Programa de Acompañamiento del Sueño en la Infancia con Terapia Ocupacional durante la pandemia por COVID-19 / Program to Support Child Sleep from the Occupational Therapy Perspective during the COVID-19 pandemic

Introducción. Se describen los resultados preliminares del Programa de Acompañamiento al Sueño en la Infancia desde Terapia Ocupacional (PASITO) en niños y niñas con trastornos del neurodesarrollo (NN-TND), de 3 a 10 años, y con insomnio; realizado entre junio de 2020 y septiembre de 2021. Población y métodos. Estudio cuasiexperimental de preintervención y posintervención con un grupo de intervención y otro grupo de control, medido por el Cuestionario de Hábitos de Sueño (CHS) y el Diario de Sueño (DS). Resultados. Participaron 22 NN-TND, 8 en el grupo control. El puntaje total del CHS del grupo de intervención mejoró (p <0,001) de 54,9 (DE 5,5) a 48,4 (DE 4,5) y se acercó al rango de referencia 42,6 (DE 4,9). El DS evidenció aumento en duración, adelanto de fase de sueño y reducción en cantidad de despertares. Conclusión. Estos resultados provisorios y favorables muestran que PASITO podría ser una intervención posible para dificultades del sueño en NN-TND

Introduction. Here we describe the interim results of the Program to Support Child Sleep from the Occupational Therapy Perspective (Programa de Acompañamiento al Sueño en la Infancia desde Terapia Ocupacional, PASITO) for children with neurodevelopmental disorders (NDDs) aged 3­10 years with insomnia, conducted between June 2020 and September 2021. Population and methods. Pre- and post-intervention quasi-experiment in an intervention group and a control group using the Sleep Habits Questionnaire (SHQ) and the Consensus Sleep Diary (CSD). Results. A total of 22 children with NDDs participated, 8 in the control group. The overall SHQ score for the intervention group improved (p < 0.001) from 54.9 (SD: 5.5) to 48.4 (SD: 4.5) and moved closer to the reference range of 42.6 (SD: 4.9). The CSD showed an increased sleep duration, earlier sleep onset, and fewer night wakings. Conclusion. These interim favorable results demonstrate that the PASITO may be a possible intervention to manage sleep problems in children with NDDs.

A saúde de adolescentes na volta às atividades escolares presenciais após dois anos de pandemia do Covid-19 ­ estudo transversal de base escolar em Pelotas/RS / The health of adolescents returning to face-to-face school activities after two years of the Covid-19 pandemic - school-based cross-sectional study in Pelotas/RS / La salud de los adolescentes que retornan a las actividades escolares presenciales después de dos años de la pandemia de Covid-19 - estudio transversal escolar en Pelotas/RS

O objetivo do estudo foi comparar a percepção sobre a massa corporal, comportamentos relacionados à saúde, e a saúde mental de escolares adolescentes durante o período de retorno às atividades escolares presenciais com o período anterior à pandemia de COVID-19. O estudo foi realizado com 425 escolares (16,96±1,39 anos; 60,2% do sexo feminino) selecionados aleatoriamente de escolas das redes pública e privada de Pelotas/RS. Para a coleta dos dados foi utilizado um questionário de autopreenchimento contendo perguntas retrospectivas e atuais sobre as variáveis analisadas. Os resultados indicaram que a percepção sobre a massa corporal, o nível de atividade física, o tempo de sono, e a saúde mental (apenas para as meninas) estão piores (p<0,05) no momento atual quando comparados ao período anterior à pandemia. Por outro lado, hábitos alimentares e tempo de tela recreativo apresentaram melhores resultados (p<0,05) no momento atual do que no período anterior à pandemia. Estes resultados mostram um complexo panorama em relação à saúde de adolescentes no período de retomada das atividades presencias, tornando o retorno às atividades escolares presenciais um desafio para os próprios adolescentes, seus familiares, para professores, e para as escolas.

The aim of this study was to compare the perception of body mass, health- related behaviors and mental health of adolescent schoolchildren during the period of return to face to face school activities with the period before COVID-19 pandemic. The study was carried out with 425 students (16.96±1.39 years; 60.2% female) randomly selected from public and private schools in Pelotas/RS. For data collection, a self-completion questionnaire was used, containing retrospective and current questions about analyzed outcomes. The results indicated that the perception of body mass, level of physical activity, sleep time, and mental health (only for girls) are worse (p<0.05) at present when compared to the period before the pandemic. On the other hand, eating habits and recreational screen time showed better results (p<0.05) at present than in the period before the pandemic. These results show a complex panorama concerning the health of adolescents in the period of resumption of face to face activities, making this return a challenge for the adolescents themselves, their families, teachers and for schools.

