Factors predicting consultation for obstructive sleep apnea among Japanese male workers in the construction and civil engineering sector: a longitudinal study using annual medical check-up data

Abstract Objectives Research on predictors for consultations regarding obstructive sleep apnea (OSA) is limited, with few longitudinal studies examining how changes in disease status and work conditions influence these behaviors. This study tracked Japanese male workers in the construction and civil engineering sector for 1 year to determine whether individual changes could predict future OSA consultations. Methods We conducted a longitudinal analysis using data from 16,279 male employees covered by the health insurance society of a construction and civil engineering company. The dataset comprised annual medical check-up findings, self-administered questionnaires, and medical claims data collected at two points, with a mean interval of 370 ± 34.3 days between assessments. Associations between time-varying factors and possible OSA consultation behavior were assessed using binary logistic regression with generalized estimating equations, while associations between changes in these factors and consultation behavior were evaluated using conventional binary logistic regression. This consultation behavior was defined as the occurrence of at least one of the following procedures in the medical insurance claims records: polysomnography, home sleep apnea testing, or pulse oximetry. Results Possible OSA consultation behavior was positively associated with the presence of comorbidities and habitual snoring and/or witnessed apnea, but inversely associated with the number of working days. However, none of the changes observed during the follow-up period were significantly associated with consultation behavior. Additionally, a high risk for OSA alone was not significantly associated with the consultation behavior. Conclusion Neither short-term within-person changes in symptoms or comorbidities nor high OSA risk prompted help-seeking, highlighting the need for proactive screening and streamlined referrals.