Comparative levels of excessive daytime sleepiness in common medical disorders.
Comparative levels of excessive daytime sleepiness in common medical disorders.
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DOI：
10.1016/j.sleep.2010.04.010
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发表时间：
2010-10
期刊：
影响因子：
4.8
通讯作者：
Drake, Christopher L.
中科院分区：
文献类型：
--
作者：
Stroe, Alice F.;Roth, Thomas;Jefferson, Catherine;Hudgel, David W.;Roehrs, Timothy;Moss, Kenneth;Drake, Christopher L.
睡眠限制和睡眠障碍是白天过度嗜睡（EDS）的常见原因。医学疾病（MD）也可能导致EDS，但以前的研究使用了非标准化的措施，选择的样本，或在单一疾病中检查EDS。本研究描述了EDS与医学疾病相关的相对程度，以提供一个大型社区样本中一系列常见医学疾病的比较数据。2612人（18-65岁）的反应进行了评估后，排除那些可疑的睡眠呼吸障碍，嗜睡症，倒班工人。使用埃普沃思嗜睡量表（ESS）和患者夜间睡眠报告对一系列医学疾病的参与者进行评估。67%的样本报告了MD。MD患者中EDS（ESS ≥ 10分）的患病率为31.4%，且随MD数目的增加而增加（0 MD = 29.4%，1 MD = 28.4%，2 MD = 31.0%，3 MD = 35.3%，4 MD = 38.4%）。疾病是EDS的独立预测因素，溃疡OR = 2.21（95% CI = 1.35 - 3.61），偏头痛OR = 1.36（95%CI = 1.08 ~ 1.72），抑郁OR = 1.46（95%CI = 1.16 - 1.83）。患有溃疡的参与者嗜睡的患病率最高，为50.0%，入睡问题（40.8%）和夜间觉醒问题（62.5%）也最高。与其他常见的MD相比，溃疡、偏头痛和抑郁症患者的EDS水平具有独立的临床意义。
Sleep restriction and sleep disorders are common causes of excessive daytime sleepiness (EDS). Medical disorders (MD) can also cause EDS, but previous studies have used non-standardized measures, selected samples, or have examined EDS in singular disorders. This study describes the relative degree of EDS associated with medical disorders to provide comparative data across a range of common medical conditions in a large unselected community-based sample. Responses of 2612 individuals (aged 18-65) were assessed after excluding those with suspected sleep disordered breathing, narcolepsy, and shift workers. Participants across a range of medical disorders were evaluated using the Epworth Sleepiness Scale (ESS) and patient reports of nocturnal sleep. Sixty-seven percent of the sample reported a MD. The prevalence of EDS (ESS ≥ 10) was 31.4% in individuals with MD and increased as a function of number of MD (0 MD = 29.4%, 1 MD = 28.4%, 2 MD = 31.0%, 3 MD = 35.3%, 4 MD = 38.4%). Disorders which were independent predictors of EDS were ulcers OR = 2.21 (95% CI = 1.35 - 3.61), migraines OR = 1.36 (95% CI = 1.08 – 1.72), and depression OR = 1.46 (95% CI = 1.16 – 1.83) after controlling for other conditions, age, gender, time in bed, caffeine, smoking and alcohol use. Participants with ulcers had the highest prevalence of sleepiness, 50.0%, as well as the highest level of problems falling asleep (40.8%) and awakenings during the night (62.5%). Individuals with ulcers, migraines, and depression have independent and clinically significant levels of EDS relative to other common MD.
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