El objetivo de este estudio fue comparar la percepción de masa corporal, comportamientos relacionados a la salud y salud mental de escolares adolescentes durante el período de retorno a las actividades escolares presenciales con el período anterior a la pandemia de COVID-19. El estudio fue realizado con 425 alumnos (16,96±1,39 años; 60,2% del sexo femenino) seleccionados aleatoriamente de escuelas públicas y privadas de Pelotas/RS. Para la recolección de datos, se utilizó un cuestionario auto-completado, conteniendo preguntas retrospectivas y actuales sobre los resultados analizados. Los resultados indicaron que la percepción de la masa corporal, el nivel de actividad física, el tiempo de sueño y la salud mental (sólo para las niñas) son peores (p<0,05) en la actualidad en comparación con el período anterior a la pandemia. Por otro lado, los hábitos alimentarios y el tiempo de pantalla recreativo mostraron mejores resultados (p<0,05) en la actualidad que en el periodo anterior a la pandemia. Estos resultados muestran un panorama complejo en relación a la salud de los adolescentes en el período de reanudación de las actividades presenciales, haciendo de este retorno un desafío para los propios adolescentes, sus familias, profesores y para las escuelas.

Actualización de las recomendaciones sobre sueño seguro / Update on safe sleep recommendatios

La muerte súbita de un lactante puede ser de causa explicada, indeterminada ­si no se investigó en forma suficiente­ o inexplicada ­cuando una investigación completa no permite determinar su causa­. La muerte súbita inexplicada, o síndrome de muerte súbita infantil, afecta en particular a las poblaciones más vulnerables. La muerte de estos niños que nacen con alteraciones del neurodesarrollo es la parte visible de una problemática que se origina en el embarazo. Disminuir la cantidad de niños vulnerables depende de políticas de salud y, sobre todo, de lograr mejorar las condiciones de vida de la población. Son acciones a largo plazo. Conocer a fondo los factores de riesgo que pueden desencadenar la muerte inesperada es lo que se puede hacer ya. La actualización de las recomendaciones sobre sueño seguro refleja nuevos conocimientos basados en la evidencia científica y un enfoque integral de los aspectos socioculturales relacionados con esta problemática.

Sudden unexpected infant death may be explained, cause by an etiology, unexplained but insufficiently investigated, or unexplained when a full investigation fails to determine the cause. Unexplained sudden death in infancy or sudden infant death syndrome particularly affects the most vulnerable populations. The death of these children who are born with alterations in their neurodevelopment is the visible part of a problem that originates in pregnancy. Reducing the number of vulnerable children depends on health policies and, above all, on improving the living conditions of the population. These are long-term actions. Knowing in depth the risk factors that can trigger unexpected death is what can be done now. The update of the recommendations on safe sleep reflects new knowledge based on scientific evidence and a comprehensive approach to the sociocultural aspects related to this problem.

Aspectos oromiofuncionais e fatores associados à autopercepção sobre a qualidade do sono em indivíduos com queixa de ronco / Oromyofunctional aspects and factors associated with self-perception of sleep quality in individuals with snoring complaints / Aspectos oromiofuncionales y factores asociados a la autopercepción de la calidad del sueño en individuos con quejas de ronquidos

Introdução: O sono é uma função vital e essencial para a sobrevivência humana e tem por objetivo favorecer o reparo corporal e mental. Objetivo: Investigar os fatores associados à autopercepção sobre a qualidade do sono, bem como possíveis alterações das estruturas orofaciais e funções estomatognáticas em indivíduos com queixa de ronco. Material e Método: Trata-se de estudo observacional, analítico e transversal, realizado com 30 indivíduos adultos com queixa de ronco durante o sono, com idade média de 45 anos e 5 meses. Para a avaliação de motricidade oromiofuncional foi utilizado o protocolo AMIOFE. Foram aplicados questionários para investigação do ronco e qualidade de sono dos participantes: Questionário de Berlin, Escala de Sonolência de Epworth e Questionário de qualidade de sono de Pittsburgh. Resultados: Os resultados do questionário de Pittsburgh indicaram disfunção na qualidade do sono em 66,67% dos participantes. A sonolência diurna foi evidenciada em 33,33%, por meio da Escala de Epworth. 60% dos participantes apresentaram alto risco para AOS, por meio dos escores obtidos no instrumento de Berlin. Indivíduos que não praticam exercício físico e com posição habitual de língua no assoalho bucal apresentaram maiores escores no questionário de Berlin. Houve correlação positiva estatisticamente significante e moderada entre as variáveis Índice de massa corporal (IMC) e os escores do Questionário de Berlin. Conclusão: Indivíduos com queixa de ronco apresentam dificuldades relacionadas à qualidade do sono. A autopercepção negativa de qualidade do sono teve relação com dados de motricidade orofacial, hábitos alimentares, composição corporal e hábitos de estilo de vida. (AU)

Introduction: Sleep is a vital and essential function for human survival and aims to promote bodily and mental repair. Objective: To investigate factors associated with self-perception of sleep quality, as well as possible alterations in orofacial structures and stomatognathic functions in individuals with snoring complaints. Material and Method: Observational, analytical and cross-sectional study, conducted with 30 adult individuals complaining of snoring during sleep, with a mean age of 45 years and 5 months. For the evaluation of orofacial myofunctional motricity, the (AMIOFE) was used. Questionnaires were applied to investigate the snoring and sleep quality of the participants: Berlin Questionnaire, Epworth Sleepiness Scale and Pittsburg Sleep Quality Index Questionnaire. Results: The Pittsburgh questionnaire results indicated sleep quality dysfunction in 66.67% of participants. Daytime sleepiness was evidenced in 33.33%, using the Epworth Scale. 60% of the participants presented high risk for obstructive sleep apnea syndrome (OSA), through the scores obtained in the Berlin questionnaire. Individuals who do not practice physical exercise and with usual tongue position on the oral floor presented higher scores in the Berlin questionnaire. There was a statistically significant and moderate positive correlation between the variables Body Mass Index (BMI) and the Berlin questionnaire scores. Conclusion: Individuals complaining of snoring self-reported difficulties related to sleep quality. The sleep quality difficulties self-reported were related to data on orofacial motricity, eating habits, body composition and lifestyle habits. (AU)

