Liu Y, Tu C L, Yao W F, Yu Y F, Wang Z, Hu J R
Department of Respiratory Medicine. Central Hospital of Jiading District, Shanghai 201800, China.
Zhonghua Yi Xue Za Zhi. 2016 Dec 27;96(48):3902-3905. doi: 10.3760/cma.j.issn.0376-2491.2016.48.011.
To study the prevalence of obstructive sleep apnea hypopnea syndrome (OSAHS) and its relationship with traffic accidents in the professional drivers. Questionnaires of OSAHS were sent to 950 professional drivers who had annual physical examination at the Central Hospital of Jiading District in Shanghai from October 2014 to September 2015. Those with moderate to severe snoring and/or Epworth Sleepiness Scale (ESS)≥9 performed the home sleep testing. All drivers were divided into OSAHS and non-OSAHS according to the survey and monitoring. The following parameters were compared such as driving ages, neck circumference, body mass index (BMI), average night sleep time, ESS, hypertension, diabetes, hypertrophy of tonsil and the incidence of traffic accidents. The risk factors of traffic accidents were analyzed by multivariate Logistic regression. Totally 826 responses were eligible, including 578 (70.0%) with self-reported snoring. There was measurement failure involving 3 of 233 the home sleep testing due to sensor off, 823 subjects were included in the study. The prevalence of OSAHS was 13.5% (111/823). The mild, moderate and severe OSAHS were 47, 38 and 26 cases respectively. There were 712 drives without OSAHS. The neck circumference[(39.8±3.8) vs (39.0±3.0) cm]and BMI[(26.7±4.2) vs (24.4±3.8) kg/m]were significantly higher in the drivers suffering from OSAHS (all <0.05). The percentage of ESS≥ 9 (57.7% vs 12.6%), hypertension (27.9% vs 5.9%), diabetes (4.5% vs 1.1%), hypertrophy of tonsil (7.2% vs 2.3%) were higher in the drivers with OSAHS (all <0.05). There were no significant difference in driving ages and average night sleep time between two groups (all >0.05). The overall incidence of traffic accidents was 5.8% (48/823) in a year. The percentage was respectively 17.1% (19/111) in OSAHS and 4.1% (29/712) in non-OSAHS (<0.001). Multiple logistic regression analysis showed that sleepiness (=30.578, 95% 10.699-87.394; <0.001), OSAHS (=14.062, 95% 4.791-41.269; <0.001) and vehicle years (=2.345, 95%: 1.183-4.646; <0.05)were the risk factors, while the average night sleep time (=0.037, 95%: 0.014-0.098; <0.001) was the protective factor. Professional drivers have higher prevalence of OSAHS, which contributes to the increased risk of traffic accidents.
研究职业司机中阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的患病率及其与交通事故的关系。2014年10月至2015年9月期间，向950名在上海市嘉定区中心医院进行年度体检的职业司机发放了OSAHS调查问卷。对有中度至重度打鼾和/或爱泼华嗜睡量表（ESS）≥9的司机进行家庭睡眠测试。根据调查和监测结果，将所有司机分为OSAHS组和非OSAHS组。比较以下参数，如驾驶年限、颈围、体重指数（BMI）、平均夜间睡眠时间、ESS、高血压、糖尿病、扁桃体肥大以及交通事故发生率。采用多因素Logistic回归分析交通事故的危险因素。共收到826份有效问卷，其中578人（70.0%）自述有打鼾症状。233例家庭睡眠测试中有3例因传感器脱落测量失败，最终纳入研究的有823名受试者。OSAHS的患病率为13.5%（111/823）。轻度、中度和重度OSAHS分别为47例、38例和26例。无OSAHS的司机有712名。OSAHS组司机的颈围[（39.8±3.8）cm比（39.0±3.0）cm]和BMI[（26.7±4.2）kg/m比（24.4±3.8）kg/m]显著更高（均P<0.05）。OSAHS组司机中ESS≥9的比例（57.7%比12.6%）、高血压（27.9%比5.9%）、糖尿病（4.5%比1.1%）、扁桃体肥大（7.2%比2.3%）均更高（均P<0.05）。两组间驾驶年限和平均夜间睡眠时间无显著差异（均P>0.05）。一年中交通事故的总发生率为5.8%（48/823）。OSAHS组为17.1%（19/111），非OSAHS组为4.1%（29/712）（P<0.001）。多因素Logistic回归分析显示，嗜睡（β=30.578，95%CI：10.699-87.394；P<0.001）、OSAHS（β=14.062，95%CI：4.791-41.269；P<0.001）和驾驶年限（β=2.345，95%CI：1.183-4.646；P<0.05）是危险因素，而平均夜间睡眠时间（β=0.037，95%CI：0.014-0.098；P<0.001）是保护因素。职业司机中OSAHS的患病率较高，这导致交通事故风险增加。
