Asociación entre índices antropométricos y presencia de apnea obstructiva del sueño en adultos / Association Between Anthropometric Indexes and Obstructive Sleep Apnea in Adults

Antecedentes: La apnea obstructiva del sueño (AOS) es un trastorno del sueño altamente prevalente producido por una obstrucción anatómica o neuromuscular de la vía aérea superior. Propósito: Identificar la asociación entre los índices antropométricos: circunferencia de cuello (CC), perímetro abdominal e índice de masa corporal (IMC), con la presencia de AOS en adultos. Métodos: Se realizó un estudio observacional retrospectivo de casos y controles en 353 individuos entre 18 y 82 años de edad con diagnóstico polisomnográfico de AOS. Se correlacionó el índice apnea hipoapnea con los índices antropométricos y los datos demográficos. El grupo control estuvo conformado por 105 adultos sin AOS y el de estudio por 248 pacientes con diagnóstico de AOS. Para determinar la asociación entre las variables se utilizaron las pruebas de Chi cuadrado de Pearson y odds ratio. Resultados Se encontró una asociación estadísticamente significativa entre el IMC y la CC, que estaban aumentados con la presencia de AOS en adultos. La presencia de AOS fue mayor en mujeres y hombres entre 56 y 82 años. Conclusiones: Las medidas antropométricas IMC y CC son factores de riesgo de AOS en adultos.

Background: Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder caused by anatomic or neuromuscular obstructions. Purpose: To identify the association between anthropometric indexes: neck circumference (NC), abdominal perimeter, and Body Mass Index (BMI), and the presence of OSA in adults. Methods: A retrospective observational case-control study was carried out in 353 individuals between the ages of 18 and 82 years with a polysomnographic diagnosis of OSA. The Apnea-Hypopnea Index was correlated with the anthropometric indexes and demographic data. The control group consisted of 105 adults without OSA and the case group were 248 patients diagnosed with OSA. Pearson Chi-square and Odds Ratio (OR) tests were used for statistical analysis. Results: Statistically significant associations between increased BMI and NC with the presence of OSA in adults were found. The presence of OSA was greater in 56-to-82-year-old women and men. Conclusions: Anthropometric measures BMI and NC are OSA risk factors in adults.

Evaluation of the relationship between sleep bruxism and pulpal calcifications in young women: A clinico-radiological study

PURPOSE: This study was performed to investigate the relationship between sleep bruxism (SB) and pulpal calcifications in young women. MATERIALS AND METHODS: A total of 100 female participants between 20 and 31 years of age who were referred to our radiology clinic for a dental check-up, including 59 SB and 41 non-SB patients, were sampled for the analysis. SB was diagnosed based on the American Academy of Sleep Medicine criteria. All teeth were evaluated on digital panoramic radiographs to detect pulpal calcifications, except third molars, teeth with root canal treatment, and teeth with root resorption. Binary logistic regression analysis was used to determine the risk factors for pulpal calcifications. The Spearman correlation coefficient was applied and the Pearson chi-square test was used for categorical variables. To test intra-examiner reproducibility, Cohen kappa analysis was applied. P values 0.05). In SB patients, the total number of pulpal calcifications was 129, while in non-SB patients, it was 84. Binary logistic analysis showed that SB was not a risk factor for the presence of pulpal calcifications (odds ratio, 1.19; 95% CI, 0.52–2.69, P>.05). CONCLUSION: No relationship was found between SB and pulpal calcifications.

