What is the impact of obstructive sleep apnea hypopnea syndrome and daytime sleepiness on work performance

Background: Obstructive sleep apnea hyponea syndrome (OSAHS) has been shown to be associated with many serious health conditions. However, the impact on occupational health is unclear. Purpose: The aim of this study was to assess the association between OSAHS, sleepiness and work performance. Methods: Ninety-three active adult subjects completed the Epworth Sleepiness Scale (ESS), the Work productivity and activity impairment (WPAI) questionnaire, the patient health questionnaire 9 (PHQ9), and answered various questions on workplace accidents and sick leaves. According to polygraph results, participants were classified as following: 73 with OSAHS and 20 healthy subjects. Results: In the group as a whole, there was no significant relationship between severity of OSAHS and the four dimensions of work limitation. However, significant differences were detected between patients with subjective sleepiness (as assessed by the ESS) with respect to presenteism (p=0.034), decline in productivity (p= 0.045) and activity impairment (p=0.004). Patients with OSAHS had more sick leaves (14.4% vs 3%, p=0.042). In addition, blue collar workers with subjective sleepiness had significantly higher absenteeism (p=0.013) and activity impairment (p=0.016). The mean of Apnea hypopnea index (AHI) was higher among White collar workers than blue collar workers (p=0.033). OSAHS was associated with higher frequency of hypertension (p= 0.041) and was more frequent among shift workers (p=0,042). Conclusion: Excessive daytime sleepiness is associated with limitation in work performance. These findings demonstrate the importance of screening for sleep-disordered breathing in the workplace.