03916nas a2200469 4500008004100000022001400041245009500055210006900150260000900219300001000228490000700238520259600245653003102841653002102872653000902893653002202902653001002924653002802934653002102962653002402983653001903007653003403026653002803060653003803088653002403126653001103150653001803161653001903179653001103198653003103209653000903240653002903249653001503278653002103293100001803314700001803332700001703350700001503367700001303382700001503395856003603410 1998 eng d a0161-810500aCorrelates of daytime sleepiness in 4578 elderly persons: the Cardiovascular Health Study.0 aCorrelates of daytime sleepiness in 4578 elderly persons the Car c1998 a27-360 v213 a

OBJECTIVES: To describe the prevalence of self-reported daytime sleepiness in older men and women and to describe their relationships with demographic factors, nocturnal complaints, health status, and cardiovascular diseases (CVD).

DESIGN: Cross-sectional survey and clinical exam.

SETTING: Participants in the Cardiovascular Health Study, 4578 adults aged 65 and older, recruited from a random sample of non-institutionalized Medicare enrollees in four U.S. communities.

MEASURES: Daytime sleepiness measured by the Epworth Sleepiness Scale (ESS), magnetic resonance imaging of the brain (MRI), cognitive function tests, and standardized questionnaires for cardiopulmonary symptoms and diseases, depressive symptoms, social support, activities of daily living, physical activity, and current medications.

RESULTS: Approximately 20% of the participants reported that they were "usually sleepy in the daytime". Although elderly black men were less likely to report frequent awakenings than those in the other three race and gender groups, they had significantly higher mean ESS scores. The following were independently associated with higher ESS scores in gender-specific models: non-white race, depression, loud snoring, awakening with dyspnea or snorting, frequent nocturnal awakenings, medications used to treat congestive heart failure, non-use of sleeping pills, a sedentary lifestyle, and limitation of activities of daily living in both men and women; additional correlates included hip circumference and current smoking in men, and hayfever in women. The following were not independently associated with ESS in the models: age, education, use of wine or beer to aid sleep, use of tricyclic antidepressants, long- or short-acting benzodiazepines, asthma, angina, myocardial infarction, congestive heart failure itself, forced vital capacity, social support, cognitive function, or MRI evidence of global brain atrophy or white matter abnormality.

CONCLUSIONS: Daytime sleepiness is common in the elderly, probably due to nocturnal disturbances such as frequent awakenings and snoring. The occasional use of sleeping pills for insomnia is associated with reduced daytime sleepiness in the elderly, while the use of medications for congestive heart failure is associated with daytime sleepiness. Surprisingly, anatomic abnormalities such as evidence of previous strokes and brain atrophy (as seen on brain MRI scans) were not associated with daytime sleepiness in these non-institutionalized elderly persons.

10aActivities of Daily Living10aAge Distribution10aAged10aAged, 80 and over10aBrain10aCardiovascular Diseases10aCircadian Rhythm10aCognition Disorders10aCohort Studies10aContinental Population Groups10aCross-Sectional Studies10aDisorders of Excessive Somnolence10aElectrocardiography10aFemale10aHealth Status10aHealth Surveys10aHumans10aMagnetic Resonance Imaging10aMale10aNeuropsychological Tests10aPrevalence10aSex Distribution1 aWhitney, C, W1 aEnright, P, L1 aNewman, A, B1 aBonekat, W1 aFoley, D1 aQuan, S, F uhttps://chs-nhlbi.org/node/1497