Excessive Daytime Sleepiness & Depression Lauren Feder & Sarah Bourne

Background - Excessive Daytime Sleepiness Magnitude of the problem - why do we care? Prevalent both in children and adults Takes a toll on many key indicators of public health: Mortality, morbidity, performance, accidents and injuries, quality of life Prevalence in the US or SC Affects 18.9-27% of individuals in the US general population EDS is characterized by persistent sleepiness and often a general lack of energy, even during the day after apparently adequate or even prolonged nighttime sleep.

Background - Depression Magnitude of the problem - why do we care? One of the most common mental illnesses in the US Prevalence in US or SC During 2013–2016, 8.1% of American adults aged 20 and over had depression in a given 2-week period. Women (10.4%) were almost twice as likely as were men (5.5%) to have had depression. About 80% of adults with depression reported at least some difficulty with work, home, and social activities because of their depression. In South Carolina in 2016 the major depression rate for all groups was 3.9 percent. In Charleston, the rate was slightly higher at 4.2 percent.

Study Question & Hypothesis Research Question Is excessive daytime sleepiness a contributing factor in depression in female graduate students? Hypothesis We hypothesize that higher levels of excessive daytime sleepiness will lead to higher incident cases of depression in female graduate students. What is unique about our study? There is a need for research concerning the association between excessive daytime sleepiness and depression, especially in females and graduate students. No studies have tested this association in South Carolina students.

Study Design Prospective cohort Exposed (EDS) Compare Outcomes between Groups Unexposed (No EDS) Follow over time Measure Incident Depression Prospective cohort Brief overview of components of the study Recruit cohort & take baseline measurements of exposure (EDS) Follow the exposed & unexposed groups over time Measure incident depression cases at specified follow-up Compare outcomes between the two groups

Study Population Target population Source/accessible population Female graduate students in the tri-county area Source/accessible population Approximately 3,500 females enrolled in graduate programs at MUSC, CofC, CSU, & the Citadel Intended sample if sampling Samples from two types of majors at each school (business majors vs. health majors?) Recruitment plan - how much time will it take Email blast and social media advertising Within one semester (ideally within a month) Inclusion criteria Females ages 18 and older currently enrolled in a full-time graduate program and residing in the tri-county area Exclusion Criteria Pre-existing psychiatric disorders Enrollment #s MUSC: 1,888 female students in 2017 Enrollment #s Citadel: 372 graduates in 2017 Enrollment #s CSU: 262 graduates in 2017 Enrollment #s CofC: 968 graduates in 2017

Measures of Exposure & Outcome Exposure: Excessive Daytime Sleepiness Epworth Sleepiness Scale Outcome: Depression CESD-R Epworth Sleepiness Scale: This scale consists of eight questions that can be scored from 0 to 3 to assess sleepiness during different daytime situations. The final score can vary from 0 to 24. A final score greater than 10 indicates EDS (Johns, 1991). Center for Epidemiologic Studies Depression Scale Revised: This scale consists of 20 questions that can be scored from 0 to 60 to assess risk of clinical depression. A final score greater than or equal to 16 indicates a person at risk of clinical depression.

References https://www.ncbi.nlm.nih.gov/pubmed/30223136?dopt=AbstractPlus https://www.sciencedirect.com/science/article/pii/B9780124201682000211#bbib10 https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145397 https://www.cdc.gov/nchs/products/databriefs/db303.htm https://www.postandcourier.com/health/new-report-shows-major-depression-surged-especially-among-adolescents-and/article_428c80fc-538f-11e8-bdb7-cb98fed0b854.html https://www.brandeis.edu/roybal/docs/CESD-R_Website_PDF.pdf