Barbara Phillips, MD, MPH, FCCP: The Jobs Most Burdened with Sleep Apnea

Sleep apnea can be dangerous for anyone, but certain occupations can put individuals at an increased risk for the sleep disorder and its associated comorbidities.

While at this year’s CHEST meeting in San Antonio, TX, Barbara Phillips, MD, MPH, FCCP, spoke with MD Magazine^® about which occupations tend to be associated with sleep apnea and what criteria may constitute high-risk levels.

MD Mag: What are some of the professions most commonly associated with sleep apnea?

Phillips: That’s a very good question. Again, I have to come back to the phenotypes of sleep apnea. For example, mild rim-related sleep apnea without terrible hypoxemia or falls in low blood oxygen is seen mostly in premenopausal, obese women. So, it would be in whatever profession they’re doing, right?

The typical sleep apnea that people learned about in medical school, if they learned about it at all, is a middle-aged obese man. Of course, [that] is seen in commercial drivers—people in safety-sensitive positions.

There is a huge awareness now in our federal government about the risk that sleep apnea plays for a crash in commercial vehicle drivers and all people in safety sensitive positions.

Again, 1 of our problems is trying to decide what sleep apnea is in this population. What is the cut-point for either you’re treated, or you’re out of a job?

Is it an apnea plus hypopnea index of 5, is it an apnea plus hypopnea index of 20, or is it something that we’re not even measuring or routinely reporting, which I think it probably is. I think it’s probably the time spent what an oxygen level below 90% that really predicts the greatest risk of a person having a crash or any other kind of accident due to inattentiveness.

I think there is an increasing awareness. We are all at risk for sleep apnea, whether we have it or not, because people who are out first responders are people [who] on the road with us, [and they] are afflicted and sometimes not treated.

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