Background:
Studies conducted in elderly and frail adult populations, especially those with heart failure, have shown a consistent relationship between poor sleep and poor physical performance. Likewise, a similar association between poor sleep and lower performance has been found in extremely fit, elite athletes. However, this relationship has not been examined in healthy, middle-aged adult populations. Here, we test the cross-sectional association of daytime sleepiness with poor physical performance in our large, bi-racial cardiovascular cohort.
Methods:
From 2013-2016, 1,223 adults from the Bogalusa Heart Study attended follow-up visits to assess physical and cognitive performance and answer questionnaires pertaining to sleep habits. The Epworth Sleepiness Scale (ESS) was used to measure daytime sleepiness on an ordinal scale from 0-24. Short Physical Performance Battery (SPPB), which consists of chair stands, balance testing, and walk speed, was the outcome measure, with a score of <10 out of 12 being considered poor physical performance. Multivariable logistic regression, adjusted for age, race, sex, sleep duration, employment status, BMI, and symptoms of sleep apnea was used to test the association between ESS [both continuously and dichotomized to abnormal (ESS>10) vs. normal (ESS≤10)] and poor physical performance.
Results:
Our study population had a mean(SD) age of 48.1(5.2) and was 58.6% female and 34.7% black. Mean(SD) ESS was 6.3(4.7). 252 (20.6%) adults exhibited poor physical performance. After covariate adjustment, ESS was significantly associated with an increased risk of poor physical performance (Odds Ratio per 1 SD increase=1.17; 95% Confidence Interval=1.01-1.35;
p
=0.03). As a dichotomous exposure, an abnormal ESS resulted in a 53% increased risk of poor physical performance (OR=1.53; 95% CI=1.05-2.23;
p
=0.03).
Conclusions:
Even among relatively healthy middle-aged adults, daytime sleepiness appears to be associated with poor physical performance.