Prevalence of excessive daytime sleepiness and associated factors in adolescents of the RPS cohort, in São Luís (MA), Brazil

ABSTRACT: Objectives: To estimate the prevalence and factors associated with excessive daytime sleepiness (EDS) in adolescents from the São Luís, Maranhão birth cohort. Method: Cross-sectional study conducted with 2,514 adolescents aged 18 and 19 years old. A hierarchical approach was used, and prevalence ratios were calculated using Poisson regression with robust variance adjustment. Sociodemographic characteristics (gender, race, economic class, and occupation), lifestyle (leisure activities, smoking, alcohol, illicit drug use, coffee and energy consumption, physical activity, body adiposity, screen time, and depression), and factors related to sleep were studied. Results: The prevalence of EDS was 36.8%. The female gender (PR = 1.33; 95%CI 1.19 - 1.49), high risk for alcohol consumption (PR = 1.26; 95%CI 1.09 - 1.46), current major depressive episode (PR = 1.26; 95%CI 1.08 - 1.46), sleep alteration score from 10 to 18 (PR = 1.43; 95%CI 1.10 - 1.85), and sleep score from 5 to 7 of daytime dysfunction (PR = 2.51; 95%CI 2.06 - 3.07) were risk factors for EDS. Economic class D/E was a protective factor for EDS (PR = 0.47; 95%CI 0.27 - 0.85). Conclusion: More than one-third of adolescents had EDS. Adolescents at higher risk need to improve their sleeping habits and lifestyle so that they no longer have EDS and can improve their quality of life.

摘要：
研究目的：旨在评估马拉尼昂州圣路易斯市出生队列青少年的日间过度嗜睡（Excessive Daytime Sleepiness，EDS）患病率及其相关影响因素。
研究方法：本研究为横断面研究，共纳入2514名18至19岁的青少年。研究采用分层分析思路，通过泊松回归结合稳健方差校正计算患病率比。调研涵盖社会人口学特征（性别、种族、经济阶层、职业）、生活方式维度（休闲活动、吸烟、饮酒、违禁药物使用、咖啡与能量饮品摄入、体力活动、体脂水平、屏幕暴露时长及抑郁状态），以及睡眠相关影响因素。
研究结果：日间过度嗜睡的患病率为36.8%。女性（患病率比PR=1.33；95%置信区间CI：1.19~1.49）、高风险饮酒行为（PR=1.26；95%CI：1.09~1.46）、当前存在重度抑郁发作（PR=1.26；95%CI：1.08~1.46）、睡眠改变评分10~18分（PR=1.43；95%CI：1.10~1.85）以及日间功能障碍睡眠评分5~7分（PR=2.51；95%CI：2.06~3.07）均为日间过度嗜睡的危险因素。经济阶层为D/E级则是日间过度嗜睡的保护因素（PR=0.47；95%CI：0.27~0.85）。
研究结论：超过三分之一的青少年存在日间过度嗜睡问题。高危青少年需改善睡眠习惯与生活方式，以缓解日间过度嗜睡症状，提升生活质量。