Abstract
Abstract
Introduction
Daytime sleepiness impacts performance and well-being. The present study used validated measures to explore associations of community-level daytime sleepiness with sleep health, preferred sleep phase, physical inactivity, and overall health.
Methods
Data were from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study of N=1007 adults age 22-60 from the community. Daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). Outcomes of interest included the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), endorsement of a preference for an advanced or delayed sleep phase on the Sleep Disorders Symptom Check List (SDSCL), STOP-BANG sleep apnea questionnaire score, sedentary time assessed with the International Physical Activity Questionnaire (IPAQ), and the global health item on the SF-12, operationalized as excellent/good or fair/poor health. Through regression analyses, we assessed whether daytime sleepiness was independently associated with several sleep, circadian and physical health outcomes, adjusting for habitual sleep duration and sociodemographic factors like age, sex, education, and race/ethnicity.
Results
Our adjusted models indicate that daytime sleepiness was associated with insomnia (B=0.57; 95%CI: 0.50, 0.65; p<0.0001), sleep quality (B=0.34; 95%CI: 0.29, 0.39; p<0.0001), advanced sleep phase (OR=1.06; 95%CI: 1.03, 1.09; p<0.0001), delayed sleep phase (OR=1.05; 95%CI: 1.02, 1.07; p=0.0003), STOP-BANG score (B=0.08; 95%CI: 0.07, 0.10; p<0.0001), sedentary minutes (B=6.12; 95%CI: 2.77, 9.47; p=0.0004), and overall poor health (OR=1.10; 95%CI: 1.07, 1.13; p<0.0001). After additional adjustment for habitual sleep duration, all relationships were maintained.
Conclusion
Daytime sleepiness is associated with more severe insomnia, preference for advanced or delayed sleep timing, worse sleep quality, and greater risk of sleep apnea. Moreover, daytime sleepiness was associated with greater sedentary time and worse overall health. Since these relationships are independent of sleep duration, they likely do not reflect an effect of sleep deprivation.
Support
This work was supported by a grant from Jazz Pharmaceuticals. The SHADES study was funded by R21ES022931. Dr. Grandner is supported by R01MD011600.