Different aspects of daytime sleepiness among subjects with obesity.

Excessive daytime sleepiness (EDS) and obesity are often associated. The Epworth Sleepiness Scale (ESS) is the main tool used for EDS screening and The Basic Nordic Sleep Questionnaire (BNSQ) is also used, but the two scales reflect different aspects of sleepiness. Our aim was to investigate how these two different instruments reflect EDS among 303 obese (BMI≥30 kg/m2) patients (80.9% females), referred to rehabilitation in Akureyri, Iceland. Feeling sleepy (scores 4 and 5 in BNSQ) revealed EDS in 176 participants (58%), 89 (29%) subjects reported dozing off (ESS >10) and 77 subjects reported both (Table 1). <bold>Table 1</bold> Baseline characteristics and sleep-related symptoms, shown as % or mean±SD (range), in different daytime sleepiness categories. <table-wrap><object-id>erj;64/suppl_68/PA1755/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td></td><td>Total n = 303</td><td>No EDS n=115</td><td> Only dozing off n=12 </td><td> Only sleepy n=99 </td><td>Dozing off <bold>and</bold> sleepy n=77</td></tr><tr><td>Female gender (%)</td><td>79.9</td><td>80.9</td><td>75.0</td><td>82.0</td><td>81.8</td></tr><tr><td>Age (years)</td><td>42.0 ±11.6 (18-72)</td><td>40.3±12</td><td>49.5±10.6</td><td>39.4±11.8</td><td>39.9±9.7</td></tr><tr><td>Body mass index (kg/m2)</td><td>44.0 ± 6.2 (31.3-69.0)</td><td>44.2 ±6.5</td><td>43.4±7.0</td><td>44.1±6.4</td><td>43.9±6.1</td></tr><tr><td>HRQoL (Icelandic QoL scale)</td><td>37.0 ± 10.7 (4-61)</td><td>42.3± 9.6</td><td>34.0±9.7</td><td>35.5±9.7</td><td>33.1±10.6</td></tr><tr><td>ESS, total score</td><td>8.5 ± 4.7 (0-24)</td><td>7.3± 3.3</td><td>13.4±2.1</td><td>6.7±2.8</td><td>14.5±3.0</td></tr><tr><td>Difficulties initiating sleep ≥3 n/week (%)</td><td>32.2</td><td>14.8</td><td>8.3</td><td>50.5</td><td>39.0</td></tr><tr><td>Difficulties maintaining sleep ≥3 n/week (%)</td><td>42.1</td><td>26.1</td><td>58.3</td><td>50.5</td><td>51.9</td></tr><tr><td>Not feeling rested ≥3 /week (%)</td><td>36.5</td><td>13.9</td><td>33.3</td><td>47.5</td><td>57.1</td></tr><tr><td>Snoring ≥3 n/week (%)</td><td>59.9</td><td>48.7</td><td>50.0</td><td>58.6</td><td>79.2</td></tr><tr><td>Sweating ≥3 n/week (%)</td><td>19.1</td><td>14.8</td><td>25.0</td><td>16.2</td><td>28.6</td></tr><tr><td>nGER ≥1 n/week (%)</td><td>19.4</td><td>13.9</td><td>16.7</td><td>24.2</td><td>22.1</td></tr></tbody></table></table-wrap> <bold>Conclusion:</bold> Majority of obese subjects report EDS. Feeling sleepy is nearly twice as common as dozing off. Our findings show the importance of using not only the ESS to identify EDS in subjects with obesity.