Excessive daytime sleepiness in a general population sample: The role of sleep apnea, age, obesity, diabetes, and depression

Psychiatry , Universidad Autónoma de Madrid, Madrid, Madrid, Spain
Journal of Clinical Endocrinology &amp Metabolism (Impact Factor: 6.31). 09/2005; 90(8):4510-5. DOI: 10.1210/jc.2005-0035
Source: PubMed

ABSTRACT Excessive daytime sleepiness (EDS) is commonly considered a cardinal sign of sleep apnea; however, the mechanism underlying the association is unclear.
The purpose of this study was to assess the association between the complaint of EDS and sleep apnea, considering a wide range of possible risk factors in a population sample.
We examined this question in the Penn State cohort (a random sample of 16,583 men and women from central Pennsylvania, ranging in age from 20 to 100 yr). A random subset of this cohort (n = 1,741) was further evaluated for one night in the sleep laboratory.
The main measure was a complaint of EDS.
The final logistic regression model indicated depression was the most significant risk factor for EDS followed by body mass index, age, typical sleep duration, diabetes, smoking, and finally sleep apnea. The strength of the association with EDS decreased with increasing age, whereas the association of depression with EDS was stronger in the young. EDS is more prevalent in the young (<30 yr), suggesting the presence of unmet sleep needs and depression, and in the very old (>75 yr), suggesting increasing medical illness and health problems. EDS was associated with a reduced report of typical sleep duration without any association with objective polysomnographic measures.
It appears that the presence of EDS is more strongly associated with depression and metabolic factors than with sleep-disordered breathing or sleep disruption per se. Our findings suggest that patients with a complaint of EDS should be thoroughly assessed for depression and obesity/diabetes independent of whether sleep-disordered breathing is present.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Sleep/wake disturbance is a feature of almost all common age-related neurodegenerative diseases. Although the reason for this is unknown, it is likely that this inability to maintain sleep and wake states is in large part due to declines in the number and function of wake-active neurons, populations of cells that fire only during waking and are silent during sleep. Consistent with this, many of the brain regions that are most susceptible to neurodegeneration are those that are necessary for wake maintenance and alertness. In the present review, these wake-active populations are systematically assessed in terms of their observed pathology across aging and several neurodegenerative diseases, with implications for future research relating sleep and wake disturbances to aging and age-related neurodegeneration.
    SpringerPlus 12/2015; 4(1):25. DOI:10.1186/s40064-014-0777-6
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Obstructive sleep apnea (OSA) and excessive daytime sleepiness (EDS) are common in patients with type 2 diabetes mellitus (T2DM). This study was aimed to evaluate the prevalence and risk factors of the OSA and EDS among Iranian patients with T2DM. We conducted a cross-sectional study on randomly selected 173 patients with T2DM aged 30 to 65. We assessed daytime sleepiness using the Epworth sleepiness scale and risk of OSA using the STOP-BANG questionnaire. Further information was demographic and anthropometric characteristics plus metabolic profile. Of all, 122 (74 %) patients were at high risk for OSA and 78 (45 %) patients suffered from EDS. Patients at high risk for OSA were older and had higher BMI, waist circumference, neck circumference, systolic, and diastolic blood pressure. In addition, men were significantly at a higher risk for OSA than women. Logistic regression revealed that age, male sex, and neck circumference were independent predictors of risk for OSA. The only independent predictor of EDS was age. Patients with T2DM are at high risk for OSA; also, daytime sleepiness is highly prevalent in this population. Our results indicated that the evaluation of OSA, EDS, and their risk factors should be included in the clinical management of patients with T2DM.
    International Journal of Diabetes in Developing Countries 02/2015; DOI:10.1007/s13410-014-0281-0 · 0.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this research is to investigate the prevalence of excessive daytime sleepiness (EDS) in primary school children in Hong Kong and to explore the interrelationship between EDS, unhealthy sleep behavior, and depression. 911 primary 4–6 students were recruited to a cross-sectional study. They completed a pack of questionnaires measuring sleepiness, depression, unhealthy sleep behaviors, and some socio-demographic information. Univariate logistic regression was performed to identify the potential risk factors of UBS on EDS and depression. A multivariate logistic regression was performed to examine the mediation role of EDS between UBS and depression. An EDS prevalence rate of 25.1 % was observed. Staying up late to study was significantly associated with both EDS and depression, eating before sleep was strongly associated with EDS and an inconsistent sleep time was strongly associated with depression. EDS only partially mediated the relationship between staying up late to study and depression. Unhealthy sleep behaviors are common among children and which may be due to heavy homework, poor time management, lack of house rule regarding snack time. They will increase the risk of depression and excessive sleepiness.
    Journal of Child and Family Studies 01/2014; DOI:10.1007/s10826-014-0013-6 · 1.42 Impact Factor

Full-text (2 Sources)

Available from
Sep 25, 2014