Obstructive sleep apnoea syndrome as a predictor of work disability☆

Received 9 September 2008; accepted 14 January 2009. published online 02 March 2009.

Summary

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.

Keywords: Sleep apnoea, Sickness absence, Disability pension

a Centre of Expertise for Work Organizations, Finnish Institute of Occupational Health, Lemminkäisenkatu 14-18B, FI-20520 Turku, Finland

b Centre of Expertise for Work Organizations, Finnish Institute of Occupational Health, Topeliuksenkatu 41aA, 00250 Helsinki, Finland

c Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 6BT London, UK

d Department of Pulmonary Diseases, University of Turku, Lemminkäisenkatu 2, FI-20520, Finland

e Sleep Research Unit at Department of Physiology, University of Turku, Lemminkäisenkatu 2, FI-20520, Finland

Corresponding author. Tel.: +358 30 474 7559; fax: +358 30 474 7556.

☆ Funding: This study was supported by the Academy of Finland (project numbers 117 604, 124 271, 124 322, 129 262 and 126 602) and the Social Insurance Institution of Finland.

PII: S0954-6111(09)00028-6

doi:10.1016/j.rmed.2009.01.014

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