Clinical symptoms and related factors of obstructive sleep apnea among overweight and obese taxi drivers
DOI:
https://doi.org/10.13181/mji.v24i4.1279Keywords:
obstructive sleep apnea, occupational lung disease, taxi driverAbstract
Background: Obstructive sleep apnea (OSA) is common condition in commercial drivers while overweight and obesity as the most important risk factors. This study aimed to know the clinical symptoms and risk factors of OSA in overweight and obese taxi drivers in Jakarta, Indonesia.
Methods: A cross-sectional study was done in 103 taxi drivers in Jakarta from November 2011–September 2013, by systematic random sampling from 10 taxi stations. Inclusion criteria were taxi drivers with body mass index (BMI) which 23–29.9 and mild or moderate OSA. Portable polysomnography (PSG) test was used to diagnose OSA. Parametric and nonparametric test were used in bivariate analysis. Logistic regression multivariable was used to final evaluate risk factors of OSA.
Results: There were 54 (52.4%) of 103 drivers with OSA and 49 (47.6%) without OSA. Clinical symptoms found significantly (p<0.05) were snoring, unrefreshing sleep, occasional sleep while driving, and headache or nausea on waking up in the morning. Risk factors for OSA were increased BMI (OR=0.60, 95% CI=0.45–0.79, p=0.001), snoring history in the family (OR=4.92, 95% CI=1.82–13.31, p=0.002) and sleep duration <7 hours within 24 hours (OR=5.14, 95% CI=1.37–19.23, p=0.015).
Conclusion: Clinical symptoms of OSA were snoring, unrefreshing sleep, occasional sleep while driving and headache or nausea on waking up in the morning. Risk factors of OSA were increased BMI, snoring history in the family and sleep duration <7 hours within 24 hours.
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References
De Backer W. Obstructive sleep apnea/hypopnea syndrome. Definitions and pathopysiology. In: Randerath WJ, Sanner BM, Somers VK, editors. Sleep apnea. Current diagnosis and treatment. Prog Respir Res; 2006. p. 90–6. http://dx.doi.org/10.1159/000093150
White DP. Sleep apnea. Proc Am Thorac Soc. 2006;3:124–8. http://dx.doi.org/10.1513/pats.200510-116JH
Patil SP, Schneider H, Schwartz AR, Smith PL. Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest. 2007;132(1):325–7. http://dx.doi.org/10.1378/chest.07-0040
American Academy of Sleep Medicine. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep. 1999;22(5):667–89.
Young T, Skatrud J, Peppard PE. Risk factors for obstructive sleep apnea in adults. JAMA. 2004;291(16):2013–6. http://dx.doi.org/10.1001/jama.291.16.2013
Smith IE. Alternatif therapies for obstructive sleep apnea syndrome: behavioral and pharmacological options. In: Randerath WJ, Sanner BM, Somers VK, editors. Sleep apnea. Current diagnosis and treatment. Prog Respir Res; 2006. p. 174–9. http://dx.doi.org/10.1159/000093165
Pack AI. Advances in sleep-disordered breathing. Am J Respir Crit Care Med. 2006;173(1):7–15. http://dx.doi.org/10.1164/rccm.200509-1478OE
Scott AJ. Sleepiness and fatigue risk for the transportation industry. Occupational and Environmental Med. 2003;3:81–108. http://dx.doi.org/10.1016/S1526-0046(02)00054-7
George CF. Sleep apnea, alertness, and motor vehicle crash. Am J Respir Crit Care. 2007;176(10):954–6. http://dx.doi.org/10.1164/rccm.200605-629PP
Hartenbaum N, Collop N, Rosen IM, Philips B, George CF, Rowley JA, et al. Sleep apnea and commercial motor vehicle operators: statement from the joint task force of the American College of Chest Physicians, American College of Occupational and Environmental Medicine, and the National Sleep Foundation. Chest. 2006;130(3):902–5. http://dx.doi.org/10.1378/chest.130.3.902
George CF. Sleepiness, sleep apnea, and driving: still miles to go before we safely sleep. Am J Respir Crit Care Med. 2004;170(9):927–8. http://dx.doi.org/10.1164/rccm.2408009
Howard ME, Desai AV, Grunstein RR, Hukins C, Armstrong JG, Joffe D, et al. Sleepiness, sleep-disordered breathing, and accident risk factors in commercial vehicle drivers. Am J Respir Crit Care Med. 2004;170(9):1014–21. http://dx.doi.org/10.1164/rccm.200312-1782OC
Hui DS, Chan JK, Ko FW, Choy DK, Li TS, Chan AT, et al. Prevalence of snoring and sleep-disordered breathing in a group of commercial bus drivers in Hong Kong. Intern Med J. 2002;32(4):149–57. http://dx.doi.org/10.1046/j.1444-0903.2001.00196.x
Viegas CA, de Oliviera HW. Prevalence of risk factors for obstructive sleep apnea syndrome in interstate bus drivers. J Bras Pneumol. 2006;32(2):144–9.
