ABSTRACT
Los trastornos del sueño son frecuentes en la población y una causa importante de morbilidad. El objetivo de esta revisión es evaluar las alteraciones del sueño en periodos de emergencia y desastres. A lo largo de la historia, la esfera biopsicosocial y el sueño de las personas ha sido abrumada por múltiples eventos a gran escala, tales como desastres naturales, tragedias provocadas por el hombre, conflictos bélicos, crisis sociales y pandemias, cuya experiencia puede derivar en problemas de salud a corto, mediano y/o largo plazo. En los estudios analizados, se ha observado el impacto negativo de las emergencias y desastres en el sueño, por lo que ha cobrado gran relevancia la difusión y promoción de medidas que incentiven el buen dormir. Debido a la llegada del COVID-19 y a la situación de confinamiento por periodos prolongados en el hogar para prevenir su propagación, han surgido importantes consecuencias a nivel social. Ciertos factores ocupacionales y características de los desastres se asocian a mayor comorbilidad, un alto riesgo de experimentar agotamiento físico, trastornos psicológicos e insomnio en grupos altamente vulnerables, como lo son los profesionales de la salud, rescatistas y socorristas. El insomnio es el trastorno de sueño más frecuente en la población general y su empeoramiento en el contexto de pandemia por COVID-19 representa un nuevo problema en salud pública. Es por ello, que es indispensable promover campañas de prevención de salud física y mental orientados a la pesquisa precoz y manejo de patologías de la esfera psicosocial, dentro de las posibilidades socioeconómicas.
Sleep disorders are common in the population and are major cause of morbidity. The objective of this review is to assess sleep disturbances in times of emergency and disasters. Throughout history, the biopsychosocial field and sleep have been affected by multiple large-scale events, such as natural disasters, man-caused tragedies, armed conflicts, social crises and pandemics, the experience of which can lead to short, medium and/or long term health problems. In several studies, the negative impact of emergencies and disasters on sleep have been analyzed, emphasizing the importance of the diffusion and promotion of measures that encourage good sleep. The arrival of COVID-19 and consequent home confinement for prolonged periods caused important social consequences. Certain occupational factors and characteristics of disasters are associated with greater comorbidity: a high risk of experiencing physical exhaustion, psychological disorders and insomnia, especially in highly vulnerable groups, such as health professionals, rescuers and first aids-responders. Insomnia is the most frequent sleep disorder in the general population and its worsening in the context of the COVID-19 pandemic, represents a new public health problem. It is essential to promote physical and mental health prevention campaigns, aimed at early screening and management of pathologies in the psychosocial sphere, within socioeconomic possibilities.
Subject(s)
Humans , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/psychology , Sleep Wake Disorders/prevention & control , Disaster Emergencies , Quarantine , Health Personnel/psychology , Disasters , Pandemics , Emergency Responders/psychology , COVID-19 , Sleep Initiation and Maintenance Disorders/classification , Sleep Initiation and Maintenance Disorders/diagnosisABSTRACT
El Síndrome de Treacher Collins (STC) es una enfermedad congénita del desarrollo craneofacial, siendo una complicación frecuente la obstrucción de la vía aérea. Objetivo: Describir clínicamente tres casos de STC y sus hallazgos polisomnográficos. Diseño: Estudio observacional, descriptivo y retrospectivo. Revisión de fichas clínicas y polisomnografías (PSG). Resultados: Se incluyeron tres pacientes con STC, de 1, 17 y 20 años, dos hombres. Todos presentaron malformaciones faciales compatibles con el STC. El paciente menor tuvo apneas desde el nacimiento. En las PSG, todos presentaron eficiencia del sueño disminuida e índice de microdespertares aumentado. Solo un paciente tuvo diagnóstico de Síndrome de Apnea/Hipoapnea Obstructiva del Sueño (SAHOS) severo. Conclusiones: Aún cuando las anomalías craneofaciales no difirieron entre los pacientes, hubo sólo un caso de SAHOS severo. Las otras alteraciones descritas en la PSG afectan la calidad de vida, siendo relevante la búsqueda activa de trastornos respiratorios del sueño en estos pacientes.
Treacher Collins Syndrome (STC) is a congenital craniofacial disorder, being the airway obstruction a frequent complication. Objective: To describe clinical and polysomnographic findings of three cases with STC. Methods: An observational, descriptive and retrospective study. Review of clinical records and nocturnal polysomnography was carried out. Results: Three patients with STC were included of 1, 17 and 20 years old, two were males. All of them with facial malformations compatible with STC. Only the youngest presented apneas since birth. All patients had decreased sleep efficiency and increased arousal index. Only one patient presented with severe Obstructive Sleep Apnea Syndrome (OSAS). Conclusions: Despite the fact that all the patients had similar craniofacial anomalies, only one presented with severe OSAS. The other abnormalities described in the polysomnography affect the quality of life, being relevant performing an active screening of breathing-related sleep disorders in these patients.
Subject(s)
Humans , Male , Female , Infant , Adolescent , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/etiology , Polysomnography/methods , Mandibulofacial Dysostosis/complications , Phenotype , Retrospective Studies , Sleep Apnea, Obstructive/etiologyABSTRACT
Congenital central hypoventilation syndrome (CCHS) and rapid-onset obesity syndrome with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) are rare causes of hypoventilation during sleep in the pediatric population. This group of disorders are characterized by the absence or decrease in the automatic control of ventilation, decreased sensitivity of chemoreceptors to CO2, causing hypoventilation during sleep and even in wakefulness, in the most severe cases. For these reasons it is important to diagnose and treat them promptly. The objective of this review is to provide current and complete literature, to be able to identify, treat and refer this group of children early, and thus reduce the complications and/or associated comorbidities in the short and long term, improving their quality of life.
