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Hits and misses: screening commercial drivers for obstructive sleep apnea using guidelines recommended by a joint task force.

Authors
Platt-AB; Wick-LC; Hurley-S; Soto-Calderon-H; Wieland-W; Staley-B; Maislin-G; Gurubhagavatula-I
Source
J Occup Environ Med 2013 Sep; 55(9):1035-1040
NIOSHTIC No.
20044292
Abstract
OBJECTIVE: To evaluate joint task force criteria-based screening for severe obstructive sleep apnea (s-OSA) in commercial drivers. METHODS: Among a community-based cohort of licensed commercial vehicle drivers, we assessed utility of the joint task force criteria. We conducted full, 14-channel overnight polysomnography in all drivers, defining s-OSA as an apnea-hypopnea index of 30 or more per hour. RESULTS: One hundred of 104 drivers with successful polysomnography studies were predominantly obese (median body mass index = 32.8 kg/m; interquartile range = 26.8 to 37.4) and had a median apnea-hypopnea index of 20.6 per hour (interquartile range = 10.0 to 34.2). Examination-based criteria were more effective (sensitivity = 80%; negative posttest probability [nPTP] = 17%) than symptom-based criteria (sensitivity = 63%; nPTP = 23%). Examination and symptom-based criteria combined had high sensitivity (97%) and low nPTP (7%), but poor specificity (19%). CONCLUSIONS: Examination-based criteria missed 20% of s-OSA cases. Combining examination with confidentially reported symptoms improved sensitivity but required confirmatory polysomnography in 86%, supporting universal screening of all drivers.
Keywords
Sleep-disorders; Humans; Men; Women; Trucking; Truck-drivers; Motor-vehicles; Statistical-analysis; Body-weight
Contact
Alec B. Platt, MD, MSCE, FCCP, 2608 Keiser Blvd, Wyomissing, PA 19610
CODEN
JOEMFM
Publication Date
20130901
Document Type
Journal Article
Email Address
alecplatt@gmail.com
Funding Type
Grant
Fiscal Year
2013
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-009149
Issue of Publication
9
ISSN
1076-2752
Source Name
Journal of Occupational and Environmental Medicine
State
PA
Performing Organization
University of Pennsylvania
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