A Sleep Center of CNY* partnership with the Onondoga County Sheriff’s Department (OCSD), Beginning August 1, 2019

Objective

The goal of this proposal is to improve OCSD police performance, health, and community relations by addressing systemic deficiencies in the diagnosis and treatment of OSA.

Background

An American Medical Association study of 4,957 Police Officers estimates that 33.6% have Obstructive Sleep Apnea (OSA)1, a disease afflicting an estimated 1 Billion people worldwide. Characterized by airway obstruction leading to reduced levels of blood oxygen and sleep fragmentation, OSA is associated with excessive daytime sleepiness, lower quality of life, reduced cognitive performance, increased motor vehicle and workplace accident risk, hypertension, cardiovascular disease, and type 2 diabetes.
In addition, police officers with OSA report “higher rates of ‘uncontrolled anger’ towards suspects and citizens and increased absenteeism and serious administrative errors.”2  Additionally, “[ ]more than a third of officers who died in the line of duty were killed in motor vehicle crashes, a problem that is widely overlooked.”3

3-Level Project Initiative

This project will implement an OSA treatment model pioneered at the Sleep Center of CNY located in Syracuse. It uses innovative technology and a digital platform to enhance screening and diagnosis. And, similar to the US Army sleep medicine initiative, this treatment model utilizes oral appliances as the frontline therapy and other forms of OSA treatment, such as CPAP, as alternatives. Research and clinical practice have demonstrated that oral appliance therapy provides better long-term treatment success for many patients who fail with CPAP.
As the only otolaryngologist and board-certified sleep physician in New York State who is also a dentist, Dr. Sall has developed unique clinical insights to: 1) provide effective, convenient and non-invasive OSA screening, diagnosis and treatment for OCSD police officers, 2) facilitate a new collaborative care model with other physicians and dentists, and 3) overcome the limitations of CPAP with oral appliance therapy.

Notes: 1 & 2: 1. “Sleep Disorders, Health, and Safety in Police Officers,” as published in JAMA, December 21, 2011-Vol 306, No. 23 3:  “Sleep Problems in Police Officers Take Heavy Toll,” Anahad O’Connor, NYTIMES.com, December 20, 2011.

Socioeconomic Impact

The socioeconomic impact of untreated OSA is hard to quantify. However, we do know that untreated OSA costs the national healthcare system approximately $150B per year.4 This total includes $86.9B in lost productivity and $32.7B in motor vehicle and workplace accidents. Approximately $30B represents healthcare and medication costs. The annual per capita cost estimate is $461. Based on this data, the annual Syracuse Metro area cost burden is $307,384,000.

Police, Law Enforcement, & Community Benefit

Police deserve access to medical diagnosis and treatment innovations such as this project to perform their best, especially in situations where deficits in physical and emotional response can have serious personal and public consequences. A successful project with 800 OCSD employees has the potential to expand into the entire Syracuse community of 660,000. Not including the more immediate value to each officer’s personal health and happiness along with lower incidence of uncontrolled anger and errors, a successful project will improve community relations. And, fiscally, every 10% reduction in the incidence of OSA in Syracuse offers a $30million potential annual savings.

Wider Impact

Currently, no comprehensive program like this exists in the US. The publicity generated from this joint project with the OCDS will increase the awareness of the medical risks associated with untreated OSA and be used as a guide for citizens in our community to seek care. In addition, the data collected from a successful project (medical outcomes and police performance data) will be a national case study and model for the positive socioeconomic impact of public health initiatives such as Better Sleep, Better Community, Safer Syracuse.

The number of people that will benefit from the community project goes well beyond the screened, diagnosed, and treated employees of the OCSD.  The larger goal of this project is to increase the awareness of the community benefits associated with OSA treatment by focusing in on the 800 employees of the sheriff’s department and the 660,000 people they serve.

Based on the latest data available, between 16-23% of the population suffers from OSA.  Since 85% of the patients with OSA are undiagnosed the potential estimate of patients in the Syracuse Metro community is between 105,000 and 151,00.
The local exposure and publicity this community care project will generate should lead to increased awareness as well as a higher standard of care for residents of Syracuse suffering from OSA, which is a serious medical condition.


*Sleep Center of CNY is an informational website operated and maintained by Dr. Edward T. Sall, MD DDS MBA. Material in this presentation was produced in association with ProSomnus Sleep Technologies