Work Productivity Among People With Sleep Apnea With Excessive Sleepiness: Findings From the 2016 US National Health and Wellness Survey

Abstract

SESSION TITLE: Obstructive Sleep Apnea: Insights & Management SESSION TYPE: Original Investigation Slide PRESENTED ON: Sunday, October 29, 2017 at 01:30 PM - 03:00 PM PURPOSE: Few population-based studies have explored how excessive sleepiness (ES) affects work productivity among patients with sleep apnea (SA). METHODS: Data were obtained from the 2016 US National Health and Wellness Survey, an annual, representative, cross-sectional, general health survey (N=97,503). Respondents self-reporting a SA diagnosis were categorized as having excessive sleepiness (ES) (Epworth Sleepiness Scale [ESS≥11]) or not having ES (ESS<11) and compared with a non-SA control group. Respondents reporting narcolepsy were excluded. Work productivity in the three groups was measured using the Work Productivity and Activity Impairment General Health (WPAI-GH) questionnaire, a 6-item validated instrument consisting of: absenteeism (percentage of work time missed because of one's health in the past seven days), presenteeism (percentage of impairment while at work in the past seven days because of one's health), overall work productivity loss (an overall impairment percentage estimate combining absenteeism and presenteeism), and activity impairment (percentage of impairment in daily activities because of one's health in the past seven days) (Reilly, Zbrozek, & Dukes, 1993). Outcomes were examined by three groups: SA w/ES, SA w/o ES, and non-SA controls using one-way ANOVAs (continuous outcomes). Generalized linear models controlling for covariates examined the effect of SA/ES status on WPAI-GH. RESULTS: Thirty-five percent of the patients with SA also had ES (358/1,018). Overall, SA w/ES had greater impairment in both work productivity and daily activities compared to the other two groups after controlling for covariates. The SA w/ES group (N=358) missed 7.93% of their work hours in the past week compared to 5.74% in the SA w/o ES group (N=660; p=0.193) and 3.91% in the non-SA control group (N=48,188; p<0.001). Presenteeism was 25.98% in the SA w/ES group compared to 19.24% in the SA w/o ES group (p=0.005) and 14.75% in the non-SA controls (p<0.001 vs SA w/ES). Non work-related activity impairment was 31.09% in the SA w/ES group versus 25.46% in SA w/o ES (p<0.001) and 19.93% in non-SA controls (p<0.001 vs SA w/ES). CONCLUSIONS: These data provide support that people with SA had impaired productivity compared to non-SA controls and that those who also had ES showed even greater deficits. The SA w/ES group was associated with substantial increases in work and daily activity impairment compared to SA patients without ES and non-SA controls. CLINICAL IMPLICATIONS: ES can reduce a patient’s ability to effectively complete work and non-work activities and results in significantly more impairment compared to those who have SA without ES. Therefore, ES is an important symptom to assess during clinical evaluations of patients with SA. DISCLOSURE: Kathleen Sarmiento: Consultant fee, speaker bureau, advisory committee, etc.: Jazz Pharmaceuticals Shay Bujanover: Employee: Jazz Pharmaceuticals, Shareholder: Jazz Pharmaceuticals Kathleen Villa: Employee: Jazz Pharmaceuticals employee, Shareholder: Jazz Pharmaceuticals Vicky Li: Employee: Kantar Health, Consultant fee, speaker bureau, advisory committee, etc.: Jazz Pharmaceuticals Natalia Flores: Employee: Kantar Health, Consultant fee, speaker bureau, advisory committee, etc.: Jazz Pharmaceuticals The following authors have nothing to disclose: Carl Stepnowsky No Product/Research Disclosure Information