It may not be enough that the proposed insured “uses their CPAP”. Without the subsequent sleep studies to create the paper trail, the underwriter is left with very little choice but to assume that there is still a potential issue, resulting in Standard or worse.
Sleep apnea is a chronic disorder where breathing repeatedly stops and starts during sleep. When breathing is paused, carbon dioxide builds up in the bloodstream. A receptor in the blood stream takes note and the brain is then signaled to wake the sleeping individual and breathe in air. Breathing normally again will restore the oxygen levels and the individual falls back asleep. It is rare that the individual even realizes they were having difficulty breathing.
Sleep apnea, if not treated, can lead to hypertension, heart problems, lung damage, lack of concentration, and a high risk of driving accidents. It is because of these possible scenarios that the life insurance industry takes an extra look at applicants who have sleep apnea.
Most sleep apnea conditions are recognized by others witnessing the signs of the individual while sleeping or awake, or the condition is suspected because of its effects on the body. Sleep apnea is typically characterized by paused breathing or instances of abnormally shallow breathing while sleeping. Snoring is also extremely common. During the day, sleep apnea sufferers are prone to fatigue, slower reaction times, and vision problems. Behavioral effects such as moodiness, belligerence, and a decrease in attentiveness can also occur. Treatments for sleep apnea can include:
Depending on the individual, sleep apnea can be characterized as mild, moderate, or severe. With any severity, the key to getting good life insurance rates is the management of the condition. If your client has mild or moderate sleep apnea and she undergoes effective treatment, such as using a CPAP device, and have no other risk factors, many insurance carriers would consider offering the best classification rating. If it's severe sleep apnea, no other risk factors, and with effective management, it could be considered anywhere from Preferred to Standard.
If the medical records show that a sleep study test has been advised, but hasn't been done, some carriers will not even consider coverage until the study is done. These sleep study tests, which health insurance often covers, reveal brain wave activity, respiratory patterns, chest muscle activity and oxygenation.
When the life insurance underwriters determine that sleep apnea has been diagnosed, but the patient is non-compliant (e.g. a doctor prescribed a CPAP device which is not being used) insurance costs will reflect this. Premiums could double or even triple.
When reviewing an applicant’s sleep study test underwriters look for 2 key items:
The AHI calculates apnea (pauses in breathing) and hypopnea (shallow breathing) during an individual’s sleep. The index values range from 0-30+; the lower the number the better your AHI. The oxygen saturation is your balance of oxygen in the blood. Normal blood oxygen levels are considered to be 95-100 percent.
Even though the doctor may note “moderate” sleep apnea, this diagnosis is subjective which is why underwriters will review the sleep study tests.
Example: An individual’s doctor told him he had moderate to severe sleep apnea. The sleep study showed that his AHI was 17 and his oxygen saturation was at 90%. While the doctor may see this as moderate to severe, a life insurance carrier may consider the sleep apnea to be mild or even non-existent.
Many people with sleep apnea are able to buy affordable life insurance.