by Bernice Casey Senior Underwriting Consultant
As Americans’ habits continue to change and impact their health, we’re seeing an increasing prevalence of a number of disorders and diseases. Some of these are easily treatable, and may seem like an inconvenience rather than a cause for serious concern. One of these chronic conditions is sleep apnea. However, if left untreated, this disorder can lead to an increased risk of high blood pressure, heart attack, stroke, or work-related and driving accidents, which is why it could impact potential carrier offers for life insurance.
Sleep apnea can be characterized by the presence of periodic pauses in breathing during sleep. The term apnea means cessation or near cessation of air flow. Hypopnea, a milder version of sleep apnea, indicates partial pauses during which airflow is diminished but does not stop. The types of apnea most often referred to are: central sleep apnea, obstructive sleep apnea (most commonly seen) and mixed sleep apnea. Sleep-disordered breathing is also a general term used to describe the presence of apnea and hypopnea.
Currently, obstructive sleep apnea (OSA) is thought to affect about 4% of men and 2% of women, though these numbers rise with age. Because obesity is a contributing factor to the disorder and is on the rise, the number of individuals with OSA could be even higher than projected. Hypertension, arrhythmias and smoking can also contribute to an increased risk of OSA. Typically, we will see clients who are affected by this disorder with the common symptoms of fatigue, daytime napping, snoring or witnessed apnea as reported to a physician by a spouse.
When underwriting OSA, most carriers will want to review the actual overnight sleep study that records various physiological parameters during sleep. Based on these results, the underwriter can determine the severity of the OSA and the recommended treatment. Once this is known, the patient’s compliance is key. If a continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) machine is recommended, the underwriter will follow up with the doctor for additional studies that determine if the amount of oxygen provided by the BiPAP or CPAP is actually controlling the symptoms and whether or not regular, ongoing use is taking place. Other treatments might include an intra-oral appliance or surgical correction of the upper airway obstruction.
Overall, if complete medical records that include the sleep study and follow up of recommended consistent use of treatment are provided, an informed offer will follow from the underwriter. Mild or moderate sleep apnea with less comorbidity is preferable for a better offer. Also, remember to document any steps a particular client has taken to control and minimize the effects of the disorder in your cover letter. Don’t “fall asleep at the wheel” when completing your field underwriting with clients who have sleep apnea. Call your Life Sales Consultant for help in obtaining the most favorable underwriting decision possible.
FOR AGENT USE ONLY. NOT FOR USE WITH THE GENERAL PUBLIC. 12056 – 2011/11/15