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      Síndrome da apneia obstrutiva do sono em motoristas de caminhão Translated title: Obstructive sleep apnea syndrome in truck drivers

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          Abstract

          OBJETIVO: Estimar a prevalência da síndrome da apneia obstrutiva do sono (SAOS) e verificar os fatores associados à chance de desenvolver SAOS em motoristas de caminhão. MÉTODOS: A população desse estudo constituiu-se de motoristas de caminhão de duas filiais de uma empresa transportadora (n = 209), com idade média de 38,8 anos, sendo 98,5% do sexo masculino. O índice de massa corpórea médio foi de 26,5 ± 4,4 kg/m². Os participantes responderam questionários sobre dados sociodemográficos, atividade física e SAOS. A prevalência de SAOS foi estimada por meio do Questionário de Berlim e sua associação com os fatores estudados foi verificada pela análise de regressão univariada e multivariada. RESULTADOS: A prevalência de SAOS na população foi de 11,5%. Dos 209 motoristas, 72 (34,5%) referiram dormir ao volante enquanto dirigiam ao menos uma vez e 81 (38,7%) referiram roncar durante o sono. As variáveis estatisticamente significativas associadas à SAOS foram vínculo empregatício informal (OR = 0,27; p = 0,01), índice de massa corpórea > 25 kg/m² (OR = 13,64; p = 0,01) e qualidade do sono ruim (OR = 3,00; p = 0,02). CONCLUSÕES: Apesar de a prevalência de SAOS ter sido inferior à observada em outros estudos com motoristas, essa prevalência é superior à da população em geral. Os resultados ainda sugerem que as características do trabalho, entre as quais o vínculo de trabalho, estão associadas à SAOS. Esses dados evidenciam a relevância de se levar em consideração a atividade de trabalho em estudos que investiguem fatores associados à SAOS.

          Translated abstract

          OBJECTIVE: To determine the prevalence of obstructive sleep apnea syndrome (OSAS), as well as to identify factors associated with a greater risk of developing OSAS, among truck drivers. METHODS: The study population comprised 209 truck drivers (mean age, 38.8 years; 98.5% males) at two branches of a transportation company. The mean body mass index was 26.5 ± 4.4 kg/m². The participants completed questionnaires regarding sociodemographic data, physical activity and OSAS. The prevalence of OSAS was estimated using the Berlin Questionnaire, associations between OSAS and the factors studied being assessed through univariate and multivariate regression analysis. RESULTS: The prevalence of OSAS in the population was 11.5%. Of the 209 truck drivers, 72 (34.5%) reported having fallen asleep while driving and 81 (38.7%) reported snoring. The following variables were found to present statistically significant associations with OSAS: informal employment (OR = 0.27; p = 0.01); body mass index > 25 kg/m² (OR = 13.64; p = 0.01); and poor sleep quality (OR = 3.00; p = 0.02). CONCLUSIONS: The prevalence of OSAS in this study was lower than that reported in other studies of truck drivers and yet higher that that observed for the general population. In addition, our results suggest that work characteristics, such as employment status, are associated with OSAS. These data show the relevance of considering work activity in studies of factors associated with OSAS.

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          Most cited references30

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          Obesity preventing and managing the global epidemic

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            Obesity and weight loss in obstructive sleep apnea: a critical review.

            Clinic-based and epidemiological studies demonstrate a strong association between obesity and obstructive sleep apnea. However, defining the causal relationship between excess body weight and sleep-disordered breathing remains difficult. Potential mechanisms to be considered include: (1) alterations in upper airway structure; (2) alterations in upper airway function; (3) alterations in the balance between ventilatory drive and load and (4) obesity-induced hypoxemia. Additional evidence for the role of obesity in obstructive sleep apnea comes from clinical studies of weight loss in patients with sleep-disordered breathing. Significant weight loss has been reported in most studies, which has been associated with varying degrees of improvement in sleep-disordered breathing, oxygen hemoglobin saturation, sleep architecture and daytime performance. Surgical and nonsurgical approaches to weight loss have been evaluated, although most studies to date suffer from methodological limitations including lack of random assignment to treatment groups, confounding of treatment interventions, absence of untreated controls and lack of adequate follow-up assessment. Implications for research and clinical practice are discussed.
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              Obstructive sleep apnea.

              L Victor (1999)
              Obstructive sleep apnea is a significant medical problem affecting up to 4 percent of middle-aged adults. The most common complaints are loud snoring, disrupted sleep and excessive daytime sleepiness. Patients with apnea suffer from fragmented sleep and may develop cardiovascular abnormalities because of the repetitive cycles of snoring, airway collapse and arousal. Although most patients are overweight and have a short, thick neck, some are of normal weight but have a small, receding jaw. Because many patients are not aware of their heavy snoring and nocturnal arousals, obstructive sleep apnea may remain undiagnosed; therefore, it is helpful to question the bedroom partner of a patient with chronic sleepiness and fatigue. Polysomnography in a sleep laboratory is the gold standard for confirming the diagnosis of obstructive sleep apnea; however, the test is expensive and not widely available. Home sleep studies are less costly but not as diagnostically accurate. Treatments include weight loss, nasal continuous positive airway pressure and dental devices that modify the position of the tongue or jaw. Upper airway and jaw surgical procedures may also be appropriate in selected patients, but invasiveness and expense restrict their use.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                jbpneu
                Jornal Brasileiro de Pneumologia
                J. bras. pneumol.
                Sociedade Brasileira de Pneumologia e Tisiologia (São Paulo )
                1806-3756
                June 2009
                : 35
                : 6
                : 500-506
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Universidade de São Paulo Brazil
                [3 ] Universidade de São Paulo Brazil
                Article
                S1806-37132009000600002
                10.1590/S1806-37132009000600002
                8114e70b-69b0-4462-b2fc-cd5cb75da168

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1806-3713&lng=en
                Categories
                RESPIRATORY SYSTEM

                Respiratory medicine
                Sleep apnea, obstructive,Sleep disorders,Questionnaires,Apneia do sono tipo obstrutiva,Transtornos do sono,Questionários

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