El síndrome de hipoventilación central congénita (CCHS) y síndrome de obesidad de inicio rápido con disfunción hipotalámica, hipoventilación y desregulación autonómica (ROHHAD), son causas poco comunes de hipoventilación durante el sueño en la población pediátrica. Este grupo de trastornos se caracterizan por ausencia o disminución en el control automático de la ventilación, sensibilidad disminuida de los quimioreceptores al CO2, provocando hipoventilación durante el sueño e incluso en vigilia, en los casos más severos. Por estas razones es importante diagnosticarlos y tratarlos oportunamente. El objetivo de esta revisión es proporcionar literatura actual y completa, para poder identificar, tratar y referir a éste grupo de niños tempranamente, y así disminuir las complicaciones y/o comorbilidades asociadas a corto y largo plazo, mejorando su calidad de vida.
Subject(s)
Humans , Child , Obesity Hypoventilation Syndrome/physiopathology , Sleep Wake Disorders/physiopathology , Hypoventilation/physiopathology , Obesity Hypoventilation Syndrome/complications , Prognosis , Respiration, Artificial , Sleep , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/etiology , Sleep Wake Disorders/therapy , Polysomnography , Hypoventilation/complications , Hypoventilation/congenital , Hypoventilation/diagnosis , Hypoventilation/therapyABSTRACT
ABSTRACT Objective: To report a case of recurrent isolated sleep paralysis (RISP), a benign parasomnia with worrisome and frightening sleep paralysis episodes. Case description: We describe a case of RISP in a sixteen-year-old girl who seeks medical attention for anxiety symptoms. The sleep paralysis and associated auditory and tactile hallucinations began three years before with worsening in the last year, causing fear of sleeping. The episodes were intensely frightening causing negative impact in patient's sleep, school performance and social function. Medical conditions were excluded, and she started treatment with a selective serotonin reuptake inhibitor with complete resolution of symptoms. Comments: Sleep complaints are often devalued. Therefore, clinicians should actively ask their patients about their sleep during health assessment.
RESUMO Objetivo: Relatar um caso de paralisia do sono isolada e recorrente (PSIR), uma parassonia benigna com episódios inquietantes e assustadores de paralisia do sono. Descrição do caso: Descreve-se um caso de PSIR de uma adolescente de dezesseis anos que buscou cuidados médicos devido a sintomas de ansiedade. A paralisia do sono e as alucinações auditivas e táteis associadas haviam começado três anos antes, com agravamento no último ano, causando medo de dormir. Os episódios eram extremamente perturbadores, gerando um impacto negativo no sono, desempenho escolar e vida social da paciente. Condições médicas foram excluídas e começou um tratamento com um inibidor seletivo da recaptação de serotonina, com resolução completa dos sintomas. Comentários: Queixas relacionadas ao sono são frequentemente subvalorizadas. Portanto, os médicos devem perguntar aos seus pacientes sobre problemas relacionados com o sono durante a avaliação clínica.
Subject(s)
Humans , Female , Adolescent , Sleep Wake Disorders/diagnosis , Sleep Paralysis/complications , Sleep Paralysis/psychology , Fear/psychology , Anxiety/etiology , Anxiety/psychology , Recurrence , Sleep Wake Disorders/etiology , Social Change , Administration, Oral , Treatment Outcome , Fluvoxamine/administration & dosage , Fluvoxamine/therapeutic use , Selective Serotonin Reuptake Inhibitors/administration & dosage , Selective Serotonin Reuptake Inhibitors/therapeutic use , Sleep Paralysis/diagnosis , Sleep Paralysis/drug therapy , Diagnosis, Differential , Academic Performance/psychology , Hallucinations/etiology , Hallucinations/psychologyABSTRACT
Introducción: el objetivo de este estudio es develar si la técnica Neuromuscular Funcional (NMF) puede ser considerada como opción de tratamiento en el Síndrome de Apnea Obstructiva de Sueño (SAOS) y si se complementa con la Terapia Miofun-cional Orofacial o hace parte de ella.Métodos: la fenomenología trascendental de Husserl es el enfoque metodoló-gico que se adoptó para este estudio, siguiendo la ruta para su desarrollo: epojé, reducción trascendental fenomenológica y síntesis. El contenido real se obtuvo mediante dos entrevistas semiestructuradas, aplicadas a un informante clave que contó con los criterios de inclusión presupuestados. Resultados: en la primera etapa se identificaron 10 noesis y 266 noemas, que fue-ron relacionados entre sí; en la fase de reducción trascendental las noesis se redujeron a 5 y los noemas a 14. Análisis y discusión: el Método Chiavaro como fenómeno se decanta en las di-mensiones: (a) Enfoque Sistémico, (b) Técnica Neuromuscular Funcional y (c) Téc-nica Respiratoria. La prioridad del fenómeno NMF es la explicación de la alteración dentro del enfoque sistémico a partir de la lógica Función-Estructura-Función, de esta manera el SAOS se considera una manifestación de esas relaciones y como tal se le cataloga como adaptación o como función en disfunción.Conclusiones: la Técnica NMF hace parte de la neurorrehabilitación mientras que la TMO para intervenir el SAOS se inscribe en la fisiología del ejercicio
Introduction: the objective of this study is to reveal if the Functional Neuromuscu-lar technique (In Spanish: NMF) can be considered as a treatment option for OSA. Additionally, this paper seeks to assess if the aforementioned is derived from, a por-tion of or if it is complemented by Orofacial Myofunctional Therapy (OMT). Methods: Husserl's transcendental phenomenology is the methodological approach that was adopted for this study, following the path to its development: epoché, phenomenologi-cal transcendental reduction and synthesis. The actual content was obtained through two semi-structured interviews applied to a key informant who met the preconceived inclusion criteria.Results: in the first stage 10 noesis and 266 noems , which were related to each other, were identified; in the phase of transcendental reduction, the noesis were reduced to 5 and the noems to 14. Analysis and discussion: the Chiavaro Method as a phenomenon is composed of three dimensions: (a) Systemic Approach, (b) Functional Neuromuscular Technique and (c) Respi-ratory Technique. The priority of the NMF phenomenon is the explanation of the alteration within the systemic approach based on the Function-Structure-Function logic, ergo the OSA is considered a manifestation of these relationships and as such it is classified as adaptation or as a function in dysfunction.Conclusions: the NMF technique is a part of neurorehabilitation whilst OMT for the in-tervention of OSA is subscribed to the physiology of exercise.
