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Benefit of continuous positive airway pressure on work quality in patients with severe obstructive sleep apnea

  • Elsa BotokekyEmail author
  • N. Freymond
  • F. Gormand
  • P. Le Cam
  • G. Chatte
  • J. Kuntz
  • M. N. Liegeon
  • M. Gaillot-Drevon
  • A. Massardier-Pilonchery
  • A. Fiquemont
  • E. Fort
  • M. Marcu
  • T. Petitjean
  • B. Charbotel
Sleep Breathing Physiology and Disorders • Original Article
  • 36 Downloads

Abstract

Background

The objective of this prospective study was to assess the effect of CPAP therapy on job productivity and work quality for patients with severe obstructive sleep apnea (OSA).

Methods

A convenience sample of patients diagnosed with severe OSA using polysomnography or polygraphy and with a therapeutic indication for CPAP was enrolled in our study. Patients completed two self-administered questionnaires: the first before CPAP therapy and the second during the first 6 months after CPAP treatment. OSA symptoms were evaluated through self-administered questionnaires assessing potential effects on occupational activity: excessive daytime sleepiness was rated by the Epworth Sleepiness Scale (ESS), emotional status was rated by the Hospital Anxiety and Depression (HAD) scale, work quality was rated by the Work Role Functioning Questionnaire (WRFQ).

Results

Forty patients (30 men, mean age 47.3 ± 8.3, mean BMI 31.6 ± 7.4, mean apnea-hypopnea index 51.8 ± 16.3) showed a beneficial effect of CPAP therapy on ESS score (mean 11.6 to 8.2, p < 0.0001), the anxiety dimension (mean 57.5% to 20%, p = 0.0002), and the overall anxiety-depressive score (mean 50% to 22.5%, p = 0.0006). Mean WRFQ scores were significantly improved in the second questionnaire for the dimensions of timetable requirements (69.3% to 83.5%, p < 0.0001), productivity requirements (71.4% to 82.2%, p < 0.0001), mental requirements (72.0% to 84.3%, p < 0.0001), and social requirements (82.6% to 91.4%, p < 0.003).

Conclusions

We observed that adherence to CPAP therapy for patients with severe OSA mitigates the impact of symptoms on work including excessive daytime sleepiness, impairment of work ability, and anxiety and depressive disorders.

Keywords

Obstructive sleep apnea CPAP Job productivity Work limitation 

Abbreviations

AHI

Apnea-hypopnea index

AUDIT-C questionnaire C

Alcohol Use Disorders Identification Test Consumption

BMI

Body mass index

CCTIRS

Comité consultatif sur le traitement de l’information en matière de recherche en santé

CNIL

Comité consultatif sur le traitement de l’information en matière de recherche en santé

