Excessive Daytime Sleepiness More Prevalent in Shift Workers Than Patients With OSA, Study Finds

Shift workers were found to have a higher incidence of excessive daytime sleepiness (EDS) compared with patients with obstructive sleep apnea (OSA), according to study findings published this week in the Journal of Sleep Research.

When considering conditions that may cause EDS, shift work has been indicated as a notable risk factor. The impact of irregular sleep schedules caused by shift work has additionally been linked with burnout among police and increased risk of type 2 diabetes, which may be precipitated by disturbances in the circadian rhythm.

Patients with OSA also represent a distinct at-risk population, as the condition is a common comorbidity of EDS. Moreover, both conditions could prove dangerous in workers, with a prior study indicating that those with EDS are more likely to be involved in occupational incidents (2.5 times more likely) compared with workers with OSA (2 times more likely).

Researchers sought to determine the prevalence of EDS in shift workers (n = 290) and patients with OSA (n = 300), using a group of workers in aeronautical mechanics. “For airline pilots, work and rest times have been regulated due to the high demand of their job, but for aeronautical maintenance technicians these are not yet established, although their job is equally demanding, where failures impact the safety of an aircraft,” explained the study authors.

Both groups were compared with one another and also with a group of regular workers (n = 140). In the overall study cohort, 730 working-age individuals (aged 18-67 years) were examined, with EDS defined as an Epworth Sleepiness Scale (ESS) score of 11 or greater.

In the study findings, EDS was found to be prevalent in 37.1% of regular workers, 40.7% of patients with OSA, and 60.7% of shift workers. Shift workers were also shown to exhibit the highest median (interquartile range [IQR]) ESS score (12.0 [6.0]; range, 0-22) compared with patients with OSA (9.0 [7.0]; range, 0—24) and regular workers (9.0 [6.0]; range, 0-21).

Compared with the shift workers, patients with OSA had a lower ESS score based on the Kruskal-Wallis test (KW), an independent sample comparison (KW&thinsp;=&thinsp;−117.36; P&thinsp;<&thinsp;.001).

“Sleep hygiene education for companies’ workers and management is important for implementing mitigation strategies for EDS and fatigue,” concluded the study authors.

Reference

Reis C, Staats R, Pellegrino P, et al. The prevalence of excessive sleepiness is higher in shift workers than in patients with obstructive sleep apnea. J Sleep Res. Published online May 12, 2020. doi:10.1111/jsr.13073