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BACKGROUND: Excessive daytime sleepiness is one of the principal symptoms of sleep disturbances, and is often associated with serious consequences including traffic and industrial accidents, decreased productivity, and interpersonal problems. However, there are few epidemiologic studies on excessive daytime sleepiness in a large scale sample targeting Japanese general population. METHODS: The survey was performed using a self-administered questionnaire in June 2000, targeting a population randomly selected from among 300 communities throughout Japan. This questionnaire included information about sleep habits and sleep problems. Excessive daytime sleepiness measured according to a question “Do you fall asleep when you must not sleep (for example when you are driving a car)?” RESULTS: A total of 28,714 subjects completed the questionnaire. The prevalence of excessive daytime sleepiness was 2.5% (male=2.8% and female=2.2%). Backward elimination analysis showed that the following were associated with excessive daytime sleepiness: male sex, young age, short sleep duration, subjective insufficient sleep, loss of deep sleep, disagreeable sensations in the legs, interruption of sleep by snoring or dyspnea, and feeling psychological stress. Interruption of sleep by snoring or dyspnea was the strongest associated factor (adjusted odds ratio=2.46, 95% confidence interval=1.76-3.43) of excessive daytime sleepiness. CONCLUSIONS: These results suggest that excessive daytime sleepiness in Japanese is associated with several sleep problems. These findings may be useful in attempts to prevent excessive daytime sleepiness in the general population of Japan.

Results OHS was identified in 55 of the 611 patients with OSAS (9%). OHS patients were younger, heavier, and more somnolent than non-OHS patients and displayed more severe OSAS, liver dysfunctions, higher total cholesterol, and impaired pulmonary function. However, these differences were resolved except for pulmonary function after correction for obesity. Daytime hypercapnia was associated with impaired pulmonary function. Percent vital capacity (%VC) was most closely correlated with PaCO2 in OHS.Conclusion OHS patients display numerous abnormalities due to obesity compared with non-OHS patients. Impaired pulmonary function, particularly %VC, may play an important role in the development of daytime hypercapnia independent of obesity in OHS patients.

To describe the long-term effects of nasal continuous positive airway pressure (CPAP) on the rate of traffic car accidents, excessive daytime sleepiness (EDS) and mood in patients with obstructive sleep apnoea syndrome (OSAS), we investigated the changes of these parameters before and after nasal CPAP treatment using a questionnaire. Seventy-five male patients who were diagnosed with severe OSAS by polysomnography were evaluated for driving competence, by looking at their driving history for 2 yr, for EDS by the Epwarth Sleepiness Scale (ESS) and for mood by the Self-related Depression Scale (SDS), and then underwent nasal CPAP treatment. After 2 yr of treatment, questionnaires inquiring about the patients' use of CPAP, their ESS, SDS and driving history during treatment were sent to the patients. A total of 47 patients (63%) responded to these questionnaires. Forty-six of the 47 responders had continued to use the nasal CPAP and completed the questionnaire. No traffic car accidents were observed among the 39 routine car users during treatment, while 13 of 39 patients (33%) had had car accidents before treatment. Although near-miss accidents had been reported by 32 of 39 patients (82%) before treatment, only four patients reported near-miss accidents during nasal CPAP treatment. The mean score of ESS was significantly (P<0.01) reduced in 46 patients after nasal CPAP. The mean score of SDS was also decreased (P<0.01) after nasal CPAP in 46 patients. Although 26 of 41 patients had been depressive on SDS before treatment, the mood was improved in 13 patients after nasal CPAP. These results suggest that long-term nasal CPAP treatment reduces the rate of traffic car accidents and improves the EDS and the mood in patients with OSAS.

Objective To assess changes in response to nasal continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea syndrome (OSAS) concerning excessive daytime sleepiness (EDS), depressive state, and quality of life (QOL).Patients and Methods We assessed for EDS using the Epworth sleepiness scale (ESS), for mood using The Zung self-depression scale (SDS), and for QOL using ShortForm 36 (SF-36) in 132 patients with obstructive sleep apnea syndrome (OSAS) and control subjects. Patients had severe OSAS (apnea-hypopnea index, 59.4±23.8/h) and were more hypersomnolent and depressed, and had poorer QOL than 38 age-and gender-matched controls.Results