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UBC Theses and Dissertations

The impact of obstructive sleep apnea on occupational injuries Hirsch Allen, Aaron Joshua (AJ)


Background: Obstructive Sleep Apnea (OSA) is a common but under diagnosed respiratory disorder characterized by recurrent upper airway obstruction during sleep. OSA results in sleep fragmentation and hypoxemia and is associated with neurocognitive impairments. OSA negatively affects vigilance and work performance, yet there is limited evidence on the relationship between OSA and the risk of occupational injuries (OI). It is hypothesized that individuals with OSA would have an increased risk of OI, and that OSA treatment may reduce this risk. Dissertation Objectives: 1. Summarize the existing evidence on the relationship between OSA and OI (Chapter 1). 2. Evaluate the association between the presence and severity of OSA and the risk of OI, both before and after diagnosis (Chapters 2-4). 3. Evaluate the impact of Continuous Positive Airway Pressure (CPAP) treatment on the risk of OI (Chapter 5). Methods: Patients referred to the UBC Sleep Disorders Clinic (SDC) for suspected OSA (2003-2011) were recruited to participate and diagnosed with OSA using polysomnography (PSG). Rates and risk of OI in the five years pre and post-PSG were calculated and compared by OSA status by linking to workers claims data. In addition, a matched sample of residents linked to claims data was drawn from the provincial health registry and compared to the OSA group. CPAP adherence data was collected from all OSA patients whose charts were available, and the impact of CPAP on the risk of OI was assessed using a pre/post treatment design.

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