Authors ? for the Sonnoamico group

BACKGROUND

Obstructive sleep apnea (OSA) is a global health problem highly prevalent, peaking to 24% in men and 9% in women. However, most cases (80%) are not diagnosed.

AIM

The present survey aimed to assess determinants of OSA in a population of workers.

METHODS

The survey was performed on the workers of an Italian telecommunication company (TIM Group), and comprised a screening and a clinical phase. In the first phase, 6734 employees aged >50 years answered an online questionnaire, the STOP BANG TEST. Of these, 4051 (60%) performed the clinical phase, including a nocturnal polygraphy. Multivariable generalized linear models with gamma distribution were used to estimate the association between time under 90% oxygen saturation (T90) and Body Mass Index (BMI), smoking habits, controlling for sex and age. Interactions between risk factors and demographic variables were also tested.

RESULTS

Median T90 was 0.7 minutes (p25-75:0-4.4) in the whole cohort and was markedly affected by BMI, and smoking habits (p<0.001). Median T90 was 0.1 minutes (0-0.7) in normal weight subjects and increased to 4.2 (0.9-13.7) and 12.2 (4.6-27.7) minutes in obese and severely obese respectively (p<0.001). T90 increased from 0.6 (0-3.7) in non-smokers to 1.8 (0.2-9.5) minutes in past smokers exposed to >15 pack-years. These findings were confirmed in multivariable analysis. A significant interaction was detected between gender and smoking habits (p=0.013), as the increase in T90 with respect to non-smokers was larger in women than men.

CONCLUSION

Obesity emerged as the main risk factor for prolonged oxygen desaturation. The noxious effect of smoking habits on T90 was larger in women than men.