Role of Snoring and Daytime Sleepiness in Occupational Accidents

Lindberg, Eva; Carter, Ned; Gíslason, Þórarinn; Janson, Christer

doi:10.1164/ajrccm.164.11.2102028

Cited by 272 publications

(165 citation statements)

References 19 publications

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“…This is in contrast to a previous study among men, where the occurrence of symptoms of OSAS (snoring and excessive daytime sleepiness) resulted in an increased long-term risk of occupational accidents (OR adj 2.2, 95% CI 1.3-3.8) (21). Even though a gender difference cannot be ruled out, the discrepancy can also be due to a lower power of the present study.…”

Section: Discussioncontrasting

confidence: 99%

“…Subjects scoring 3-5 on both the snoring and EDS questions were categorized as having symptoms of obstructive sleep apnea syndrome (OSAS). A similar definition was used in a previous study on men (21) BMI was calculated as weight in kg divided by height in meters squared. The self-reported weight and height from the baseline questionnaire were used.…”

Section: Questionnairesmentioning

confidence: 99%

“…Based on previous research, it is well known that subjects with obstructive sleep apnea run an increased risk of traffic accidents (18)(19)(20), and we have previously reported that symptoms of obstructive sleep apnea syndrome (OSAS) also are an independent risk factor for occupational accidents among men (21). However, our knowledge of the impact of OSAS symptoms on occupational accidents among women as well as the impact of other sleep disturbances, such as insomnia, on accident risk is still limited (22,23).…”

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Role of sleep disturbances in occupational accidents among women

Hägg¹,

Torén²,

Lindberg³

2015

Scand J Work Environ Health

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Role of sleep disturbances in occupational accidents among women by Hägg SA, Torén K, Lindberg E In this population-based cohort study among women, the importance of insomnia symptoms for occupational accident risk is clarified. Insomnia symptoms that were persistent over ten years was an independent risk factor for overall work accident risk but not for more severe accidents requiring sick leave. Original article Scand J Work Environ Health. 2015;41(4):368-376. doi:10.5271/sjweh.3495 Role of sleep disturbances in occupational accidents among women Objectives This population-based cohort study was performed to assess the association between sleep disturbances and the risk of occupational accidents among women. AffiliationMethods Data were collected by questionnaires on two different occasions (2000 and 2010) and data on work injuries were also collected from Swedish government records (ISA). Insomnia symptoms were defined as having severe or very severe problems with (i) difficulty initiating sleep, (ii) difficulty maintaining sleep, or (iii) early morning awakening. Symptom of obstructive sleep apnea syndrome (OSAS) was defined as reporting both snoring and daytime sleepiness. Working-age respondents (20-67 years of age) who responded to both baseline and follow-up questionnaires and had worked for part or all of the 10-year follow-up period (N=4320) were included in the study. ResultsOf the subjects responding to the questionnaire, 12.2% reported ≥1 accident and 6.3% reported an accident requiring sick leave in the government register. Blue-collar workers and night and shift work were more common in the group with occupational accidents. Subjects with insomnia symptoms both at baseline and follow-up (persistent insomnia symptoms) ran a higher risk of being involved in an self-reported occupational accident [adjusted OR (OR adj ) 1.5, 95% confidence interval (95% CI) 1.2-2.0] after adjusting for age, body mass index, smoking, alcohol dependency, white-or blue-collar worker, years at work, night work, and physical activity. Persistent insomnia symptoms did not reach statistical significance as an independent predictor of register-reported occupational accident with sick leave (OR adj 1.4, 95% CI 0.99-2.1). No significant association was found between symptoms of OSAS and self-reported or register-based occupational accidents.Conclusions Persistent insomnia symptoms were associated with an increased risk of self-reported occupational accidents, while no significant association was found with occupational accidents with sick leave reported to government register.