Introducción: El sueño es uma función vital y essencial para la supervivência human, tien como objetivo promover la reparación corporal y mental. Objetivo: Investigar los factores asociados con la autopercepción de la calidad del sueño, así como posibles alteraciones en las estructuras orofaciales y funciones estomatognáticas en individuos con quejas de ronquidos. Metodo: Se trata de estudio observacional, analítico, transversal, realizado con 30 individuos adultos con queja de ronquidos durante el sueño y edad media de 45 años y 5 meses. Para la evaluación de la motricidad oromiofuncional se utilizó el protocolo (AMIOFE/OMES). Se aplicaron cuestionarios para investigar el ronquido y la calidad de sueño de los participantes: Cuestionario de Berlín; Escala de Somnolencia de Epworth; Cuestionario de Calidad del Sueño de Pittsburgh. Resultados: Los resultados del cuestionario de Pittsburgh indicaron disfunción en la calidad del sueño en 66,67%. La Escala de Epworth evidenció somnolencia diurna en 33,33%. El 60% presentaron alto riesgo de AOS, conforme las puntuaciones obtenidas en el instrumento de Berlín. Los que no practican ejercicio físico y que tienen la posición habitual de la lengua en el piso de la boca obtuvieron puntuaciones más altas en el cuestionario de Berlín. Hubo correlación positiva estadísticamente significativa y moderada entre las variables del IMC y las puntuaciones del Cuestionario de Berlín. Conclusión: Individuos con quejas de ronquidos refieren dificultades relacionadas con la calidad del sueño. Las dificultades estuvieron relacionadas con datos de motricidad orofacial, hábitos alimentarios, composición corporal y los hábitos de estilo de vida. (AU)

Asociación entre calidad y cantidad de sueño con índice de masa corporal en adolescentes universitarios: Estudio transversal / Association between sleep quality and quantity and body mass index in college adolescents: A cross-sectional study

Introducción: La modificación en los patrones de sueño incrementa la susceptibilidad para la ganancia de peso. Objetivo: Estimar la asociación entre la calidad y la cantidad de horas de sueño por noche con el Índice de Masa Corporal (IMC) en adolescentes universitarios mexicanos. Materiales y métodos: Estudio transversal en estudiantes de nuevo ingreso de Enfermería en una Universidad Pública de México. Muestreo por conveniencia de n=134 estudiantes (18­19 años), voluntarios y matriculados en la facultad. La calidad y cantidad de sueño se midió con el Índice de Calidad de Sueño de Pittsburgh. El IMC se calculó con la fórmula estándar. El protocolo fue aprobado por el Comité de Ética de la facultad, los participantes firmaron el Consentimiento Informado. Resultados: Edad promedio de 18,21 años (DE= ,42 años), 82,84% mujeres, 45,52% (IC 95%= 35,46 ­ 52,86%) con sobrepeso u obesidad. El 44,02% de los participantes reportó dormir ≤ 6 horas por noche, 50,00% refirió una mala calidad de sueño en las últimas cuatro semanas. Después de ajustar por edad, sexo y ocupación, la calidad del sueño no se asoció con el IMC (OR= 1,01; IC 95%= ,94 ­ 1,08; z= ,31; p= ,75); el incremento en el IMC se asoció con una mayor probabilidad de dormir 6 horas o menos (OR= 1,08; IC 95%= 1,01 ­ 1,16; z= 2,25; p= ,02). Discusión: Las alteraciones hormonales, los factores conductuales y el entorno pudieran explicar la asociación. Conclusiones: Es recomendable implementar estrategias educativas para mejorar la higiene del sueño en esta población.

Introduction: Changes in sleep patterns increase susceptibility to weight gain. Objective: To estimate the association between the quality and quantity of sleep hours per night and Body Mass Index (BMI) in Mexican college adolescents. Materials and methods: Cross-sectional study conducted among incoming nursing students in a public university in Mexico. Convenience sampling was used, involving n=134 students (18-19 years old), volunteers, and enrolled in the nursing program. Sleep quality and quantity were measured through the Pittsburgh Sleep Quality Index (PSQI). BMI was calculated using the standard formula. The protocol was approved by the School of Nursing Ethics Committee, and the participants signed informed consent. Results: Mean age 18.21 years (SD= .42 years), 82.84% female, 45.52% overweight or obese (95% CI= 35.46 - 52.86%). 44.02% of participants reported sleeping ≤ 6 hours per night, and 50.00% reported poor sleep quality in the past four weeks. After adjustment for age, sex, and occupation, sleep quality was not associated with BMI (OR= 1.01; 95% CI= .94 - 1.08; z= .31; p= .75); increased BMI was associated with a greater likelihood of sleeping 6 hours or less (OR= 1.08; 95% CI= 1.01 - 1.16; z= 2.25; p= .02). Discussion: Hormonal changes, behavioral factors, and the environment may explain the association. Conclusions: It is advisable to implement educational strategies to improve sleep hygiene among this population.

