Midlife daytime drowsiness linked to increased risk of mortality
Those struggling with excessive daytime sleepiness in midlife may face a heightened risk of premature demise, according to a recent study.
The research, presented at the SLEEP 2025 annual meeting, looked into the relationship between excessive daytime sleepiness and mortality in over 40,000 female veterans. Surprisingly, this association was only apparent in women between the ages of 50 and 65.
High scores on the Epworth Sleepiness Scale, a tool used to assess sleepiness throughout everyday situations, were linked to a 16% increased likelihood of all-cause mortality in these midlife women, even after accounting for health and demographic factors.
Curiously, no significant connections were discovered in younger or older age groups. Researchers propose that this could be due to unique hormonal or metabolic transformations happening during midlife, that make this group more susceptible to sleep-related health concerns.
"Healthcare providers should prioritize evaluating excessive daytime sleepiness and related management in women approaching their 50s and early 60s," says Arash Maghsoudi, lead author of the study and an instructor at Baylor College of Medicine in Houston.
Excessive sleepiness is often associated with an array of negative health implications and reduced quality of life. Meaning, the inability to stay awake during waking hours, when one should ideally be alert, can prove detrimental to one's overall health.
The study was based on a retrospective analysis of medical records from 1999 to 2022, focusing on female veterans who either had a sleep disorder or received sleep-related care. The study sample had an average age of 48. Clinical notes were scrutinized to detect Epworth Sleepiness Scale scores.
One intriguing finding was that there was no association found between excessive daytime sleepiness and mortality in older women - a group often struggling with multiple health issues.
"This suggests that the hormonal, metabolic, or resilience factors at play in middle-aged women warrant further investigation," Maghsoudi explains.
The study received funding from the National Heart, Lung, and Blood Institute, the Center for Innovations in Quality, Effectiveness, and Safety, and the Michael E. DeBakey VA Medical Center in Houston.
The Science Behind It All
The study findings hint at hormonal or metabolic factors playing a significant role in the vulnerability of middle-aged women to sleep-related health issues. Some possible hormonal and metabolic factors contributing to this vulnerability include:
- Estrogen and Progesterone Decline: During menopause, decreases in these hormones can result in sleep disturbances.
- Blood Sugar and Cortisol Fluctuations: Changes in estrogen levels can impact insulin sensitivity, leading to irregular blood sugar levels and stress responses that disrupt sleep.
- Hot Flashes and Night Sweats: Menopause-related hot flashes and night sweats can lead to sleep disruptions and poor sleep quality.
- Obstructive Sleep Apnea (OSA) and Restless Legs Syndrome (RLS): Hormonal changes during menopause can raise the risk of OSA and RLS, further complicating sleep.
- The study in question highlights a potential link between excessive daytime sleepiness and mortality in women aged 50 to 65, which could be related to hormonal or metabolic transformations happening during midlife.
- Arash Maghsoudi, the lead author of the study, suggests that hormonal and metabolic factors, such as estrogen and progesterone decline, blood sugar and cortisol fluctuations, hot flashes and night sweats, obstructive sleep apnea (OSA), and restless legs syndrome (RLS), may contribute to this vulnerability in middle-aged women.
- The researchers propose that health-and-wellness professionals should prioritize evaluating excessive daytime sleepiness and related management in women approaching their 50s and early 60s, given the potential risks associated with this demographic.
- The study findings also hint at a need for further investigation into the unique hormonal, metabolic, or resilience factors at play in middle-aged women, as there was no association found between excessive daytime sleepiness and mortality in older women, a group often struggling with multiple health issues.
