Abstract
Objective Through a causal framework, we aim to assess the association between weight change and daytime sleepiness, and the role of obstructive sleep apnoea (OSA) in this relationship. Methods From the Sleep Heart Health Study, we selected individuals who were: (1) 40–64 years old, with (2) body mass index (BMI) ≥18.5 kg/m2, (3) no history of stroke, treatment for OSA, and tracheostomy at baseline. We used multiple linear regression to assess the relationship between five-year weight change and daytime sleepiness (assessed through Epworth Sleepiness Scale (ESS)) at five years, adjusting for daytime sleepiness, demographics, diabetes, subjective sleep duration, sleep disturbance, smoking status, weight, and use of antidepressants and benzodiazepines at baseline, in those with complete data (N = 1468). We further assessed the potential mediating role of OSA in this relationship. Results At baseline, the study participants were on average 55 years old, 46% males, with mean BMI 28 kg/m2; and 25% had ESS>10. ESS at five years worsened by 0.36 units (95% confidence interval (CI) 0.12–0.61, p = 0.004) with every 10-kg weight gain. When stratified by sex, this relationship was only found in women (0.55, 95% CI 0.25–0.86, p < 0.001; p-interaction = 0.02). Approximately one-fifth of the relationship between weight change and daytime sleepiness was mediated by severity of OSA at five years. Conclusion Weight gain has a detrimental effect on daytime sleepiness, mostly through pathways other than OSA. This study provides further evidence and understanding of the relationship between obesity and excessive daytime sleepiness.
| Original language | English |
|---|---|
| Pages (from-to) | 109-118 |
| Number of pages | 10 |
| Journal | Sleep Medicine |
| Volume | 36 |
| DOIs | |
| Publication status | Published - 1 Aug 2017 |
Keywords
- Causal inference
- Causal mediation
- Daytime sleepiness
- Obesity
- Obstructive sleep apnoea
- Weight change
Cite this
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The relationship between weight change and daytime sleepiness : the Sleep Heart Health Study. / Ng, Winda L.; Orellana, Liliana; Shaw, Jonathan E.; Wong, Evelyn; Peeters, Anna.
In: Sleep Medicine, Vol. 36, 01.08.2017, p. 109-118.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - The relationship between weight change and daytime sleepiness
T2 - the Sleep Heart Health Study
AU - Ng, Winda L.
AU - Orellana, Liliana
AU - Shaw, Jonathan E.
AU - Wong, Evelyn
AU - Peeters, Anna
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Objective Through a causal framework, we aim to assess the association between weight change and daytime sleepiness, and the role of obstructive sleep apnoea (OSA) in this relationship. Methods From the Sleep Heart Health Study, we selected individuals who were: (1) 40–64 years old, with (2) body mass index (BMI) ≥18.5 kg/m2, (3) no history of stroke, treatment for OSA, and tracheostomy at baseline. We used multiple linear regression to assess the relationship between five-year weight change and daytime sleepiness (assessed through Epworth Sleepiness Scale (ESS)) at five years, adjusting for daytime sleepiness, demographics, diabetes, subjective sleep duration, sleep disturbance, smoking status, weight, and use of antidepressants and benzodiazepines at baseline, in those with complete data (N = 1468). We further assessed the potential mediating role of OSA in this relationship. Results At baseline, the study participants were on average 55 years old, 46% males, with mean BMI 28 kg/m2; and 25% had ESS>10. ESS at five years worsened by 0.36 units (95% confidence interval (CI) 0.12–0.61, p = 0.004) with every 10-kg weight gain. When stratified by sex, this relationship was only found in women (0.55, 95% CI 0.25–0.86, p < 0.001; p-interaction = 0.02). Approximately one-fifth of the relationship between weight change and daytime sleepiness was mediated by severity of OSA at five years. Conclusion Weight gain has a detrimental effect on daytime sleepiness, mostly through pathways other than OSA. This study provides further evidence and understanding of the relationship between obesity and excessive daytime sleepiness.
AB - Objective Through a causal framework, we aim to assess the association between weight change and daytime sleepiness, and the role of obstructive sleep apnoea (OSA) in this relationship. Methods From the Sleep Heart Health Study, we selected individuals who were: (1) 40–64 years old, with (2) body mass index (BMI) ≥18.5 kg/m2, (3) no history of stroke, treatment for OSA, and tracheostomy at baseline. We used multiple linear regression to assess the relationship between five-year weight change and daytime sleepiness (assessed through Epworth Sleepiness Scale (ESS)) at five years, adjusting for daytime sleepiness, demographics, diabetes, subjective sleep duration, sleep disturbance, smoking status, weight, and use of antidepressants and benzodiazepines at baseline, in those with complete data (N = 1468). We further assessed the potential mediating role of OSA in this relationship. Results At baseline, the study participants were on average 55 years old, 46% males, with mean BMI 28 kg/m2; and 25% had ESS>10. ESS at five years worsened by 0.36 units (95% confidence interval (CI) 0.12–0.61, p = 0.004) with every 10-kg weight gain. When stratified by sex, this relationship was only found in women (0.55, 95% CI 0.25–0.86, p < 0.001; p-interaction = 0.02). Approximately one-fifth of the relationship between weight change and daytime sleepiness was mediated by severity of OSA at five years. Conclusion Weight gain has a detrimental effect on daytime sleepiness, mostly through pathways other than OSA. This study provides further evidence and understanding of the relationship between obesity and excessive daytime sleepiness.
KW - Causal inference
KW - Causal mediation
KW - Daytime sleepiness
KW - Obesity
KW - Obstructive sleep apnoea
KW - Weight change
UR - http://www.scopus.com/inward/record.url?scp=85021766819&partnerID=8YFLogxK
U2 - 10.1016/j.sleep.2017.05.004
DO - 10.1016/j.sleep.2017.05.004
M3 - Article
VL - 36
SP - 109
EP - 118
JO - Sleep Medicine
JF - Sleep Medicine
SN - 1389-9457
ER -