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Original Research: SLEEP MEDICINE |

Increased Risk of Lost Workdays Prior to the Diagnosis of Sleep Apnea

Noora Sjösten, PhD; Jussi Vahtera, MD, PhD; Paula Salo, PhD; Tuula Oksanen, MD; Tarja Saaresranta, MD, PhD; Marianna Virtanen, PhD; Jaana Pentti, BSci; Mika Kivimäki, PhD
Author and Funding Information

From the Finnish Institute of Occupational Health (Drs. Sjösten, Vahtera, Salo, Oksanen, and Ms. Pentti), Turku Finland; the Finnish Institute of Occupational Health (Dr. Virtanen), Helsinki, Finland; the Department of Epidemiology and Public Health (Dr. Kivimäki), University College London, London, UK; and the Department of Pulmonary Diseases and Sleep Research Unit (Dr. Saaresranta), Department of Physiology, University of Turku, Turku, Finland.

Correspondence to: Noora Sjösten, PhD, Finnish Institute of Occupational Health, Lemminkäisenkatu 14-18b, 20520 Turku, Finland; e-mail: noora.sjosten@ttl.fi


This work was performed at the Finnish Institute of Occupational Health, Finland.

This study was supported by the Social Insurance Institution of Finland, and the Academy of Finland (projects No. 117 604, No. 124 271, No. 124 322, No. 126 602, No. 129 262, and No. 129 264).

Dr. Saaresranta has received a total of €2,100 due to presentations in national symposia for Boehringer Ingelheim, Finland; Resmed Finland; and MSD Finland. Drs. Sjösten, Vahtera, Salo, Oksanen, Virtanen and Kivimäki, and Ms. Pentti have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(1):130-136. doi:10.1378/chest.08-2201
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Background:  The impact of sleep apnea on work disability, in terms of sickness absence and disability pension, is unclear. We sought to estimate the total number of lost workdays caused by sleep apnea either due to medically certified sickness absences or disability pensions during the 5 years prior to the year of a sleep apnea diagnosis.

Methods:  This is a register-linkage case-control study of Finnish public sector employees who had received a diagnosis of sleep apnea between 1995 and 2005 (n = 957) and randomly selected control subjects who had not received a diagnosis of sleep apnea (n = 4,785), matched for age, gender, socioeconomic position, type of employment, and organization. The annual sum of lost workdays, due to either medically certified sickness absences or disability pensions prior to diagnosis, was calculated for each participant (mean follow-up time, 5 years).

Results:  After adjustment for comorbid conditions (eg, hypertension, ischemic heart disease, diabetes, asthma/other chronic lung disease, and depression), an increased risk of lost workdays was found in employees in whom sleep apnea developed compared to control subjects (rate ratio [RR], 1.61; 95% confidence interval [CI], 1.24 to 2.09 in men; and RR, 1.80; 95% CI, 1.43 to 2.28 in women). In women, the excess risk was already pronounced 5 years prior to the year of diagnosis, whereas in men the highest risk was noticed 1 year before the year of diagnosis.

Conclusion:  Sleep apnea may severely threaten work ability years before diagnosis. These results emphasize the importance of the early identification and treatment of employees with sleep apnea.

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