Wei-Te Wu1, Su-Shan Tsai2, Yu-Jen Lin3, Ming-Hsiu Lin4, Trong-Neng Wu5, Tung-Sheng Shih4, Saou-Hsing Liou6. 1. National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan. 2. Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan. 3. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan. 4. Institute of Labor, Occupational Safety and Health, Ministry of Labor, Taipei, Taiwan. 5. National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Healthcare Administration, Asia University, Taichung, Taiwan. 6. National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Occupational Safety and Health, China Medical University, Taichung, Taiwan; Department of Public Health, National Defense Medical Center, Taipei, Taiwan. Electronic address: shliou@nhri.org.tw.
Abstract
BACKGROUND: Professional drivers' work under conditions predisposes them for development of sleep-disordered breathing (SDB) and cardiovascular disease (CVD). However, the effect of SDB on CVD risk among professional drivers has never been investigated. A cohort study was used to evaluate the effectiveness of overnight pulse oximeter as a sleep apnea screening tool to assess the 8-year risk of CVD events. METHODS: The Taiwan Bus Driver Cohort Study (TBDCS) recruited 1014 professional drivers in Taiwan since 2005. The subjects completed questionnaire interview and overnight pulse oximeter survey. This cohort was linked to the National Health Insurance Research Dataset (NHIRD). Researchers found 192 CVD cases from 2005 to 2012. Cox proportional hazards model was performed to estimate the hazard ratio for CVD. The statistical analysis was performed using SAS software in 2015. RESULTS: ODI4 and ODI3 levels increased the 8-year CVD risk, even adjusting for CVD risk factors (HR: 1.36, 95% CI: 1.05 to 1.78; p=0.022, and HR: 1.40, 95% CI: 1.03 to 1.90; p=0.033). ODI4 and ODI3 thresholds of 6.5 and 10events/h revealed differences of CVD risks (HR: 1.72, 95% CI: 1.00 to 2.95; p=0.048, and HR: 1.76, 95% CI: 1.03 to 3.03; p=0.041). Moreover, the ODI levels had an increased risk for hypertensive disease (not including essential hypertension). CONCLUSIONS: This study concludes that ODI for a sign of SDB is an independent predictor of elevated risk of CVD. Further research should be conducted regarding measures to prevent against SDB in order to reduce CVD risk in professional drivers.
BACKGROUND: Professional drivers' work under conditions predisposes them for development of sleep-disordered breathing (SDB) and cardiovascular disease (CVD). However, the effect of SDB on CVD risk among professional drivers has never been investigated. A cohort study was used to evaluate the effectiveness of overnight pulse oximeter as a sleep apnea screening tool to assess the 8-year risk of CVD events. METHODS: The Taiwan Bus Driver Cohort Study (TBDCS) recruited 1014 professional drivers in Taiwan since 2005. The subjects completed questionnaire interview and overnight pulse oximeter survey. This cohort was linked to the National Health Insurance Research Dataset (NHIRD). Researchers found 192 CVD cases from 2005 to 2012. Cox proportional hazards model was performed to estimate the hazard ratio for CVD. The statistical analysis was performed using SAS software in 2015. RESULTS: ODI4 and ODI3 levels increased the 8-year CVD risk, even adjusting for CVD risk factors (HR: 1.36, 95% CI: 1.05 to 1.78; p=0.022, and HR: 1.40, 95% CI: 1.03 to 1.90; p=0.033). ODI4 and ODI3 thresholds of 6.5 and 10events/h revealed differences of CVD risks (HR: 1.72, 95% CI: 1.00 to 2.95; p=0.048, and HR: 1.76, 95% CI: 1.03 to 3.03; p=0.041). Moreover, the ODI levels had an increased risk for hypertensive disease (not including essential hypertension). CONCLUSIONS: This study concludes that ODI for a sign of SDB is an independent predictor of elevated risk of CVD. Further research should be conducted regarding measures to prevent against SDB in order to reduce CVD risk in professional drivers.
Authors: Eric A Mann; Srinivas Nandkumar; Nancy Addy; B Gail Demko; Neil S Freedman; M Boyd Gillespie; William Headapohl; Douglas B Kirsch; Barbara A Phillips; Ilene M Rosen; Logan D Schneider; Carl J Stepnowsky; Kathleen L Yaremchuk; Malvina B Eydelman Journal: J Clin Sleep Med Date: 2020-01-14 Impact factor: 4.062
Authors: Joshua M Bock; Kirk J Rodysill; Andrew D Calvin; Soumya Vungarala; Karine R Sahakyan; Stephen S Cha; Anna Svatikova; Francisco Lopez-Jimenez; Virend K Somers Journal: Front Cardiovasc Med Date: 2021-12-15