Subject(s)
Humans , Apnea , Sleep Wake Disorders/diagnosis , Therapeutics/psychology , Sleep Apnea, Obstructive/diagnosis , Neurological Rehabilitation , Sleep , Therapeutics/methods , Facial Pain , Exercise , Sleep Apnea, Central/diagnosis , Speech, Language and Hearing Sciences , Mouth BreathingABSTRACT
El sueño es uno de los actos fisiológicos más importantes para la estructuración funcional y anatómica de áreas del sistema nervioso central. Las alteraciones del sueño durante la infancia y su relación con trastornos del neurodesarrollo es compleja y sumam ente interesante, donde destaca la multiplicidad de causas de estos trastornos. Bajo esta premisa se realiza una revisión sobre las alteraciones del sueño en los trastornos del neurodesarrollo (TND), por déficit de atención e hiperactividad (TDAH) y del espectro autista (TEA). El sueño está presente desde la etapa fetal y va modificando su expresión en sintonía con la madurez del sistema nervioso central. Los trastornos del sueño y su relación con TDAH, TEA y otros TND son complejos, pero existen avances sobre la etiología de los mismos. Una mayor compresión de las funciones pleiotrópicas de los genes implicados en los trastornos del ciclo vigilia-sueño y en las desviaciones del desarrollo neurológico podría conducir a nuevas estrategias diagnósticas y terapéuticas de manera precoz con el fin de mejorar la calidad de vida del paciente, familiares y cuidadores.
The development and establishment of the normal sleep patterns are very important processes in the final anatomical and physiological architecture of the central nervous system. The relationship between sleep disturbances during childhood with neurodevelopmental disorders is complex and potentially synergistic. Sleep patterns are present since the fetal period but their structure and physiology is modified according with the maturation of the central nervous system. Sleep disorders and their relationship with attention deficit hyperactivity disorders(ADHD), autism spectrum disorders(ASD) and other neurodevelopmental disorders (TDN) are not well understood yet, but significant progresses have been made in understanding associations and potential etiological correlations. We reviewed sleep disturbances in NDT, in ADHD and in ASD. A greater understanding of the pleiotropic functions of the genes involved in sleep-wake cycle disorders and deviations from neurological developme nt could lead to new diagnostic and therapeut ic strategies in an early stage in order to improve the quality of life of the patient, relatives and caregivers.
Subject(s)
Humans , Child, Preschool , Attention Deficit Disorder with Hyperactivity/complications , Sleep Wake Disorders/complications , Autism Spectrum Disorder/complications , Attention Deficit Disorder with Hyperactivity/genetics , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/genetics , Circadian Rhythm , Autism Spectrum Disorder/geneticsABSTRACT
A prevenção da fibrilação atrial (FA) envolve uma abordagem individualizada, multidisciplinar e integrada do paciente, que vai além da arritmia per se. Por se tratar de uma arritmia multifatorial e com fisiopatologia complexa, os pacientes com FA devem ser avaliados em sua integralidade, que inclui aspectos eletrocardiográficos, eletrofisiológicos, medidas comportamentais e otimização de tratamento de doenças crônicas, como hipertensão arterial e insuficiência cardíaca. Neste artigo descrevere-mos as principais intervenções estudadas na literatura com benefício na prevenção da fibrilação atrial
AF (atrial fibrillation) prevention involves an ndividualized, multidisciplinary and integrated approach taken by the patient, which emcompasses more than just arrhy- thmima per se. Because it is a multifactorial arrhythmia with complex physiopathology, patients with AF should undergo a complete assessment, including electrocardiographic and electrophysiological aspects, behavioral measures and optimization of the treatment of chronic diseases, such as hypertension and heart failure. In this article we describe the main interventions studied in literature that are beneficial in the prevention of atrial fibrillation
Subject(s)
Humans , Male , Female , Atrial Fibrillation/prevention & control , Anti-Arrhythmia Agents/therapeutic use , Arrhythmias, Cardiac/therapy , Sleep Wake Disorders/complications , Sleep Wake Disorders/diagnosis , Tobacco Use Disorder , Comorbidity , Risk Factors , Diabetes Mellitus , Secondary Prevention/methods , Heart Failure , Hypertension , ObesityABSTRACT
Objetivo: analisar a produção científica nacional e internacional relacionada aos instrumentos utilizados para avaliar padrão de sono em crianças com doenças crônicas. Método: revisão integrativa realizada em bases de dados (PubMed, Web of Science, CINHAL, LILACS, SciELO) que compreendeu o período de 2006-2016. Resultados: foram selecionados 16 artigos para compor a revisão e encontrados vários instrumentos confiáveis para avaliar o sono, porém nenhum adaptado para o Português do Brasil, com exceção da polissonografia e do actigraphy. Crianças com doenças crônicas apresentam distúrbios do sono que se correlacionavam com dor, fadiga, problemas de comportamento, falta de atividade física e obesidade. Conclusão: no Brasil, o uso de instrumentos específicos para avaliar o sono em crianças ainda é pouco explorado. A utilização desses instrumentos na prática clínica poderia auxiliar enfermeiros a traçarem estratégias para diminuir os distúrbios do sono na população infanto-juvenil.
