0713 Determinants of Excessive Daytime Sleepiness Among Males and Females Across the Lifespan

Abstract Introduction The developmental trajectory of excessive daytime sleepiness (EDS) differs between males and females. EDS is more prevalent in males than females at ages 5-10, yet it peaks earlier in females at ages 15-17 and remains more prevalent at ages 20-30 than in males. However, the determinants of EDS at critical developmental periods within males and females are not well understood. Methods We analyzed data from the Penn State Child Cohort, a randomly selected population-based sample of 699 school-age children who were followed-up three times during adolescence, young adulthood and early adulthood from ages 5 to 33y (median follow-up time 15.4y, quartiles 13.4-17.3y). We defined EDS in a developmentally appropriate way at each time-point. We stratified by sex and examined demographic (e.g., race/ethnicity), clinical (e.g., body mass index BMI, waist circumference WC, Tanner stage), polysomnographic (e.g., obstructive sleep apnea OSA, total sleep time TST), and self-reported (e.g., internalizing disorders, insomnia) risk factors of EDS. Results At ages 5-10, black race, ADHD, BMI, WC, and OSA were associated with EDS among males, while asthma/allergies were among females. At ages 12-14, WC, insomnia, and eveningness were associated with EDS among females, while black race was among males. At ages 15-17, BMI, WC, insomnia, and eveningness were associated with EDS among females, while Tanner stages 4-5 and Hispanic ethnicity were among males. At ages 18-20, alcohol and eveningness were associated with EDS among females, while asthma/allergies were among males. At ages 20-24, employment, internalizing disorders, and longer TST were associated with EDS among males, while eveningness was among females. At ages 25-33, ADHD, longer TST, insomnia, and eveningness were associated with EDS among females, while black race, WC and eveningness were among males; BMI and OSA were associated in both sexes. Conclusion Childhood EDS in males is related to black race, ADHD, obesity and OSA. In mid-adolescence, all females were pubertally mature and males at later pubertal stages reported similarly high EDS. Adult EDS is related to obesity and OSA in both sexes, while the association of eveningness and long TST starts earlier in females and in males, respectively. Support (if any) R01HL136587, R01MH136472