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Sleep-Disordered Breathing and Quality of Life of Railway Drivers in Greece^*

^* From the Sleep Unit (Drs. Nena, Tsara, and Christaki), 2nd Chest Department, George Papanikolaou General Hospital, Thessaloniki, Greece; the Department of Pneumonology (Drs. Steiropoulos and Bouros), University Hospital, and the Laboratory of Hygiene and Environmental Protection (Dr. Constantinidis), Medical School, Democritus University of Thrace, Alexandroupolis, Greece; and the Neurological Clinic (Dr. Katsarou), Hippokration Hospital, Thessaloniki, Greece.

Correspondence to: Evangelia Nena, MD, George Papanikolaou General Hospital, Sleep Unit, 2nd Chest Department, Exohi, Thessaloniki 57010, Greece; e-mail: evangelianena{at}yahoo.gr

Abstract

Background: Sleep-disordered breathing (SDB) and especially obstructive sleep apnea (OSA) are associated with daytime sleepiness and an increased risk for motor vehicle crashes. Previous studies have assessed the prevalence of OSA among professional drivers, but no study so far has focused on railway drivers. The aim of this study was to assess the prevalence of SDB among Greek railway drivers, and correlate it with daytime sleepiness, quality of life, and symptoms.

Methods: The following three different questionnaires were anonymously answered by 226 train drivers: a general questionnaire on their demographics and sleep habits; the Greek version of the Epworth sleepiness scale (ESS); and the Medical Outcomes Study 36-item short form (SF-36). Of the 226 drivers, 50 underwent a sleep study, a physical examination, and an assessment of their respiratory function.

Results: Participants were all men, had a mean (± SD) age of 46.9 ± 3.9 years, were overweight (mean body mass index [BMI], 28.7 ± 3.7 kg/m²), and were smokers (59.7%). Snoring was reported by 69.9% of them, and apneas by 11.5%. The mean ESS score was 5.4 ± 3.2. SF-36 scores were similar to those of the Greek population. The mean apnea-hypopnea index (AHI) was 11 ± 14 events per hour, and the mean pulse oximetric saturation was 93.2 ± 2.5%. According to AHI severity, they were divided into the following three groups: group 1, normal breathing function in sleep (n = 19; AHI, < 5 events per hour); group 2, mild OSA (n = 20; AHI, 5.1 to 15 events per hour); group 3, moderate/severe OSA (n = 11; AHI, > 15 events per hour). The three groups differed in terms of BMI, and neck, waist, and hip circumferences. No difference was detected, though, in ESS and SF-36 scores.

Conclusion: The majority of the Greek railway drivers are overweight and smokers. The most common reported symptom in the questionnaires is snoring, without significant daytime impairment, while sleep studies show a potentially higher prevalence of OSA.

Trial registration: Democritus University of Thrace Identifier: 2979/5–2003.

Trial registration: Union of the Greek Railway Drivers Identifier: 536/10–2003.

Key Words: obstructive sleep apnea • professional drivers • quality of life • sleep apnea • sleep-disordered breathing • sleepiness • snoring