title: Sleepiness in patients with moderate to severe sleep-disordered breathing.
abstract: BACKGROUND
  Population-based studies suggest that complaints of sleepiness are absent in many individuals with sleep-disordered breathing. We investigated the prevalence of sleepiness as well as factors associated with sleepiness in individuals with moderate to severe sleep-disordered breathing (apnea-hypopnea index > or = 15).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  The Sleep Heart Health Study.
  
  
  METHODS
  Sleep Heart Health Study participants (N = 6440).
  
  
  RESULTS
  Sleepiness was defined as an Epworth Sleepiness Scale score >10 or a report of at least frequently feeling unrested or sleepy. Forty-six percent of participants with moderate to severe sleep-disordered breathing (n = 1149) reported sleepiness. Characteristics associated with sleepiness after adjustment for confounders included presence of respiratory disease, shorter self-reported weekday and weekend sleep, sleep durations, complaints of insufficient sleep, complaints of sleep maintenance insomnia, early morning awakening, habitual snoring, and complaints of awakening with leg cramps or leg jerks. Some respiratory polysomnography measures were associated with sleepiness, but sleep-stage percentages and measures of sleep disruption were not.
  
  
  CONCLUSIONS
  In this community-based cohort, subjective sleepiness is absent in many individuals with significant sleep-disordered breathing. Comorbid conditions, including respiratory disease, sleep restriction, insomnia, and nocturnal leg complaints, are important risk factors for sleepiness in individuals with moderate to severe sleep-disordered breathing.
authors.affiliation: Department of Medicine, University of Washington Sleep Disorders Center, Box 359803, 325 Ninth Avenue, Seattle, WA 98104, USA. vkapur@u.washington.edu
authors.forename: Vishesh K
authors.initials: VK
authors.lastname: Kapur
authors.forename: Carol M
authors.initials: CM
authors.lastname: Baldwin
authors.forename: Helaine E
authors.initials: HE
authors.lastname: Resnick
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Gottlieb
authors.forename: F Javier
authors.initials: FJ
authors.lastname: Nieto
mesh_terms: D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology*; D020921:Sleep Arousal Disorders / Q000175:diagnosis / Q000453:epidemiology; D012894:Sleep Stages / Q000502:physiology; D011795:Surveys and Questionnaires
chemical_list: D010100:Oxygen