1. Excessive Daytime Sleepiness & Depression
Lauren Feder & Sarah Bourne

2. 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 % 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.

3. 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.

4. 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.

5. 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

6. 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
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

7. 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.

8. References