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The prevalence of excessive daytime sleepiness and associated factors in older diabetic patients

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Abstract

Objectives

Sleep disorders are a frequent health problem in older patients with diabetes mellitus (DM). There has been no study investigating the factors associated with excessive daytime sleepiness (EDS) in older diabetic patients. We aimed to investigate the prevalence and associated factors of EDS.

Methods

We performed a retrospective cross-sectional study in older diabetic patients. The Epworth Sleepiness Scale score of ≥ 11 points indicated EDS. All patients underwent comprehensive geriatric assessment including demographic characteristics, blood pressures, comorbid diseases, cognitive and nutritional states, basic and instrumental daily living activity indexes, lower urinary tract symptoms, and laboratory values.

Results

Of 227 patients, 73.1% were females, with a mean age of 78.8 ± 6.5. The prevalence of EDS was 19.8%. Patients with EDS were mostly males with dementia and used significantly more medication with more anticholinergic drug burden, falls, urge incontinence, and nocturia (p < 0.05). They had higher SARC-F and lower Barthel index, Lawton-Brodie, Tinetti, MMSE scores, and high-density lipoprotein than the patients without EDS (p < 0.05). After adjusting for age, sex, and dementia, all parameters that were significant in univariate analysis remained associated with EDS, except for falls, and MMSE scores.

Conclusion

The EDS was found in one in five older diabetic patients. There was a significant relationship between EDS and drug use, anticholinergic drug burden, impaired excretory functions, sarcopenia, decreased functional capacity, falls, gait-balance disorder, and cognitive dysfunction. The recognization of EDS and the implementation of interventions may be helpful in the management of geriatric syndromes.

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Authors and Affiliations

  1. Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. Ilhan Varank Training and, Research Hospital, Department of Internal Medicine, Division of Geriatrics, University of Health Sciences Istanbul, 34785, Sancaktepe, Istanbul, Turkey

    Nezahat Muge Catikkas

  2. Faculty of Medicine, Department of Internal Medicine, Bezmialem Vakif University, 34093, Fatih, Istanbul, Turkey

    Muhammed Tunc

  3. Faculty of Medicine, Department of Geriatric Medicine, Bezmialem Vakif University, 34093, Fatih, Istanbul, Turkey

    Pinar Soysal

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  1. Nezahat Muge Catikkas
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NMC: Methodology, Writing—Original Draft Preparation, Writing—Review & Editing, Formal Analysis. MT: Writing—Review & Editing. PS: Conceptualisation, Methodology, Writing—Review & Editing, Supervision.

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Correspondence to Pinar Soysal.

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The authors declare that they have no conflict of interest. The study was conducted in compliance with the current guidelines of the Helsinki Declaration. The ethics approval was obtained from the local Ethics Committee (Number: E-35700536–108.99–99855 and file number: 2023/99855) and all patients gave their signed consent.

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Catikkas, N.M., Tunc, M. & Soysal, P. The prevalence of excessive daytime sleepiness and associated factors in older diabetic patients. Aging Clin Exp Res 35, 3205–3214 (2023). https://doi.org/10.1007/s40520-023-02602-9

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