’ health and lower medical costs.
Whether all these sleep programs deliver on their promises is not yet clear. A study published last year in the Journal of the American Medical Association followed nearly 33,000 employees of BJ’s Wholesale Club for 18 months and found the wellness program did not lead to significant reductions in health spending.
Harry Liu, a researcher at the Rand Corp. who studies job-based wellness initiatives, said that while studies show “improving sleeping habits can reduce absenteeism and improve productivity,” it’s uncertain if employers’ efforts will have long-term effects for individual workers.
A study published by researchers at the University of Minnesota, Harvard Medical School and other institutions in October found that 1,200 commercial truck drivers who participated in an employer sleep apnea screening and treatment program saved an average of $441 per month in health costs compared with drivers who were not treated. An earlier study of members of a health plan serving Union Pacific employees also found overall health savings among workers who were diagnosed with sleep apnea and got treatment.
About 1 in 4 large employers offer programs to help workers get better sleep and more than half plan to implement such efforts by 2021, according to a 2019 survey by benefits firm Willis Towers Watson. Most businesses hire contractors to manage the programs.
Benefits officials say promoting a good night’s sleep for employees is as important as making sure their blood sugar and cholesterol are under control.
Despite the public’s concerns about privacy, employers say workers have been eager to reveal information about how they sleep to company vendors. To protect employees’ medical privacy, the data on individual workers does not go to their bosses; companies receive only aggregated data to measure program spending and effectiveness.
Katie Kirkland, director of benefits at Southern, said a lack of sleep may promote an unhealthy lifestyle of not exercising or eating a poor diet.
In addition to reducing medical costs, the company was motivated to offer its program because state transportation department rules require that some employees who operate heavy equipment and have certain health conditions be tested for sleep apnea and get treated if diagnosed.
With a diagnosis of apnea, a patient is typically prescribed a continuous positive airway pressure (CPAP) machine. But Kirkland said many workers needed help sustaining treatment because of difficulties in learning to sleep with a mask.
"With sleep apnea, there is a high drop-off rate, where you pay a lot for the equipment and then it doesn’t get used,” she said. “We found it’s a much better experience with the personal coaching.”