Introdução: A modificação nos padrões de sono aumenta a suscetibilidade ao ganho de peso. Objetivo: Estimar a associação entre a qualidade e a quantidade de sono por noite e o índice de massa corporal (IMC) em adolescentes universitários mexicanos. Materiais e métodos: Estudo transversal de estudantes de enfermagem ingressantes em uma universidade pública no México. Amostragem por conveniência de n=134 estudantes (18-19 anos de idade), voluntários e matriculados na faculdade. A qualidade e a quantidade do sono foram medidas com o Índice de Qualidade do Sono de Pittsburgh. O IMC foi calculado com a fórmula padrão. O protocolo foi aprovado pelo Comitê de Ética da faculdade e os participantes assinaram o Termo de Consentimento Livre e Esclarecido. Resultados: Idade média de 18,21 anos (DP= ,42 anos), 82,84% do sexo feminino, 45,52% (IC 95%= 35,46 - 52,86%) com sobrepeso ou obesidade. 44,02% dos participantes relataram dormir ≤ 6 horas por noite, 50,00% relataram qualidade de sono ruim nas últimas quatro semanas. Após o ajuste para idade, sexo e ocupação, a qualidade do sono não foi associada ao IMC (OR= 1,01; IC 95%= ,94 - 1,08; z= ,31; p= ,75); o aumento do IMC foi associado a uma maior probabilidade de dormir 6 horas ou menos (OR= 1,08; IC 95%= 1,01 - 1,16; z= 2,25; p= ,02). Discussão: Alterações hormonais, fatores comportamentais e o ambiente podem explicar a associação. Conclusões: É aconselhável implementar estratégias educacionais para melhorar a higiene do sono nessa população.

Problemas do sono em adultos assistidos na Estratégia de Saúde da Família / Sleep problems in adults assisted in the Family Health Strategy

Objetivo: Estimar a prevalência e investigar fatores associados aos problemas do sono em adultos cadastrados na Estratégia de Saúde da Família em 2016.Métodos: Estudo transversal, amostral, com 791 indivíduos, com idade igual ou superior a 18 anos, realizado entre 2017 e 2018. Os problemas de sono foram mensurados pelo Mini Sleep Questionnaire, questionário validado no Brasil.Resultados: A prevalência de problemas de sono foi de 49,6%. Destes, 10,4% tiveram alterações leves, 7,6% moderadas e 31,6% graves. Observou-se associação estatisticamente significante entre não ter uma atividade de trabalho remunerada, não ter atividade de lazer, hábito de fumar, presença de doença crônica e autoavaliação negativa da saúde com os problemas do sono.Conclusão: Observou-se elevada prevalência de problemas de sono. Esses resultados podem contribuir para uma melhor compreensão dos problemas do sono na população adulta e, assim, colaborar com a adoção de medidas mais eficazes para o enfrentamento desse problema

Objective: To estimate the prevalence and investigate factors associated with sleep problems in adults enrolled in the Family Health Strategy in 2016. Methods: Cross-sectional sample study with 791 individuals aged 18 years or over, carried out between 2017 and 2018. Sleep problems were measured using the Mini Sleep Questionnaire, a questionnaire validated in Brazil. Results: The prevalence of sleep problems was 49.6%. Of these, 10.4% had mild, 7.6% moderate, and 31.6% severe alterations. There was a statistically significant association between not having a paid work activity, not having leisure activities, smoking, chronic disease, and negative self-assessment of health with sleep problems. Conclusion: There was a high prevalence of sleep problems. These results can contribute to a better understanding of sleep problems in the adult population and, thus, collaborate with adopting more effective measures to treat them

Melatonina, lactancia materna y sueño: revisión del tema / Melatonin, breastfeeding and sleep: topic review

Se revisa en el binomio madre-recién nacidos o/y lactantes, los diferentes ritmos circadianos, especialmente del sueño, la secreción de melatonina y las características de la leche materna. Se aconseja manejo para evitar la cronodisrupción

It is reviewed in the binomial mother-newborns or/and infants, the different circadian rhythms, especially sleep, melatonin secretion and the characteristics of breast milk. Handling is advised to avoid chrono disruption

Características clínicas y demográficas de los pacientes con apnea obstructiva de sueño manejados quirúrgicamente en el servicio de otorrinolaringología del Hospital Militar Central entre los años 2016-2020 / Clinical and demographic characteristics of patients with obstructive sleep apnea surgically managed in the otorhinolaryngology service of the Central Military Hospital of Bogota between 2016-2020

