Clinical symptoms and related factors of obstructive sleep apnea among overweight and obese taxi drivers

  • Agus D. Susanto Doctoral programme, Faculty of Medicine, Gadjah Mada University, Yogyakarta
  • Barmawi Hisyam Doctoral programme, Faculty of Medicine, Gadjah Mada University, Yogyakarta
  • Lientje S. Maurits Doctoral programme, Faculty of Medicine, Gadjah Mada University, Yogyakarta
  • Faisal Yunus Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan Hospital, Jakarta
Keywords: obstructive sleep apnea, occupational lung disease, taxi driver
Abstract viewed: 2601 times
PDF downloaded: 1020 times

Abstract

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.

References

  1. 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

  2. White DP. Sleep apnea. Proc Am Thorac Soc. 2006;3:124–8. http://dx.doi.org/10.1513/pats.200510-116JH

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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.

  15. Gülbay BE, Acican T, Doğan R, Baççioğlu A, Güllü E, Karadağ G. The evaluation of excessive daytime sleepiness in taxi drivers. Tuberk Toraks. 2003;51(4):385–9. Turkish.

  16. 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

  17. 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.

  18. 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

  19. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540–5.

  20. Shiomi T, Sasanabe R. Advances in diagnosis and treatment of sleep apnea syndrome in Japan. JMAJ. 2009;52(4):224–30.

  21. 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.

  22. 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

  23. 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

  24. 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

  25. 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

  26. 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

  27. 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

  28. 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

  29. 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

  30. 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

  31. 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.

  32. 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.

  33. 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

  34. 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

Published
2015-12-31
How to Cite
1.
Susanto AD, Hisyam B, Maurits LS, Yunus F. Clinical symptoms and related factors of obstructive sleep apnea among overweight and obese taxi drivers. Med J Indones [Internet]. 2015Dec.31 [cited 2024Apr.26];24(4):206-14. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/1279
Section
Clinical Research