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. 2024 Dec;56(1):2352028.
doi: 10.1080/07853890.2024.2352028. Epub 2024 May 27.

Prevalence, dimensions, and correlates of excessive daytime sleepiness in community-dwelling older adults: the Yilan study, Taiwan

Chiu-Jui Huang  1 , Nai-Wei Hsu  2   3   4 , Hsi-Chung Chen  5   6
Affiliations

Prevalence, dimensions, and correlates of excessive daytime sleepiness in community-dwelling older adults: the Yilan study, Taiwan

Chiu-Jui Huang et al. Ann Med. 2024 Dec.

Abstract

Background: Daytime sleepiness is an important health problem. However, the dimensionality of the Epworth Sleepiness Scale (ESS) in older adults remains unclear. This study aimed to determine the prevalence of ESS-defined excessive daytime sleepiness in older adults. Furthermore, the dimensionality of ESS and its respective correlates were also compared.

Materials and methods: This is a community-based survey in which community-dwelling older adults aged ≥ 65 years participated. Excessive daytime sleepiness was assessed using the ESS and was defined as an ESS score of > 10. Exploratory factor analysis was performed to identify the ESS factors. Multiple logistic regression analysis was used to examine the independent correlates of the ESS-defined and factor-specific correlates of excessive daytime sleepiness.

Results: In total, 3978 older adults participated in this study. The mean age was 76.6 ± 6.7 years, with 53.8% ≥ 75 years, and 57.1% were female. The prevalence of ESS-defined excessive daytime sleepiness was 16.0%. An exploratory factor analysis revealed two factors in the ESS, which were designated as 'passive' and 'active' according to the soporific levels of ESS items loaded in each factor. Multiple logistic regression showed that male, illiteracy, depression, disability, short sleep duration and no exposure to hypnotics were risk indicators for ESS-defined excessive daytime sleepiness. However, the correlates for passive and active factor-defined excessive daytime sleepiness differ in pattern, especially in variables related to education, exercise, mental health, and sleep.

Conclusions: The prevalence of ESS-defined excessive daytime sleepiness is high, and its correlates vary among older adults. This study also suggests a dual ESS structure in community-dwelling older adults.

Keywords: Correlates; daytime sleepiness; dimensionality factor analysis; older adults.

Plain language summary

Daytime sleepiness is prevalent in older adults.The Epworth Sleepiness Scale (ESS) has dual constructs in older adults.Correlates for excessive daytime sleepiness vary by constructs of the ESS.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Prevalence of ESS-defined daytime sleepiness in various morbid conditions.
See this image and copyright information in PMC

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