Introducción: la apnea obstructiva del sueño (AOS) conlleva un alto riesgo cardiovascular, metabólico y neurológico. Los dispositivos de presión positiva continua (CPAP) o dispositivos de avance mandibular (DAM) pueden ferulizar la vía aérea superior (VAS) y mejorar la obstrucción; sin embargo, la adherencia es muy baja. Se ha demostrado que los procedimientos quirúrgicos de la VAS pueden llevar a una reducción significativa en la frecuencia de apneas e hipopneas. El objetivo del estudio fue describir las características clínicas y demográficas y los cambios en la somnolencia diurna excesiva, en el índice de apnea e hipopnea (IAH) y en la saturación de oxígeno (SpO2 ) de los pacientes con AOS manejados quirúrgicamente en el Servicio de Otorrinolaringología entre los años 2016 a 2020. Materiales y métodos: Se realizó un estudio observacional descriptivo tipo serie de casos. Resultados: se incluyeron nueve pacientes que cumplían los criterios de inclusión, el 77,8 % presentaban sobrepeso u obesidad. Se disminuyó la puntuación de la Epworth Sleepiness Scale (ESS) en el 100 % de los pacientes pre y posquirúrgicos. Adicionalmente, la polisomnografía (PSG) pre y posoperatoria mostró un aumento en la eficiencia de sueño con la mejoría de parámetros de oxigenación. Se encontró una disminución en el IAH en el 88,8 % de los pacientes. Conclusión: los hallazgos en este estudio sugieren que la cirugía de VAS es segura para realizar en pacientes con AOS. No todos los pacientes son candidatos a manejo quirúrgico y es importante una selección adecuada para disminuir las complicaciones.

Introduction: Obstructive sleep apnea (OSA) is a pathology that leads to a high risk of developing cardiovascular, metabolic, and neurological diseases. Positive airway pressure (CPAP) or mandibular advancement devices (MAD) can open superior airway (SAW) improve the obstruction, however, adherence is too low. It has already been shown that surgical SAW procedures, compared with medical management, can lead to a significant reduction in the frequency of apneas and hypopneas. The aim of this study was to describe the clinical and demographic characteristics, changes in excessive daytime sleepiness using Epworth Sleepiness Scale (ESS), apnea-hipopnea index (AHI) and SpO2 in patients with OSA managed surgically. Methods: A descriptive observational case series type study was carried out. Results: Nine patients were included, 77.8% were overweight or obese. A decrease in the ESS was found in 100% of the patients when pre- and post-operative scores were compared. Additionally, pre and postoperative polysomnography (PSG) showed an increase in sleep efficiency with improvement in oxygenation parameters such as mean saturation and minimum saturation. Regarding respiratory events, we found a decrease in AHI in 88.8% of patients. Conclusion: The findings in this study suggest that SAW surgery is safe to perform in patients with OSA. However, it is necessary to keep in mind that not all patients are candidates for surgical management and that adequate patient selection is important to reduce procedural complications.

Cambios en la calidad del sueño durante el semestre académico en estudiantes de la salud / Changes in sleep quality during an academic semester in health careers students / Alterações na qualidade do sono durante o semestre letivo em estudantes da área da saúde

Introducción: La calidad del sueño tiene efectos en la salud física y mental, su alteración en estudiantes universitarios dificulta los procesos de memoria, concentración y capacidad de aprendizaje. En Colombia los estudios de sueño se centran principalmente en estudiantes de medicina y enfermería, y muy pocos identifican su relación con la carga académica. Objetivo: Describir los cambios en la calidad del sueño durante un semestre académico y acorde al ciclo de formación en universitarios de una facultad de salud y rehabilitación de Cali, Colombia. Materiales y métodos: Estudio descriptivo, prospectivo mediante la aplicación del Índice de calidad del sueño de Pittsburgh al inicio y cierre del semestre a 241 estudiantes de Fisioterapia, Nutrición y Terapia ocupacional. Resultados: La mayoría de participantes eran mujeres, de 20 años o menos y de estratos socioeconómicos medio y bajo. Al inicio del semestre el 76,35% de estudiantes dormían 7 horas o más y al final se redujo al 49,79%. Al inicio del estudio el 24,90% presentaban mala calidad del sueño y al final la cifra ascendió a 54,36%. Conclusiones: Se presentó un incremento significativo de mala calidad del sueño al final del semestre académico, siendo mayor el cambio en los estudiantes del ciclo profesional.

Introduction: Sleep quality affects physical and mental health and its alteration in university students hinders memory processes, concentration, and learning capacity. In Colombia, studies on sleep patterns focus mainly on medical and nursing students and few of them identify its relationship with academic load. Objective: To describe sleep quality changes during an academic semester and according to education cycles in university students from a health and rehabilitation program in Cali, Colombia. Materials and methods: Descriptive prospective study, which applied the Pittsburg Sleep Quality Index at the beginning and end of the semester to 241 Physiotherapy, Nutrition, and Occupational Therapy students. Results: Most participants were women, aged 20 years old or younger, and belonged to medium to low socioeconomic strata. At the beginning of the semester, 76.35% of students were able to sleep 7 hours or more and at the end this population decreased to 49.79%. At the beginning of the study, 24.9% displayed poor sleep quality, whereas this group increased to 54.36% at the end. Conclusions: There was a significant increase in poor sleep quality at the end of the academic semester, the change being greater in students from the professional cycle.

