Excessive Daytime Sleepiness and Risk of Sleep Apnea: A Retrospective Analysis of Peruvian Adults

Sleep apnea is a highly prevalent chronic disorder and a leading causal factor of excessive daytime sleepiness (EDS).

This study aimed: (1) To evaluate the presence of EDS and the type of sleep apnea in the adult population assessed; (2) to identify factors associated with the type of sleep apnea; and (3) to evaluate the ability of EDS to predict the type of sleep apnea.

This study employed an observational, descriptive, and cross-sectional design, utilizing a retrospective analysis of secondary data. A total of 350 adults evaluated at a specialized sleep center in Lima, Peru, were included. EDS was assessed using the Epworth Sleepiness Scale (ESS), while the type of sleep apnea was determined through overnight polysomnography.

EDS was present in 84.6% (n= 296) of participants, with a predominance of ESS levels II and III. According to the polysomnographic diagnosis, 8.0% (n = 28) showed no evidence of sleep apnea, 49.1% (n = 172) were diagnosed with central sleep apnea, and 42.9% (n = 150) with obstructive sleep apnea. Male sex (OR = 5.32; 95% CI: 2.01-14.06) and symptoms, such as daytime sleepiness (OR = 3.51; 95% CI: 1.52-8.10), difficulty falling asleep (OR = 5.20; 95% CI: 2.32-11.64), awakening with sleepiness (OR = 35.11; 95% CI: 8.16-151.07), and choking sensation upon awakening (OR = 15.62; 95% CI: 2.10-116.42), were significantly associated with sleep apnea. EDS emerged as the main predictor in the decision tree model, which achieved an overall accuracy of 58.5%.

Daytime sleepiness is associated with sleep apnea, underscoring its clinical relevance. However, the model´s moderate predictive accuracy reinforces the importance of polysomnography as the gold standard diagnosis.

EDS was found to be highly prevalent and significantly associated with both central and obstructive sleep apnea. These findings highlight the clinical importance of screening for EDS in primary care as a practical approach to identifying individuals at higher risk of sleep apnea, supporting timely referral for polysomnography.