Prevalence Of Excessive Daytime Sleepiness Research Articles

Global Prevalence of Excessive Daytime Sleepiness in Patients with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

Global Prevalence of Excessive Daytime Sleepiness in Patients with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

Feature Contributions and Predictive Accuracy in Modeling Adolescent Daytime Sleepiness Using Machine Learning: The MeLiSA Study.

Background: Excessive daytime sleepiness (EDS) among adolescents poses significant risks to academic performance, mental health, and overall well-being. This study examines the prevalence and risk factors of EDS in adolescents in Bangladesh and utilizes machine learning approaches to predict the risk of EDS. Methods: A cross-sectional study was conducted among 1496 adolescents using a structured questionnaire. Data were collected through a two-stage stratified cluster sampling method. Chi-square tests and logistic regression analyses were performed using SPSS. Machine learning models, including Categorical Boosting (CatBoost), Extreme Gradient Boosting (XGBoost), Support Vector Machine (SVM), Random Forest (RF), K-Nearest Neighbors (KNN), and Gradient Boosting Machine (GBM), were employed to identify and predict EDS risk factors using Python and Google Colab. Results: The prevalence of EDS in the cohort was 11.6%. SHAP values from the CatBoost model identified self-rated health status, gender, and depression as the most significant predictors of EDS. Among the models, GBM achieved the highest accuracy (90.15%) and precision (88.81%), while CatBoost had comparable accuracy (89.48%) and the lowest log loss (0.25). ROC-AUC analysis showed that CatBoost and GBM performed robustly in distinguishing between EDS and non-EDS cases, with AUC scores of 0.86. Both models demonstrated the superior predictive performance for EDS compared to others. Conclusions: The study emphasizes the role of health and demographic factors in predicting EDS among adolescents in Bangladesh. Machine learning techniques offer valuable insights into the relative contribution of these factors, and can guide targeted interventions. Future research should include longitudinal and interventional studies in diverse settings to improve generalizability and develop effective strategies for managing EDS among adolescents.

Duration of N1 sleep is a factor for excessive daytime sleepiness in epilepsy patients with interictal epileptiform discharges: A polysomnographic study

PurposeThis study aimed to identify the occurrence of excessive daytime sleepiness (EDS) in epilepsy patients with interictal epileptiform discharges and to explore the impact of interictal sleep architecture and sleep-related events on EDS. MethodsThis study included 101 epilepsy patients with interictal epileptiform discharges (IED) and 100 control patients who underwent simultaneous polysomnography and video ambulatory electroencephalography for >7 h throughout a single night. Multiple sleep latency tests were used to assess EDS. Comorbid EDS was present in 25 and 11 patients in the IED epilepsy and control groups, respectively. In addition, univariate and multivariate logistic regression analyses were performed to explore the factors influencing EDS. ResultsThe epilepsy group had a higher prevalence of comorbid EDS and shorter R sleep duration. Univariate logistic regression analysis indicated that an increased risk of EDS may be associated with prolonged N1 sleep duration, higher arousal index, lower mean saturation (mSaO2), higher oxygen desaturation index (ODI), and duration of wake after sleep onset (WASO). Multivariate logistic regression analysis revealed that N1 sleep duration was significantly correlated with EDS. ConclusionIn epilepsy patients with IED, the arousal index, mSaO2, ODI, and duration of WASO were weakly correlated with EDS, and the duration of N1 sleep demonstrated a significant positive correlation with EDS, which requires further research.

Excessive daytime sleepiness in myotonic dystrophy: a narrative review.