Introdução: A qualidade do sono tem efeitos na saúde física e mental, sua alteração em estudantes universitários dificulta os processos de memória, concentração e capacidade do aprendizagem. Na Colômbia, os estudos do sono se concentram basicamente em estudantes de medicina e enfermería, e poucos identificam sua relação com a carga acadêmica. Objetivo: Descrever as alterações na qualidade do sono durante um semestre letivo de acordo com o ciclo de formação em estudantes universitários de uma escola de saúde e reabilitação em Cali, Colômbia. Materiais e métodos: Estudo descritivo, prospectivo por meio da aplicação do Índice de Qualidade do Sono de Pittsburgh no início e final do semestre em 241 alunos de Fisioterapia, Nutrição e Terapia Ocupacional. Resultados: A maioria dos participantes foram mulheres, com idade igual ou inferior a 20 anos e de estratos socioeconômicos médio e baixo. No início do semestre, 76,35% dos alunos dormiam 7 horas ou mais, e no final diminuiu para 49,79%. No início do estudo, 24,90% tinham má qualidade do sono e no final o número subiu para 54,36%. Conclusões: Houve um aumento significativo da má qualidade do sono no final do semestre letivo, sendo a alteração maior nos estudantes do ciclo profissional.

Physical activity, sedentary behavior and sleep measured by smartwatch: a scoping review protocol / Atividade física, comportamento sedentário e sono medidos por smartwatch: protocolo de revisão de escopo

The health impacts of physical activity (PA), sedentary behavior (SB), and sleep are well established; thereby, the identification of instruments to assess and monitor these behaviors at a populational lev-el is relevant. In this context, smartwatches, which are wristwatch-shaped devices equipped with sen-sors, have been identified as alternatives for objectively measuring PA, SB, and sleep. Therefore, this protocol aimed at describing the goals and methods of a scoping review to map the literature on the use of smartwatches to objectively measure PA, SB, and/or sleep across the lifespan (e.g., children, adolescents, adults, and elderly) and in different contexts. Studies will be included if they use smart-watches to objectively measure at least one of the behaviors (PA, SB, and sleep) in children, adoles-cents, adults, and older adults, published after 2013. No language filter will be applied. Searches will be carried out in six databases (Pubmed/Medline, Scopus, Web of Science, LILACS, IEEE Xplore Digital Library, Scielo, Health Technology Assessment Database, and Cochrane clinical trials) and two clinical trial repositories. The screening and data extraction will be performed independently by two authors who had previous experience in reviews and technologies. The synthesis of the results will follow the Joanna Briggs Institute framework for extracting the results in scoping reviews. The results can contribute to scientific progress by identifying gaps and research trends, guiding future studies, and informing companies, healthcare professionals, and the general public who use smart-watch as a measurement tool for physical activity, sedentary behavior, and sleep

Os impactos da atividade física (AF), comportamento sedentário (CS) e sono na saúde são bem estabelecidos, tornando-se relevante identificar instrumentos que permitam avaliar e monitorar esses comportamentos em nível populacional. Nesse contexto, os smartwatches, que são dispositivos em formato de relógio de pulso, com-postos por sensores, tem sido apontado como alternativa para mensurar objetivamente AF, CS e sono. Portanto, o objetivo deste protocolo foi descrever os objetivos e métodos de uma revisão de escopo para mapear a literatura científica sobre o uso de smartwatches para medir objetivamente AF, CS e/ou sono em diferentes populações e contextos. Os estudos serão incluídos se usarem smartwatches para medir objetivamente pelo menos um dos comportamentos (AF, CS e sono) em crianças, adolescentes, adultos e idosos, publicados após 2013. Nenhum filtro de idioma será aplicado. As buscas serão realizadas em sete bases de dados (Pubmed/Medline, Scopus, Web of Science, IEEE Xplore Digital Library, Scielo, LILACS, Health Technology Assessment Database e Cochrane Clinical Trials) e dois repositórios de ensaios clínicos. A triagem e extração dos dados serão realizadas de forma independente por dois autores com experiência prévia em revisões e tecnologias. A síntese dos resultados seguirá o framework do Joanna Briggs Institute para extração dos resultados nas revisões de escopo. Os resultados podem contribuir para o progresso científico, identificando lacunas e tendências de pesquisa, orientando futuros estudos, empresas que atuam neste mercado, profissionais de saúde e o público em geral que utilizam smartwatch como um instrumento de medição para atividade física, comportamento sedentário e sono

Alterações comportamentais na pandemia de COVID-19, sobrepeso e obesidade de escolares Quilombolas / Behaviors changing during the COVID-19 pandemic and overweight and obese Quilombola schoolchildren's

