High Risk of Obstructive Sleep Apnea in Commercial Drivers

Review Looks at Occupational Risk Factors for Sleep Apnea

About 40 percent of commercial drivers may have obstructive sleep apnea (OSA), suggests a research review in the June 2017 Journal of Occupational and Environmental Medicine.

Paul D. Blanc, MD, MSPH, of University of California San Francisco and colleagues reviewed and analyzed previous studies of occupation as a risk factor for OSA. All studies used sleep laboratory testing (polysomnography, or PSG) to diagnose OSA.

Analysis of pooled data from 16 studies suggested that 41 percent of commercial drivers may have OSA — nearly twice as high as for non-obese men in the general population. Further analysis of a select group of studies estimated a 35 percent rate of mild OSA in commercial drivers and a 12 percent rate of moderate to severe OSA.

Data from eight studies suggested a possible increase in OSA risk among workers exposed to solvents — although this risk could not be statistically confirmed. A handful of other studies suggested possible increases in OSA among railroad workers, shift workers, and World Trade Center disaster responders.

Obstructive sleep apnea is a common condition, but little is known about possible occupational factors associated with it. The researchers suggest that commercial drivers may have other OSA risk factors, including stress, high rates of obesity and high blood pressure, and abnormal sleep/wake schedules. Regardless of the other factors involved, daytime sleepiness and other OSA symptoms may be associated with an increased risk of accidents.

Further studies are needed to clarify possible occupational associations with OSA. Dr. Blanc and colleagues conclude, “Pending more definitive data, clinicians should take into account occupational factors in considering sleep disorders and OSA, which carry significant associated costs from comorbidities and occupational disability.”
About the Author — Dr. Blanc may be contacted for interviews at paul.blanc@ucsf.edu.

About ACOEM — ACOEM (www.acoem.org), an international society of 4,500 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.

About JOEM — The Journal of Occupational and Environmental Medicine (www.joem.org) is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.


Schwartz DA, Vinnikov D, Blanc PD. Occupation and obstructive sleep apnea: a meta-analysis. J Occup Environ Med. 2017;59(6):502-8.