What are the important risk factors for daytime sleepiness and fatigue in women?

STUDY
OBJECTIVE: To analyze the relation between different risk factors and excessive daytime sleepiness (EDS) and fatigue in women from a general-population sample.
DESIGN: Cross-sectional population study.
SETTING: The municipality of Uppsala, Sweden. PARTICIPANTS: Five thousand five hundred eight women (response rate 73.3%) aged 20 to 60 years. MEASUREMENTS AND
RESULTS: EDS, fatigue, and potential risk factors were assessed in a self-administered questionnaire. Risk factors for EDS and fatigue were analyzed using a multiple logistic regression model. In the whole population, 16.1% of the women reported EDS and 14.3% fatigue. The risk of having EDS and fatigue decreased with increasing age: adjusted odds ratios (95% confidence interval) for EDS and fatigue were 0.73 (0.66-0.88) and 0.86 (0.77-0.96) per 10 years, respectively. The combination of anxiety and depression was highly related to both EDS and fatigue (4.51 [3.51-5.79] and 7.00 [5.39-9.10], respectively). Insomnia, somatic disease, snoring, being overweight, and being on sick leave were also independently related to both conditions, whereas lifestyle factors, such as physical inactivity and smoking, were related to fatigue but not to EDS. Having children did not influence the risk of either EDS or fatigue.
CONCLUSION: Psychological distress, insomnia, and somatic disease are the most important conditions in women reporting daytime sleepiness and fatigue. Because 1 in 5 (21%) of the women in this study reported sleepiness, fatigue, or both, interventions that improve psychiatric health and reduce insomnia are important in improving the quality of life in women with these sleep symptoms.