Objective: to examine Brazilian and international scientific production on the use of sleep pattern assessment instruments in children with chronic diseases. Method: this integrative review was conducted on the PubMed, Web of Science, CINHAL, LILACS, and SciELO databases for 2006 to 2016. Results: 16 articles were selected for review, and several reliable sleep assessment instruments were found. However, none was adapted to Brazilian Portuguese, except for polysomnography and actigraphy. Children with chronic diseases have sleep disorders that correlate with pain, fatigue, behavior problems, lack of physical activity, and obesity. Conclusion: in Brazil, specific sleep assessment instruments are little used with children. Use of these instruments in clinical practice could help nurses to outline strategies to reduce sleep disorders among children and adolescents.
Objetivo: analizar la producción científica nacional e internacional en cuanto a los instrumentos utilizados para evaluar el patrón de sueño en niños con enfermedades crónicas. Método: se trata de una revisión integrativa realizada en bases de datos (PubMed, Web of Science, CINHAL, LILACS, SciELO) en el período de 2006-2016. Resultados: se seleccionaron 16 artículos para componer la revisión y se encontraron varios instrumentos confiables para evaluar el sueño, pero ninguno adaptado a Portugués de Brasil, con excepción de la polisomnografía y del actigrafía. Los niños con enfermedades crónicas presentan trastornos del sueño que se asocian con dolor, cansancio, problemas de comportamiento, falta de actividad física y obesidad. â¯Conclusión: en Brasil, el uso de instrumentos específicos para evaluar el sueño en niños todavía es poco explorado. La utilización de estos instrumentos en la práctica clínica podría ayudar a los enfermeros a trazar estrategias para disminuir los disturbios del sueño en la población infanto-juvenil.
Subject(s)
Child , Adolescent , Pediatric Nursing , Sleep Wake Disorders/diagnosis , Chronic Disease , Surveys and Questionnaires , Sleep/physiology , Data Collection/instrumentation , ReviewABSTRACT
Abstract Objectives This study proposed a version of the Children's Sleep Habits Questionnaire for infants under 12 months (CSHQ-I). Methods The sample was comprised of 299 infants, aged between 2 weeks and 12 months. Results Exploratory factor analysis revealed four subscales: Bedtime Resistance, Sleep Anxiety, Positive Sleep Habits, and Daytime Sleepiness. The CSHQ-I total scale presented good test-retest reliability and internal consistency. The CSHQ-I also showed good concurrent validity, with significant associations found between the CSHQ-I total scale and subscales and a measure of infant sleep-wake behaviors. Conclusions The present study suggested the CSHQ-I as a reliable instrument to assess sleep problems in infants during the first year of life.
Resumo Objetivos Este estudo propôs uma versão do Questionário de Hábitos de Sono das Crianças para bebés com menos de 12 meses (CSHQ-I). Métodos Amostra composta de 299 bebés, entre duas semanas e 12 meses. Resultados A análise fatorial exploratória revelou quatros subescalas: resistência a ir para a cama, ansiedade do sono, hábitos de sono positivos e sonolência diurna. A escala completa do CSHQ-I apresentou boa confiabilidade teste-reteste e consistência interna. O CSHQ-I também mostrou boa validade concorrente, com associações significativas encontradas entre a escala completa e subescalas do CSHQ-I e uma medida de comportamentos de sono-vigília dos bebés. Conclusões O presente estudo sugeriu o CSHQ-I como um instrumento confiável para avaliar os problemas de sono em bebés durante o primeiro ano de vida.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Rats , Sleep/physiology , Surveys and Questionnaires , Psychometrics , Sleep Wake Disorders/diagnosis , Socioeconomic Factors , Reproducibility of Results , Longitudinal Studies , Maternal AgeABSTRACT
Resumen: El presente estudio se orientó a analizar la Unidad de Sala de Pre-partos/ partos, la cual forma parte de una de las seis áreas que componen la Unidad de Obstetricia y Ginecología del Hospital Regional de Talca. El puesto se basa principalmente en el desarrollo sistémico de entrada, salida del personal y su estancia en el desarrollo de la actividad, debido a la exigencia laboral que presenta esta en cuanto a demandas físicas, psicológicas y organizacionales dentro del área de trabajo. Al ser considerada una unidad de urgencia, se caracteriza por presentar la mayor complejidad dentro del servicio, debido a que se evidencian casos de alto riesgo de pacientes y, por otro lado, situaciones programa das en el caso de cesáreas electivas e inducciones de parto. El levantamiento realizado permitió hallar factores de tiempos de traba jo y actividades, físicos (carga física, sobrecarga postural) y mentales (carga mental y factores psicosociales). Estos factores fueron evaluados por una lista de verificación, descripción de actividades, porcentaje de carga cardiovascular, evaluación de mobiliario de trabajo y medidas antropométricas, RULA, cuestionario de Pittsburgt (calidad del sueño) y la aplicación de la encuesta de riesgos psicosociales SUSESO-ISTAS 21. Se concluye que, al ir en aumento el porcentaje de pacientes que ingre san al servicio en situaciones programadas y de urgencia, se dificulta su atención en las unidades por falta de camas disponibles, complicación en su traslado y estadía en ellas. Por ello, se recomiendan soluciones que disminuyan la carga de trabajo y mejoren el ambiente laboral.
