Obstructive sleep apnoea syndrome as a predictor of work disability

Abstract

Study objectives: This study examined whether obstructive sleep apnoea syndrome (OSAS) is associated with increased risk of work disability during six years following the diagnosis.

Design: Prospective follow-up study.

Setting: Ten municipalities and six hospital districts in Finland.

Participants: A total of 766 employees with OSAS (cases), and their control subjects (n=3,827) matched for age, gender, socioeconomic position, type of employment contract and type of organization.

Interventions: N/A.

Measurements: Data on all (>9 days) or very long-term (>90 days) sickness absences and for disability pensions were obtained from national registers. Diagnosis of OSAS was determined according to the Hospital Discharge Register, which includes data on all hospital admissions.

Results: According to the Cox proportional hazards models the hazard of the first sickness absence period (all sickness absences) during the follow-up was 1.7-fold (95% confidence interval (CI): 1.5-2.0) in male and 2.1-fold (95% CI: 1.8-2.4) in female sleep apnoea cases compared to controls after adjustments for sociodemographic factors. Both men and women with OSAS had a 2-fold increase in the risk for disability pension compared to controls. With regard to cause-specific work disability, employees with OSAS had a particularly pronounced risk of long-term work disability caused by injuries (HR 3.1 95% CI: 1.8-5.2) and mental disorders (HR: 2.8, CI 95%: 2.1-3.7).

Conclusions: These results suggest that OSAS is associated with an increased risk of both sickness absence and disability pension. They emphasize the need to identify the employees with this disorder and to improve general practitioners' knowledge about screening of sleep apnoea symptoms and indicators.