title: The relationship between excessive daytime sleepiness and depressive and anxiety disorders in women.
abstract: OBJECTIVE
  Excessive daytime sleepiness (EDS) is a common clinical symptom that affects women more than men. However, the association of excessive sleepiness with depressive and anxiety disorders in the broader population is unclear. The aim of this study was, therefore, to examine the association between excessive daytime sleepiness as measured by the Epworth Sleepiness Scale, and depressive and anxiety disorders in a population-based sample of women.
  
  
  METHODS
  Using the Structured Clinical Interview for DSM-IV Disorders (Non-Patient) (SCID-I/NP), 944 women aged 20-97 years (median 49 years, IQR 33-65 years) were assessed for depressive and anxiety disorders as part of the Geelong Osteoporosis Study. EDS was assessed using the Epworth Sleepiness Scale (ESS, cut-off > 10). Lifestyle factors were documented by self-report, height and weight were measured, and socioeconomic status categorised according to the Index of Relative Socio-Economic Advantage and Disadvantage.
  
  
  RESULTS
  Overall, 125 (13.2%) of the women were identified with EDS. EDS was associated with an increased likelihood for both current (OR = 2.11, 95% CI 1.10-4.06) and lifetime history (OR = 1.95, 95% CI 1.28-2.97) of depressive disorders, but not anxiety disorders, independent of age and alcohol consumption. These findings were not explained by antidepressant or sedative use, body mass index, physical activity, smoking, or socioeconomic status.
  
  
  CONCLUSIONS
  These results suggest that excessive daytime sleepiness is associated with current and lifetime depressive, but not anxiety disorders. Clinically, this highlights the need to take into account the possible bidirectional relationship between depressive disorders and excessive sleepiness when assessing mental health issues in patients with EDS.
authors.affiliation: School of Medicine, Deakin University, Geelong, Australia. achayley@deakin.edu.au
authors.forename: Amie C
authors.initials: AC
authors.lastname: Hayley
authors.forename: Lana J
authors.initials: LJ
authors.lastname: Williams
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
authors.forename: Gerard A
authors.initials: GA
authors.lastname: Kennedy
authors.forename: Felice N
authors.initials: FN
authors.lastname: Jacka
authors.forename: Julie A
authors.initials: JA
authors.lastname: Pasco
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications* / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications* / Q000523:psychology; D006970:Disorders of Excessive Somnolence / Q000150:complications* / Q000523:psychology; D005221:Fatigue / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011795:Surveys and Questionnaires
keywords: Anxiety disorders; Epworth Sleepiness Scale; depressive disorders; epidemiology; excessive daytime sleepiness; women