Socioeconomic status and occupation as risk factors for obstructive sleep apnea in Sweden: A population-based study

Abstract 

Objectives

The aim of this study was to investigate whether there is an association between socioeconomic status, occupation and obstructive sleep apnea.

Methods

A nationwide database was constructed by linking the Swedish Census to the Hospital Discharge Register and the Cause of Death Register to obtain data on all first adult hospitalizations for obstructive sleep apnea diagnosed in Sweden during the study period from 1997 to 2001. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were calculated.

Results

A total of 10,336 male and 2,602 female first hospitalizations during the study period for obstructive sleep apnea were retrieved for adults aged 35 and older. The overall SIRs for hospitalizations for obstructive sleep apnea were close to unity between different socioeconomic groups and regions. Among male occupations, increased risks were noted for several occupational groups such as sales agents, seamen, drivers, engine and motor operators, and cooks and stewards. For female occupations, an increased risk was observed only among drivers. Adjustment for obesity had no effect on the risk levels.

Conclusions

Socioeconomic status and occupation have a minor effect on the population’s likelihood of hospitalization for obstructive sleep apnea. Although the increased risks found for seamen, engine and motor operators, and cooks and stewards may be partly explained by their work-related exposure, residual confounding due to smoking and alcohol might be present.

Keywords: Obstructive sleep apnea, Occupation, Follow-up study, Standardized incidence ratios