4.4 Article

Obstructive sleep apnea and excessive daytime sleepiness among commercial motor vehicle drivers in Lusaka, Zambia

Journal

JOURNAL OF CLINICAL SLEEP MEDICINE
Volume 19, Issue 7, Pages 1191-1198

Publisher

AMER ACAD SLEEP MEDICINE
DOI: 10.5664/jcsm.10538

Keywords

obstructive sleep apnea; OSA; excessive daytime sleepiness; EDS; HROSA; road traffic accidents; RTA; continuous positive airway pressure

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This study aims to assess the prevalence of excessive daytime sleepiness and obstructive sleep apnea risk among commercial motor vehicle drivers in Zambia, as well as their impact on road traffic accident rates. The results show a high prevalence of high risk obstructive sleep apnea and excessive daytime sleepiness among the surveyed drivers.
Study Objectives: Obstructive sleep apnea (OSA) is a risk factor for a major public health problem, car crashes, due to excessive daytime sleepiness (EDS). Commercial vehicle driving (CVD) is a hazardous occupation, having a high fatality rate worldwide. There have been no studies on EDS and OSA in Zambia despite the high rate of annual road traffic accidents (RTAs). We aim to determine the prevalence of EDS and OSA risk among CVDs in Lusaka, Zambia, to assess the impact of OSA on high RTA rates. Methods: This was a cross-sectional study. The STOP BANG questionnaire and the Epworth Sleepiness Scale were used. Consecutive sampling of drivers was done who were divided into low and high risk of OSA (HROSA). The risk factors associated with OSA in the bivariate analyses were subjected to a multivariate logistic regression model. Results: One hundred thirty-six drivers participated in the study (all male) with a mean age of 48 & PLUSMN;5 years. The prevalence of HROSA was 22.8% out of whom 67.7% also had a EDS. Only 9.6% of the total cohort had EDS without HROSA. Using Fisher's exact test, HROSA was significantly associated with older age (> 50 years, P < .001), obesity (body mass index >30, P < .001), neck circumference of > 40 cm (P = .032), and hypertension (P < .001). Snoring and EDS were significantly associated with RTAs (P < .0001 and P = .007, respectively). Conclusions: High risk of OSA and EDS are common among CMV drivers in Zambia and underdiagnosed. The risk factors for OSA are amenable to preventive interventions.

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