The relationship between weight change and daytime sleepiness: the Sleep Heart Health Study

Winda L. Ng, Liliana Orellana, Jonathan E. Shaw, Evelyn Wong, Anna Peeters

Research output: Contribution to journalArticleResearchpeer-review

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 languageEnglish
Pages (from-to)109-118
Number of pages10
JournalSleep Medicine
Volume36
DOIs
Publication statusPublished - 1 Aug 2017

Keywords

  • Causal inference
  • Causal mediation
  • Daytime sleepiness
  • Obesity
  • Obstructive sleep apnoea
  • Weight change

Cite this

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title = "The relationship between weight change and daytime sleepiness: the Sleep Heart Health Study",
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.",
keywords = "Causal inference, Causal mediation, Daytime sleepiness, Obesity, Obstructive sleep apnoea, Weight change",
author = "Ng, {Winda L.} and Liliana Orellana and Shaw, {Jonathan E.} and Evelyn Wong and Anna Peeters",
year = "2017",
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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 journalArticleResearchpeer-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

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U2 - 10.1016/j.sleep.2017.05.004

DO - 10.1016/j.sleep.2017.05.004

M3 - Article

VL - 36

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EP - 118

JO - Sleep Medicine

JF - Sleep Medicine

SN - 1389-9457

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