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Association between continuous positive airway pressure usage and workforce attachment in obstructive sleep apnea
Christine Benn Christiansen1, Jeppe Suusgaard Kjølhede2, Mads Hashiba Jensen3
1Department of Neurology, Bispebjerg Hospital, 2400, Copenhagen, NV, Denmark; Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark.
Sleep Medicine
|March 18, 2026
Summary
Higher education is linked to continuous positive airway pressure (CPAP) use for obstructive sleep apnea (OSA). Workforce detachment before OSA diagnosis reduces CPAP usage, especially for women.
Area of Science:
- Sleep Medicine and Public Health
- Occupational Health and Epidemiology
Background:
- Obstructive sleep apnea (OSA) significantly impacts quality of life and workforce participation.
- Continuous positive airway pressure (CPAP) is a primary treatment for OSA, but its association with employment outcomes requires further investigation.
- Socioeconomic factors like education and sex may influence CPAP adherence and its effect on workforce attachment.
Purpose of the Study:
- To investigate the relationship between CPAP usage and workforce participation in individuals with OSA.
- To examine the moderating roles of sex and education level in the association between OSA, CPAP use, and employment status.
Main Methods:
- A nationwide registry-based study in Denmark identified 31,113 individuals aged 30-64 diagnosed with OSA between 2005-2017.
- Participants were classified based on CPAP usage (users, non-users, no treatment), education level, and employment status.
- Odds ratios (ORs) for workforce attachment were estimated in relation to CPAP use, controlling for demographic and clinical factors.
Main Results:
- Individuals with vocational and college education showed higher odds of CPAP usage compared to those with no formal education.
- Workforce participation declined post-OSA diagnosis across all CPAP usage groups, but was higher among CPAP users.
- Workforce detachment prior to OSA diagnosis was associated with significantly reduced odds of CPAP use (OR 0.72).
- Among women employed at diagnosis, subsequent unemployment was linked to reduced CPAP usage odds (OR 0.73).
Conclusions:
- Higher education levels correlate positively with CPAP usage in OSA patients.
- Pre-diagnosis workforce detachment is a predictor of lower CPAP utilization.
- The findings underscore the complex interplay between OSA, CPAP therapy, education, sex, and sustained workforce participation, suggesting targeted interventions may be beneficial.
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