Excessive daytime sleepiness (EDS) is a common and debilitating symptom in both forms of myotonic dystrophy (DM), significantly impacting patients' quality of life. The review focuses on the purpose of examining the current understanding of EDS in these conditions, the difficulty in correctly accessing it, the recent findings related to its etiology and prevalence, and a summary of potential therapeutic implications. We conducted a comprehensive search through PubMed, selecting studies that provided significant insights into the mechanisms, prevalence, and management of EDS in DM1 and DM2. EDS is highly prevalent in both DM1 and DM2. Polysomnographic studies have revealed prominent dysregulation of REM sleep in DM1, suggesting a possible narcoleptic-like phenotype and alterations in NREM sleep that contributes to daytime sleepiness. Other factors have been proposed to explain EDS in DM1, including dysregulation of the sleep-wake circadian rhythm through nocturnal actigraphy analysis. The central origin of EDS is increasingly delineated supported by serotonin and orexin pathways dysfunction, and recent neuroradiological findings showing that in DM1 hippocampus volume was positively correlated with self-reported fatigue and somnolence. Sleep-disordered breathing and respiratory dysfunctions are prevalent in DM, their direct correlation with EDS remains complex and inconclusive, but respiratory evaluation should be recommended if obstructive sleep apneas or respiratory muscle dysfunctions are suspected. Drug interventions, such as modafinil and mexiletine, have shown promise in managing excessive daytime sleepiness and reducing myotonia without significant cardiac conduction effects. Enhancing EDS management in myotonic dystrophy is key to improving overall patient well-being.

Food insecurity and the risk of sleep disorders in people living with HIV/AIDS as a neglected health concern: A national survey in Iran

Food insecurity (FI) and sleep problems are major modifiable health issues among people living with HIV/AIDS (PLWH), and there is limited knowledge about their prevalence among this underrepresented population. Our study aimed to assess the relationship between FI and sleep problems as important environmental factors affecting PLWH in Iran.The national survey was conducted on 1185 confirmed HIV-positive patients who attended consulting centers in 15 geographically diverse provinces in Iran, during 2021–2022. Standard questionnaires were used to measure FI and sleep problems (Insomnia, Obstructive Sleep apnea (OSA), Excessive Daytime Sleepiness (EDS), and Poor sleep quality), and a logistic regression model was used to assess the association between FI and the odds of experiencing sleep problems.About 764 (The prevalence of FI = 64.47 %) of the participants had insecure status, with a mean score of 11.73 (SE = 0.34). Those with FI had a higher prevalence of insomnia, EDS, and poor sleep quality (54.84 %, 31.79 %, and 55.17 %, respectively) compared to those without FI (30.69 %, 17.03 %, and 40.42 %, respectively). FI increased the odds of being at risk for Insomnia (OR = 2.39, 95 % CI: 1.81–3.15), EDS (OR = 1.44, 95 % CI: 1.04–2.01), and poor sleep quality (OR = 1.79, 95 % CI: 1.29–2.48) in the multiple regression model. The results highlight the strong association between FI and a broad range of sleep problems in PLWH. Considering the impact of FI and impaired sleep health on PLWH, more attention is needed for at-risk groups for screening and intervention purposes.

#2856 Sleep disturbances in non-dialysis dependent chronic kidney disease—The CKD-REIN cohort study

