Excessive Sleepiness Could
Be More Than Poor Sleep
Doctors commonly view excessive daytime sleepiness as a cardinal
sign of disturbed or inadequate sleep. But a new study suggests
it could also signal depression or even diabetes, regardless of
whether an individual doesn't sleep well.
Among a random sample of 16,500 men and women ranging in age from
20 to 100 years old from central Pennsylvania, 8.7 percent had
excessive daytime sleepiness.
Researchers, who considered a wide range of possible reasons
for why these individuals were excessively sleepy during the daytime,
found that excessive daytime sleepiness was more strongly associated
with depression and obesity or metabolic factors than with sleep-disordered
breathing or sleep disruption.
Depression was by far the most significant risk factor for excessive
daytime sleepiness, they report in the Journal of Clinical Endocrinology
and Metabolism.
The likelihood of being excessively sleepy during the daytime
was more than three times higher in those who reported they were
being treated for depression.
The investigators also observed strong ties between excessive
daytime sleepiness and diabetes. Individuals reporting treatment
for diabetes were close to two times more likely to report excessive
daytime sleepiness than those who were not being treated for diabetes.
Being overweight also increased the likelihood of excessive daytime
sleepiness.
Excessive daytime sleepiness was more common in people younger
than age 30, a finding that hints at the presence of unmet sleep
needs and depression, and in the over-75 crowd, suggesting increasing
medical illness and health problems, they explain.
Smoking also emerged as a risk factor for excessive daytime sleepiness,
a link that hasn't been shown before. It could be that smokers
use the stimulant effect of nicotine to self-treat their daytime
drowsiness, the authors suggest.
Sleep apnea -- brief episodes when breathing stops during sleep
-- was not a significant player in excessive daytime sleepiness.
This is consistent with prior studies that have reported only
weak associations between sleep apnea and excessive daytime sleepiness.
The authors conclude that adults plagued by excessive daytime
sleepiness should be thoroughly evaluated for depression and diabetes,
regardless of whether or not sleep-disordered breathing is present.
SOURCE: The Journal of Clinical Endocrinology and Metabolism,
August 2005.
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