Work-related risk factors of sleep apnea: evidence from the Korean work, sleep, and health study

Occupational exposures are hypothesized to contribute to obstructive sleep apnea (OSA) risk, yet evidence from large, population-based studies remains scarce. This study aimed to investigate the association between a wide range of work-related factors and sleep apnea risk among Korean workers.

We analyzed data from the Korean Work, Sleep, and Health Study (KWSHS), a nationwide longitudinal panel survey conducted between 2022 and 2024. Work-related exposures included long working hours, shift work, occupational stress, emotional labor, physical or chemical hazards, and ergonomic factors. Sleep apnea risk was assessed using the Berlin Questionnaire. To account for repeated measurements within individuals, generalized estimating equation models were applied to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, and occupation. Subgroup analyses were performed according to obesity status.

Among 8,976 workers, long working hours (> 52 h per week; OR 1.22, 95% CI 1.04-1.43), high occupational stress (OR 1.93, 95% CI 1.76-2.12), high emotional labor (OR 1.74, 95% CI 1.50-2.02), physical or chemical exposures (OR 1.37, 95% CI 1.25-1.50), and ergonomic strains (OR 1.36, 95% CI 1.25-1.48) were significantly associated with increased odds of high sleep apnea risk. Shift work was not significantly associated with OSA risk, which may be partially explained by the healthy worker effect or adaptation among long-term shift workers. Associations with physical and chemical exposures were stronger among non-obese participants.

Work-related psychosocial and environmental factors contribute meaningfully to sleep apnea risk. Addressing workplace conditions may represent an important strategy for sleep apnea prevention.