Assessment of Screening Tests for Sleep Apnea Syndrome in the Workplace

Abstract

Objectives: The Epworth sleepiness scale (ESS) is often used for screening of sleep apnea syndrome (SAS) in the workplace. We conducted pulse oximetry for workers of a large transportation company, who were selected based on their response to a questionnaire that included ESS and breathing pattern during sleep. Methods: Pulse oximetry was performed for 803 of 3,761 male workers. A 3% oxygen desaturation index (ODI) ≥15 was defined to represent sleep disordered breathing (SDB). We evaluated the frequencies of severe snoring and sleep apnea in the past three months reported by the bed partner or a family member. The relationships between 3% ODI ≥15 and various parameters were analyzed. Results: Of the 715 workers with valid recordings, 3% ODI was ≥15 in 108. The prevalence of 3% ODI ≥15 was high among workers with a body mass index (BMI) ≥25 kg/m², or for whom severe snoring (≥4 days/wk) or sleep apnea (≥2 days/mo) was reported, but did not correlate with ESS scores. Multivariate analysis showed that 3% ODI ≥15 correlated significantly with BMI, and reported severe snoring and sleep apnea, but not ESS scores. The prevalence of 3% ODI ≥15 was high among obese workers. ESS scores did not correlate with 3% ODI ≥15, irrespective of obesity. Conclusions: Our findings suggest that severe snoring, sleep apnea and BMI, but not ESS, are useful screening tools for SAS.