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Background: The association between nighttime sleep disturbance and daytime sleepiness remains unclear. This study aimed to examine the relationships between various domains of nighttime sleep disturbance, daytime sleepiness, and their specific dimensions. Methods: This was a community‐based cross‐sectional study. The participants were adults aged 65 years and older from Yilan City, Taiwan. Daytime sleepiness (DS) was defined using the Epworth Sleepiness Scale (ESS) with scores ≥ 11. The ESS dimensions were further examined using exploratory factor analysis. The highest 15% factor scores for each factor were defined as factor‐specific DS. Various domains of nighttime sleep disturbance were assessed using the Pittsburgh Sleep Quality Index. Logistic regression analysis was used to examine the independent relationships among various nighttime sleep disturbances, ESS, and its dimensions. Results: Of the 2585 participants, a total of 59.0% were women. Two factors were identified by exploratory factor analysis and were designated as 'passive factor' and 'active factor'. Multiple logistic regression analyses elucidated that short sleep duration was a common risk indicator for ESS‐defined (odds ratio (OR): 2.01; 95% confidence interval (CI): 1.43–2.83), passive factor‐defined (OR: 2.23, 95% CI: 1.65–3.00), and active factor‐defined DS (OR: 1.47, 95% CI: 1.07–2.00). Hypnotic use was associated with a lower risk of both ESS‐defined (OR: 0.66, 95% CI: 0.47–0.92) and passive factor‐defined DS (OR:0.69, 95% CI: 0.52–0.92). Bathroom use (OR: 1.41, 95% CI: 1.04–1.91), coughing or snoring (OR: 2.14, 95% CI: 1.01–4.56), and sleep efficiency (OR: 0.42; 95% CI: 0.31–0.57) were uniquely associated with active factor‐defined DS. Conclusion: Two factors were identified in the ESS, revealing factor‐specific correlates of DS. Specifically, ESS‐ and passive factor‐defined DS shared similar correlates. In contrast, some correlates seem unique to active‐factor‐defined DS. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between daytime sleepiness and mortality risk among older adults. The moderating effects of sex and physical function were examined. This 9-year follow-up study was conducted with community-dwelling individuals aged ≥65 years. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). Exploratory factor analysis (EFA) was used to examine the ESS factors. Handgrip strength was measured to assess physical function, and the highest quartile was defined as good muscle power. Cox regression analysis was used to estimate the 9-year all-cause mortality risk. The interaction terms were examined to evaluate their moderating effect. In total, 2588 individuals participated in the study. The EFA explored two factors: the passive factor (PF) and the active factor (AF). After controlling for various covariates, the cutoff-defined daytime sleepiness (ESS≥11), total raw scores, and factor scores of the ESS all failed to predict mortality risk. The 3-way interaction terms showed statistical significance in terms of [sex × PF × muscle power (p = 0.03)] but not for [sex × AF × muscle power (p = 0.11)]. Specifically, PF predicted mortality risk in women with good muscle power (hazard ratio (HR): 1.48; 95 % confidence interval (CI): 1.04–2.10), which is female-specific. In contrast, AF predicted mortality risk only in men with good muscle power (HR: 1.35; 95 % CI: 1.02–1.78). The ESS-measured daytime sleepiness in older adults is multidimensional. The mortality risk for each dimension was determined based on sex and physical function. • The Epworth Sleepiness Scale (ESS) had dual construct in older adults. • Sex- and muscle power modified mortality risk conferred from daytime sleepiness. • Dimensions of the ESS conferred sex-specific mortality risk. [ABSTRACT FROM AUTHOR]