title: Excessive daytime sleepiness at work and subjective work performance in the general population and among heavy snorers and patients with obstructive sleep apnea.
abstract: OBJECTIVE
  To evaluate excessive daytime sleepiness (EDS) at work and effects on reported work performance among men in the general population and male patients suffering from snoring and obstructive sleep apnea syndrome (OSAS).
  
  
  METHODS
  A cross-sectional study of Swedish men between the ages of 30 and 64 years in the county of Kopparberg, in mid-Sweden. A random sample of the general population (n = 285) and consecutive patients referred to a sleep laboratory who fulfilled objective diagnostic criteria (snorers = 289, OSAS = 62) responded to a questionnaire. Responders from the general population were divided into 2 groups, nonsnorers (n = 223) and snorers (n = 62). To validate a question on snoring in the questionnaire, 50 men, randomly selected from the sample of the general population, underwent sleep apnea screening in their homes.
  
  
  RESULTS
  The specificity of the questions about snoring was 83% and the sensitivity was 42%. The risk ratios for reporting EDS at work were 4-fold for snorers in the general population, 20-fold for snoring patients, and 40-fold for patients with OSAS as compared with nonsnoring men in the general population. Patients with OSAS and snoring patients both showed increased ratios on measures of difficulties with concentration, learning new tasks, and performing monotonous tasks when compared with nonsnorers.
  
  
  CONCLUSIONS
  Snoring and sleep apnea were highly associated with excessive EDS at work and subjective work performance problems. The results provide additional evidence that snoring is not merely a nuisance.
authors.affiliation: Department of Internal Medicine, Avesta Hospital, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Ulfberg
authors.forename: N
authors.initials: N
authors.lastname: Carter
authors.forename: M
authors.initials: M
authors.lastname: Talbäck
authors.forename: C
authors.initials: C
authors.lastname: Edling
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D012680:Sensitivity and Specificity; D012891:Sleep Apnea Syndromes / Q000150:complications*; D012913:Snoring / Q000150:complications*; D017132:Workplace