Abstract Background and Aims Sleep disturbances are common in patients on dialysis, but little is known about their prevalence and determinants in earlier chronic kidney disease (CKD) stages. We assessed the prevalence of insomnia, excessive daytime sleepiness (EDS), and sleep apnea, and studied their relation with kidney function, before and after accounting for various other potential determinants in patients with moderate or severe CKD. Method This study included 2657 nephrology outpatients with non-dialysis dependent CKD (mean age, 67 ± 12 years; 66% men; mean eGFR, 33 ± 12 mL/min/1.73 m2) from the French CKD-REIN (CKD-Renal Epidemiology and Information Network) cohort study who completed the Basic Nordic Sleep Questionnaire at baseline. Insomnia was defined as having badly or rather badly been sleeping, or having had difficulties falling asleep or awakened too early without being able to fall asleep again at least 3 times per week, over the past 3 months. And EDS, as feeling excessively sleepy during daytime at least 3 times per week over the past 3 months. Sleep apnea with or without continuous positive airway pressure use were identified from medical records. For each sleep disturbance, we assessed the crude prevalence by sex and by estimated glomerular filtration rate (eGFR) categories. We estimated adjusted odds ratios (OR) with 95% confidence interval (95% CI) associated with eGFR decrease (per 10 mL/min/1.73 m2) and urinary albumin-to-creatinine ratio (ACR) categories (A1-A3), as well as with age, sex, education (years), smoking, alcohol consumption, physical activity (estimated by the Global Physical Activity Questionnaire), performance score in Instrumental Activities of Daily Living [IADL], obesity, diabetes, cardiovascular disease, depression, patient-reported cramps, itching and stress or worry about CKD, and relevant drug use. Results Overall prevalence of insomnia, EDS, and sleep apnea were 23%, 15%, and 14%, respectively, with differences between women and men for insomnia, 30% vs 19%, EDS, 17% vs 13%, and sleep apnea, 10% vs 17%, respectively (all P-values <.001). Crude prevalence of EDS significantly increased with decreasing eGFR category (without interaction with sex), but not those for insomnia and sleep apnea (Figure). ACR categories were not associated with either sleep disturbances. In multivariable analyses, factors significantly associated with higher prevalence of insomnia included female sex, smoking, low physical activity, depression, and thyroid hormone use. There were also strong dose-response relations between insomnia prevalence and to what extend patients reported being bothered by cramps or itching, or stressed/worried about CKD. The crude relation of eGFR with EDS tended to weaken (ORs [95% CI], 1.10 [0.99-1.22] per 10 mL/min decrease, p-value 0.09) in multivariable analysis, which showed higher ORs associated with past smoking, depression, lower IADL score, insomnia, and betablocker use, as well as dose-response relations with itching, and stress/worry about CKD. Factors significantly associated with increased prevalence of sleep apnea included male sex, alcohol consumption, lower IADL score, obesity, depression, and cardiovascular disease. Conclusion This analysis of baseline data from the CKD-REIN cohort shows that, in patients with non-dialysis dependent CKD, EDS alone appeared to be related to kidney function level. The study, however, suggests the potential role of modifiable CKD-related symptoms, cramps and itching, and of being stressed or worried about CKD, in addition to that well-documented for behavioral and clinical risk factors, and drugs in the risk of insomnia and EDS.

Excessive daytime sleepiness in older adults of a municipal physical activity program

Physical exercise has been shown to have a favorable impact on the health of the individual. Its combination with other healthy lifestyles can positively impact various areas, including sleep quality. To determine the frequency of excessive daytime sleepiness in older adults of a municipal physical activity program in Santiago de Cali, Colombia. Cross-sectional study that included 605 older adults from a community program of the Secretary of Recreation and Sports of the City of Cali, Colombia, during October 2018 and June 2019. To determine the presence of excessive daytime sleepiness, the Epworth Sleepiness Scale was used. 81.5% of the population was female with a mean age of 73±8 years. The prevalence of excessive daytime sleepiness was 10.5%. Significant differences were only found in the frequency of excessive daytime sleepiness by socioeconomic stratum, being more common in the low socioeconomic stratum (13% vs 4% P=0.03). Excessive daytime sleepiness is a phenomenon that affects older adults; however, its frequency may be lower in those who are physically active.

Excessive Daytime Sleepiness Prevalence and Its Correlation with the Educational Level among Patients in the Pulmonary Diseases Department - Sleep Unit - Hassan II University Hospital, Fes – Morocco

This study aims to assess the prevalence of excessive daytime sleepiness (EDS) among adults. We conducted a descriptive and analytical study of 151 patients at Hassan II University Hospital in Fes. With the objective of identifying the causes of EDS and its impact on individuals with lower educational levels. The study tools included an Arabic translation of the Epworth Sleepiness Scale, after verifying its validity and reliability. The scale effectively identifies sleep disorders and risk factors for EDS. The participants' ages ranged from 18 to 65+ years, with a male ratio of 34.4% (52) and a female ratio of 65.6% (99). Results showed no high prevalence of EDS in the sample. However, statistically significant differences were found in sleepiness on the basis of the educational level.

Effect of shift work on excessive daytime sleepiness in female nurses: results from the Japan Nurses' Health Study.