Abstract: The present study was oriented to analyze the Unit of Labor/Delivery Room, which is part of one of the six areas that make up the Obstetrics and Gynecology Unit of the Regional Hospital of Talca. The position is mainly based on the systemic development of entry, exit of staff and their stay in the development of the activity, due to the labor require ment that this presents in terms of physical, psychological and orga nizational demands within the work area. As an emergency unit, it is characterized by presenting the greatest complexity within the service, due to the fact that there are cases of high risk of patients and, on the other hand, situations programmed in the case of elective cesareans and labor induction. The data collected made possible to find factors of work times and activities, physical (physical load, postural overload) and mental (men tal load and psychosocial factors). These factors were evaluated by a checklist, description of activities, percentage of cardiovascular load, evaluation of work furniture and anthropometric measurements, RULA, Pittsburgt questionnaire (quality of sleep) and the application of the psychosocial risk survey SUSEO-ISTAS twenty-one. It is concluded that, as the percentage of patients entering the service in programmed and urgent situations increases, it becomes difficult for them to attend to the units due to the lack of available beds, com plication in their transfer and stay in them. Therefore, solutions that reduce the workload and improve the work environment are recom mended.
Subject(s)
Humans , Health Personnel , Delivery Rooms , Ergonomics , Posture , Quality of Life , Sleep Wake Disorders/diagnosis , Chile , Anthropometry , Surveys and Questionnaires , Risk Factors , Workload , Workplace , Emergency Service, Hospital , Occupational Stress/diagnosis , Hospitals, Public , Interior Design and FurnishingsABSTRACT
El diagnóstico y tratamiento de los trastornos de sueño, especialmente los asociados al Ritmo Circadiano, utilizan métodos costosos, invasivos e incómodos tanto para los pacientes como para los médicos, quienes deben realizar un seguimiento de los hábitos de sueño. La actigrafía ha sido aceptada como una herramienta válida para el estudio y diagnóstico de trastornos circadianos. Más de 300 dispositivos se comercializan actualmente para el uso personal, pero pocos de estos han sido probados para un uso diagnóstico. En este estudio comparativo compuesto por 21 sujetos, se informa acerca de los patrones de sueño y actividad registrados por algunos dispositivos, como Micro-Mini Motionlogger Watch, Condor Act Trust, MisFit Flash y Fitbit Flex. No se observan diferencias significativas en el análisis del patrón de actividad de descanso entre dispositivos. Tampoco se observan para el sueño Onset (inicio), el Tiempo Total de Sueño y la Eficiencia del Sueño. Según el tipo de estudio y análisis deseado, éstos dispositivos pueden resultar alternativos para los registros de actividad y sueño.
This is a comparative analysis of actigraphy performance in comparison with different sleep Parameters. Actigraphy is a non-invasive and valid method of monitoring human rest activity cycles. The report describes the role of actigraphy to assess the study of sleep-wake patterns and circadian rhythms, evaluating its development as a diagnostic tool, with a comparative analysis of actigraphy performance in comparison with different sleep parameters. The diagnosis and treatment of sleep disorders, especially those associated with the cicardian rhythm, employ very expensive costs, invasives or unconfortable for the patients the same as for physicians, who must perform a demand of the sleeping habits. The International Classification of Sleep Disorders has identified more than 80 sleep disorders, all of them have associated treatments. Actinography has been accepted as a valid tool for the study and diagnosis of circadian disorders. All these aspects are discussed in the article
Subject(s)
Humans , Adult , Sleep Wake Disorders/diagnosis , Analysis of Variance , Sleep Disorders, Circadian Rhythm/diagnosis , Actigraphy/methodsABSTRACT
Este artigo (2/2) compõe uma revisão sobre fundamentos do sono e transtornos do sono (TS), sendo aqui considerados: 1-Incapacidade de dormir na hora desejada-atraso de fase, avanço de fase, ''jet lag'', ritmo sono-vigília irregular, sono/vigília de livre curso, transtornos dos trabalhadores em turnos; 2-Movimentos ou comportamentos anormais durante o sono. Este segundo grupo é aqui subdividido em: A1-Parassonias relacionadas ao sono NREM (Non-rapid eye movement) despertar confusional, sonambulismo, terror noturno, síndrome da cabeça explosiva, alucinações relacionadas ao sono, enurese noturna e parassonias causadas por doenças e medicações; A2-Parassonias relacionadas ao sono REM (rapid eye movement) - transtorno comportamental do sono REM, pesadelos, paralisias recorrentes isoladas do sono, promulgação sono ''dream enactment behavior"; B-Transtornos do movimento relacionados ao sono-bruxismo, síndrome das pernas inquietas, movimentos periódicos das pernas, câimbras do sono, movimentos rítmicos relacionados ao sono, mioclonias proprioespinhais do início do sono, movimentos relacionados à medicação, mioclonias em doenças sistêmicas e mioclonias benignas do sono em bebês.(AU)
This is the second part (2/2) of an article that intends to review major topics regarding sleep fundamentals and sleep disorders (SD), now considering: 1-Circadian rhythm disorders-delayed onset sleep phase disorder, advanced onset sleep phase disorder, jet lag, irregular sleep-wake rhythm, free-running type, shift work type; 2-Abnormal movements or behaviours during sleep. This second category is divided in two groups: A1-NREM (Non-rapid eye movement) parasomnias confusional awakening, sleepwalking, night terrors, explosive head syndrome, sleep-related hallucinations, nocturnal enuresis and parasomnias related to diseases or medications; A2-REM (Rapid eye movement) parasomnias-REM sleep behaviour disorder, nightmares, recurrent isolated sleep paralysis, dream enactment behaviour; B-Sleep related movement disorders-bruxism, restless legs syndrome, periodical limb movement disorders, nocturnal leg cramps, sleep related rhythmic movement disorder, propriospinal myoclonus, movements related to medication use, myoclonus related to systemic diseases and benign myoclonus of sleep.(AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Sleep Wake Disorders/diagnosis , Sleep Disorders, Circadian Rhythm/diagnosis , Sleep Disorders, Circadian Rhythm/drug therapy , Parasomnias/diagnosis , REM Sleep Behavior Disorder/diagnosis , REM Sleep Behavior Disorder/drug therapy , Clonazepam/therapeutic use , Melatonin/therapeutic use , Movement DisordersABSTRACT
