• Can. Respir. J. · Jul 2014

    Excessive daytime sleepiness among rural residents in Saskatchewan.

    • John A Gjevre, Punam Pahwa, Chandima Karunanayake, Louise Hagel, Donna Rennie, Joshua Lawson, Roland Dyck, James Dosman, and Saskatchewan Rural Health Study Team.
    • Can. Respir. J. 2014 Jul 1; 21 (4): 227-33.

    BackgroundObstructive sleep apnea (OSA) is a common diagnosis in clinical practice. Excessive daytime sleepiness may be a warning for possible OSA.ObjectivesTo assess the prevalence of excessive daytime sleepiness as measured by the Epworth Sleepiness Scale (ESS) in a rural community population; potential risk factors for OSA were also assessed.MethodsIn 2010, a baseline respiratory health questionnaire within the Saskatchewan Rural Health Study was mailed to 11,982 households in Saskatchewan. A total of 7597 adults within the 4624 (42%) respondent households completed the ESS questionnaire. Participants were categorized according to normal or high (>10) ESS scores. Data obtained included respiratory symptoms, doctor-diagnosed sleep apnea, snoring, hypertension, smoking and demographics. Body mass index was calculated. Multivariable logistic regression analysis examined associations between high ESS scores and possible risk factors. Generalized estimating equations accounted for the two-tiered sampling procedure of the study design.ResultsThe mean age of respondents was 55.0 years and 49.2% were male. The prevalence of ESS>10 and 'doctor diagnosed' OSA were 15.9% and 6.0%, respectively. Approximately 23% of respondents reported loud snoring and 30% had a body mass index >30 kg⁄m2. Of those with 'doctor-diagnosed' OSA, 37.7% reported ESS>10 (P<0.0001) and 47.7% reported loud snoring (P<0.0001). Risk of having an ESS>10 score increased with age, male sex, obesity, lower socioeconomic status, marriage, loud snoring and doctor-diagnosed sinus trouble.ConclusionsHigh levels of excessive daytime sleepiness in this particular rural population are common and men >55 years of age are at highest risk. Examination of reasons for residual sleepiness and snoring in persons with and without sleep apnea is warranted.

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