We investigated the relationship between shift work and excessive daytime sleepiness (EDS) among participants in the Japan Nurses' Health Study (JNHS). Responses of 9,728 female nurses to the 6th follow-up questionnaire were cross-sectionally analyzed. EDS was defined as an Epworth Sleepiness Scale score ≥11. EDS-associated factors were evaluated using Poisson regression analysis after adjustment for multiple confounders. Of the participants (mean age, 52.2 ± 8.0 yr), 28.7% were engaged in shift work, and the overall prevalence of EDS was 24.6%. EDS-associated factors were investigated separately in women aged <40 yr (n=250), 40-59 yr (n=7,467), and ≥60 yr (n=2,011). Current engagement in shift work (prevalence ratio: 1.92 [95% confidence interval: 1.20-3.06], compared with no experience of shift work) and obesity (2.08 [1.11-3.88] for BMI ≥30 and 1.39 [1.02-1.90] for BMI of 25.0-30.0, compared with BMI of 18.5-25.0) showed an independent association with EDS in women aged ≥60 yr. The effect of shift work on EDS in female nurses differed by age, as shift work and obesity contributed to EDS only in older participants. Shift work should be assigned after full consideration of age, sleep, and health status to minimize medical errors.

Excessive Daytime Sleepiness in Patients With Hypertension: A Systematic Review.

We must remember that there are many subclinical cases of obstructive sleep apnea (OSA), even if the patient or family members typically become aware of it through symptoms such as snoring and excessive daytime sleepiness (EDS). EDS is a common symptom among hypertensive patients.This interesting and remarkable systematic review aims to comprehensively survey the current literature on the prevalence and association of EDSamong hypertensive patients.PubMed, SCOPUS, Web of Science, and Science Direct were systematically searched for relevant literature. Rayyan QRCI (Rayyan Systems Inc., Cambridge, MA) was employed throughout this comprehensive process.This review included nine studies with a total of 58,517 patients, and 34,398 (58.8%) were males. EDS prevalence among hypertensive patients ranged from 12.1% to 88.3%. This reviewstated that individuals with hypertension (HTN) had EDS that was worse than that of patients with normotension. In one of the studies included in this analysis, sympathovagal imbalance was noted alongside EDS and HTN. Older age, primary education, being overweight, working, obesity, depression, and having had the condition for longer are all associated with EDS in HTN patients.

The prevalence of excessive daytime sleepiness and associated factors in older diabetic patients

The prevalence of excessive daytime sleepiness and associated factors in older diabetic patients

Excessive Daytime Sleepiness and Insomnia Symptoms in Adolescents With Major Depressive Disorder: Prevalence, Clinical Correlates, and the Relationship With Psychiatric Medications Use.

Excessive daytime sleepiness (EDS) and insomnia symptoms are common in patients with major depressive disorder (MDD), which might lead to a poor prognosis and an increased risk of depression relapse. The current study aimed to investigate the prevalence, and sociodemographic and clinical correlates of EDS and insomnia symptoms among adolescents with MDD. The sample of this cross-sectional study included 297 adolescents (mean age=15.26 years; range=12-18 years; 218 females) with MDD recruited from three general and four psychiatric hospitals in five cities (Hefei, Bengbu, Fuyang, Suzhou, and Ma'anshan) in Anhui Province, China between January and August, 2021. EDS and insomnia symptoms, and clinical severity of depressive symptoms were assessed using Epworth sleepiness scale, Insomnia Severity Index, and Clinical Global Impression-Severity. The prevalence of EDS and insomnia symptoms in adolescents with MDD was 39.7% and 38.0%, respectively. Binary logistic regression analyses showed that EDS symptoms were significantly associated with higher body mass index (odds ratio [OR]=1.097, 95% confidence interval [CI]=1.027-1.172), more severe depressive symptoms (OR=1.313, 95% CI=1.028-1.679), and selective serotonin reuptake inhibitors use (OR=2.078, 95% CI=1.199-3.601). And insomnia symptoms were positively associated with female sex (OR=1.955, 95% CI=1.052-3.633), suicide attempts (OR=1.765, 95% CI=1.037-3.005), more severe depressive symptoms (OR=2.031, 95% CI=1.523-2.709), and negatively associated with antipsychotics use (OR=0.433, 95% CI=0.196-0.952). EDS and insomnia symptoms are common among adolescents with MDD. Considering their negative effects on the clinical prognosis, regular screening and clinical managements should be developed for this patient population.

Obesity and Its Relation to Excessive Daytime Sleepiness in Civilian Pilots.

