The risk of death is more than two times higher in older adults who have sleep apnea and report struggling with excessive daytime sleepiness, report Nalaka S. Gooneratne, from the University of Pennsylvania Health System (Pennsylvania, USA), and colleagues.  Their study involved 289 adults with neither dementia nor depression who were recruited from the community. Results of adjusted proportional hazards modeling show that subjects with moderate to severe sleep apnea who reported struggling with excessive daytime sleepiness at baseline were more than twice as likely to die , as compared to subjects who had neither problem.  The team reports that: "Excessive daytime sleepiness, when associated with sleep apnea, can significantly increase the risk of death in older adults.”