Sobre la prevalencia de apnea obstructiva del sueño en estudiantes universitarios con somnolencia diurna excesiva

On the prevalence of obstructive sleep apnea among university students with excessive daytime sleepiness

Señor editor:

La apnea obstructiva del sueño (AOS) es un trastorno respiratorio caracterizado por episodios repetidos de colapso parcial o total de la vía aérea superior durante el sueño que causan despertares e incapacidad para lograr y mantener las etapas de sueño más reparadoras, lo que resulta en somnolencia diurna excesiva (SDE). ¹ Las personas con SDE pueden presentar uno o más de los siguientes síntomas: sensación de somnolencia excesiva, quedarse dormido sin darse cuenta, episodios de sueño prolongando no reparador, necesidad de varias siestas en un mismo día e inercia del sueño (dificultad prolongada para despertarse, irritabilidad, comportamientos automáticos o confusión). ²

Dear Editor:

Obstructive sleep apnea (OSA) is a respiratory disorder characterized by repeated episodes of partial or complete collapse of the upper airway during sleep. These episodes cause awakenings and an inability to achieve and maintain the most restorative stages of sleep, resulting in excessive daytime sleepiness (EDS).¹ Individuals struggling with EDS may experience one or more of the following symptoms: feelings of excessive sleepiness, episodes of inadvertently falling asleep or sleep attacks, prolonged main sleep episode that is nonrestorative, recurrent naps in the same day, and sleep inertia, which is characterized by prolonged difficulty waking up, irritability, automatic behavior, or confusion.²

Letter to the editor

Ines Pinto-Coaquira¹ Miriam Legua Barrios1

1 Universidad Privada San Juan Bautista - Ica Campus - Faculty of Health Sciences - Professional School of Human Medicine - Ica - Peru.

Open access

Received: 28/11/2025

Accepted: 26/03/2026

Corresponding author: Ines Pinto Coaquira. Escuela Profesional de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Privada San Juan Bautista. Ica. Perú.
E-mail: ines.pinto@upsjb.edu.pe.

Keywords: Sleep Apnea, Obstructive; Sleepiness; Students; Sleep Wake Disorders; Prevalence (MeSH).

Palabras clave: Apnea Obstructiva del Sueño; Somnolencia; Estudiantes; Trastornos del Sueño; Prevalencia (DeCS).

How to cite: Pinto-Coaquira I, Legua-Barrios M.On the prevalence of obstructive sleep apnea among university students with excessive daytime sleepiness. Rev. Fac. Med. 2026;74:e124259. English. doi: https://doi.org/10.15446/revfacmed.v74.124259.

Cómo citar: Pinto-Coaquira I, Legua-Barrios M. [Sobre la prevalencia de apnea obstructiva del sueño en estudiantes universitarios con somnolencia diurna excesiva]. Rev. Fac. Med. 2026;74:e124259. English. doi: https://doi.org/10.15446/revfacmed.v74.124259.

Copyright: ©2026 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, as long as the original author and source are credited.

In the case of university students, several recent systematic reviews have found that the prevalence of EDS among medical and dental students is high, ranging from 33.32% to 42.70%.3,4 In this regard, Campo Arias et al.,1 reported a prevalence of 28.40% in 655 health sciences students in a study recently published in the Revista de la Facultad de Medicina. Although the figure found by Campo-Arias et al.1 is slightly lower than what was reported in those other reviews, their most significant contribution to the study of this condition in this population is providing information on the prevalence of OSA among health sciences students with EDS. Specifically, they found a prevalence of 10.21% among the 186 students diagnosed with EDS, with most cases classified as mild OSA (94.74%), which is a rarely considered cause in this population, where the presence of this symptom is usually attributed to reduced sleep hours due to high academic workloads.1

The study by Campo-Arias et al.1 stands out not only for its relevance but also for its methodological rigor. Unlike investigations on the prevalence of OSA and other causes of EDS in similar populations, such as medical students,5,6 their sample is much larger and includes students from various health sciences rather than only medicine,5,6 which significantly strengthens the representativeness of the findings. In any case, it is important to clarify that in the study by Campo-Arias et al.1 there was an overrepresentation of medical students in the subgroup of students with EDS (67.20%), and this could limit the generalization of the results to students in other health science programs.

Another methodological aspect that increases the reliability of the findings by Campo-Arias et al.1 is the use of the Epworth Sleepiness Scale, an instrument with a high internal consistency widely used for identifying EDS.7 Furthermore, the study utilized home respiratory polygraphy, a tool that allows for the diagnostic confirmation of OSA based on objective measurements.1,8 These methods allowed for a more precise determination of OSA prevalence in students with EDS. However, the exclusion of OSA cases in students without marked symptoms may have caused an underestimation of the true prevalence.1

Likewise, the inclusion of variables such as biological sex, age, socioeconomic status, program, and academic semester is in line with the purpose of the study and this allows for a better understanding of the general characteristics of the sample. However, the lack of variables related to EDS that are often observed in college students—such as mental health disorders (primarily anxiety and depression)9,10 sleep deprivation syndrome, or poor sleep hygiene habits11—limits the potential to more accurately determine the extent to which AOS contributes to the development of EDS.

The prevalence of OSA reported by Campo-Arias et al.1, which was 10.21% among 186 health sciences students with EDS, is higher than the 6.25% reported by Costa et al.5 in 64 medical students in Brazil and the 1.69% reported by Suzuki et al.6 in 59 medical students in Japan, which may be explained by differences in sample sizes and the diagnostic methods used. It is important to clarify that in the study by Suzuki et al.6 the prevalence increases to 3.03% if only the 33 students with EDS are included, and that in the work by Costa et al.,5 most students did not have EDS, as evidenced by an average ESS score of 8.81±4.48. This variability highlights the need for multicenter studies with homogeneous criteria, preferably using polysomnography as the diagnostic gold standard.

As previously mentioned, the most valuable contribution of the study by Campo-Arias et al.1
is providing information on the prevalence of OSA among university students with EDS, as it is a cause of EDS rarely considered in this population, with limited evidence in the literature. The findings by Campo-Arias et al.1 show that while just over 10% of students with EDS had OSA and most of these cases were mild, this disorder must be taken into account in this population. This is especially true given that evidence shows that early detection and timely treatment of OSA can reduce the risk of cardiovascular diseases12 and improve cognitive functioning.13

Finally, the findings by Campo-Arias et al.1 highlight the need to continue investigating this disorder in the university population. In this regard, it is recommended that future studies include probability samples that equitably represent students from all health science programs or even other fields of study, as a significant limitation of the work by Campo-Arias et al.1 was the overrepresentation of medical students.

Conflicts of interest

None stated by the authors.

Funding

None stated by the authors.

Acknowledgments

None stated by the authors.

References

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