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The effect of OSAS on sick leave and work disability

Depts of ¹ Clinical Psychology, ² Education and Health Promotion, and ⁴ Public Health and Primary Health Care, University of Bergen, and ⁵ Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, and ⁶ Dept of Mental Health, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway, ³ Neurological/Mental Health Division, The George Institute for International Health and University of Sydney, Sydney, Australia.

CORRESPONDENCE: B. Sivertsen, Dept of Clinical Psychology, University of Bergen, Christiesgt. 12, 5015 Bergen, Norway. Fax: 47 55589877. E-mail: borge.sivertsen{at}psykp.uib.no

Keywords: Epidemiology, obstructive, population-based, risk factors, sickness absence, sleep apnoea

Received: March 24, 2008
Accepted July 9, 2008

The objective of the present study was to examine the independent contribution of symptoms of obstructive sleep apnoea syndrome (OSAS) to long-term sick leave and permanent work disability.

Using a historical cohort design with 4 yrs of follow-up, information on sick leave and disability benefit recipiency were merged with health information from the Hordaland Health Study, carried out in western Norway during 1997–1999. Persons aged 40–45 yrs (n = 7,028) were assessed for self-reported symptoms of OSAS (snoring, breathing cessations and daytime sleepiness), body mass index, somatic conditions and other potential confounders. The outcomes, cumulative sick leave of 8 weeks and permanent work disability, were identified in records from the National Insurance Administration.

After excluding participants with work disability at baseline, symptoms of OSAS were found to be a significant predictor of both subsequent long-term sick leave and permanent work disability. These effects remained significant after adjustment for a range of possible confounding factors. Daytime sleepiness showed the greatest explanatory power, followed by breathing cessations and snoring.

It is concluded that self-reported symptoms of obstructive sleep apnoea syndrome are an independent risk factor for subsequent long-term sick leave and permanent work disability. These findings need to be replicated using objective measures of obstructive sleep apnoea syndrome.

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