Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Can Respir J. 2013 Jan-Feb;20(1):42-6. doi: 10.1155/2013/469391.
Loud snoring is a common symptom in the general population. The evidence-based literature indicates that snoring may be associated with sleep fragmentation and sleep apnea, which may affect cognitive function and predispose to occupational injury. High rates of occupational injury occur on farms and may be related to personal and health factors. Thus, loud snoring may not be a trivial symptom and should be considered as important in medical assessments.
A prospective cohort study was conducted in Saskatchewan. Baseline questionnaires were completed for 5502 individuals by representatives from 2390 farms. Sleep patterns at baseline were categorized as the following: no reported sleep disorders; physician-diagnosed sleep apnea (treatment unknown); and loud snoring. Survival analyses were used to relate sleep patterns with subsequent injury.
A total of 6.7% (369 of 5502) of participants reported a possible sleep disorder. Of these, 69.4% (256 of 369) reported loud snoring only. Loud snoring was only associated with a consistent increase in risk (eg, HR 1.45 [95 CI 1.07 to 1.99 for work-related injury]) for five farm injury outcomes. Relationships between physician-diagnosed sleep apnea and time to first injury were not significant, presumably because a diagnosis of sleep apnea implied treatment for sleep apnea.
Sleep disorders are an important potential risk factor for occupational injury on farms. Substantial proportions of farm residents report loud snoring and this is related to subsequent injury. Some of these cases may represent sleep fragmentation or undiagnosed obstructive sleep apnea. Identification and clinical management of sleep disorders related to snoring should be part of health assessments conducted by physicians.
大声打鼾是普通人群中的常见症状。循证医学文献表明,打鼾可能与睡眠碎片化和睡眠呼吸暂停有关,这可能会影响认知功能并增加职业伤害的风险。农场的职业伤害发生率较高,可能与个人和健康因素有关。因此,大声打鼾可能不是一个微不足道的症状,在医学评估中应被视为重要症状。
在萨斯喀彻温省进行了一项前瞻性队列研究。2390 个农场的代表为 5502 个人完成了基线调查问卷。根据基线睡眠模式将睡眠分为以下几类:无报告的睡眠障碍;医生诊断的睡眠呼吸暂停(治疗方法未知);和大声打鼾。生存分析用于研究睡眠模式与随后的伤害之间的关系。
共有 6.7%(5502 名参与者中的 369 名)报告可能存在睡眠障碍。其中,69.4%(369 名中的 256 名)仅报告大声打鼾。只有大声打鼾与持续增加的风险相关(例如,与工作相关的伤害的 HR 为 1.45 [95%CI 1.07 至 1.99]),与五种农场伤害结果相关。医生诊断的睡眠呼吸暂停与首次受伤时间之间的关系不显著,这可能是因为睡眠呼吸暂停的诊断意味着对睡眠呼吸暂停进行了治疗。
睡眠障碍是农场职业伤害的一个重要潜在危险因素。大量农场居民报告大声打鼾,这与随后的伤害有关。其中一些病例可能代表睡眠碎片化或未诊断的阻塞性睡眠呼吸暂停。识别和临床管理与打鼾相关的睡眠障碍应成为医生进行健康评估的一部分。