O estudo descreveu as alterações comportamentais durante a pandemia de COVID-19 e sua asso-ciação com o sobrepeso e obesidade atual de crianças e adolescentes. Participaram do estudo 1.004 crianças e adolescentes de comunidades rurais em áreas de remanescentes de quilombos de Feira de Santana, Bahia (50,3% meninos; Idade: 9,04 ± 1,52 anos). Desfechos: sobrepeso e obesidade, com base nos valores de Índice de Massa Corporal para idade e sexo, avaliados nos pontos de corte da In-ternational Obesity Taskforce. Alterações comportamentais (apetite, sono, psicológicas, sociais) foram avaliadas por meio de questionário preenchido pelos pais. A análise de dados incluiu estatística des-critiva, bivariada e regressão de Poisson múltipla, com estimador robusto de variância, para estimar Razões de Prevalência (RP) e Intervalos de 95% de Confiança (IC95%). A significância estatística foi fixada em valores de p<0,05. Covariáveis: idade, sexo, infecção por COVID-19 e insegurança ali-mentar. Após o período pandêmico, 24% dos participantes estavam com excesso de peso (sobrepeso = 15,5%; obesidade: 8,5%). As principais alterações comportamentais ocorreram no apetite (comer muito mais do que o habitual = 45,6%) e no sono (ir dormir e acordar mais tarde do que o habitual, em 74% e 62,2%, respectivamente). Comer mais que o habitual foi fator associado ao sobrepeso (RP = 1,63; IC95%: 1,14 - 2,32) e à obesidade (RP = 2,00; IC95%:1,22 - 2,25) entre os participantes, após ajuste por sexo, idade, infecção por COVID-19 e insegurança alimentar. As prevalências de sobrepe-so e obesidade subsequentes ao período pandêmico se associaram às alterações comportamentais no apetite ocorridas durante a pandemia entre escolares Quilombolas

The aim of the study was to describe behaviors changes during COVID-19 pandemic and its association with subsequent overweight and obesity among Quilombola schoolchildren. Participants in this study were 1,004 children and adolescents from rural communities in the Quilombo areas of Feira de Santana, Bahia (50.3% boys; Age: 9.04 ± 1.52 years). The outcomes were overweight and obesity prevalence based on age-and-sex Body Mass Index values, evaluated according to the International Obesity Task Force cut-offs. Behavior changes (appetite, sleep, psychological, and social) were measured by a proxy report questionnaire. The analysis included descriptive statistics and multiple Poisson regression models, using robust variance to estimate Prevalence Ratio (PR) and 95% Confidence Intervals (95%CI). Co-variables: age, sex, COV-ID-19 infection, and food insecurity. The results presented 24% of overweight subsequent to the pandemic period (overweight without obesity = 15.5%; obesity = 8.5%). Main behavior changes occurred in diet (eating more than usual = 45.6%) and sleep (time to go to bed/time to wake up later than usual, among 74% and 62.2% of participants, respectively). Eating mor than usual was associated to overweight without obesity (PR = 1.63; 95%CI: 1.14 - 2.32) and obesity (PR = 2.00; 95%CI: 1.22 - 2.25), when adjusted by sex, age, COVID-19 infection, and food insecurity. Being overweight and obese subsequent to the COV-ID-19 pandemic was associated with behavior changes in the appetite during the pandemic period among Quilombola schoolchildren

Calidad de sueño y aprendizaje en estudiantes de medicina: Revisión narrativa / Sleep Quality and Learning in Medical Students: Narrative Review

Ha habido un gran avance en el estudio de los procesos de consolidación de la memoria en los último 30 años, especialmente la asociada al hipocampo, en los que el sueño juega un papel indispensable. Hay evidencia clara que muestra que los estudiantes de medicina duermen menos y están menos satisfechos con su calidad de sueño que estudiantes de otras profesiones. Si bien hay evidencia que sustenta la asociación entre sueño y aprendizaje, medido como rendimiento académico, las diferencias metodológicas entre los estudios dificultan obtener conclusiones claras.

SUMMARY There has been a great advancement in our understanding of the processes of memory consolidation and the role of sleep in them. There is clear evidence showing that medical students sleep fewer hours and are less satisfied with their sleep quality than other university students. There is also evidence that links sleep and academic performance, however, methodologic differences between studies make it difficult to draw clear conclusions.

Study on the method of polysomnography sleep stage staging based on attention mechanism and bidirectional gate recurrent unit / 生物医学工程学杂志

Polysomnography (PSG) monitoring is an important method for clinical diagnosis of diseases such as insomnia, apnea and so on. In order to solve the problem of time-consuming and energy-consuming sleep stage staging of sleep disorder patients using manual frame-by-frame visual judgment PSG, this study proposed a deep learning algorithm model combining convolutional neural networks (CNN) and bidirectional gate recurrent neural networks (Bi GRU). A dynamic sparse self-attention mechanism was designed to solve the problem that gated recurrent neural networks (GRU) is difficult to obtain accurate vector representation of long-distance information. This study collected 143 overnight PSG data of patients from Shanghai Mental Health Center with sleep disorders, which were combined with 153 overnight PSG data of patients from the open-source dataset, and selected 9 electrophysiological channel signals including 6 electroencephalogram (EEG) signal channels, 2 electrooculogram (EOG) signal channels and a single mandibular electromyogram (EMG) signal channel. These data were used for model training, testing and evaluation. After cross validation, the accuracy was (84.0±2.0)%, and Cohen's kappa value was 0.77±0.50. It showed better performance than the Cohen's kappa value of physician score of 0.75±0.11. The experimental results show that the algorithm model in this paper has a high staging effect in different populations and is widely applicable. It is of great significance to assist clinicians in rapid and large-scale PSG sleep automatic staging.

