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However, the role of excessive daytime sleepiness in postoperative neurocognitive disorders is unknown. Here, we investigated whether preoperative moderate\u2013severe excessive daytime sleepiness is associated with postoperative neurocognitive disorder severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational cohort study included older non\u2010cardiac surgery patients who completed preoperative Epworth sleepiness scale questionnaires, home sleep apnea testing, and pre\u2010 and postoperative delirium assessments and cognitive testing. Cognitive scores were combined with reflective factor analysis into a global cognitive index. Moderate\u2013severe excessive daytime sleepiness was defined as an Epworth Sleepiness Scale score greater than 12. Postoperative neurocognitive disorder severity was assessed by the global cognitive index change from before to 6\u2010weeks and 1\u2010year after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 96 subjects who completed testing, 11 subjects exhibited moderate\u2013severe excessive sleepiness. In a multivariable analysis adjusting for prespecified confounders and precision variables (age, sex, respiratory event index, baseline cognitive performance and surgery duration), moderate\u2013severe EDS was significantly associated with 6\u2010week postoperative change in global cognition (mean difference \u22120.24; 95% CI \u22120.48, \u22120.004;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046), but was not associated with peak postoperative delirium severity scores (OR 3.66; 95% CI, 0.96, 13.91;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.057).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preoperative moderate\u2013severe EDS is associated with decreased 6\u2010week postoperative global cognitive performance after adjustment for relevant confounders and precision variables. These results suggest that pre\u2010existing moderate\u2013severe excessive daytime sleepiness is a risk factor for increased postoperative neurocognitive disorder severity.<\/jats:p>\n                    <jats:p>\n                      Trial Registration:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n                      : NCT03273335.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70685","type":"journal-article","created":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T07:01:22Z","timestamp":1788073282000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Moderate\u2013Severe Excessive Daytime Sleepiness Is Associated With Postoperative Cognitive Dysfunction in Older Surgical 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