Obstructive sleep disorders can significantly impact an individual's overall well-being and performance, especially in safety-critical roles where alertness and focus are paramount. At KINNECT, we prioritise the health and safety of candidates and employees by implementing a comprehensive screening process to identify and manage obstructive sleep disorders effectively. This document outlines what obstructive sleep disorders are, the criteria we use to determine when a sleep study investigation is required, and the steps we take for diagnosis and management.
Obstructive Sleep Disorders: An Overview
Obstructive sleep disorders encompass a range of conditions characterised by disruptions in normal breathing patterns during sleep. One of the most common forms is obstructive sleep apnea (OSA), where the upper airway becomes partially or completely blocked during sleep, leading to pauses in breathing (apneas). These disruptions can result in poor sleep quality, excessive daytime sleepiness, and various health risks, including cardiovascular problems and reduced cognitive function.
Risk Factors for Obstructive Sleep Apnoea
Several risk factors can increase the likelihood of developing obstructive sleep apnoea:
Body Mass Index (BMI) and Weight: Higher BMI and excessive weight are significant risk factors for OSA. Excess fat deposits around the upper airway can obstruct breathing.
Neck Circumference: A larger neck circumference is often associated with a greater risk of airway obstruction during sleep.
Gender: Males are generally at higher risk for OSA than females, although the risk for females increases after menopause.
Age: The risk of OSA increases with age, particularly for individuals over 40.
Other Factors: Additional risk factors include a family history of OSA, smoking, and the use of alcohol or sedatives.
KINNECT's Criteria for Sleep Study Investigation
KINNECT employs a systematic approach to determine when a sleep study investigation is necessary to confirm or rule out an obstructive sleep disorder. Our criteria take into account various risk factors that may indicate the presence of such disorders. These risk factors include:
1. STOP Bang Score: Candidates or employees with a STOP Bang score of 3 or more have a significantly increased risk of OSA. The STOP Bang screening tool assesses for a history of snoring, tiredness, observed apnea and high blood pressure, and also takes into account body mass index (BMI), age, neck circumference, and gender.
2. Epworth Sleepiness Scale (ESS) Score: For safety-critical roles, an Epworth Sleepiness Scale score of 11 or more is considered indicative of potential obstructive sleep disorders. For non-safety-critical roles, a score of 16 or more triggers consideration.
The Screening Process
When a candidate or employee records risk factors as per the criteria mentioned above, KINNECT recommends the following screening process:
1. Level 2 Home Sleep Study: The individual is required to undertake a Level 2 home sleep study initially to screen for obstructive sleep disorders. This study is a convenient and cost-effective way to monitor sleep patterns and assess potential disruptions. The home sleep study can be arranged through a local pharmacy.
2. Consultation with Medical Practitioner: If the sleep study indicates the presence of an obstructive sleep disorder, the individual is required to consult with their treating Medical Practitioner regarding the treatment of their sleep disorder.
3. Evidence of Treatment and Management: Individuals diagnosed with obstructive sleep disorders are further required to provide evidence of the treatment and management of their sleep disorder. This includes CPAP (Continuous Positive Airway Pressure) machine reports/logs, which are essential for monitoring treatment effectiveness.