RESUMO Objetivo Correlacionar o sono e o comportamento em indivíduos com transtorno específico da aprendizagem. Método Na análise do sono, foram utilizados o Questionário de Hábitos Gerais de Sono, o Diário de Sono e a Escala de Distúrbios do Sono em Crianças (EDSC) e, para análise do comportamento, foi utilizado o Child Behavior Checklist (CBCL). Resultados 65,5% dos indivíduos com transtorno específico de aprendizagem apresentaram indicativo de distúrbios de sono, sendo os mais frequentes os distúrbios de transição sono-vigília e escores totais para distúrbios de sono acima do aceitável. Além disso, os indivíduos com transtorno específico de aprendizagem apresentaram maior latência de sono que o respectivo grupo controle. Quanto ao comportamento, 72,4% dos indivíduos com transtorno específico de aprendizagem apresentaram quadro clínico de problemas comportamentais. No grupo controle, nenhum dos participantes apresentou indicativo de problemas de sono ou comportamento. No grupo transtorno específico de aprendizagem, os distúrbios de sono encontrados apresentaram correlação com os problemas comportamentais. Conclusão Indivíduos com transtorno específico da aprendizagem apresentaram altos índices de distúrbios de sono e alterações comportamentais. Quanto piores os distúrbios de sono, piores foram os aspectos comportamentais dos indivíduos com transtorno específico da aprendizagem.
ABSTRACT Purpose This study aimed to correlate sleep profile and behavior in individuals with Specific Learning Disorder (SLD). Methods The Sleep General Habits Questionnaire, Sleep Diary, and Sleep Disturbance Scale for Children (SDSC) were used in analysis of sleep, whereas the Child Behavior Checklist (CBCL) inventory was used in analysis of behavior. Results 65.5% of the individuals with SLD presented symptoms of sleep disorders, most frequently wakefulness-sleep transition and sleep disturbance total score, which showed values higher than acceptable. In addition, individuals with SLD presented higher sleep latency than those with typical development. Concerning behavior, 72.4% of the individuals with SLD presented clinical condition of behavior problems. In the control group, none of the participants showed symptoms of sleep or behavior problems. In the SLD group, correlation was observed between behavioral problems and sleep disturbance. Conclusion Individuals with SLD showed high rates of sleep disturbance and behavioral problems. The worse the sleep disturbance, the worse the behavioral aspects in these individuals.
Subject(s)
Humans , Male , Female , Child , Sleep Wake Disorders/complications , Specific Learning Disorder/complications , Sleep Wake Disorders/diagnosis , Case-Control Studies , Surveys and Questionnaires , ChecklistABSTRACT
Esta é uma primeira parte (1/2) da abordagem de fundamentos do sono e transtornos do sono (TS) sobre aspectos: neurobiológicos (neuroanatômicos, neuroquímicos e fisiológicos); clínicos (anamnese e exame físico; exames subjetivos - questionários e escalas; exames objetivos - polissonografia, teste de latências múltiplas e actigrafia). É valorizada a terceira Classificação Internacional dos Transtornos do Sono (ICSD-3) para abordar aspectos clínicos, diagnósticos e terapêuticos, segundo as quatro queixas principais referentes dos TS: Insônia, Sonolência excessiva diurna, Movimentos e comportamentos anormais durante o sono e Incapacidade de dormir na hora desejada. Neste artigo abordamos apenas: 1-Insônia - dificuldade em adormecer ou manter-ser dormindo, acordar cedo, ou um distúrbio na qualidade do sono que faz com que o sono pareça inadequado ou não restaurador; duração: aguda ou crônica; 2- Sonolência excessiva diurna; consequente a distúrbios do sono, privação do sono; distúrbios centrais da hipersonia; distúrbios médicos ou psiquiátricos. (AU)
This is the first part (1/2) on this paper about sleep fundamentals and sleep disorders (TS) questions: neurobiological (neuroanatomical, neurochemical and physiological); clinical (anamnesis and physical examination; subjective exams - questionnaires and scales; objective examinations - polysomnography, multiple latency tests and actigraphy). The third International Classification of Sleep Disorders (ICSD-3) is valued to address clinical, diagnostic and therapeutic aspects, according to the four main complaints regarding TS: Insomnia, Excessive daytime drowsiness, Abnormal movements and behaviors during sleep, and Inability to sleep at the desired time. In this paper, it is discussed the only first two: 1-Insomnia: difficulty falling as-leep, staying asleep, early morning waking, non- restorative sleep, quality of sleep, and amount of sleep; duration: acute or chronic. (AU)
Subject(s)
Humans , Sleep Wake Disorders/classification , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/drug therapy , Polysomnography/methods , Sleep Disorders, Circadian Rhythm/diagnosis , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/drug therapyABSTRACT
