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What are the important risk factors for excessive daytime sleepiness in a population-based cohort?
Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
Department of Biomedicine and Clinical Sciences, Division of Neurobiology, Faculty of Medicine, Linköping University, Linköping, Sweden; Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
Department of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Umeå University, Faculty of Medicine, Department of Diagnostics and Intervention. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
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2025 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869Article in journal (Refereed) Epub ahead of print
Abstract [en]

Excessive daytime sleepiness (EDS) is a common complaint in the general population and is associated with cardiovascular disease and increased mortality. We aimed to investigate whether sleep duration is related to excessive daytime sleepiness in the general population, both in itself and in combination with other factors. We performed a cross-sectional analysis in the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort (n = 27,976; 14,436 females; aged 50–64 years) to assess how sleep-related factors along with anthropometric, lifestyle, socioeconomic factors as well as somatic disease and psychological distress, were related with EDS assessed by the Epworth sleepiness scale (ESS). Analyses were performed using logistic regression modelling with EDS defined by an ESS score of ≥11 as the main outcome. Both short and long sleep duration were related to EDS with increasing ORs for decreasing sleep duration (7 h vs. reference (8 h): OR 1.2, 95% CI 1.02–1.3 to ≤4 h: 1.9; 1.4–2.5). In addition to sleep-related factors such as insomnia (1.3; 1.2–1.4), poor sleep quality (1.2; 1.04–1.4), snoring (1.5; 1.4–1.6), and nocturnal gastro-oesophageal reflux (1.5; 1.21–1.8), psychological distress showed a strong association with EDS. This included sadness/depression (1.2; 1.1–1.3), stress (some stress: 1.4; 1.1–1.7 to constant stress over 5 years: 1.7; 1.3–2.2), and self-rated "control in life" (lowest quartile: 1.7; 1.6–2.0). Daytime sleepiness is multifactorial and associated with both sleep duration and sleep quality. Strong associations were also established with factors related to psychological distress. Further research may investigate interventions targeting both sleep and psychological health to reduce daytime sleepiness at the societal level.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025.
Keywords [en]
adults, epidemiology, Epworth, SCAPIS, sleepiness
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:umu:diva-234011DOI: 10.1111/jsr.14449ISI: 001391018600001PubMedID: 39776162Scopus ID: 2-s2.0-85214192292OAI: oai:DiVA.org:umu-234011DiVA, id: diva2:1926603
Funder
Swedish Heart Lung Foundation, 20230298Swedish Heart Lung Foundation, 20200485Swedish Heart Lung Foundation, 20210529EU, Horizon 2020, 965417Region Västra Götaland, ALFGBG 966283Region StockholmUniversity of GothenburgKarolinska InstituteLinköpings universitetLund UniversityUmeå UniversityUppsala UniversityKnut and Alice Wallenberg FoundationSwedish Research CouncilVinnovaAvailable from: 2025-01-13 Created: 2025-01-13 Last updated: 2025-02-20

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Claesson, MartinFranklin, Karl A.Hultin, MagnusSahlin, Carin

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