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Association of daytime sleepiness with obstructive sleep apnoea and comorbidities varies by sleepiness definition in a population cohort of men
Author(s) -
Adams Robert J.,
Appleton Sarah L.,
Vakulin Andrew,
Lang Carol,
Martin Sean A.,
Taylor Anne W.,
McEvoy R. Doug,
Antic Nick A.,
Catcheside Peter G.,
Wittert Gary A.
Publication year - 2016
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12829
Subject(s) - epworth sleepiness scale , medicine , nocturia , excessive daytime sleepiness , body mass index , polysomnography , pittsburgh sleep quality index , depression (economics) , population , physical therapy , cohort , sleep disorder , psychiatry , insomnia , apnea , sleep quality , macroeconomics , urinary system , environmental health , economics
Background and objective To determine correlates of excessive daytime sleepiness (EDS) identified with the Epworth Sleepiness Scale (ESS) and a more broad definition, while accounting for obstructive sleep apnoea (OSA) in community dwelling men. Methods Participants of the Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) Study ( n = 837, ≥ 40 years) without a prior OSA diagnosis, underwent in‐home full unattended polysomnography (PSG, Embletta X100), completed the ESS, STOP questionnaire and Pittsburgh Sleep Quality Index in 2010–2011. In 2007–2010, questionnaires and biomedical assessment (in South Australian public hospital‐based clinics) identified medical conditions. An alternate EDS definition (EDS Alt ) consisted of ≥ 2 of 3 problems (feeling sleepy sitting quietly; feeling tired/fatigued/sleepy; trouble staying awake). Results EDS Alt (30.4%, n = 253), but not ESS ≥ 11 (EDS ESS , 12.6%, n = 104), increased significantly across OSA severity and body mass index categories. In adjusted analyses, EDS ESS was significantly associated with depression: odds ratio (OR), 95%CI: 2.2 (1.3–3.8) and nocturia: 2.0 (1.3–3.2). EDS Alt was associated with depression, financial stress, relationship, work‐life balance problems and associations with nocturia and diabetes were borderline. After excluding men with EDS ESS , EDS Alt was associated with oxygen desaturation index (3%) ≥ 16 and the highest arousal index quartile but not with comorbidities. Conclusion Sleepiness not necessarily leading to dozing, but not ESS ≥ 11, was related to sleep disordered breathing. Clinicians should be alert to (1) differing perspectives of sleepiness for investigation and treatment of OSA, and (2) the presence of depression and nocturia in men presenting with significant Epworth sleepiness regardless of the presence of OSA.