title: Predictors for Development of Excessive Daytime Sleepiness in Women: A Population-Based 10-Year Follow-Up.
abstract: OBJECTIVE
  To analyze predictors of excessive daytime sleepiness (EDS) and to analyze how changes within risk factors over time predict incident EDS in women.
  
  
  METHODS
  Population-based prospective study.
  
  
  METHODS
  General population of the City of Uppsala, Sweden.
  
  
  METHODS
  From a random, general population sample of 7,051 women from the Sleep and HEalth in women ("SHE") cohort, 4,322 women without EDS at baseline were followed up after 10 y.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  At baseline and follow-up, women answered a questionnaire on sleeping habits, somatic disease, obesity, insomnia, anxiety and depression, lifestyle, and social factors. The risk of incident EDS was analyzed from changes over time in risk factors using logistic regression modeling. Of the women, EDS developed in 7.9%. Incident: insomnia (adjusted odds ratio = 5.01; 95% confidence interval 3.63-6.92), anxiety and/or depression (3.34; 2.22-5.02), somatic disease (1.73; 1.17-2.55), obesity (1.91; 1.14-2.57), snoring (1.91; 1.17-3.10) and smoking (4.31; 1.95-9.54) were all independent risk factors for the development of EDS. In addition, persistent: insomnia (4.44; 2.97-6.65) and anxiety and/or depression (4.91; 3.17-7.62) increased the risk of developing EDS. Apart from incident: snoring and obesity, similar results were obtained when only including women without somatic disease in the analyses.
  
  
  CONCLUSIONS
  Insomnia, anxiety and/or depression, and smoking were the most important factors for predicting incident excessive daytime sleepiness (EDS) and, in addition, somatic disease, obesity, and snoring predicted EDS. It is important not only to treat these conditions but also to inform women of the importance of a healthy lifestyle in order to prevent and reduce EDS in women.
authors.affiliation: Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Sweden.
authors.forename: Jenny
authors.initials: J
authors.lastname: Theorell-Haglöw
authors.affiliation: Stress Research Institute, Stockholm University, Sweden.
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Åkerstedt
authors.affiliation: Stress Research Institute, Stockholm University, Sweden.|Department of Psychology, Stockholm University, Sweden.
authors.forename: Johanna
authors.initials: J
authors.lastname: Schwarz
authors.affiliation: Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Lindberg
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D012913:Snoring / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
keywords: daytime sleepiness; longitudinal; population-based; risk factors; women