Structural equation modelling for the effect of physical exercise on excessive daytime sleepiness

•Regular exercise lowers the risk of EDS by weakening causality from depression and sleep quality.

ObjectivesThe present study aimed to examine the effect of physical exercise on excessive daytime sleepiness (EDS) which is a significant public health problem.Study designThis is a population-based cohort study.MethodsWe hypothesized that those who engage in regular exercise would have lower chances of dozing in the daytime and examined causal relationships between EDS and known risk factors for EDS using structural equation model (SEM).ResultsWe found that causal relationships from both depression and sleep quality to EDS were relatively weaker in those who regularly engage in physical exercise, which resulted in lower chances of having EDS.ConclusionRegular exercise may play a protective role in EDS prevention.