Demographic and clinical characteristics in disability assessment of sleep disorder patients

Öz

Aim: This study aimed to investigate the impact of demographic and clinical characteristics in the disability assessment of patients with sleep disorders. Material and Methods: A retrospective analysis was conducted on 122 patients referred for disability evaluations related to sleep disorders. Demographic data, clinical parameters, and disability outcomes were analyzed. Key parameters such as the Epworth Sleepiness Scale (ESS), Apnea-Hypopnea Index (AHI), and the presence of other sleep disorders were assessed across patient subgroups. Results: Patients applying for military service eligibility assessments had a mean age of 25.3 ± 8.7 years and a median ESS score of 7. Obstructive sleep apnea syndrome (OSAS) was present in 37.5% of cases. Fifty percent of these patients were deemed unfit for military service. Patients applying for health reports for driver’s licenses had a mean age of 47.6 ± 5.6 years and a mean body mass index (BMI) of 35.3 ± 8.6 kg/m2. Severe OSAS was diagnosed in most cases, and eligibility for driver’s licenses was confirmed for all patients. Patients applying for disability reports had a mean age of 47.7 ± 9.2 years, a mean BMI of 34.4 ± 6.8 kg/m2, and a median AHI of 40. Severe OSAS was diagnosed in 79.5% of those granted disability retirement. Excessive daytime sleepiness was significantly less common in this group compared to other disability subgroups. Conclusions: Severe OSAS plays a prominent role in functional impairment and disability assessments, particularly in high-risk occupational settings. Other sleep disorders and sleep duration variations also influence disability outcomes, underlining the need for comprehensive sleep evaluations in disability determinations.

Anahtar Kelimeler

• sleep disorders
• obstructive sleep apnea
• disability evaluation
• military service
• driver’s licenses
• excessive daytime sleepiness

Destekleyen Kurum

YOK

Etik Beyan

The study was performed in accordance with the Declaration of Helsinki, and was approved by the Başakşehir Çam and Sakura City Hospital Clinical Research Ethics Committee (Date: 19.04.2023, Decision No: 154).

Teşekkür

YOK

Uyku bozukluğu hastalarının engellilik değerlendirmesinde demografik ve klinik özellikler

Öz

Amaç: Bu çalışma, uyku bozukluğu olan hastaların engellilik değerlendirmelerinde demografik ve klinik özelliklerin etkisini araştırmayı amaçlamıştır. Yöntemler: Uyku bozukluklarıyla ilgili engellilik değerlendirmelerine yönlendirilen 122 hasta üzerinde retrospektif bir analiz yapılmıştır. Demografik veriler, klinik parametreler ve engellilik sonuçları analiz edilmiştir. Epworth Uykululuk Ölçeği (ESS), Apne-Hipopne İndeksi (AHI) ve diğer uyku bozukluklarının varlığı gibi temel parametreler hasta alt grupları arasında değerlendirilmiştir. Bulgular: Askerlik hizmetine uygunluk değerlendirmesine başvuran hastaların ortalama yaşı 25,3 ± 8,7 yıl, median ESS skoru ise 7 olarak bulunmuş, vakaların %37,5’inde OSAS tespit edilmiştir. Bu hastaların yarısı askerlik için uygun bulunmamıştır. Sürücü belgesi sağlık raporu için başvuran hastaların ortalama yaşı 47,6 ± 5,6 yıl, ortalama BMI değeri 35,3 ± 8,6 kg/m² olarak saptanmıştır. Vakaların çoğunda şiddetli OSAS teşhis edilmiş ve tüm hastalar için sürücü belgesi uygunluk raporu verilmiştir. Engellilik raporu için başvuran hastaların ortalama yaşı 47,7 ± 9,2 yıl, ortalama BMI değeri 34,4 ± 6,8 kg/m² ve median AHI değeri 40 olarak bulunmuştur. Engellilik nedeniyle emeklilik hakkı tanınan hastaların %79,5’inde şiddetli OSAS teşhis edilmiştir. Aşırı gündüz uykululuğu bu grupta diğer engellilik alt gruplarına göre belirgin şekilde daha az yaygın bulunmuştur. Sonuçlar: Şiddetli OSAS, işlevsel bozulma ve engellilik değerlendirmelerinde önemli bir rol oynamaktadır, özellikle yüksek riskli meslek gruplarında daha belirgindir. Diğer uyku bozuklukları ve uyku süresindeki değişiklikler de engellilik sonuçlarını etkilemektedir. Bu durum, engellilik belirlemelerinde kapsamlı uyku değerlendirmelerinin önemini vurgulamaktadır.

