IMPACT OF SELF-REPORTED SLEEP-BREATHING DISTURBANCES ON PSYCHOSOCIAL PERFORMANCE IN THE SWEDISH OBESE SUBJECTS (SOS) STUDY

Patients with severe obesity commonly have obstructive sleep apnea (OS A). In order to determine the impact of OSA on psychosocial morbidity in severe obesity, subjects enrolled in the Swedish Obese Subjects (SO S) Study were classified into two subgroups based on questionnaire dat a: one group with a high likelihood and one with a low likelihood of O SA. These groups were contrasted and multivariable analysis was used t o examine whether OSA had independent effects on divorce rate, sick le ave, work performance, income and self-estimated general health after adjustment for obesity, fat distribution, alcohol, smoking, medication s and coexisting medical conditions. A high likelihood of OSA was iden tified in 338 men and 155 women, compared with 216 men and 481 women w ho had a low likelihood of OSA. Men with OSA were identical in age to men without OSA and had slightly higher levels of visceral fat (p = 0. 01), but were similar in most psychosocial variables except self-perce ived general health. Women with OSA were identical in age and visceral fat mass to women without OSA, but were characterized by a higher rat e of impaired work performance, sick leave and divorce. When frequent sleepiness was used as an additional discriminator between OSA and non -OSA groups, marked differences in psychosocial morbidity were observe d. Multivariable analysis revealed either OSA or frequent sleepiness o r both to be independent predictors of amount of sick leave, worse sel f-rated general health, impaired work performance and divorce rate. Th erefore OSA, measured by self report, is an important independent pred ictor of psychosocial morbidity in subjects with severe obesity.