Se cree que los ancianos necesitan dormir menos. Sin embargo, no es la necesidad de sueño sino la capacidad de dormir lo que disminuye con la edad, en paralelo a la mayor prevalencia de enfermedades cardiovasculares o metabólicas, o de depresión. Poco se ha descripto sobre los hallazgos polisomnográficos de esta población. En el presente estudio analizamos los hallazgos polisomnográficos en pacientes mayores de 65 años. Se realizó un estudio descriptivo a partir del análisis de una base de datos de 551 pacientes mayores de 65 años evaluados entre junio de 2013 y diciembre de 2014. Todos los sujetos se realizaron una polisomnografía (PSG) nocturna de 6 horas de duración. Las variables analizadas fueron: latencia de sueño (LS), eficacia de sueño (ES), latencia de fase REM (Lat R), % de R, índice de apneas hipopneas (IHA) y movimientos periódicos de piernas durante el sueño (PLMS). Se dividió la población en 3 grupos: G1: de 65 a 70 años; G2: 71 a 75; G3: mayor de 75 años. Se analizaron los datos de la serie general y las diferencias intergrupos. El IHA se incrementó con la edad y resultó más severo en los pacientes mayores de 75 años en relación con el grupo de menor edad. El incremento del IAH no se asoció a un incremento del índice de masa corporal ni a mayor somnolencia diurna. (AU)
It is believed that the elderly need less sleep. However, it is not the need for sleep but the ability to sleep that decreases with age, in parallel to the increasing prevalence of cardiovascular or metabolic disease, or depression. Little has been described about the polysomnographic findings of this population, hypothesizing that there are several alterations that prematurely corrected could improve the quality of life as the years go by. We analyzed the polysomnographic findings in patients over 65 years of age. A descriptive study was carried out based on the analyses of a database of 551 patients over 65 years of age evaluated between June 2013 to December 2014. All subjects underwent nocturnal PSG of 6 hours duration. The polysomnographic variables analyzed were: sleep latency (LS), sleep efficiency (ES), latency R phase (Lat R), % R, Apneas Hypoapneas Index (AHI) and Periodic Limb Movements of Sleep (PLMS). The population was divided into 3 groups: G1: from 65 to 70 years G2: 71 to 75, G3 greater than 75. AHI increased with age, being more severe in patients over 75 years of age in relation to the younger age group. The increase in AHI was not associated with an increase in Body Mass Index (BMI) or greater daytime sleepiness. (AU)
Subject(s)
Humans , Male , Female , Aged , Polysomnography/statistics & numerical data , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Apnea Syndromes/diagnosis , Sleep Apnea Syndromes/physiopathology , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/etiology , Sleep Wake Disorders/prevention & control , Cardiovascular Diseases/complications , Body Mass Index , Epidemiology, Descriptive , Age Factors , Sleep Disorders, Circadian Rhythm/diagnosis , Sleep Disorders, Circadian Rhythm/physiopathology , Nocturnal Myoclonus Syndrome/diagnosis , Nocturnal Myoclonus Syndrome/physiopathology , Depression/complications , Sleep Latency/physiology , Sleepiness , Sleep Initiation and Maintenance Disorders/prevention & control , Metabolic Diseases/complicationsABSTRACT
Distúrbios do sono são os mais comuns sintomas não-motores encontrados na doença de Parkinson (DP). OBJETIVOS: Avaliar a relação entre actigrafia e distúrbios do sono mais incidentes na DP. MÉTODOS: Pacientes com e sem DP foram avaliados quanto aos sintomas motores, qualidade do sono, cronotipo e objetivamente através do uso do actímetro. RESULTADOS: Encontrou-se uma significante redução da qualidade do sono entre os pacientes com DP (p = 0.0023), uma pior qualidade subjetiva do sono, maior uso de medicamentos para insônia, mais distúrbios do sono e uma maior fragmentação do ritmo atividade-repouso (IV) (p=0.0271). CONCLUSÃO: Pacientes com DP possuem uma pior qualidade de sono e um ritmo atividade-repouso mais fragmentado. A actigrafia pode ser útil na avaliação da qualidade do sono e do ciclo atividade repouso em pacientes com DP, contribuindo para o rastreio e acompanhamento de eventuais distúrbios do ritmo circadiano a esta doença associados. (AU)
Sleep disorders are the most common non-motor symptom found in Parkinson's Disease (PD). OBJECTIVES: To evaluate the relationship between actigraphy and more incidents sleep disorders in PD. METHODS: Patients with and without PD were assessed regarding motor symptoms, sleep quality, chronotype and objectively through the use of an actimeter. RESULTS: It was found a significant reduction of sleep quality among the patients with PD (p = 0.0023), a worse subjective sleep quality, they used more medications to sleep, they had more sleep disorders and a significantly higher fragmentation of pace (IV) (p = 0.0271). CONCLUSION: Patients with PD have a worse sleep quality and a rest-activity rythm fragmented. Actigraphy can be useful for assessing the quality of sleep and activity/rest cycle in patients with PD, contributing to the screening and follow-up of any circadian rhythm disorders associated to this disease. (AU)
Subject(s)
Humans , Male , Female , Aged , Parkinson Disease/complications , Parkinson Disease/diagnosis , Sleep Wake Disorders/diagnosis , Actigraphy/methods , Symptom Assessment/methods , Motor Disorders , Sleep Wake Disorders/etiology , Case-Control Studies , REM Sleep Behavior Disorder/diagnosisABSTRACT