Anahtar Kelimeler

• Uyku bozuklukları
• obstrüktif uyku apnesi
• engellilik değerlendirmesi
• askerlik hizmeti
• ehliyetler
• aşırı gündüz uykululuğu

Destekleyen Kurum

YOK

Etik Beyan

The study was performed in accordance with the Declaration of Helsinki, and was approved by the Başakşehir Çam and Sakura City Hospital Clinical Research Ethics Committee (Date: 19.04.2023, Decision No: 154).

Teşekkür

YOK

Kaynakça

1. Holder S and Narula NS. Common Sleep Disorders in Adults: Diagnosis and Management. Am Fam Physician. 2022;105(4):397-405.
2. Staner L. Sleep and anxiety disorders. Dialogues Clin Neurosci. 2003;5(3):249-58.
3. Peng J, Zhang J, Wang B, et al. The relationship between sleep quality and occupational well-being in employees: The mediating role of occupational self-efficacy. Front Psychol. 2023;14:1071232.
4. Pilcher JJ and Morris DM. Sleep and Organizational Behavior: Implications for Workplace Productivity and Safety. Front Psychol. 2020;11:45.
5. Rodrigues T and Shigaeff N. Sleep disorders and attention: a systematic review. Arq Neuropsiquiatr. 2022;80(5):530-38.
6. Krysta K, Bratek A, Zawada K, and Stepanczak R. Cognitive deficits in adults with obstructive sleep apnea compared to children and adolescents. J Neural Transm (Vienna). 2017;124(Suppl 1):187-201.
7. Leger D and Bayon V. Societal costs of insomnia. Sleep Med Rev. 2010;14(6):379-89.
8. Streatfeild J, Smith J, Mansfield D, Pezzullo L, and Hillman D. The social and economic cost of sleep disorders. Sleep. 2021;44(11):zsab132.