Qualidade do Sono e da Sonolência Diurna em Estudantes de Fisioterapia de uma Instituição na Amazônia Brasileira / Sleep Quality and Daytime Sleepiness with Students of physiotherapy in an Institution from the Brazilian Amazon

Introdução: A importância do sono vai além da obviedade de uma necessidade fisiológica básica, pois passa também pela possibilidade da existência de distúrbios à saúde humana decorrentes de sua privação. Além da má qualidade do sono e da sonolência diurna, a restrição do sono pode ser causadora de inúmeros problemas aos indivíduos. Objetivos: esta investigação pretendeu avaliar a qualidade do sono e o nível de sonolência diurna de acadêmicas do curso de Fisioterapia entre diferentes campi e períodos do curso em uma instituição de ensino superior pública do estado do Pará. Métodos: Participaram 156 alunas que responderam aos questionários autoaplicáveis: Índice de Qualidade de Sono de Pittsburgh (PSQI) e Escala de Sonolência de Epworth (ESE). Os dados foram tratados por meio de frequência absoluta e relativa, utilizando o Excel (Office 2010) com teste de qui-quadrado para as proporções da amostra estudada e o Teste T student no aplicativo BioEstat 5.3, com p<0.05 para significância estatística. Resultados: Foi verificada a qualidade de sono ruim (PSQI =5 - 10) em 60,25% (n=94) da amostra geral. Foi visto ainda que 52,56% das pessoas avaliadas sofrem de sonolência diurna excessiva. Evidenciou-se que estudantes com sonolência diurna excessiva eram os que demonstravam ter qualidade do sono pior, observando-se resultados significativos entre qualidade de sono e sonolência diurna. Conclusão: Verificou-se, portanto, a presença de sonolência diurna em metade das estudantes de fisioterapia e a predominância de má percepção do sono em quase totalidade da referida amostra. Recomenda-se, fortemente, que sejam feitos novos estudos visando analisar, de forma mais integral e profunda, a sonolência diurna e a qualidade de sono entre essas estudantes. (AU)

Introduction: The importance of sleep goes beyond the obvious basic of a physiological need, but also because of the possibility of disturbances to human health due to its deprivation. In addition to poor sleep quality and daytime sleepiness, restricting sleep can be a problem for many individuals. Objectives: This research aimed to evaluate the quality of sleep and the level of daytime sleepiness of students attending physiotherapy courses from different campuses and periods at a public higher education institution in the state of Pará. Methods: 156 students who answered the self-administered questionnaires included: Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESE). Data were treated using absolute and relative frequency, using Excel (Office 2010) with chi-square test for the proportions of the sample studied and Student's T test in the BioEstat 5.3 application, with p <0.05 for statistical significance. Results: Poor sleep quality (PSQI = 5 - 10) was verified in 60.25% (n = 94) of the general sample. It was also observed that 52.56% of those evaluated suffer from excessive daytime sleepiness. Evidencing that students with excessive daytime sleepiness were those who showed worse sleep quality, significant results were observed as to sleep quality and daytime sleepiness. Conclusion: The presence of daytime sleepiness in half of the physiotherapy students and the predominance of poor sleep perception were verified in almost all of the entire sample. We strongly recommend that further studies be carried out in order to analyze in a more integral and profound way the daytime sleepiness and sleep quality among. (AU)

Application of noninvasive positive pressure ventilation for sleep disordered breathing in China / 临床耳鼻咽喉头颈外科杂志

After more than 30 years of development, noninvasive positive pressure ventilation (NPPV) has become one of the main treatments of sleep-disordered breathing (SDB) in the world. It is the wide application of this technology that makes breakthrough in SDB treatment, and has given rise to a new interdisciplinary area sleep medicine. In China, sleep medicine started in late of 1980's, in recent years, with the development of economy and the improvement of recognization, the application of NPPV in Chinese market has become one of the fastest growing in the world. NPPV technology also extends gradually to the treatments of patients with respiratory failure due to different causes, such as severe acute respiratory syndrome and COPD.

Sleep Forensics: a critical review of the literature and brief comments on the Brazilian legal situation / Medicina do sono Forense: uma revisao critica da literatura e breves comentarios sobre a situacao brasileira

Sleep medicine is a relatively new field among Medical Sciences. Its legal aspects are still obscure, either for lack of knowledge of the biological mechanisms underlying violent behaviour during sleep or the virtual absence of clear legal and uniformly accepted guidelines as to whether to punish or treat those disorders. An updated review of the pertinent literature was performed to determine the most prevalent pathological conditions involving violence and sleep and to identify their most common precipitating factors, attempting to provide some technical support to aid Brazilian medical-experts or assistants in preparing substantial and scientific-based reports in a legal environment.