INTRODUCTION: Excessive daytime sleepiness (EDS) is often associated with decreased work performance and fatigue in civil pilots. However, aeromedical recommendations for the evaluation of EDS are associated with suspicion of obstructive sleep apnea (OSA). Currently, many studies have found an association between obesity and EDS, regardless of OSA. This study aims to determine whether there is a relationship between obesity and EDS in Indonesian civilian pilots, as well as its risks for developing OSA.METHODS: This study used a cross-sectional design and was carried out at the Directorate General Civil Aviation Medical. Subjects were asked to fill out questionnaires, including the Epworth Sleepiness Scale to measure EDS and STOP-Bang to assess OSA risk, followed by anthropometric measurements for body mass index (BMI) and waist circumference as obesity indicators.RESULTS: A total of 156 subjects were obtained, with an EDS prevalence of 16.7%. There was no significant relationship between obesity and EDS, but the prevalence of EDS was higher in obese subjects based on waist circumference than based on BMI (17.8% vs. 15.6%). Most obese pilots with EDS had a low risk of OSA (83.3% and 80%).CONCLUSION: The prevalence of EDS was found to be higher in pilots with central obesity compared to BMI-categorized obesity. The incidence of EDS was not correlated with the risk of OSA.Brahmanti RS, Sampurna B, Ibrahim N, Adi NP, Siagian M, Werdhani RA. Obesity and its relation to excessive daytime sleepiness in civilian pilots. Aerosp Med Hum Perform. 2023; 94(11):815-820.

Excessive day time sleepiness and its associated factors among adult population in an urban area of southern Rajasthan

Background: Sleep problems have been considered as an unmet public health problem. Sleep problems are mostly under reported and neglected by the Indian population. Very limited studies have been conducted in India on this aspect. Aims and Objectives: The aim of the study was to estimate the prevalence of excessive day time sleepiness (EDS) and its associated factors among urban adult population. Materials and Methods: A community based cross-sectional study was conducted among 409 adults of 20–60 years age group in urban Udaipur. Socio-demographic and other details were obtained using a semi structured questionnaire. Using Epworth Sleepiness Scale, assessment of EDS was assessed. Results: In the present study, mean age of the participants was 40.8 ± 11.3 years. Considering the ESS score of 10 or more, EDS was observed in 60.2% subjects. EDS was associated with age, gender, milk consumption, and mobile use. No significant association was found between EDS with central obesity, body mass index, marital status, literacy, occupation, exercise, smoking, and consumption of alcohol. Conclusion: In the present study, the prevalence of EDS was high. Therefore, early identification of excessive sleep problems and appropriate intervention that address the various determinants of the sleep problems is of prime importance.

Prevalence of sleep disturbances in patients with long COVID assessed by standardised questionnaires and diagnostic criteria: A systematic review and meta-analysis

ObjectiveWe aimed to study the prevalence of sleep disturbances in patients with long COVID-19. MethodsWe conducted a systematic review and meta-analysis of the pooled prevalence of sleep disturbances in patients post COVID-19. We systematically searched relevant studies from three databases, including Medline, Embase and Scopus. Original articles were included based on specific criteria: peer-reviewed, observational studies involving adults (18 or older) with confirmed post COVID-19 status through PCR testing and focused on sleep in the context of post COVID-19. Exclusion criteria included non-English articles, studies with insufficient data, and narrative/systematic reviews. The search was performed from 31st July 2023 to 15th August 2023. We identified 35 eligible papers; however, we excluded 6 studies which did not describe the sleep assessment. We used a random-effects meta-analysis model to estimate the pooled prevalence of sleep disturbances. Results29 studies involved 13,935 long COVID-19 patients; approximately 39% of participants were male aged 18 to 97 years. The overall pooled prevalence of sleep disturbance was 46% (95% CI: 38–54%). Subgroup analyses revealed that the pooled prevalence of poor sleep quality was 56% (95% CI: 47–65%). The pooled prevalence of insomnia was 38% (95% CI: 28–48%). Finally, the pooled prevalence of excessive daytime sleepiness was 14% (95% CI: 0–29%). ConclusionSleep disturbances are common in long COVID-19 patients. The healthcare sector should recognise these sleep issues and provide an early, effective treatment to prevent long-term sequelae of sleep problems.

Impact of Hemodialysis on Sleep Disorders in Patients With End-Stage Renal Disease in a Tertiary Care Academic Hospital.