9. Uehli K, Mehta AJ, Miedinger D, et al. Sleep problems and work injuries: a systematic review and meta-analysis. Sleep Med Rev. 2014;18(1):61-73.
10. Ropponen A, Silventoinen K, Hublin C, Svedberg P, Koskenvuo M, and Kaprio J. Sleep patterns as predictors for disability pension due to low back diagnoses: a 23-year longitudinal study of Finnish twins. Sleep. 2013;36(6):891-7.
11. Rod NH, Kjeldgard L, Akerstedt T, et al. Sleep Apnea, Disability Pensions, and Cause-Specific Mortality: A Swedish Nationwide Register Linkage Study. Am J Epidemiol. 2017;186(6):709-18.
12. Gocmen A and Ethemoglu O. The relationship between sleep disorders with patients' demographic-clinical characteristics and quality of life in patients with multiple sclerosis. Clin Neurol Neurosurg. 2023;232:107888.
13. Luo M, Dong Y, Fan B, et al. Sleep Duration and Functional Disability Among Chinese Older Adults: Cross-Sectional Study. JMIR Aging. 2024;7:e53548.
14. Acır I, Atay ZVO, Atay M, and Yayla V. Sleep quality and Laboratory Findings in Patients with Varicose Vein Leg Pain. Journal of Neuroscience and Neurological Disorders. 2023;7(1):022-26.
15. Izci B, Ardic S, Firat H, Sahin A, Altinors M, and Karacan I. Reliability and validity studies of the Turkish version of the Epworth Sleepiness Scale. Sleep Breath. 2008;12(2):161-8.
16. Berry RB, Quan SF, Abreu AR, et al. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, version 2.6. Darien, Illinois: American Academy of Sleep Medicine; 2020. Available online at https://aasm.org/clinical-resources/scoring-manual/; accessed January 18, 2025.
17. Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest. 2014;146(5):1387-94.
18. American Academy of Sleep Medicine. International classification of sleep disorders, 3rd ed. Darien, IL: American Academy of Sleep Medicine, 2014.
19. Türkiye Cumhuriyeti Sosyal Güvenlik Kurumu ve Sağlık Bakanlığı. Maluliyet Tespiti İşlemleri Yönetmeliği. Resmî Gazete. 3 Ağustos 2013; Sayı: 28727.
20. Senaratna CV, Perret JL, Lodge CJ, et al. Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Med Rev. 2017;34:70-81.
21. Medical standards for military service: appointment, enlistment, or induction. Department of Defense Instruction 6130.03, Vol. 1. May 28, 2024. Available online at https://www.esd.whs.mil/DD; accessed December 20, 2024.
22. Alger SE, Bennett C, Bennett N, et al. Insufficient Sleep and Behavioral Health in the Military: A 5-Country Perspective. Curr Psychiatry Rep. 2024;26(5):229-39.
23. Mysliwiec V, Gill J, Lee H, et al. Sleep disorders in US military personnel: a high rate of comorbid insomnia and obstructive sleep apnea. Chest. 2013;144(2):549-57.
24. Seelig AD, Jacobson IG, Smith B, et al. Sleep patterns before, during, and after deployment to Iraq and Afghanistan. Sleep. 2010;33(12):1615-22.
25. Peterson AL, Goodie JL, Satterfield WA, and Brim WL. Sleep disturbance during military deployment. Mil Med. 2008;173(3):230-5.
26. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, and Castro CA. Mild traumatic brain injury in U.S. Soldiers returning from Iraq. N Engl J Med. 2008;358(5):453-63.
27. Lew HL, Pogoda TK, Hsu PT, et al. Impact of the "polytrauma clinical triad" on sleep disturbance in a department of veterans affairs outpatient rehabilitation setting. Am J Phys Med Rehabil. 2010;89(6):437-45.
28. Romero-Corral A, Caples SM, Lopez-Jimenez F, and Somers VK. Interactions between obesity and obstructive sleep apnea: implications for treatment. Chest. 2010;137(3):711-9.
29. Teran-Santos J, Jimenez-Gomez A, and Cordero-Guevara J. The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med. 1999;340(11):847-51.
30. Felix M, Intriago Alvarez MB, Vanegas E, et al. Risk of obstructive sleep apnea and traffic accidents among male bus drivers in Ecuador: Is there a significant relationship? Ann Med Surg (Lond). 2022;74:103296.
31. Lloberes P, Levy G, Descals C, et al. Self-reported sleepiness while driving as a risk factor for traffic accidents in patients with obstructive sleep apnoea syndrome and in non-apnoeic snorers. Respir Med. 2000;94(10):971-6.
32. Schiza SE and Bouloukaki I. Screening for obstructive sleep apnoea in professional drivers. Breathe (Sheff). 2020;16(1):29364.
33. Lal C, Weaver TE, Bae CJ, and Strohl KP. Excessive Daytime Sleepiness in Obstructive Sleep Apnea. Mechanisms and Clinical Management. Ann Am Thorac Soc. 2021;18(5):757-68.
34. Basoglu OK and Tasbakan MS. Elevated risk of sleepiness-related motor vehicle accidents in patients with obstructive sleep apnea syndrome: a case-control study. Traffic Inj Prev. 2014;15(5):470-6.
35. Fusetti M, Fioretti AB, Valenti M, Masedu F, Lauriello M, and Pagliarella M. Cardiovascular and metabolic comorbidities in patients with obstructive sleep apnoea syndrome. Acta Otorhinolaryngol Ital. 2012;32(5):320-5.
36. Bonsignore MR, Baiamonte P, Mazzuca E, Castrogiovanni A, and Marrone O. Obstructive sleep apnea and comorbidities: a dangerous liaison. Multidiscip Respir Med. 2019;14:8.
37. Accattoli MP, Muzi G, dell'Omo M, et al. [Occupational accidents, work performance and obstructive sleep apnea syndrome (OSAS)]. G Ital Med Lav Ergon. 2008;30(3):297-303.
38. Zhou X, Zhou B, Li Z, et al. Periodic limb movements in patients with obstructive sleep apnea syndrome. Sci Rep. 2021;11(1):15341.
39. Shandra CL, Kruger A, and Hale L. Disability and sleep duration: evidence from the American Time Use Survey. Disabil Health J. 2014;7(3):325-34.