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Role of sleep disturbances in occupational accidents among women

Hägg¹,

Torén²,

Lindberg³

2015

Scand J Work Environ Health

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“…As a consequence of excessive daytime sleepiness, subjects with OSA are similarly at increased risk of occupational injuries [40].…”

Section: Non Cardiovascular Risks Of Osamentioning

confidence: 99%

Obstructive sleep apnea: one more target in cardiac rehabilitation

Rovere

Fanfulla

Febo

2015

Monaldi Arch Chest Dis

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Obstructive sleep apnea: one more target in cardiac rehabilitation. M.T. La Rovere, F. Fanfulla, O. Febo.Obstructive sleep apnea (OSA) is a highly prevalent sleep-related breathing disorder, often unrecognized and undiagnosed, in patients with established cardiovascular diseases. Considerable evidence is now available in support of a significant association between OSA and increased risk for cardiovascular disease morbidity. OSA has also been recognised as a potential public health issue associated with societal consequences including accidents and work economics. Treatment of OSA would reduce cardiovascular risk and the overall usage of health care resources. OSA might be a modifiable risk factor and screening for OSA should be implemented in cardiac rehabilitation settings.

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Sleep-disordered breathing-related neurocognitive impairment, time to think beyond hypoxia and sleep fragmentation?

2014

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It has been well accepted that sleep-disordered breathing (SDB) is associated with impaired neurocognitive and behavioral performance and may consequently cause motor vehicle accidents and occupational injuries [1][2][3]. However, the relevant pathophysiological mechanism causing this is unclear. In particular, the key determinants of the neurocognitive/ behavioral impairment in SDB are not known. Many candidate factors such as hypoxia, sleep fragmentation, apneahypopnea index (AHI), BMI, sleep time, and metabolic factors have been studied, but none show a strong correlation with neurocognitive/behavioral impairment [4,5]. Of these factors, intermittent hypoxia and sleep fragmentation has the strongest evidence and may play a more important role than other factors [4][5][6]. However, lack of robust findings means that it is difficult to claim these two parameters as "key determinants". In a landmark US study in this field (APPLES study), Quan et al. tested long-term neurocognitive outcomes of continuous positive airway pressure (CPAP) on 1,204 obstructive sleep apnea (OSA) patients, using a robust randomized, double-blind, and sham-controlled design [7]. They found that severity of O 2 desaturation was the strongest predictor, but explaining only <2 % of the variance of neurocognitive performance. Sleep fragmentation was not a significant predictor [7]. In a multicenter European study, 1,649 OSA patients with excessive daytime sleepiness (EDS) were compared with 1,233 OSA patients without EDS [8]. The two groups were found to have only 1 % difference in SpO 2 nadir, no difference in mean SpO 2 , and only four events per hour difference in Arousal index (37/h in EDS and 33/h in non-EDS group) [8].Given the above context, it is not surprising that in the current issue of the journal, Olaithe et al. found that neither hypoxia nor sleep fragmentation significantly predict cognitive performances in any domain [9]. The authors thoroughly assessed different domains of cognitive function and overnight polysomnography (PSG) in 150 Australians ranging from no-OSA to severe OSA. They examined the potential relationships between hypoxia/sleep fragmentation and cognitive function using structured equation modeling and carefully controlled for the confounding factors of IQ and age. They found that hypoxia was unrelated to any cognitive measures. Although modest relationships between sleep fragmentation and certain domains of cognition were found, the significance was lost after controlling for age [9]. Indeed, given that daytime cognition is affected by so many coexisting factors, any claim of relationship without a rigorous control of confounding factors would be misleading. From this aspect, the well-controlled study from Olaithe et al. can certainly add weight in the literature [9]. Importantly, data from Olaithe et al. and other studies may imply that we should not limit our thoughts solely to hypoxia and sleep fragmentation when considering the mechanisms of SDB-related cognitive impairment. Recent data have suggested ot...

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Role of Snoring and Daytime Sleepiness in Occupational Accidents

Cited by 272 publications

References 19 publications

Role of sleep disturbances in occupational accidents among women

Role of sleep disturbances in occupational accidents among women

Obstructive sleep apnea: one more target in cardiac rehabilitation

Sleep-disordered breathing-related neurocognitive impairment, time to think beyond hypoxia and sleep fragmentation?

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