Although hemodialysis (HD) has prolonged the survival of patients with end-stage renal disease (ESRD), it has also adversely affected the sleep and emotional state of these patients. We evaluated the impact of HD on sleep duration, quality, and other sleep-related disorders. We recruited consecutive adult patients visiting our tertiary care dialysis unit. We included only ESRD patients who had an estimated glomerular filtration rate (eGFR) of <15 mL/min/1.73m2. We excluded patients with unrelated comorbidities or on medications that could affect sleep. Basic demographic information, anthropometric data, and appropriate lab investigations were obtained. Objective information related to their sleep duration and quality was asked using a predefined proforma. Subjective sleep scores were obtained by using the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), and insomnia severity index (ISI). For comparison, the patients were divided into HD and conservative treatment (CT) groups based on their treatment modality. The baseline characteristics of the patients were noted. The Shapiro-Wilk test was used to test normality. Correlations were obtained by using Student's t-test for parameters that were normally distributed and the Mann-Whitney-Wilcoxon test for those that were not. Of the 56 patients we studied, 59% were males. The average age and body mass index (BMI) were 45.7 years and 20.98 kg/m2, respectively. Overall, 41% of patients were assigned to the HD group, and the remaining to the CT group. The CT group had fewer comorbidities compared to the HD group. The average sleep duration was similar in both groups (HD: 6.64 hours, CT: 6.49 hours). There was a weak-to-moderate positive correlation between the sleep scores. Overall, one-half of the patients had excessive daytime sleepiness (EDS) (46.43%) and insomnia (48.21%), and two-thirds of them were poor sleepers (66.07%). Symptoms suggestive of sleep-disordered breathing (SDB) were seen in 25% of patients, restless legs syndrome (RLS) in 19.64% of patients, and periodic limb movement disorder (PLMD) in 44.64% of patients. Patients undergoing HD had poorer sleep quality compared to the CT group (p=0.038). The odds of developing poor sleep were 3.6 times higher in the HD group. This cross-sectional study focuses on the quantification of objective and subjective deterioration of sleep quality in ESRD patients on HD. The prevalence of EDS (63.64%), insomnia (51.52%), and poor sleep quality (84.84%) in the HD group was more than the previously reported values. The PSQI, ESS, and ISI scores were higher in HD patients, indicating poorer sleep quality. Our study highlights the underestimation of sleep disorders in HD patients in underserved areas. Theresults warrant a meticulous evaluation of the same by a keen nephrologist, followed byreferral to sleep providers where necessary.

Impact of chronotype, insomnia symptoms, sleep duration, and electronic devices on nonrestorative sleep and daytime sleepiness among Japanese adolescents

ObjectivesNonrestorative sleep (NRS) and excessive daytime sleepiness (EDS) are important indicators of daytime dysfunction. Electronic media use before bedtime greatly affects adolescent sleep quality. However, few studies have examined factors associated with these symptoms. Therefore, we aimed to investigate the impact of chronotype, electronic device use before bedtime, and insomnia symptoms on NRS and EDS in Japanese adolescents. MethodsA web-based cross-sectional survey of 2067 adolescents was conducted in 2022 to mainly assess sleep-related issues (sleep duration, chronotype, insomnia symptoms, NRS, and EDS), time spent using electronic devices, physical activity, and mental health. ResultsWe analyzed data of 1880 adolescents (age, 16.4 ± 0.8 years; males, 56.7%). NRS and EDS prevalence rates were 54.9% and 39.4%, respectively. In multivariate analysis, evening chronotype [odds ratio (OR): 2.14, 95% confidence interval (CI): 1.58–2.89], difficulty initiating sleep (OR: 1.94, 95% CI: 1.43–2.64), <5 h sleep (OR: 1.77, 95% CI: 1.24–2.54), 5–6 h sleep (OR: 1.52, 95% CI: 1.20–1.93), and using electronic devices just before bedtime (OR: 1.48, 95% CI: 1.08–2.04) were associated with NRS. Evening chronotype (OR: 1.40, 95% CI: 1.07–1.82), early morning awakening (OR: 1.60, 95% CI: 1.02–2.50), using electronic devices just before bedtime (OR: 2.08, 95% CI: 1.48–2.93), and using electronic devices 30 min before bedtime (OR: 1.57, 95% CI: 1.07–2.29) were associated with EDS. ConclusionChronotype may be an important factor influencing NRS and EDS. Discontinuing electronic device use at least 30 min before bedtime could benefit affected adolescents.

