{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:04:29Z","timestamp":1790679869416,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Excessive daytime sleepiness (EDS) is a common but variable symptom in obstructive sleep apnea (OSA), with unclear associations with disease severity and clinical features. This study aimed to compare demographic and clinical characteristics of OSA patients with and without EDS in an Iranian population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional study, 117 patients aged 18\u201365 years with polysomnography\u2010confirmed OSA were recruited at Rasoul Akram Hospital, Tehran, Iran, from April 2022 to March 2023. EDS was assessed using the Epworth Sleepiness Scale (ESS \u2265 10). Data on demographics, anthropometric measures, clinical variables (e.g., AHI), and medical history were collected. Statistical analyses included Spearman correlations, t\u2010tests, Mann\u2010Whitney U tests, and chi\u2010square tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 117 patients (63.2% male, mean age 38.18 \u00b1 2.43 years), 42.7% had EDS. No significant correlation was found between AHI and ESS (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      = 0.121,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.194), nor differences in OSA severity (mild, moderate, severe) between sleepy and non\u2010sleepy groups (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.998). AHI correlated with age, weight, BMI, neck, and waist circumference (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05); ESS correlated with height, weight, and neck circumference (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Head\/neck disease or injury was associated with the absence of EDS (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.014), with a trend linking opioid use to EDS (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.082).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EDS in OSA patients is not strongly tied to AHI but is associated with specific anthropometric features. The novel head\/neck disease finding suggests neurological influences on EDS. These results advocate for phenotype\u2010specific OSA management in Middle Eastern populations<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71720","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:49:00Z","timestamp":1790678940000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing Demographic and Clinical Features of Obstructive Sleep Apnea Patients With and Without Sleepiness: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4463-7399","authenticated-orcid":false,"given":"Fatemeh","family":"kashaninasab","sequence":"first","affiliation":[{"name":"Sleep Medicine Fellowship. Department of Psychiatry Rasool Akram Medical Complex Clinical Research Development Center (RCRDC) Iran University of Medical Sciences (IUMS)  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8920-9466","authenticated-orcid":false,"given":"Yousef","family":"Fathalian","sequence":"additional","affiliation":[{"name":"Iran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6968-1498","authenticated-orcid":false,"given":"Mahboobeh","family":"Khoozan","sequence":"additional","affiliation":[{"name":"Mental Health Research Center, Department of Psychiatry, School of Medicine Iran University of Medical Sciences (IUMS)  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3934-9619","authenticated-orcid":false,"given":"Mirfarhad","family":"Ghalehbandi","sequence":"additional","affiliation":[{"name":"Sleep Medicine Fellowship, Mental Health Research Center, Department of Psychiatry, School of Medicine Iran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6933-3223","authenticated-orcid":false,"given":"Nasim","family":"Nikoubakht","sequence":"additional","affiliation":[{"name":"Sleep Medicine Fellowship,Department of Anesthesiology, School of Medicine Hazrat\u2010e Rasool General Hospital, Iran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/sjoh.sjoh_77_24"},{"issue":"11","key":"e_1_2_13_3_1","first-page":"1","article-title":"Prevalence of Obstructive Sleep Apnea Symptoms Among the Adult Population in Al\u2010Ahsa, Saudi Arabia","volume":"14","author":"Alsultan A.","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy624"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2015.02.001"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20102600(19)30198\u20105"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2003.35"},{"issue":"6","key":"e_1_2_13_8_1","first-page":"877","article-title":"Racial\/Ethnic Differences in Sleep Disturbances: The Multi\u2010Ethnic Study of Atherosclerosis (MESA)","volume":"38","author":"Chen X.","year":"2015","journal-title":"Sleep"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2016.12.003"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200707\u2010114MG"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.CON.0000522245.13784.f6"},{"key":"e_1_2_13_12_1","volume-title":"Prevalence of Obstructive Sleep Apnea in a High\u2010Risk Population Using the Stop\u2010Bang Questionnaire in Tehran","author":"Foroughi M.","year":"2017"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2018.01.003"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.069"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41606\u2010025\u201000133\u2010y"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6506"},{"key":"e_1_2_13_17_1","volume-title":"A Comparison of the Upper Lip Bite Test (A Simple New Technique) With Modified Mallampati Classification in Predicting Difficulty in Endotracheal Intubation: A Prospective Blinded Study","author":"Khan Z. 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