Gülbay BE, Acican T, Do?an R, Baççio?lu A, Güllü E, Karada? G. The evaluation of excessive daytime sleepiness in taxi drivers. Tuberk Toraks. 2003;51(4):385–9. Turkish.
Firestone RT, Mihaere K, Gander PH. Obstructive sleep apnea among professional taxi drivers: a pilot study. Accid Anal Prev. 2009;41(3):552–6. http://dx.doi.org/10.1016/j.aap.2009.02.006
Wiadnyana IPGP, Susanto AD, Amri Z, Antariksa B. The Prevalence of suspected obstructive sleep apnea and related factors on "X" taxi drivers in Jakarta. J Respir Indo. 2010;30:32–8. Indonesian.
Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, Islam S, et al. Validation of the Berlin questionnaire and American Society of Anesthesiologist checklist as screening tools for obstructive sleep apnea in surgical patients. Anesthesiology. 2008;108(5):822–30. http://dx.doi.org/10.1097/ALN.0b013e31816d91b5
Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540–5.
Shiomi T, Sasanabe R. Advances in diagnosis and treatment of sleep apnea syndrome in Japan. JMAJ. 2009;52(4):224–30.
Widysanto A, Yunus F, Yusuf I, Sutrisna B, Suradi. Oxygen desaturation index as a risk factor for coronary artery disease in male subject with obstructive sleep apnea. J Respir Indo. 2012;3:161–6. Indonesian.
McNicholas WT. Diagnosis of obstructive sleep apnea in adults. Proc Am Thorax Soc. 2008;5(2):154–60. http://dx.doi.org/10.1513/pats.200708-118MG
Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc. 2008:5(2);136–43. http://dx.doi.org/10.1513/pats.200709-155MG
Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165(9):1217–39. http://dx.doi.org/10.1164/rccm.2109080
Lee YC, Eun YG, Shin SY, Kim SW. Prevalence of snoring and high risk of obstructive sleep apnea syndrome in young male soldiers in Korea. J Korean Med Sci. 2013;28(9):1373–7. http://dx.doi.org/10.3346/jkms.2013.28.9.1373
Chang SJ, Chae KY. Obstructive sleep apnea syndrome in children: epidemiology, pathophysiology, diagnosis and sequelae. Korean J Pediatr. 2010;53(10):863–71. http://dx.doi.org/10.3345/kjp.2010.53.10.863
Wolk R, Shamsuzzaman ASM, Somers VK. Obesity, sleep apnea, and hypertension. Hypertension. 2013;42(6):1067–74. http://dx.doi.org/10.1161/01.HYP.0000101686.98973.A3
Khan A, Patel NK, O'Hearn DJ, Khan S. Resistant hypertension and obstructive sleep apnea. Int J Hypertension. 2013: 2013:1–6. http://dx.doi.org/10.1155/2013/193010
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230–5. http://dx.doi.org/10.1056/NEJM199304293281704
Chuang CY, Lee CC, Chang YK, Sung FC. Oxidative DNA damage estimated by urinary 8-hydroxydeoxyguanosine: influence of taxi driving, smoking and areca chewing. Chemosphere. 2003:52(7):1163–71. http://dx.doi.org/10.1016/S0045-6535(03)00307-2
Autority of Health Research and Developed, Ministry of Health Republic of Indonesia. Basic Health Research (RISKESDAS) 2010. Ministry of Health Republic of Indonesia. 2010. p. 400–16.
Chin K, Oga T, Takahashi K, Takegami M, Nakayama-Ashida Y, Wakamura T, etal. Associations between obstructive sleep apnea, metabolic syndrome, and sleep duration, as measured with an actigraph, in an urban male working population in Japan. Sleep. 2010;33(1):89–95.
Risso TT, Poyares D, Rizzi CF, Pulz C, Guilleminault C, Tufik S, et al. The impact of sleep duration in obstructive sleep apnea patients. Sleep Breath. 2013;17(2):837–43. http://dx.doi.org/10.1007/s11325-012-0774-3
Kim NH, Lee SK, Eun CR, Seo JA, Kim SG, Choi KM, et al. Short sleep duration combined with obstructive sleep apnea is associated with visceral obesity in Korean adults. Sleep. 2013;36(5):723–9. http://dx.doi.org/10.5665/sleep.2636
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