Prevalence of excessive daytime sleepiness and its association with daily life factors in Japanese first-year university students.

As lifestyles have shifted to favor nighttime activities, daytime sleepiness and sleep-related problems have become increasingly common in Japan. Excessive daytime sleepiness (EDS) is an adverse consequence of sleep loss and an important public health concern. EDS may cause academic difficulties, behavioral abnormalities, and psychological dysfunction; therefore, it is a particularly important issue among university students. We conducted a cross-sectional study to investigate the prevalence of EDS and its associated lifestyle factors among Japanese university students. A questionnaire was completed by 1470 first-year university students, aged 19.0 (± 1.0) years. Using the questionnaire, we collected information on (1) demographic variables, (2) lifestyle variables, and (3) sleep habits and daytime sleepiness. Daytime sleepiness was measured using the Japanese version of the Epworth Sleepiness Scale, a frequently used subjective scale for assessing sleepiness. The overall prevalence of EDS was 57% (53% in men and 61% in women). Multivariate logistic regression analysis revealed that the following factors were associated with EDS: female sex, exercise habits, long commuting times, later wake-up times, and shorter sleep duration. Given that more than 50% of first-year university students reported having EDS, interventions should be considered to decrease its risk, including educational programs that provide strategies to extend sleep duration and delay wake-up time. Such strategies may also be valuable for students with other potential risk factors, such as exercise habits or long commute times, that are associated with EDS.

Residual excessive daytime sleepiness in patients with sleep apnea syndrome receiving continuous positive airway pressure in Japan: A single-center study

Excessive daytime sleepiness (EDS) is a symptom of sleep apnea syndrome (SAS). In some patients with SAS who undergo continuous positive airway pressure (CPAP) therapy, EDS persists (residual EDS). However, knowledge of residual EDS in Japan is limited. Therefore, we examined EDS as defined by the Japanese version of the Epworth Sleepiness Scale (a score of ≥11) before and after long-term (≥1 year) CPAP therapy in 490 patients with SAS. Good adherence to CPAP therapy was defined as its use for at least 4 h during 70% of the nights. The prevalence of residual EDS was 9.4%. Residual EDS was negatively associated with good adherence to CPAP therapy. Furthermore, the longer the CPAP therapy duration after initiation, the lower the prevalence of residual EDS. Therefore, the findings on the prevalence of residual EDS and its association with CPAP therapy in Japan are probably similar to those of other countries.

Sleep of migraine patients is ameliorated by ketogenic diet, independently of pain control

Objective/backgroundMigraine patients are frequently affected by sleep complaints. The ketogenic diet (KD) is an option for the treatment of migraine. Our aim was: 1) to assess the effects of KD on sleep complaints in patients affected by migraine and 2) to verify if sleep changes were related to the effects of the diet on headache symptoms. Patients/methodsFrom January 2020 to July 2022 we consecutively enrolled 70 migraine patients who were treated with KD as a preventive therapy. We collected information regarding: 1) anthropometric measures; 2) migraine intensity, frequency and disability; 3) subjective sleep complaints, i.e. insomnia, sleep quality, by the Pittsburgh Sleep Quality Index (PSQI), and excessive Daytime Sleepiness (EDS), by the Epworth Sleepiness Scale (ESS). ResultsAfter 3 months of KD therapy, anthropometric measures considerably changed, i.e. body mass index and free fat mass, and migraine significantly improved, i.e. lower intensity, frequency and disability. Regarding sleep, we observed that insomnia affected a decreased rate of patients (T0: 60% versus T1: 40%, p < 0.001). Similarly, patients with poor sleep were significantly less after KD therapy (T0: 74.3% versus T1: 34.3%, p < 0.001). Finally, EDS prevalence declined at the follow-up (T0: 40% versus T1: 12.9%, p < 0.001). Sleep features modifications were not correlated with migraine improvements and with anthropometric changes. ConclusionsFor the first time we demonstrated that KD may improve sleep complaints in migraine patients. Interestingly, the positive effect of KD on sleep is independent of migraine improvements and anthropometric modifications.