A medicina do sono é um campo relativamente novo dentro das Ciências Médicas. Seus aspectos legais encontram-se ainda na obscuridade, seja por falta de conhecimento dos mecanismos biológicos do desenvolvimento dos transtornos de comportamento e da violência praticada em estados alterados de sono, seja por virtual ausência de previsão legal do binômio tratamento/punição. Realizamos revisão atualizada da literatura para determinar as condições patológicas mais prevalentes envolvendo violência e sono, identificar seus fatores precipitantes mais comuns e os critérios médico-legais que podem auxiliar eventuais médicos-peritos ou assistentes na elaboração de pareceres abalizados em âmbito legal.

Sleep medicine services in Saudi Arabia: The 2013 national survey

We conducted this national survey to quantitatively assess sleep medicine services in the Kingdom of Saudi Arabia [KSA] and to identify obstacles that specialists and hospitals face, precluding the establishment of this service. A self-administered questionnaire was designed to collect the following: General information regarding each hospital, information regarding sleep medicine facilities [SFs], the number of beds, the number of sleep studies performed and obstacles to the establishment of SFs. The questionnaire and a cover letter explaining the study objectives were mailed and distributed by respiratory care practitioners to 32 governmental hospitals and 18 private hospitals and medical centers in the KSA. The survey identified 18 SFs in the KSA. The estimated per capita number of beds/year/100,000 people was 0.11 and the per capita polysomnography [PSG] rate was 18.0 PSG/year/100,000 people. The most important obstacles to the progress of sleep medicine in the KSA were a lack of trained sleep technologists and a lack of sleep medicine specialists. The sleep medicine services provided in the KSA have improved since the 2005 survey; however, these services are still below the level of service provided in developed countries. Organized efforts are needed to overcome the identified obstacles and challenges to the progress of sleep medicine in the KSA

Sleep spindles: validated concepts and breakthroughs: [review]

INTRODUCTION: Sleep spindles, the hallmark of sleep synchronization in stage 2 non-REM sleep, are rhythmic and monomorphic waves, between 10 and 14 Hz, with a maximum amplitude in the vertex (Cz), with bilateral irradiation to central regions (C3 and C4). OBJECTIVE: In this article we present an overview of sleep spindles ranging from well established concepts of morphology, generation mechanisms, maturational features, abnormal patterns and pathological aspects since the knowledge is important to identify the normal and abnormal patterns. CONCLUSION: Centro-parietal and frontal spindle are normal pattern and extreme spindle is abnormal, mostly found in children mentally retarded up to 5 years-old. In this review research boundaries of memory consolidation, synaptic potentiation and brain plasticity were also presented.

INTRODUÇÃO: Fusos de sono, marco da sincronização do sono no estágio 2 do sono não-REM, são ondas rítmicas e monomórficas, entre 10 e 14 Hz, com amplitude máxima no vértex (Cz), e irradiação bilateral para áreas centrais (C3 e C4). OBJETIVO: Neste artigo apresentamos uma revisão sobre fusos de sono abrangendo conceitos bem estabelecidos de morfologia, mecanismos de geração, características maturacionais, padrões anormais e aspectos patológicos, uma vez que o conhecimento se faz necessário para a identificação de padrões normais e patológicos. CONCLUSÕES: Fusos centro-parietal e frontal são padrões fisiológiocs normais do sono fase 2 enquanto fusos extremos é um padrão patológico encontrado em crianças abaixo de 5 anos com retardo mental. Fronteiras da pesquisas quanto à consolidação da memória, potenciação sináptica e plasticidade cerebral também foram revisados.