Department of Psychiatry and Psychology Mayo Clinic, Rochester, MN; Center for Sleep Medicine Mayo Clinic, Rochester, MN.
National Institute of Mental Health Intramural Research Program, Genetic Epidemiology Research Branch, Bethesda, MD.
Sleep Health. 2020 Feb;6(1):79-87. doi: 10.1016/j.sleh.2019.09.004. Epub 2019 Nov 2.
This study examined the prevalence, sociodemographic features, patterns of comorbidity, and impact on functional impairment of excessive sleepiness (Ex.S) and associated symptoms in a nationally representative sample of adults using the National Comorbidity Survey Replication (NCS-R) dataset.
Participants ≥18 years (n = 5,962) were queried about their sleep using the Composite International Diagnostic Interview (CIDI). Specifically, respondents were questioned about feeling sleepy during the day and falling asleep in permissive situations, feelings of insufficient sleep despite adequate time in bed, and/or difficulty waking up. Those endorsing daytime sleepiness and at least one additional symptom were considered to have Ex.S plus associated symptoms. Associations between Ex.S plus associated symptoms and sociodemographics, Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) mental disorders, chronic physical conditions, and functional impairment were examined.
The prevalence of Ex.S plus associated symptoms in U.S. adults was 23.34% (standard error [SE] = 0.88) and significantly co-occurred with insomnia-related symptoms after adjusting for confounders (Odds ratio [OR] = 5.65; 95% confidence interval [CI] = 4.55-7.02). The presence of Ex.S and associated symptoms was more common in women, particularly younger women, those with lower family income, and the unemployed (all P<.001). After controlling for demographic characteristics and other confounders, Ex.S plus associated symptoms was associated with having a DSM-IV mental disorder (OR = 4.25; 95% CI = 3.53-5.10), a chronic physical condition (OR = 2.57; 95% CI = 1.94-3.42) and greater disability (P<.001).
Ex. S with associated symptoms was common, frequently co-occurred with other mental and physical conditions, and was associated with substantial disability. Dissipation of some associations after controlling for insomnia-related symptoms indicated that physical-mental comorbidity and disability were greater among individuals with more pervasive sleep disturbances.
本研究使用国家共病调查复制（NCS-R）数据集，调查了在全国代表性成年人样本中，过度嗜睡（Ex.S）及其相关症状的患病率、社会人口学特征、共病模式以及对功能障碍的影响。
使用复合国际诊断访谈（CIDI）对年龄≥ 18 岁的参与者（n = 5962）的睡眠情况进行了调查。具体而言，受访者被问及白天感到困倦和在允许的情况下入睡、尽管睡眠时间充足但仍感到睡眠不足以及/或难以醒来等情况。那些白天嗜睡并至少出现一种其他症状的人被认为患有 Ex.S 伴相关症状。研究了 Ex.S 伴相关症状与社会人口统计学、精神障碍诊断与统计手册，第四版（DSM-IV）精神障碍、慢性躯体疾病和功能障碍之间的关联。
美国成年人 Ex.S 伴相关症状的患病率为 23.34%（标准误差[SE] = 0.88），在调整混杂因素后，与失眠相关症状显著同时发生（优势比[OR] = 5.65；95%置信区间[CI] = 4.55-7.02）。Ex.S 和相关症状的出现更常见于女性，尤其是年轻女性、家庭收入较低者和失业者（均 P<.001）。在控制人口统计学特征和其他混杂因素后，Ex.S 伴相关症状与 DSM-IV 精神障碍（OR = 4.25；95%CI = 3.53-5.10）、慢性躯体疾病（OR = 2.57；95%CI = 1.94-3.42）和更大的残疾（P<.001）相关。
伴有相关症状的 Ex.S 很常见，常与其他精神和躯体疾病同时发生，并与严重残疾相关。在控制与失眠相关的症状后，一些关联的消失表明，在存在更普遍的睡眠障碍的个体中，身体-精神共病和残疾更为严重。
