Obstructive sleep apnea: a risk factor for work disability.
OBJECTIVE
To examine obstructive sleep apnea (OSA) as a risk factor for work disability.


METHODS
Consecutive patients referred to the University of California San Francisco Sleep Disorders Center with suspected OSA (n = 183).


METHODS
All patients underwent overnight polysomnography after completing a written survey which assessed work disability due to sleep problems, occupational characteristics and excessive daytime sleepiness (EDS) defined as an Epworth Sleepiness Scale score > 10.


RESULTS
Among 150 currently employed patients, 83 had OSA on polysomnography (apnea-hypopnea index > or = 5). Compared with patients in whom both OSA and EDS were absent, patients with the combination of OSA and EDS were at higher risk of both recent work disability (adjusted odds ratio [OR], 13.7; 95% confidence interval [CI], 3.9-48) and longer-term work duty modification (OR, 3.6; CI, 1.1-12). When either OSA or EDS were absent, the strength of the association with work disability was less than when both OSA and EDS were present. When OSA was examined without respect to EDS, patients with OSA were at increased risk of recent work disability relative to patients without OSA (OR 2.6; 95% CI 1.2-5.8), but the association of OSA with longer-term work duty modification did not meet standard criteria for statistical significance (OR = 2.0, 95% CI 0.8-5.0).


CONCLUSIONS
The combination of OSA and EDS contributes to work disability, and OSA by itself contributes to recent work disability. These findings should highlight to employers and clinicians the importance of OSA in the workplace to encourage patients to be screened for OSA, particularly in situations of decreased productivity associated with EDS.
Omachi
Theodore A
TA
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, CA 94143-0111, USA. omachi@ucsf.edu
Claman
David M
DM
Blanc
Paul D
PD
Eisner
Mark D
MD
D000041:Absenteeism; D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D004185:Disability Evaluation; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis* / Q000534:rehabilitation; D004650:Employee Performance Appraisal; D005260:Female; D006801:Humans; D007587:Job Description; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis* / Q000534:rehabilitation; D017286:Polysomnography; D012050:Rehabilitation, Vocational; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000534:rehabilitation; D014940:Work Schedule Tolerance