OBJECTIVES: While respiratory distress is accepted as the only indication for diaphragmatic plication surgery, sleep disorders have been underestimated. In this study, we aimed to detect the sleep disorders that accompany diaphragm pathologies. Specifically, the association of obstructive sleep apnea syndrome with diaphragm eventration and diaphragm paralysis was evaluated. METHODS: This study was performed in Süreyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital between 2014-2016. All patients had symptoms of obstructive sleep apnea (snoring and/or cessation of breath during sleep and/or daytime sleepiness) and underwent diaphragmatic plication via video-assisted mini-thoracotomy. Additionally, all patients underwent pre- and postoperative full-night polysomnography. Pre- and postoperative clinical findings, polysomnography results, Epworth sleepiness scale scores and pulmonary function test results were compared. RESULTS: Twelve patients (7 males) with a mean age of 48 (range, 27-60) years and a mean body mass index of 25 (range, 20-30) kg/m2 were included in the study. Preoperative polysomnography showed obstructive sleep apnea syndrome in 9 of the 12 patients (75%), while 3 of the patients (25%) were regarded as normal. Postoperatively, patient complaints, apnea hypopnea indices, Epworth sleepiness scale scores and pulmonary function test results all demonstrated remarkable improvement. CONCLUSION: All patients suffering from diaphragm pathologies with symptoms should undergo polysomnography, and patients diagnosed with obstructive sleep apnea syndrome should be operated on. In this way, long-term comorbidities of sleep disorders may be prevented.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Diaphragmatic Eventration/physiopathology , Diaphragm/physiopathology , Polysomnography/methods , Respiratory Paralysis/physiopathology , Sleep Apnea, Obstructive/physiopathology , Sleep Wake Disorders/physiopathology , Diaphragmatic Eventration/diagnosis , Forced Expiratory Volume/physiology , Postoperative Period , Preoperative Period , Reference Values , Reproducibility of Results , Respiratory Paralysis/diagnosis , Severity of Illness Index , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/surgery , Sleep Wake Disorders/diagnosis , Statistics, Nonparametric , Supine Position/physiology , Vital Capacity/physiologyABSTRACT
Whether sleep problems of menopausal women are associated with vasomotor symptoms and/or changes in estrogen levels associated with menopause or age-related changes in sleep architecture is unclear. This study aimed to determine if poor sleep in middle-aged women is correlated with menopause. This study recruited women seeking care for the first time at the menopause outpatient department of our hospital. Inclusion criteria were an age ≥40 years, not taking any medications for menopausal symptoms, and no sleeping problems or depression. Patients were assessed with the Pittsburgh Sleep Quality Index (PSQI), modified Kupperman Index (KI), and Menopause Rating Scale (MRS). A PSQI score of <7 indicated no sleep disorder and ≥7 indicated a sleep disorder. Blood specimens were analyzed for follicle-stimulating hormone and estradiol levels. A total of 244 women were included in the study; 103 (42.2%) were identified as having a sleep disorder and 141 as not having one. In addition, 156 (64%) women were postmenopausal and 88 (36%) were not menopausal. Follicle-stimulating hormone and estradiol levels were similar between the groups. Patients with a sleep disorder had a significantly higher total modified KI score and total MRS score (both, P<0.001) compared with those without a sleep disorder. Correlations of the PSQI total score with the KI and MRS were similar in menopausal and non-menopausal women. These results do not support that menopause per se specifically contributes to sleep problems.
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Estrogens/blood , Menopause/blood , Sleep Wake Disorders/etiology , Behavior Rating Scale , Depression/diagnosis , Estradiol/blood , Follicle Stimulating Hormone/blood , Hot Flashes/complications , Outpatients , Postmenopause/blood , Quality of Life , Surveys and Questionnaires , Sweating , Symptom Assessment , Sleep Wake Disorders/blood , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/physiopathologyABSTRACT
This study came up with the main objective to inspect the sleep quality and sleep disorders among traffic agents in Rio de Janeiro, Brazil. A cross-sectional and descriptive study was carried out in which 118 traffic agents were surveyed. To this end, the Pittsburgh Quality of Sleep Index (PSQI) questionnaire was administered. The results demonstrate that the mean PSQI global score was 8.5 ± 2.4. Thirty four subjects had high sleep quality and 84 had low sleep quality. Global PQSI scores had a mean of 3.5 ± 1.37. Those categorized as low sleep quality ranged from 6-12 with a mean of 7.52 ± 1.64. Related to the usual medications, drugs most commonly used are those intended for the treatment of anxiety (9.32%), sleep inducers (10.17%), hypertension (24.58%), anti-depressants (16%), and analgesics (30.51%). The relationship of insomnia severity to age was significant from a statistical point of view (p = 0.001). Poor sleep quality has a negative impact on general health and well-being and can produce signs and symptoms associated with concussions. The relatively moderate sleep deficits experienced by subjects in this study did not affect, at first, the performance on professional activities.
Este estudio surgió con el objetivo principal de inspeccionar la calidad del sueño y trastornos del sueño entre los agentes de tránsito en Río de Janeiro, Brasil. Un estudio transversal y descriptivo se llevó a cabo en el que se encuestó a 118 agentes de tránsito. Para este fin, fue administrado el cuestionario Índice de Calidad del sueño de Pittsburgh (ICSP). Los resultados demuestran que la puntuación media ICSP global fue de 8,5 ± 2,4. Treinta y cuatro sujetos tenían alta calidad del sueño y 84 tuvieron baja calidad del sueño. Puntajes globales ICSP tenían una media de 3,5 ± 1,37. Aquellos categorizados con baja calidad de sueño variaron de 6-12 con una media de 7,52 ± 1,64. En cuanto a los medicamentos habituales, los medicamentos utilizados más comúnmente son los destinados para el tratamiento de la ansiedad (9,32%), inductores del sueño (10,17%), la hipertensión (24,58%), antidepresivos (16%) y analgésicos (30,51%). La relación de la gravedad del insomnio con la edad fue significativa desde el punto de vista estadístico (p = 0,001). La mala calidad del sueño tiene un impacto negativo en la salud general y el bienestar, y puede producir signos y síntomas asociados con las conmociones cerebrales. Los déficits de sueño relativamente moderadas que experimentan los sujetos en este estudio no afectaron, en un primer momento, el desempeño de las actividades profesionales.