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      Effect of age and gender in the prevalence of excessive daytime sleepiness among a sample of the Saudi population

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          Abstract

          The aim of this study is to assess whether the effect of gender on the excessive daytime sleepiness (EDS) is influenced by two confounders (age and hours of sleep per night). A cross-sectional study was conducted at King Abdulaziz Medical City-Riyadh (KAMC-R). A total of 2095 respondents answered a questionnaire that included questions regarding gender, age, hours of sleep per night, and daytime sleepiness using the Epworth Sleepiness Scale (ESS). The prevalence of EDS was 20.5% (females 22.2%, males 19.5%, p-value = 0.136). The EDS did not differ between genders, age groups, or hours of sleep per night (<6 vs. ⩾6 h). However, stratified statistical analysis shows that the prevalence of EDS did differ according to gender (25.3% in females, 19.0% in males, p-value = 0.036) in respondents with shorter hours of sleep per night. EDS was strongly related to female gender and young age (ages ⩽ 29 years) in respondents with short hours of sleep. This study reveals that one out of five of the general Saudi population has EDS. The effect of gender on EDS appeared to be influenced by hours of sleep per night. High EDS strongly related to female gender with short hours of sleep.

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          Most cited references39

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          Reliability and factor analysis of the Epworth Sleepiness Scale.

          The Epworth Sleepiness Scale (ESS) is a self-administered eight-item questionnaire that has been proposed as a simple method for measuring daytime sleepiness in adults. This investigation was concerned with the reliability and internal consistency of the ESS. When 87 healthy medical students were tested and retested 5 months later, their paired ESS scores did not change significantly and were highly correlated (r = 0.82). By contrast, ESS scores that were initially high in 54 patients suffering from obstructive sleep apnea syndrome returned to more normal levels, as expected, after 3-9 months' treatment with nasal continuous positive airway pressure. The questionnaire had a high level of internal consistency as measured by Cronbach's alpha (0.88). Factor analysis of item scores showed that the ESS had only one factor for 104 medical students and for 150 patients with various sleep disorders. The ESS is a simple and reliable method for measuring persistent daytime sleepiness in adults.
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            Sleepiness in different situations measured by the Epworth Sleepiness Scale.

            W. Johns (1994)
            This investigation examines how the sleep propensity (SP) in one test situation, such as the Multiple Sleep Latency Test (MSLT), is related to sleepiness in daily life, as assessed by the Epworth Sleepiness Scale (ESS). This is a self-administered questionnaire, the item scores from which provide a new method for measuring SPs in eight different real-life situations. The ESS item scores were analyzed separately in four groups of subjects: 150 adult patients with a variety of sleep disorders, 87 medical students who answered the ESS on two occasions 5 months apart, 44 patients who also had MSLTs and 50 patients whose spouses also answered the ESS about their partner's sleepiness. The ESS item scores were shown to be reliable (mean rho = 0.56, p < 0.001). The SP measured by the MSLT was related to three of the eight item scores in a multiple regression (r = 0.64, p < 0.001). The results of nonparametric ANOVA, Spearman correlations, Wilcoxon's t tests, item and factor analysis suggest that individual measurements of SP involve three components of variation in addition to short-term changes over periods of hours or days: a general characteristic of the subject (his average SP), a general characteristic of the situation in which SP is measured (its soporific nature) and a third component that is specific for both subject and situation. The SP in one test situation, including the MSLT, may not be a reliable indicator of a subject's average SP in daily life. Perhaps we should reexamine the current concept of daytime sleepiness and its measurement.
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              Daytime sleepiness and sleep habits of Australian workers.

              Excessive daytime sleepiness in the general community is a newly recognized problem about which there is little standardized information. Our aim was to measure the levels of daytime sleepiness and the prevalence of excessive daytime sleepiness in a sample of Australian workers and to relate that to their self-reported sleep habits at night and to their age, sex, and obesity. Sixty-five percent of all 507 employees working during the day for a branch of an Australian corporation answered a sleep questionnaire and the Epworth sleepiness scale (ESS) anonymously. Normal sleepers, without any evidence of a sleep disorder, had ESS scores between 0 and 10, with a mean of 4.6 +/- 2.8 (standard deviation). They were clearly separated from the "sleepy" patients suffering from narcolepsy or idiopathic hypersomnia whose ESS scores were in the range 12-24, as described previously. ESS scores > 10 were taken to represent excessive daytime sleepiness, the prevalence of which was 10.9%. This was not related significantly to age (22-59 years), sex, obesity, or the use of hypnotic drugs but was related significantly but weakly to sleep-disordered breathing (frequency of snoring and apneas), the presence of insomnia, and reduced time spent in bed (insufficient sleep).
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                Author and article information

                Contributors
                Journal
                J Epidemiol Glob Health
                J Epidemiol Glob Health
                JEGH
                Journal of Epidemiology and Global Health
                Atlantis Press
                2210-6006
                2210-6014
                2015
                19 June 2015
                : 5
                : Suppl 1
                : S59-S66
                Affiliations
                [a ]College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia
                [b ]King Abdullah International Medical Research Center/Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud University for Health Sciences, Riyadh, Saudi Arabia
                [c ]Department of Medicine, Pulmonary Division-ICU, Sleep Disorders Center, King Saud University for Health Sciences, Riyadh, Saudi Arabia
                Author notes
                [* ]Corresponding author. Tel.: +966 12520088x17597, 17531 (work), +966 505224271 (mobile).
                Article
                JEGH-5-s59
                10.1016/j.jegh.2015.05.005
                7325828
                26099548
                b18483fc-70c1-46da-a77d-efd430b4cbc2
                © 2015 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd.

                This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 17 March 2015
                : 13 May 2015
                : 16 May 2015
                Categories
                Article

                epworth sleepiness scale,excessive daytime sleepiness,hours of sleep per night,saudi arabia

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