Kiran Paudel, Kamal Gautam, Manasi Sharma, Jeffrey A Wickersham, Md Safaet Hossain Sujan, Toan Ha, Michael M Copenhaver, Tara Ballav Adhikari, Roman Shrestha
Journal of Medicine, August 2025. Abstract
Excessive daytime sleepiness (EDS) is a notable public health concern that needs comprehensive screening and effective care to mitigate potential adverse consequences. However, our understanding about EDS among men who have sex with men (MSM), particularly in low- and middle-income countries, remains limited or inadequate. Therefore, this study aims to assess the prevalence of EDS and identify the factors associated with EDS among MSM in Nepal. In Kathmandu, Nepal, a respondent-driven cross-sectional survey was carried out among 250 MSM, aged ≥ 18 years old. EDS, depressive symptoms, and social support were measured using the Epworth Sleepiness Scale (ESS-8), Patient Health Questionnaire (PHQ-9), and Oslo Social Support (OSS-3) scale, respectively. Multivariable logistic regression analysis was performed to identify potential factors associated with the outcome variable. The adjusted odds ratio (aOR) was calculated with a 95% confidence interval (CI). The prevalence of EDS among the study participants was 11.9%. MSM with moderate to severe depressive symptoms (aOR: 6.9; 95% CI: 2.5–18.7), strong social support (aOR: 4.9; 95% CI: 1.1–21.8) and disclosed sexual orientation to health care providers (aOR: 3.9; 95% CI: 1.4–11.5) had higher odds of having EDS. This study highlights preliminary evidence of a moderate prevalence of EDS among Nepalese MSM. Notably, depressive symptoms have been identified as a significant risk factor for higher scores on the ESS. This study should serve as a groundwork for future research on sleep-related disorders among MSM in Nepal.