Obstructive sleep apnea syndrome and sleep disorders in individuals with occupational injuries

Abstract

Abstract Background Some sleep disorders are known risk factors for occupational injuries (OIs). This study aimed to compare the prevalence of obstructive sleep apnea syndrome (OSAS) in a population of patients with OIs admitted to the emergency room (ER) with hospital outpatients as controls. Methods Seventy-nine patients with OIs and 56 controls were recruited at the University Hospital of Basel, Switzerland between 2009 and 2011. All patients completed a questionnaire and underwent a full-night attended polysomnography (PSG). We considered an apnea–hypopnea index (AHI) > 5 as an abnormal finding suggestive of a diagnosis of OSAS. Results Patients with OIs did not differ from controls regarding sex, age, body mass index, and job risk of OI. Patients with OIs tended to have an abnormal AHI (n = 38 [48%] vs. n = 16 [29%], odds ratio [OR] = 2.32 [95% confidence interval (CI):1.05–5.13]), and a higher AHI (8.0 vs. 5.6 events/h; Cohen’s d 0.28, p = 0.028) compared with controls. Patients with OIs also had abnormal limb movement index, arousal index, and signs of sleep bruxism compared with controls. Compared with 36 controls (66%), 70 patients with OIs (89%) had either excessive daytime sleepiness (EDS), and/or an abnormal finding during PSG (OR = 4.32, 95% CI:1.65–11.52). However, patients with OIs did not differ from controls regarding EDS or oxygen desaturation index. Conclusions Patients treated in the ER for OI had more abnormal findings suggestive of OSAS or other sleep disorders compared with a control group of hospital outpatients. Screening for these conditions should be part of the postaccident medical investigation.

Keywords

• Obstructive sleep apnea syndrome
• Occupational accidents
• Sleep fragmentation
• Polysomnography
• Excessive daytime sleepiness