Predictors for Progression of Sleep Disordered Breathing among Public Transport Drivers: A 3-Year Follow-Up Study

J Clin Sleep Med. 2015 Apr 15;11(4):419-25. doi: 10.5664/jcsm.4596.

Abstract

Study objectives: Sleep-disordered breathing (SDB) is associated with an increased risk of motor vehicle crashes. This study aimed to understand SDB progression and related factors among professional drivers.

Methods: A total of 524 professional male drivers from a transportation company were included in this study. These drivers completed overnight in-home pulse oximetry studies both in 2006 and in 2009. Participants with abnormal results (oxygen desaturation index [ODI] ≥ 10 events/h) comprised the SDB group. Data included questionnaire information on demographics, medical history, SDB symptoms, and anthropometric measurements.

Results: A total of 318 male workers were recruited for further analysis. Fifty of these workers belonged to the SDB group. Workers with untreated SDB significantly progressed to a more severe state after three years. Baseline body mass index (BMI), baseline ODI, and change in BMI were all significant positive predictors of SDB progression (β = 0.823, 0.242, and 1.626; p = 0.047, 0.013, and 0.004, respectively). Compared with non-SDB drivers, SDB subjects showed a greater proportion of newly diagnosed cardiovascular disease (38.0%) at follow-up.

Conclusions: Untreated SDB was a gradually progressive disorder in professional drivers over a three-year period. Subjects with high BMI and moderate to severe SDB should be closely monitored to allow for early detection of worsening SDB. Weight control should be highlighted in the management of SDB.

Commentary: A commentary on this article appears in this issue on page 409.

Keywords: body mass index; longitudinal study; oxygen desaturation index; predictors; professional drivers; progression; sleep disordered breathing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Automobile Driving / statistics & numerical data
  • Body Mass Index
  • Cardiovascular Diseases / etiology
  • Disease Progression
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Oximetry
  • Risk Factors
  • Sleep Apnea Syndromes / complications
  • Sleep Apnea Syndromes / etiology*
  • Sleep Apnea Syndromes / pathology
  • Surveys and Questionnaires
  • Transportation / statistics & numerical data