Evidence map›Paper›PMID 40827569›Full record

ArticleJournal of sleep research2026

Changes in Self-Reported Excessive Daytime Sleepiness Are Associated With 5-Year All-Cause Mortality Risk Among Veterans.

Katherine G Bay, Arash Maghsoudi, Amin Ramezani, Drew A Helmer, Amir Sharafkhaneh, Javad Razjouyan

Abstract read
In one paragraph

Article in Journal of sleep research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Katherine G BayCenter for Innovations in Quality, Effectiveness and Safety (IQuESt), Houston, Texas, USA.ORCID 0009-0008-8489-3227
Arash MaghsoudiCenter for Innovations in Quality, Effectiveness and Safety (IQuESt), Houston, Texas, USA.
Amin RamezaniBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.ORCID 0009-0002-7952-3009
Drew A HelmerCenter for Innovations in Quality, Effectiveness and Safety (IQuESt), Houston, Texas, USA.
Amir SharafkhanehDepartment of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Javad RazjouyanCenter for Innovations in Quality, Effectiveness and Safety (IQuESt), Houston, Texas, USA.

Funding

Using Large Electronic Health Records and Advanced Analytics to Develop Predictive Frailty Trajectories in Patients with Heart FailureK25HL152006 · NHLBI · BAYLOR COLLEGE OF MEDICINE · PI RAZJOUYAN, JAVAD · 2020 to 2024
$719k
Baylor College of MedicineCenter for Innovations in Quality, Effectiveness and Safety CIN 13-413Michael E. DeBakey VA Medical CenterNHLBI NIH HHS K25 HL152006NHLBI NIH HHS K25HL152006
6 · The paper itself

Abstract

Excessive daytime sleepiness (EDS) is linked to adverse clinical outcomes. This study evaluated changes in a validated tool to assess EDS, the Epworth Sleepiness Scale (ESS) and mortality risk. This retrospective cohort study included Veterans receiving sleep-related services in the Department of Veterans Affairs (VA) from October 4, 1999 to August 18, 2018, with two qualifying ESS measures. ESS values were extracted from patient notes using a validated natural language processing (NLP) pipeline (96% accuracy). ESS scores were categorised as Normal (0-10) or Abnormal (11-24). Patients were grouped based on ESS changes: Normal-Normal, Normal-Abnormal, Abnormal-Abnormal and Abnormal-Normal. Cox proportional hazards models adjusted for time, age, sex, race and comorbid conditions assessed the risk of 5-year all-cause mortality. Among 17,967 qualifying Veterans (mean age: 56.3 (SD 13.5) years), 11.75% died within 5 years of the second ESS measure. At baseline, 9342 (52.0%) had EDS, for whom 2232 (12.4%) improved to normal by the second exam (Abnormal-Normal). The Normal-Abnormal group had a 25% higher adjusted all-cause mortality risk within 5 years (aHR: 1.25, 95% CI: 1.09, 1.44) compared to the Normal-Normal group, with progressively increasing risk after age 55. In contrast, neither persistent abnormal sleepiness (Abnormal-Abnormal) nor improvement from abnormal to normal (Abnormal-Normal) was associated with significantly different mortality risk compared to the Normal-Normal group. ESS can efficiently identify EDS, which may serve as a clinical marker for 5-year all-cause mortality risk, particularly among Veterans seeking VHA sleep services aged 55 and older.

Indexed as

Disorders of Excessive SomnolenceSelf ReportVeteransAdultAgedCause of DeathFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsUnited StatesUnited States Department of Veterans Affairsall‐cause mortalityEpworth sleepiness scaleexcessive daytime sleepinessnatural language processing

Identifiers

PMID40827569
PMCPMC12496456

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.