title: Daytime sleepiness associated with poor sustained attention in middle and late adulthood.
abstract: OBJECTIVE
  We aimed to determine the association between psychomotor vigilance task (PVT) performance and sleep-related factors including sleep duration, daytime sleepiness, poor sleep quality, insomnia, and habitual snoring in a population-based sample.
  
  
  METHODS
  This was a cross-sectional analysis from the ongoing prospective cohort study, the Korean Genome and Epidemiology Study. We measured PVT performance and documented demographics, sleep-related factors, life style, and medical conditions in community dwelling adults (N = 2499; mean age 57.1 ± 7.3; male 1259). Associations between PVT parameters and sleep-related factors were tested, adjusting for age, gender, smoking, alcohol use, education, body mass index, hypertension, diabetes, depression, and the interval between mid-sleep time and PVT test.
  
  
  RESULTS
  High Epworth Sleepiness Scale (ESS, ≥8) was associated with slower mean reciprocal response speed (mean RRT) (3.69 ± 0.02 vs. 3.77 ± 0.01, p < 0.001), higher probability for increased lapses (≥4) (OR 1.48, CI 1.12-1.88, p = 0.001), and more negative RRT slope (-0.036 ± 0.002 vs. -0.030 ± 0.001, p = 0.02). Older age, female gender, low education level, depressive mood, and the interval between mid-sleep and PVT test were also associated with poor performance. Sleep duration, habitual snoring, insomnia, or poor sleep quality (the Pittsburgh Sleep Quality Index score > 5) was not related to PVT parameters.
  
  
  CONCLUSIONS
  At the population level, our results revealed important modifiers of PVT performance, which included subjective reports of daytime sleepiness.
authors.affiliation: Department of Neurology and Bundang Clinical Neuroscience Institute, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Chang-Ho
authors.initials: CH
authors.lastname: Yun
authors.affiliation: Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea; Department of Psychology, Boston University, Boston, MA, USA.
authors.forename: Hyun
authors.initials: H
authors.lastname: Kim
authors.affiliation: Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
authors.forename: Seung Ku
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea; Department of Psychology, Sungshin Women's University, Seoul, Republic of Korea; Department of Psychiatry, Stanford University, Palo Alto, CA, USA.
authors.forename: Sooyeon
authors.initials: S
authors.lastname: Suh
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, Ansan, Republic of Korea.
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Neurology and Bundang Clinical Neuroscience Institute, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Park
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Thomas
authors.affiliation: Department of Neurology, School of Medicine, Boston University, Boston, MA, USA.
authors.forename: Rhoda
authors.initials: R
authors.lastname: Au
authors.affiliation: Institute of Human Genomic Study, College of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea; Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea. Electronic address: chol-shin@korea.ac.kr.
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
mesh_terms: D000367:Age Factors; D000368:Aged; D001288:Attention / Q000502:physiology*; D002940:Circadian Rhythm / Q000502:physiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011597:Psychomotor Performance / Q000502:physiology*; D012307:Risk Factors; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D013997:Time Factors
keywords: Insomnia; Lapse; Psychomotor vigilance; Sleep duration; Sleep quality; Snoring