Risk of permanent social security benefits and overview of work participation among patients with obstructive sleep apnea

Background
In this nationwide study, we used Danish population registries to estimate the excess risk of receiving permanent social security benefits for patients with obstructive sleep apnea (OSA) and to track their labour force participation.

Methods
We identified all Danish citizens receiving a diagnosis of OSA between 1995 and 2015. As a reference cohort, we randomly selected 10 citizens for each patient, matched by sex and birth year. Using the Fine and Gray competing risk regression, we estimated the cumulative incidences of receiving permanent social security benefits. Cox proportional hazard models were used to compare the risk of receiving permanent social security benefits in patients with OSA compared to the reference cohort. The Danish Rational Economic Agents' Model (DREAM) database was used to identify the labour market status prior to diagnosis, at time of diagnosis, and after diagnosis.

Results
We identified 48,168 patients with OSA. A total of 12,413 (25.8%) patients with OSA had received permanent social security benefits, compared with 75,812 (15.7%) individuals in the reference cohort. Patients with OSA had a significantly increased risk of receiving permanent social security benefits when compared with the reference cohort (hazard ratio, 1.95; 95% CI, 1.88–2.02; and subhazard ratio, 1.92; 95% CI, 1.85–1.98). Work participation was lower for OSA patients compared to references at all time-points.

Conclusion
Patients with OSA have a moderately increased risk of receiving permanent social security benefits in Denmark after controlling for available confounders.