Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses during sleep.
It is possible for applicants who have this condition to get approved for life insurance, depending on severity, treatment and compliance. But advisors who are placing the case need to know what to look for and what to report to the underwriter to achieve the best possible outcome.
First, what are the symptoms? Some people with OSA complain that they wake up with a very sore and/or dry throat. They may on occasion wake up with a choking or gasping sensation and sometimes they seem to wake themselves up with their own loud snoring. In addition, a person with OSA will often report sleepiness during the day due to fragmented sleep.
Other symptoms may include morning headaches, forgetfulness, and mood changes.
Treatment varies. In some cases, it may include loss of weight, surgery for milder forms, masks (devices called continuous positive airway pressure, or CPAPs, to aid breathing) or mouthpieces. CPAP, often called the most successful treatment, is connected to a source of air pressure and is used for moderate to severe sleep apnea.
Physicians usually do not prescribe medication for the treatment of OSA.
Can a person die of this condition? Several studies have concluded that sleep apnea is associated with many stroke and heart attack fatalities.
After talking to several physicians, a sleep technician and a home office underwriter, I found that their opinions were varied with no conclusions as to death as a direct result of OSA. (Note: The only time I have ever heard of anyone dying of the condition was Reggie White of the Green Bay Packers. Initially it was said he died of sleep apnea, but later the cause of death was changed to a massive heart attack.)
OSA can be connected with many types of illness. But, from a life underwritng perspective, the facts are not convincing that the condition is a definite threat to life expectancy on its own, except in the most severe cases. However, accidental death due to sleep deprivation is always a consideration.
When the client has a history of OSA or if it seems possible that OSA may be present, advisors should know that the underwriting will depend on severity, treatment and compliance. The chart illustrates how the ratings might work out.
An important question to ask is, can a person who has the condition lower a rating or become insurable?
Recently, my firm had a case where the applicant had been diagnosed originally with “moderately severe” sleep apnea 4 years ago. After a month of using the CPAP mask, it bothered him so much he decided not use it again. This applicant was declined for being medically non-compliant.