Excessive daytime sleepiness in a general population sample: The role of sleep apnea, age, obesity, diabetes, and depression
Excessive daytime sleepiness in a general population sample: The role of sleep apnea, age, obesity, diabetes, and depression
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DOI：
10.1210/jc.2005-0035
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发表时间：
2005-08-01
影响因子：
5.8
通讯作者：
Kales, A
中科院分区：
文献类型：
--
作者：
Bixler, EO;Vgontzas, AN;Kales, A
背景：日间过度嗜睡(EDS)通常被认为是睡眠呼吸暂停的基本症状；然而，潜在的机制尚不清楚。目的：考虑到人群样本中广泛的可能危险因素，本研究的目的是评估EDS主诉与睡眠呼吸暂停之间的关联。设计和背景：我们在宾州州立大学队列中对这个问题进行了研究(从宾夕法尼亚州中部随机抽取了16,583名男性和女性，年龄从20岁到100岁不等)。结果：最终的Logistic回归模型显示抑郁是EDS的最重要的危险因素，其次是体重指数、年龄、典型睡眠时间、糖尿病、吸烟，最后是睡眠呼吸暂停。与EDS的关联强度随着年龄的增长而降低，而抑郁症与EDS的关联在年轻人中更强。EDS在年轻人(<；30岁)中更普遍，表明睡眠需求未得到满足和抑郁的存在，在非常年长的人(>；75岁)中，表明医疗疾病和健康问题的增加。EDS与典型睡眠持续时间的减少有关，而与客观的多导睡眠监测没有任何关联。结论：EDS的存在与抑郁和代谢因素的关系似乎比与睡眠呼吸障碍或睡眠干扰本身更强。我们的发现表明，有EDS主诉的患者应该彻底评估抑郁症和肥胖症/糖尿病，无论是否存在睡眠呼吸障碍。
Context: Excessive daytime sleepiness (EDS) is commonly considered a cardinal sign of sleep apnea; however, the mechanism underlying the association is unclear.Objective: 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.Design and Setting: 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.Main Outcome Measure: The main measure was a complaint of EDS.Results: 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.Conclusions: 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.