The New York Metropolitan Transportation Authority (MTA) is proposing the expansion of sleep apnea screening and treatment to Long Island Rail Road train engineers and conductors, New York City Transit subway train operators and conductors, and bus operators for New York City Transit and the MTA Bus Company, becoming the first public transportation agency to systematically screen employees for obstructive sleep apnea and offer priority, specialized treatment to employees.

Pending the approval of the MTA Board on Wednesday, this program, which started at Metro-North Railroad in 2015, will expand to nearly 20,000 employees.

“Safety is our top priority and MTA is going further than any other transportation agency in the country to prevent the risks of apnea. With this proposal, we are not just working to implement industry best practices, the MTA is defining best practices,” said MTA Chairman and CEO Thomas F. Prendergast. “Sleep apnea is a serious illness and treatment will improve the quality of life for those who have it, and help them live longer.”

Sleep apnea is a medical disorder in which breathing repeatedly stops and starts while a person is sleeping, sometimes hundreds of times, when the patient’s throat muscles intermittently relax and block his or her windpipe. This results in insufficient sleep. Left untreated, someone with the disorder functions with reduced alertness and may involuntarily fall asleep.

Using a similar methodology to that already underway at Metro-North Railroad, sleep apnea screenings will include an evaluation of an employee’s Body Mass Index, neck circumference, a medical questionnaire related to sleep and sleep patterns, and relevant medical history. Employees who are deemed at risk based upon the screening will be referred for further testing and potential diagnosis and treatment.

Those referred for more detailed testing will be given a take-home overnight sleep test administered by a medical firm that specializes in sleep disorders. Based on the results, some employees may be required to undergo medical treatment for sleep apnea, which is generally treated through the use of masks that deliver continuous positive airway pressure, or oral devices that keep the airway open, either of which is worn at home during sleep.

The MTA has evaluated proposals from 13 healthcare companies who responded to a request for proposals issued last April.