Obstructive Sleep Apnea (OSA) represents a critical yet often underdiagnosed contributor to occupational morbidity, given its established links to impaired vigilance, neurocognitive dysfunction, and accident proneness. This cross-sectional study evaluated the prevalence of OSA risk and its relationship with occupational accidents among rotating shift workers. Between April and June 2024, 217 textile workers underwent assessment using the STOP-BANG questionnaire (score ≥3 indicating OSA risk) alongside the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and Insomnia Severity Index. Compared with their counterparts, those at risk were older, had higher body mass index, larger neck and waist circumferences, longer employment duration, more comorbidities, and higher daytime sleepiness scores (ESS: 4 [0–11] vs. 5 [0–16]; p = 0.007), while subjective sleep time and sleep quality indices were comparable. In total, 36.4% of workers reported an occupational accident in the past year. Accident prevalence was higher in those with OSA risk (50.0% vs. 28.1%), and OSA risk remained an independent predictor of accidents (adjusted OR = 2.55; 95% CI: 1.44–4.53; p = 0.001) in the fully adjusted model. These findings highlight OSA as a prevalent, underrecognized determinant of occupational safety among shift workers. Integrating systematic OSA screening into workplace health surveillance and implementing targeted preventive measures could mitigate accident risk, improve productivity, and contribute to a closer alignment between sleep medicine and occupational health practice.



