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Comparative Study
. 2010 Oct;11(9):890-6.
doi: 10.1016/j.sleep.2010.04.010.

Comparative levels of excessive daytime sleepiness in common medical disorders

Alice F Stroe  1 , Thomas Roth, Catherine Jefferson, David W Hudgel, Timothy Roehrs, Kenneth Moss, Christopher L Drake
Affiliations
Comparative Study

Comparative levels of excessive daytime sleepiness in common medical disorders

Alice F Stroe et al. Sleep Med. 2010 Oct.

Abstract

Introduction: 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.

Methods: 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.

Results: Sixty-seven percent of the sample reported a MD. The prevalence of EDS (ESS>or=10) was 31.4% in individuals with MD and increased as a function of a 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%).

Conclusions: Individuals with ulcers, migraines, and depression have independent and clinically significant levels of EDS relative to other common MD.

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Figures

Figure 1
Figure 1
Mean ESS score as a function of number of medical conditions ± standard error.
Figure 2
Figure 2
Relationship between prevalence of excessive sleepiness and the number of current medical conditions. Overall chi-square; P<.05.
See this image and copyright information in PMC

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