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The impact of obstructive sleep apnea and daytime sleepiness on work limitation.
Sleep Med. 2007 Dec; 9(1):42-53.SM

Abstract

BACKGROUND

Many patients with obstructive sleep apnea (OSA) participate in the work force. However, the impact of OSA and sleepiness on work performance is unclear.

METHODS

To address this issue, we administered the Epworth Sleepiness Scale (ESS), the Work Limitations Questionnaire (WLQ), and an occupational survey to patients undergoing full-night polysomnography for the investigation of sleep-disordered breathing. Of 498 patients enrolled in the study, 428 (86.0%) completed the questionnaires. Their mean age+/-standard deviation (SD) was 49+/-12 years, mean body mass index (BMI) was 31+/-7 kg/m(2) mean apnea hypopnea index (AHI) was 21+/-22 events/h, and mean ESS score was 10+/-5. Subjects worked a mean of 39+/-18 h per week. The first 100 patients to complete the survey were followed up at two years.

RESULTS

In the group as a whole, there was no significant relationship between severity of OSA and the four dimensions of work limitation. However, in blue-collar workers, significant differences were detected between patients with mild OSA (AHI 5-15/h) and those with severe OSA (AHI>30/h) with respect to time management (limited 23.1% of the time vs. 43.8%, p=0.05) and mental/personnel interactions (17.9% vs. 33.0%, p=0.05). In contrast, there were strong associations between subjective sleepiness (as assessed by the ESS) and three of the four scales of work limitation. That is, patients with an ESS of 5 had much less work limitation compared to those with an ESS 18 in terms of time management (19.7% vs. 38.6 %, p<0.001), mental-interpersonal relationships (15.5% vs. 36.0%, p<0.001) and work output (16.8% vs. 36.0%; p<0.001). Of the group followed up, 49 returned surveys and 33 who were using continuous positive airway pressure (CPAP) showed significant improvements between the initial and second follow-up in time management (26% vs. 9%, p=0.0005), mental-interpersonal relationships (16% vs. 11.0%, p=0.014) and work output (18% vs. 10%; p<0.009).

CONCLUSION

We have demonstrated a clear relationship between excessive sleepiness and decreased work productivity in a population referred for suspected sleep-disordered breathing. Screening for sleepiness and sleep-disordered breathing in the workplace has the potential to identify a reversible cause of low work productivity.

Authors+Show Affiliations

Department of Medicine and Division of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17825611

Citation

Mulgrew, A T., et al. "The Impact of Obstructive Sleep Apnea and Daytime Sleepiness On Work Limitation." Sleep Medicine, vol. 9, no. 1, 2007, pp. 42-53.
Mulgrew AT, Ryan CF, Fleetham JA, et al. The impact of obstructive sleep apnea and daytime sleepiness on work limitation. Sleep Med. 2007;9(1):42-53.
Mulgrew, A. T., Ryan, C. F., Fleetham, J. A., Cheema, R., Fox, N., Koehoorn, M., Fitzgerald, J. M., Marra, C., & Ayas, N. T. (2007). The impact of obstructive sleep apnea and daytime sleepiness on work limitation. Sleep Medicine, 9(1), 42-53.
Mulgrew AT, et al. The Impact of Obstructive Sleep Apnea and Daytime Sleepiness On Work Limitation. Sleep Med. 2007;9(1):42-53. PubMed PMID: 17825611.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of obstructive sleep apnea and daytime sleepiness on work limitation. AU - Mulgrew,A T, AU - Ryan,C F, AU - Fleetham,J A, AU - Cheema,R, AU - Fox,N, AU - Koehoorn,M, AU - Fitzgerald,J M, AU - Marra,C, AU - Ayas,N T, Y1 - 2007/09/06/ PY - 2006/09/19/received PY - 2007/01/03/revised PY - 2007/01/03/accepted PY - 2007/9/11/pubmed PY - 2008/3/15/medline PY - 2007/9/11/entrez SP - 42 EP - 53 JF - Sleep medicine JO - Sleep Med VL - 9 IS - 1 N2 - BACKGROUND: Many patients with obstructive sleep apnea (OSA) participate in the work force. However, the impact of OSA and sleepiness on work performance is unclear. METHODS: To address this issue, we administered the Epworth Sleepiness Scale (ESS), the Work Limitations Questionnaire (WLQ), and an occupational survey to patients undergoing full-night polysomnography for the investigation of sleep-disordered breathing. Of 498 patients enrolled in the study, 428 (86.0%) completed the questionnaires. Their mean age+/-standard deviation (SD) was 49+/-12 years, mean body mass index (BMI) was 31+/-7 kg/m(2) mean apnea hypopnea index (AHI) was 21+/-22 events/h, and mean ESS score was 10+/-5. Subjects worked a mean of 39+/-18 h per week. The first 100 patients to complete the survey were followed up at two years. RESULTS: In the group as a whole, there was no significant relationship between severity of OSA and the four dimensions of work limitation. However, in blue-collar workers, significant differences were detected between patients with mild OSA (AHI 5-15/h) and those with severe OSA (AHI>30/h) with respect to time management (limited 23.1% of the time vs. 43.8%, p=0.05) and mental/personnel interactions (17.9% vs. 33.0%, p=0.05). In contrast, there were strong associations between subjective sleepiness (as assessed by the ESS) and three of the four scales of work limitation. That is, patients with an ESS of 5 had much less work limitation compared to those with an ESS 18 in terms of time management (19.7% vs. 38.6 %, p<0.001), mental-interpersonal relationships (15.5% vs. 36.0%, p<0.001) and work output (16.8% vs. 36.0%; p<0.001). Of the group followed up, 49 returned surveys and 33 who were using continuous positive airway pressure (CPAP) showed significant improvements between the initial and second follow-up in time management (26% vs. 9%, p=0.0005), mental-interpersonal relationships (16% vs. 11.0%, p=0.014) and work output (18% vs. 10%; p<0.009). CONCLUSION: We have demonstrated a clear relationship between excessive sleepiness and decreased work productivity in a population referred for suspected sleep-disordered breathing. Screening for sleepiness and sleep-disordered breathing in the workplace has the potential to identify a reversible cause of low work productivity. SN - 1389-9457 UR - https://www.unboundmedicine.com/medline/citation/17825611/The_impact_of_obstructive_sleep_apnea_and_daytime_sleepiness_on_work_limitation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1389-9457(07)00045-7 DB - PRIME DP - Unbound Medicine ER -