Increased risk of lost workdays prior to the diagnosis of sleep apnea.
BACKGROUND
The impact of sleep apnea on work disability, in terms of sickness absence and disability pension, is unclear. We sought to estimate the total number of lost workdays caused by sleep apnea either due to medically certified sickness absences or disability pensions during the 5 years prior to the year of a sleep apnea diagnosis.


METHODS
This is a register-linkage case-control study of Finnish public sector employees who had received a diagnosis of sleep apnea between 1995 and 2005 (n = 957) and randomly selected control subjects who had not received a diagnosis of sleep apnea (n = 4,785), matched for age, gender, socioeconomic position, type of employment, and organization. The annual sum of lost workdays, due to either medically certified sickness absences or disability pensions prior to diagnosis, was calculated for each participant (mean follow-up time, 5 years).


RESULTS
After adjustment for comorbid conditions (eg, hypertension, ischemic heart disease, diabetes, asthma/other chronic lung disease, and depression), an increased risk of lost workdays was found in employees in whom sleep apnea developed compared to control subjects (rate ratio [RR], 1.61; 95% confidence interval [CI], 1.24 to 2.09 in men; and RR, 1.80; 95% CI, 1.43 to 2.28 in women). In women, the excess risk was already pronounced 5 years prior to the year of diagnosis, whereas in men the highest risk was noticed 1 year before the year of diagnosis.


CONCLUSIONS
Sleep apnea may severely threaten work ability years before diagnosis. These results emphasize the importance of the early identification and treatment of employees with sleep apnea.
Sjösten
Noora
N
Finnish Institute of Occupational Health, Turku Finland, Finland. Electronic address: noora.sjosten@ttl.fi.
Vahtera
Jussi
J
Finnish Institute of Occupational Health, Turku Finland, Finland.
Salo
Paula
P
Finnish Institute of Occupational Health, Turku Finland, Finland.
Oksanen
Tuula
T
Finnish Institute of Occupational Health, Turku Finland, Finland.
Saaresranta
Tarja
T
Department of Pulmonary Diseases and Sleep Research Unit, Department of Physiology, University of Turku, Turku, Finland.
Virtanen
Marianna
M
Finnish Institute of Occupational Health, Helsinki, Finland.
Pentti
Jaana
J
Finnish Institute of Occupational Health, Turku Finland, Finland.
Kivimäki
Mika
M
Department of Epidemiology and Public Health, University College London, London, UK.