Toshiyuki Hirasawa

Objectives: Research on predictors for consultations regarding obstructive sleep apnea (OSA) is limited, with few longitudinal studies examining how changes in disease status and work conditions influence these behaviors. This study tracked Japanese male workers in the construction and civil engineering sector for 1 year to determine whether individual changes could predict future OSA consultations. Methods: We conducted a longitudinal analysis using data from 16,279 male employees covered by the health insurance society of a construction and civil engineering company. The dataset comprised annual medical check-up findings, self-administered questionnaires, and medical claims data collected at two points, with a mean interval of 370 ± 34.3 days between assessments. Associations between time-varying factors and possible OSA consultation behavior were assessed using binary logistic regression with generalized estimating equations, while associations between changes in these factors and consultation behavior were evaluated using conventional binary logistic regression. This consultation behavior was defined as the occurrence of at least one of the following procedures in the medical insurance claims records: polysomnography, home sleep apnea testing, or pulse oximetry. Results: Possible OSA consultation behavior was positively associated with the presence of comorbidities and habitual snoring and/or witnessed apnea, but inversely associated with the number of working days. However, none of the changes observed during the follow-up period were significantly associated with consultation behavior. Additionally, a high risk for OSA alone was not significantly associated with the consultation behavior. Conclusion: Neither short-term within-person changes in symptoms or comorbidities nor high OSA risk prompted help-seeking, highlighting the need for proactive screening and streamlined referrals.

This study investigated factors associated with possible consultation behavior (PCB) for obstructive sleep apnea (OSA; together, PCB-OSA) among male Japanese workers to promote early intervention and treatment. Data from 20,063 male employees were retrospectively analyzed. PCB-OSA was identified by the presence of at least one of the following medical procedure codes in the medical claim records from April 1, 2018, to March 31, 2019: polysomnography, home sleep apnea test, or percutaneous arterial blood oxygen saturation with an OSA diagnosis. Binomial logistic regression was used to assess factors related to PCB-OSA and the initiation of continuous positive airway pressure treatment in both the overall cohort and the OSA risk groups, defined by our objective measure-based OSA risk scale. Age (odds ratio [OR] = 1.01, 95% confidence interval [CI] [1.00, 1.02]), hypertension (OR = 1.38, 95% CI [1.10, 1.74]), heart disease (OR = 2.17, 95% CI [1.31, 3.58]), subjective sleepiness (OR = 1.49, 95% CI [1.16, 1.92]), habitual snoring (OR = 1.41, 95% CI [1.12, 1.77]), and witnessed apnea (OR = 2.13, 95% CI [1.63, 2.80]) were significantly and positively associated with PCB-OSA. Meanwhile, blue-collar workers (OR = 0.65, 95% CI [0.51, 0.82]) were significantly and negatively associated with the behavior. In the OSA high-risk group, working 6 or more days per week (OR = 0.62, 95% CI [0.40, 0.96]) was significantly and negatively associated with PCB-OSA. The study population showed a low rate of PCB-OSA. Obesity was not associated with PCB-OSA, and blue-collar workers exhibited a negative association, highlighting the need for disease education in this population. The online version contains supplementary material available at 10.1007/s41105-026-00647-7.

Background: Few have examined the condition of subjective daytime sleepiness in workers and its relation to their work productivity. This study aimed to clarify the association between the presence of subjective daytime sleepiness and work productivity measures, including presenteeism and absenteeism, as well as factors related to the presence of the symptom in daytime workers.Methods: This cross-sectional study included 17963 daytime workers who attended the annual medical check-up. They were categorized into four groups; the daytime sleepiness group was defined as having only subjective daytime sleepiness, the insomnia group as having only insomnia symptoms, the combination group as having both subjective daytime sleepiness and insomnia symptoms, and the healthy group as having no sleep complaints. This study used demographics, health status, workplace, work productivity, and sleep items included in the self-reported medical check-up questionnaire.Results: The combination group had significantly worse presenteeism than other groups. The daytime sleepiness and insomnia groups had significantly worse presenteeism than the healthy group. The results of absenteeism were the same as presenteeism. Factors related to the positivity for subjective daytime sleepiness were presence of psychiatric disease, the positivity for habitual snoring and/or witnessed apnea, shorter sleep duration on workdays, long working hours, female sex, living alone, the amount of social jetlag, and younger age.Conclusions: Subjective daytime sleepiness, not just insomnia symptoms, has a significant negative impact on work productivity, and both workplace and individual approaches should not be ignored for addressing subjective daytime sleepiness among daytime workers.