While persistent snoring may drive your partner crazy, that’s not why insurers tread cautiously when someone who applies for life insurance shows signs of suffering from obstructive sleep apnea – a potentially deadly sleeping and breathing disorder.
Contrary to popular opinion, the key concern with sleep apnea isn’t the snoring, though some bed partners would beg to differ. The main worry is that people with sleep apnea are at increased risk of elevated blood pressure, stroke, heart attack and car accidents.
Which is why an insurer may decline cover or apply loadings on the basis of a client’s obstructive sleep apnea syndrome.
How life insurers assess sleep apnea
Questions relating to obstructive sleep apnea are now routinely included on many life insurance applications. Where someone discloses they have the disorder, the insurer will request a doctor’s report to see what treatments have been implemented and how successful they’ve been.
Further medical information may also be required where the company suspects someone may be suffering from sleep apnea but doesn’t know it because of tell-tale signs in their health history.
What you can expect when having sleep apnea (depending on the insurer you select)
- Moderate to severe sleep apnea – (i.e. an AHI greater than 30 episodes per hour), cover will usually be declined but may be reviewed after the condition has been successfully brought under control.
- Mild sleep apnea – if someone has well-established treatments in place, cover may be available with a loading (for mild sleep apnea) or possibly even at standard rates for life insurance (if their AHI is now normal/borderline and there are no other risk factors). For Income Protection Insurance, a minimum 30-day wait would apply for someone with borderline sleep apnea and loadings may apply.
If in addition to life insurance for sleep apnea the applicant has other risk factors (eg obesity, hypertension, smoking etc) as is often the case, relevant ratings may also apply.
As previously stated, these factors will vary between each life insurance company, and your life insurance application is reviewed on a case-by-case basis.
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What is sleep apnea?
Obstructive sleep apnea syndrome is a secondary sleeping/breathing disorder.
When the sufferer is asleep, their pharyngeal (throat) muscle relaxes and becomes floppy, causing the throat to repeatedly narrow and close. The person’s breathing slows down or stops altogether and in severe cases, for intervals as long as 60 to 90 seconds, blocking the flow of air to the lungs and reducing blood oxygen levels. The absence of breathing triggers a wake-up call in the brain.
The person stirs, resumes breathing with a snort or gasp, then drifts back to sleep straight away, unaware of what’s just occurred. In severe cases, this apnea/arousal pattern can repeat itself every one or two minutes throughout the night, leaving the person exhausted by the morning.
Symptoms of sleep apnea:
- Loud snoring (caused by vibrating upper respiratory airways when the throat narrows),
- Daytime fatigue/tiredness/lethargy, falling asleep at the drop of a hat (on the bus or train or at the dinner table),
- Irritability and mood swings,
- Recurrent respiratory infections,
- Poor concentration,
- Morning headaches, and
- rRduced sex drive.
People with sleep apnea are two to five times more likely to have a car accident due to daytime sleepiness (2), they are also more prone to accidents at work and likely to take more sick days.
Causes of sleep apnea
While sleep apnea can occur at any age, it’s most common in mid life, when one in 10 people are affected by the condition.
Contributing factors include:
- Obesity (especially weight gain around the neck) – two in five obese people have significant sleep apnea problems (2).
- Structural nose or throat problems (often exacerbated by smoking),
- Drinking alcohol or ingesting other relaxants (eg sleeping pills).
Men are more susceptible to sleep apnea than women, with one in four males over 30 affected by the disorder to some degree (1).
Doctors attribute the possible reasons for this gender bias to:
- hormonal differences (especially during the reproductive years),
- disparities in weight distribution (women tend to store fat in their lower body, rather than upper torso). and
- higher levels of alcohol consumption in men.
While sleep apnea may be very prevalent in the community, affecting an estimated 4% of males aged between 30 and 60 (1), it’s not widely understood and many sufferers aren’t aware of their condition.
An overnight visit to a sleep laboratory, where patients are hooked up to a polysomnogram, can rule out sleep apnoea or confirm its diagnosis and level of severity. The polysomnogram measures numerous physiological functions, including heart rate, oxygen blood levels, breathing through the nose and mouth, eye movements, brain activity and snoring. The apnoea-hypopnoea index (AHI) is used to measure the severity of obstructive sleep apnea by counting the number of breathing cessations (apnoeas) and reductions (hypopnoeas) that last 10 seconds or more per hour.
People without sleep apnea experience less than five interruptions per hour, while someone with mild sleep apnea has between 15 and 20 such episodes Treatments depend on what’s causing the problem.
- Reducing your weight by five to 10 kilos can often reduce the severity of the disorder (3),
- Reducing alcohol consumption (especially close to bed time),
- nasal sprays,
- cutting out/reducing sedative and nicotine intakes,
- nose/throat surgery,
- anti-snoring pillows.
In moderate to severe cases, the doctor might recommend using a nasal Continuous Positive Airway Pressure (CPAP) machine, a mask that must be worn to bed each night and continuously blows air into the person’s throat, keeping the air passage open. While wearing a CPAP mask to bed may take some getting used to, people who’ve been sleep deprived for a prolonged period of time often report having their first good night’s sleep in a long time after they start using it and a renewed zest for life.
If you suffer from sleep apnea and need life insurance coverage, fill in the form above and have the following information ready:
- Apnea index
- Your height and weight
- Current treatment and frequency
We can help you find the most competitively priced life insurance rates in Australia.
- Munich Re Medletter 02: What’s new in insurance medicine?
- ‘Your Lungs – Take A Deep Breath, Men’s health peer education, www.dva.gov.au
- Better Health Channel fact sheet: Sleep apnoea, www.betterhealth.vic.gov.au
Source: Zurich 2007