Automated detection of sleep-arousal using multi-scale convolution and self-attention mechanism / 生物医学工程学杂志

In clinical, manually scoring by technician is the major method for sleep arousal detection. This method is time-consuming and subjective. This study aimed to achieve an end-to-end sleep-arousal events detection by constructing a convolutional neural network based on multi-scale convolutional layers and self-attention mechanism, and using 1 min single-channel electroencephalogram (EEG) signals as its input. Compared with the performance of the baseline model, the results of the proposed method showed that the mean area under the precision-recall curve and area under the receiver operating characteristic were both improved by 7%. Furthermore, we also compared the effects of single modality and multi-modality on the performance of the proposed model. The results revealed the power of single-channel EEG signals in automatic sleep arousal detection. However, the simple combination of multi-modality signals may be counterproductive to the improvement of model performance. Finally, we also explored the scalability of the proposed model and transferred the model into the automated sleep staging task in the same dataset. The average accuracy of 73% also suggested the power of the proposed method in task transferring. This study provides a potential solution for the development of portable sleep monitoring and paves a way for the automatic sleep data analysis using the transfer learning method.

Control of Emotion and Wakefulness by Neurotensinergic Neurons in the Parabrachial Nucleus / 神经科学通报·英文版

The parabrachial nucleus (PBN) integrates interoceptive and exteroceptive information to control various behavioral and physiological processes including breathing, emotion, and sleep/wake regulation through the neural circuits that connect to the forebrain and the brainstem. However, the precise identity and function of distinct PBN subpopulations are still largely unknown. Here, we leveraged molecular characterization, retrograde tracing, optogenetics, chemogenetics, and electrocortical recording approaches to identify a small subpopulation of neurotensin-expressing neurons in the PBN that largely project to the emotional control regions in the forebrain, rather than the medulla. Their activation induces freezing and anxiety-like behaviors, which in turn result in tachypnea. In addition, optogenetic and chemogenetic manipulations of these neurons revealed their function in promoting wakefulness and maintaining sleep architecture. We propose that these neurons comprise a PBN subpopulation with specific gene expression, connectivity, and function, which play essential roles in behavioral and physiological regulation.

Dual trajectory of sleep and frail in elderly people / 中南大学学报(医学版)

The high incidence of dual sleep and frail disorders in the elderly people, often occurring together, seriously affects the physical and mental health of the older people, effective research on the dynamics of dual sleep and frail disorders is important for improving the quality of life for the older people and responding to global ageing trend. While trajectory studies provide a unique practical scientific perspective to grasp the dynamics of development, dual trajectories unite dual barriers provide an opportunity to study the dynamic dependence of both sleep and frailty simultaneously sleep trajectories and frailty trajectories in older people are interrelated and interacted through deeper mechanisms. Therefore, it is necessary for the study not only focus on the ongoing development of health problems, but also needs to consider multiple aspects and propose targeted intervention program.

Midday Napping, Nighttime Sleep, and Mortality: Prospective Cohort Evidence in China / 生物医学与环境科学（英文）

OBJECTIVE@#In developed countries, midday napping and nighttime sleep duration have been linked to long-term survival; however, little is known about such effects in less developed regions. Therefore, this study aimed to assess the associations of midday napping and nocturnal sleep with mortality in middle-aged and older Chinese adults.@*METHODS@#A nationwide cohort of 15,524 adults aged ≥ 45 years was enrolled from 28 provincial regions across mainland China and followed up from 2011 to 2018, using data from the Chinese Health and Retirement Longitudinal Study. Midday napping and nighttime sleep duration were assessed using standardized questionnaires. Cox proportional hazards models with random intercepts for the surveyed provinces were used to estimate hazard ratios ( HRs) of all-cause mortality, adjusting for sociodemographic characteristics, behavioral factors, and health status.@*RESULTS@#A total of 1,745 deaths occurred during a median follow-up of 7.1 years, and the mean (standard deviation) age was 59 (10.1) years at baseline. Compared with non-nappers, over 60 min nappers had a higher risk of all-cause mortality [ HR: 1.35, 95% confidence interval ( CI): 1.17-1.56], while no significant associations were observed among < 30 min nappers. Compared with sleep duration of 6-8 h/night, both short (< 6 h) and long (≥ 8 h) sleep duration were significantly associated with increased mortality, with corresponding HR (95% CI) estimates of 1.21 (1.05-1.38) and 1.26 (1.10-1.44), respectively. We observed significant patterns for greater risks associated with longer nap duration, with a P trend value < 0.001 for all-cause mortality. No significant evidence of an additive interaction was identified between midday napping and nighttime sleep.@*CONCLUSION@#Long midday napping and inappropriate nighttime sleep were independently associated with an increased risk of all-cause mortality in middle-aged and older Chinese populations. Biological studies are needed to validate our findings and clarify the mechanisms underlying this association.