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J Psychiatr Res. 2012 Apr;46(4):422-7. doi: 10.1016/j.jpsychires.2011.06.008. Epub 2012 Jan 31.

Determining the level of sleepiness in the American population and its correlates.

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1
Stanford Sleep Epidemiology Research Center, Stanford University, School of Medicine, 3430 W. Bayshore Road, Palo Alto, CA 94303, USA. mohayon@stanford.edu

Abstract

OBJECTIVE:

To assess the prevalence, to determine the risk factors and to evaluate the impacts of excessive sleepiness in the general population.

METHOD:

It is a cross-sectional telephone study using a representative sample consisting of 8937 non-institutionalized individuals aged 18 or over living in Texas, New York and California. They represented a total of 62.8 million inhabitants. The participation rate was 85.6% in California, 81.3% in New York and 83.2% in Texas. Interviews were managed by the Sleep-EVAL expert system. The questionnaire included questions on sleeping habits, life habits, health, DSM-IV mental disorders, DSM-IV and ICSD sleep disorders.

RESULTS:

As many as 19.5% of the sample reported having moderate excessive sleepiness and 11.0% reported severe excessive sleepiness. Moderate excessive sleepiness was comparable between men and women but severe excessive sleepiness was higher in women (8.6% vs. 13.0%). Factors associated with moderate excessive sleepiness were sleeping 6 h or less per main sleep episode (OR:2.0); OSAS (OR:2.0); insomnia disorder (OR:2.4); Restless Legs Syndrome (OR: 1.8) major depressive disorder (OR: 1.7); anxiety disorder (OR:1.5) and use of tricyclic antidepressant (OR: 2.1) presence of heart disease (OR: 1.5), cancer (1.8) and chronic pain (1.3). Factors associated with severe excessive sleepiness were similar with the addition of being a woman (OR:1.5), alcohol dependence (OR: 1.4), bipolar disorder (OR: 2.1), use of over-the-counter sleeping pills (OR: 2.5), narcotic analgesics (OR: 3.4), Antidepressants (other than SSRI or tricyclic) and presence of gastro-esophageal reflux disease (OR:1.6). Sleepy individuals were twice as likely than non-sleepy participants to have had accidents while they were at the wheel of a vehicle during the previous year.

CONCLUSIONS:

Excessive sleepiness is highly prevalent in the American population. It was strongly associated with insufficient sleep and various sleep disorders as well as mental and organic diseases.

[Indexed for MEDLINE]

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