CPAP

Continuous positive airway pressure

CPP

Comité de protection des personnes

ESS

Epworth Sleepiness Scale

HAD

Hospital Anxiety and Depression

HAS

Haute autorité de santé

OSA

Obstructive sleep apnea

Q1

The first quartile

Q3

The third quartile

WLQ

Work Limitation Questionnaire

WRFQ

Work Role Functioning Questionnaire

Notes

Compliance with ethical standards

Ethical responsibilities of authors

All persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study are omitted. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    HAS. Évaluation clinique et économique des dispositifs médicaux et prestations associées pour la prise en charge du syndrome d’apnées hypopnées obstructives du sommeil (SAHOS) Volet 1 : Volet médico-technique et évaluation clinique. 2014Google Scholar
  2. 2.
    Terán-Santos J, Jiménez-Gómez A, Cordero-Guevara J (1999) The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med 340(11):847–851CrossRefGoogle Scholar
  3. 3.
    Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, Nieto FJ et al (2008) Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 31(8):1071–1078Google Scholar
  4. 4.
    Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342(19):1378–1384CrossRefGoogle Scholar
  5. 5.
    Peker Y, Kraiczi H, Hedner J, Löth S, Johansson A, Bende M (1999) An independent association between obstructive sleep apnoea and coronary artery disease. Eur Respir J 14(1):179–184CrossRefGoogle Scholar
  6. 6.
    Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V (2005) Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 353(19):2034–2041CrossRefGoogle Scholar
  7. 7.
    Hollinger P, Khatami R, Gugger M, Hess CW, Bassetti CL (2006) Epilepsy and obstructive sleep apnea. Eur Neurol 55(2):74–79CrossRefGoogle Scholar
  8. 8.
    Punjabi NM, Shahar E, Redline S, Gottlieb DJ, Givelber R, Resnick HE et al (2004) Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health study. Am J Epidemiol 160(6):521–530CrossRefGoogle Scholar
  9. 9.
    Marin JM, Carrizo SJ, Vicente E, Agusti AGN (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365(9464):1046–1053Google Scholar
  10. 10.
    Barbé F, Durán-Cantolla J, Capote F, de la Peña M, Chiner E, Masa JF, Gonzalez M, Marín JM, Garcia-Rio F, de Atauri JD, Terán J, Mayos M, Monasterio C, del Campo F, Gomez S, de la Torre MS, Martinez M, Montserrat JM (2010) Long-term effect of continuous positive airway pressure in hypertensive patients with sleep apnea. Am J Respir Crit Care Med 181(7):718–726CrossRefGoogle Scholar
  11. 11.
    Weaver TE, Maislin G, Dinges DF, Bloxham T, George CFP, Greenberg H, Kader G, Mahowald M, Younger J, Pack AI (2007) Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep 30(6):711–719CrossRefGoogle Scholar
  12. 12.
    Sánchez AI, Martínez P, Miró E, Bardwell WA, Buela-Casal G (2009) CPAP and behavioral therapies in patients with obstructive sleep apnea: effects on daytime sleepiness, mood, and cognitive function. Sleep Med Rev 13(3):223–233CrossRefGoogle Scholar
  13. 13.
    Engleman HM, Douglas NJ (2004) Sleep. 4: sleepiness, cognitive function, and quality of life in obstructive sleep apnoea/hypopnoea syndrome. Thorax 59(7):618–622CrossRefGoogle Scholar
  14. 14.
    Sassani A, Findley LJ, Kryger M, Goldlust E, George C, Davidson TM (2004) Reducing motor-vehicle collisions, costs, and fatalities by treating obstructive sleep apnea syndrome. Sleep 27(3):453–458CrossRefGoogle Scholar
  15. 15.
    Findley L, Smith C, Hooper J, Dineen M, Suratt PM (2000) Treatment with nasal CPAP decreases automobile accidents in patients with sleep apnea. Am J Respir Crit Care Med 161(3 Pt 1):857–859CrossRefGoogle Scholar
  16. 16.
    Jurádo-Gámez B, Guglielmi O, Gude-Sampedro F, Buela-Casal G (2015) Effect of CPAP therapy on job productivity and psychosocial occupational health in patients with moderate to severe sleep apnea. Sleep Breath 19(4):1293–1299Google Scholar
  17. 17.
    Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA (1998) The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med 158(16):1789–1795CrossRefGoogle Scholar
  18. 18.
    Malet L, De Chazeron I, Schwan R, Llorca PM, Falissard B (2005) Alcohol Use Disorders Identification Test in question. L’Encéphale 31(4 Pt 1):518–519Google Scholar
  19. 19.
    Durand M-J, Vachon B, Hong QN, Imbeau D, Amick BC, Loisel P (2004) The cross-cultural adaptation of the Work Role Functioning Questionnaire in Canadian French. Int J Rehabil Res Int Z Für Rehabil Rev Int Rech Réadapt 27(4):261–268Google Scholar
  20. 20.
    Barbé F, Durán-Cantolla J, Sánchez-de-la-Torre M, Martínez-Alonso M, Carmona C, Barceló A et al (2012) Effect of continuous positive airway pressure on the incidence of hypertension and cardiovascular events in nonsleepy patients with obstructive sleep apnea: a randomized controlled trial. JAMA 307(20):2161–2168CrossRefGoogle Scholar
  21. 21.
    Giles TL, Lasserson TJ, Smith BJ, White J, Wright J, Cates CJ (2006) Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev 1:CD001106Google Scholar
  22. 22.
    Mulgrew AT, Ryan CF, Fleetham JA, Cheema R, Fox N, Koehoorn M, FitzGerald JM, Marra C, Ayas NT (2007) The impact of obstructive sleep apnea and daytime sleepiness on work limitation. Sleep Med 9(1):42–53CrossRefGoogle Scholar
  23. 23.
    Young T, Shahar E, Nieto FJ, Redline S, Newman AB, Gottlieb DJ et al (2002) Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med 162(8):893–900CrossRefGoogle Scholar
  24. 24.
    K. Johansson. Amélioration durable du SAOS après perte de poids BMJ 2011; 342: d3017 [cited 2017 Aug 15]. Available from: https://www.arairlor.asso.fr/index.php?view=article&id=761%3Aamelioration-durable-du-saos-apres-perte-de-poids&option=com_content&Itemid=101
  25. 25.
    Hoflstein V (2002) Relationship between smoking and sleep apnea in clinic population. Sleep 25(5):519–524Google Scholar
  26. 26.
    Shirani A, Paradiso S, Dyken ME (2011) The impact of atypical antipsychotic use on obstructive sleep apnea: a pilot study and literature review. Sleep Med 12(6):591–597CrossRefGoogle Scholar
  27. 27.
    Liu D, Myles H, Foley DL, Watts GF, Morgan VA, Castle D et al (2016) Risk factors for obstructive sleep apnea are prevalent in people with psychosis and correlate with impaired social functioning and poor physical health. Front Psychiatry 7:139Google Scholar
  28. 28.
    Gurubhagavatula I, Sullivan S, Meoli A, Patil S, Olson R, Berneking M et al (2017) Management of obstructive sleep apnea in commercial motor vehicle operators: recommendations of the AASM Sleep and Transportation Safety Awareness Task Force. J Clin Sleep Med 13(5):745–758Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Elsa Botokeky
    • 1
    • 2
    Email author
  • N. Freymond
    • 3
  • F. Gormand
    • 4
  • P. Le Cam
    • 4
  • G. Chatte
    • 5
  • J. Kuntz
    • 5
  • M. N. Liegeon
    • 5
  • M. Gaillot-Drevon
    • 3
  • A. Massardier-Pilonchery
    • 1
    • 2
  • A. Fiquemont
    • 6
  • E. Fort
    • 2
  • M. Marcu
    • 3
  • T. Petitjean
    • 4
  • B. Charbotel
    • 1
    • 2
  1. 1.Department of Occupational DiseasesCHU LyonPierre-BéniteFrance
  2. 2.Université de Lyon, Université Claude Bernard Lyon 1, IFSTTAR, UMRESTTELyonFrance
  3. 3.Department of Respiratory MedicineCentre Hospitalier Lyon Sud, CHU LyonPierre-BéniteFrance
  4. 4.Department of Sleep DisordersCentre Hospitalier Croix Rousse, CHU LyonLyonFrance
  5. 5.Private Practice PneumologyCaluire-et-CuireFrance
  6. 6.University Claude Bernard Lyon 1LyonFrance

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