Department of Medical Education, National Taiwan University Hospital, Taiwan.
Division of Cardiology, Department of Internal Medicine & Community Medicine Center, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan.
Ann Med. 2024 Dec;56(1):2352028. doi: 10.1080/07853890.2024.2352028. Epub 2024 May 27.
Daytime sleepiness is an important health problem. However, the dimensionality of the Epworth Sleepiness Scale (ESS) in older adults remains unclear. This study aimed to determine the prevalence of ESS-defined excessive daytime sleepiness in older adults. Furthermore, the dimensionality of ESS and its respective correlates were also compared.
This is a community-based survey in which community-dwelling older adults aged ≥ 65 years participated. Excessive daytime sleepiness was assessed using the ESS and was defined as an ESS score of > 10. Exploratory factor analysis was performed to identify the ESS factors. Multiple logistic regression analysis was used to examine the independent correlates of the ESS-defined and factor-specific correlates of excessive daytime sleepiness.
In total, 3978 older adults participated in this study. The mean age was 76.6 ± 6.7 years, with 53.8% ≥ 75 years, and 57.1% were female. The prevalence of ESS-defined excessive daytime sleepiness was 16.0%. An exploratory factor analysis revealed two factors in the ESS, which were designated as 'passive' and 'active' according to the soporific levels of ESS items loaded in each factor. Multiple logistic regression showed that male, illiteracy, depression, disability, short sleep duration and no exposure to hypnotics were risk indicators for ESS-defined excessive daytime sleepiness. However, the correlates for passive and active factor-defined excessive daytime sleepiness differ in pattern, especially in variables related to education, exercise, mental health, and sleep.
The prevalence of ESS-defined excessive daytime sleepiness is high, and its correlates vary among older adults. This study also suggests a dual ESS structure in community-dwelling older adults.
日间嗜睡是一个重要的健康问题。然而，嗜睡量表（Epworth Sleepiness Scale，ESS）在老年人中的维度仍不清楚。本研究旨在确定老年人中 ESS 定义的日间过度嗜睡的患病率。此外，还比较了 ESS 的维度及其各自的相关性。
这是一项基于社区的调查，其中包括≥ 65 岁的社区居住老年人。使用 ESS 评估日间过度嗜睡，并将 ESS 评分> 10 定义为日间过度嗜睡。进行探索性因素分析以确定 ESS 因子。使用多因素逻辑回归分析来检查 ESS 定义的独立相关性和因子特异性相关性与日间过度嗜睡的关系。
共有 3978 名老年人参与了这项研究。平均年龄为 76.6±6.7 岁，其中 53.8%≥75 岁，57.1%为女性。ESS 定义的日间过度嗜睡的患病率为 16.0%。探索性因素分析显示 ESS 有两个因子，根据每个因子中加载的 ESS 项目的催眠水平，将这两个因子分别命名为“被动”和“主动”。多因素逻辑回归显示，男性、文盲、抑郁、残疾、睡眠持续时间短和未接触催眠药是 ESS 定义的日间过度嗜睡的风险指标。然而，被动和主动因子定义的日间过度嗜睡的相关性在模式上有所不同，特别是在与教育、运动、心理健康和睡眠相关的变量上。
ESS 定义的日间过度嗜睡的患病率较高，其相关性在老年人中存在差异。本研究还表明，社区居住的老年人中存在双重 ESS 结构。
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