Language
English
Publication Date
11-1-2024
Journal
Journal of Clinical Sleep Medicine
DOI
10.5664/jcsm.11254
PMID
38935061
PMCID
PMC11530978
PubMedCentral® Posted Date
11-1-2024
PubMedCentral® Full Text Version
Post-print
Abstract
Study objectives: Excessive daytime sleepiness is prevalent and overwhelmingly stems from disturbed sleep. We hypothesized that age modulates the association between excessive daytime sleepiness and increased all-cause mortality.
Methods: We utilized the Veterans' Health Administration data from 1999-2022. We enrolled participants with sleep related International Classification of Diseases 9/10 codes or sleep services. A natural language processing pipeline was developed and validated to extract the Epworth Sleepiness Scale (ESS) as a self-reported tool to measure excessive daytime sleepiness from physician progress notes. The natural language processing's accuracy was assessed through manual annotation of 470 notes. Participants were categorized into normal-ESS (ESS 0-10) and high-ESS (ESS 11-24). We created 3 age groups: < 50 years, 50 to < 65 years, and ≥ 65 years. The adjusted odds ratio of mortality was calculated for age, body mass index, sex, race, ethnicity, and the Charlson Comorbidity Index, using normal-ESS as the reference. Subsequently, we conducted age stratified analysis.
Results: The first ESS records were extracted from 423,087 veterans with a mean age of 54.8 (± 14.6), mean body mass index of 32.6 (± 6.2), and 90.5% male. The adjusted odds ratio across all ages was 17% higher (1.15, 1.19) in the high-ESS category. The adjusted odds ratio s only became statistically significant for individuals aged ≥ 50 years in the high-ESS compared to the normal-ESS category (< 50 years: 1.02 [0.96, 1.08], 50 to < 65 years 1.13[1.10, 1.16]; ≥ 65 years: 1.25 [1.21, 1.28]).
Conclusions: High-ESS predicted increased mortality only in participants aged 50 and older. Further research is required to identify this differential behavior in relation to age.
Citation: Maghsoudi A, Azarian M, Sharafkhaneh A, et al. Age modulates the predictive value of self-reported sleepiness for all-cause mortality risk: insights from a comprehensive national database of veterans. J Clin Sleep Med. 2024;20(11):1785-1792.
Keywords
Humans, Male, Female, Middle Aged, Self Report, Veterans, Aged, United States, Age Factors, Databases, Factual, Disorders of Excessive Somnolence, Mortality, Cause of Death, Predictive Value of Tests, Risk Factors, excessive daytime sleepiness, mortality, natural language processing
Published Open-Access
yes
Recommended Citation
Maghsoudi, Arash; Azarian, Mehrnaz; Sharafkhaneh, Amir; et al., "Age Modulates the Predictive Value of Self-Reported Sleepiness for All-Cause Mortality Risk: Insights From a Comprehensive National Database of Veterans" (2024). Faculty and Staff Publications. 4520.
https://digitalcommons.library.tmc.edu/baylor_docs/4520