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Aging and sex are associated with multiple sleep latency test findings and their relationship with self-reported sleepiness

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Abstract

The aim of this study was to assess age- and sex-related differences in multiple sleep latency test (MSLT) results and in the performance of the Epworth Sleepiness Scale (ESS) at classifying objective hypersomnia (mean sleep latency (MSL) ≤ 8 min). We studied 480 consecutive adults (39.3 ± 15.3 years old [18–93], 67.7% female) who underwent hypersomnia evaluation. We fit linear regression models to investigate associations between age and sex and sleep latencies (mean and for every nap), after adjusting for total sleep time and sleep efficiency (on polysomnography), and REM-suppressing antidepressant effect. A logistic regression was performed to assess whether age and sex were associated with sleep-onset REM period (SOREMP) occurrence. ROC analysis assessed the diagnostic performance of ESS scores to identify a MSL ≤ 8 min in different age/sex groups. For every 10 years of age, there was 0.41 (95% CI 0.11–0.72, p = 0.008) min reduction in MSL. Objectively (MSL ≤ 8 min) sleepy patients had shortening of latencies in naps 4 and 5 with aging. Female sex was associated with a higher MSL only in patients with MSL > 8 min. A 2.4% reduction in the odds of SOREMP occurrence was observed for every year of age in objectively sleepy patients (p = 0.045). ESS scores had a better diagnostic performance in older (≥ 50 years old) men than younger (< 50 years old) women (p < 0.05). Older patients with objectively confirmed hypersomnia may be sleepier in later naps, possibly due to less restorative naps and/or circadian rhythm factors. Self-reported sleepiness is more predictive of objective sleepiness in older men than younger women.

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Acknowledgements

We thank Drs. Marjan Jahani Kondori, Hala Samman, and Swati Dhankikar for assistance with data collection. Funding was not available for this study.

Funding

This publication was supported by NIH grants UL1 TR002377 (NCRR/NCATS CCATS), R34 AG056639 (NAPS), and P30 AG062677 (Mayo Clinic ADRC Development Award). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. Center for Sleep Medicine, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Diego Z. Carvalho, Meghna P. Mansukhani, Erik K. St. Louis & Bhanu Prakash Kolla

  2. Department of Neurology, Mayo Clinic, Rochester, MN, USA

    Diego Z. Carvalho & Erik K. St. Louis

  3. Department of Family Medicine, Mayo Clinic, Rochester, MN, USA

    Meghna P. Mansukhani

  4. Division of Pulmonary Medicine, Mayo Clinic Hospital, Phoenix, AZ, USA

    Chad M. Ruoff

  5. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA

    Bhanu Prakash Kolla

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  1. Diego Z. Carvalho
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  5. Bhanu Prakash Kolla
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Contributions

Study conception and design: Diego Z. Carvalho. Material preparation and data collection: Meghna P. Mansukhani and Bhanu Prakash Kolla. Data Analysis: Diego Z. Carvalho. First manuscript draft writing: Diego Z. Carvalho. Writing review and editing: Meghna P. Mansukhani, Erik K. St. Louis, Chad M. Ruoff, and Bhanu Prakash Kolla. All authors read and approved the final manuscript.

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Correspondence to Diego Z. Carvalho.

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The authors have no relevant financial or non-financial interests to disclose.

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This study was approved by the Mayo Clinic Institutional Review Board (Protocol: 10-007230). The research involves human participants. All participants provided research authorization.

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Carvalho, D.Z., Mansukhani, M.P., St. Louis, E.K. et al. Aging and sex are associated with multiple sleep latency test findings and their relationship with self-reported sleepiness. Sleep Biol. Rhythms (2024). https://doi.org/10.1007/s41105-024-00512-5

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