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1.
Rev. bras. neurol ; 57(4): 31-39, out.-dez. 2021. tab, ilus
Article in English | LILACS | ID: biblio-1359225

ABSTRACT

There is a known relationship between seizures and sleep deprivation that increases epileptiform abnormalities and slow waves expressed in the EEG, but chronic insomnia, greater in patients with epilepsy (PWEs) than in healthy control, supposedly has a different mechanism linked to a hyperarousability state with increased rapid EEG activity and associated "restless REM". Therefore, there is a complex interaction at various levels between insomnia and epilepsy that may play a role in seizure presentation. The recognized interconnection between mood and anxiety disorders and insomnia should also advise special care in the management of psychiatric comorbidities in PWEs. This article raises questions related to the interaction between the brain basis of insomnia and epilepsy and the triggers of seizures, particularly sleep deprivation.


Há uma relação conhecida entre crises epilépticas e privação de sono que aumenta as anormalidades epileptiformes e as ondas lentas expressas no EEG, mas a insônia crônica, maior em pacientes com epilepsia (PCE) do que no controle saudável, supostamente tem um mecanismo diferente ligado a um estado de hiperexcitabilidade com aumento da atividade rápida do EEG e associado "REM inquieto". Consequentemente, existe uma complexa interação em vários níveis entre a insônia e a epilepsia que pode desempenhar um papel na apresentação das crises. A reconhecida interligação entre transtornos de humor e ansiedade com a insônia também deve aconselhar um cuidado especial no manejo das comorbidades psiquiátricas do PCE. Este artigo levanta questões relacionadas à interação entre a base cerebral da insônia e da epilepsia e os desencadeadores de crises epilépticas, principalmente a privação do sono.


Subject(s)
Humans , Adult , Sleep Deprivation , Epilepsy/complications , Epilepsy/diagnosis , Sleep Initiation and Maintenance Disorders/physiopathology , Sleep Initiation and Maintenance Disorders/epidemiology , Seizures/etiology , Sleep Wake Disorders , Prevalence , Risk Factors , Sleep Initiation and Maintenance Disorders/etiology , Mental Disorders
2.
Rev. bras. psiquiatr ; 39(2): 183-186, Apr.-June 2017. tab, graf
Article in English | LILACS | ID: biblio-844195

ABSTRACT

Objective: To assess the interaction of chronotype with anxiety in patients with chronic primary insomnia. Methods: Sixty-four patients (50 women) with mean age 43.9±8.1 years were investigated with the Horne and Östberg Morningness-Eveningness Questionnaire (MEQ) and State-Trait Anxiety Inventory (STAI). Results: Significant negative correlations of chronotype-MEQ score with STAI state-anxiety (r = -0.40, p < 0.05), STAI trait-anxiety (r = -0.40, p < 0.05), and STAI pre-sleep state anxiety (r = -0.30, p < 0.05) were observed. Eveningness preference was associated with higher trait, state, and pre-sleep state anxiety. Conclusions: These results suggest that chronotype may be an important parameter to identifying the origin and significance of a vicious anxiety-insomnia-depression cycle in patients with chronic primary insomnia.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Anxiety Disorders/physiopathology , Circadian Rhythm/physiology , Circadian Clocks/physiology , Sleep Initiation and Maintenance Disorders/physiopathology , Sleep Initiation and Maintenance Disorders/psychology , Anxiety Disorders/complications , Psychiatric Status Rating Scales , Reference Values , Time Factors , Chronic Disease , Statistics, Nonparametric , Self Report , Sleep Initiation and Maintenance Disorders/etiology
3.
J. pediatr. (Rio J.) ; 91(6,supl.1): S26-S35, nov.-dez. 2015. tab
Article in English | LILACS | ID: lil-769809

ABSTRACT

Resumo Objetivos: Revisar as características clínicas, as comorbidades e o manejo da insônia na infância e adolescência. Fonte dos dados: Revisão não sistemática da literatura feita na base dados PubMed, na qual foram selecionados artigos publicados nos últimos cinco anos, com o uso da palavra-chave insônia e o filtro faixa etária pediátrica. Adicionalmente foram incluídos artigos e livros-texto clássicos da literatura sobre o tema. Síntese dos dados: Na infância existe predomínio da insônia comportamental na forma de distúrbio de início do sono por associações inadequadas e/ou distúrbio pela falta de estabelecimento de limites. Na adolescência a insônia está mais associada a problemas de higiene do sono e atraso de fase. Transtornos psiquiátricos (ansiedade, depressão) ou do neurodesenvolvimento (transtorno do déficit de atenção, autismo, epilepsias) ocorrem com frequência em associação ou como comorbidade do quadro de insônia. Conclusões: A queixa de insônia nas crianças e nos adolescentes deve ser valorizada e adequadamente investigada pelo pediatra, que levará em consideração a associação com diversas comorbidades, que também devem ser diagnosticas. As causas principais de insônia e fatores desencadeantes variam de acordo com a idade e o nível de desenvolvimento. A abordagem terapêutica deve incluir medidas de higiene do sono e técnicas comportamentais e em casos individualizados tratamento farmacológico.


Abstract Objectives: To review the clinical characteristics, comorbidities, and management of insomnia in childhood and adolescence. Sources: This was a non-systematic literature review carried out in the PubMed database, from where articles published in the last five years were selected, using the key word “insomnia” and the pediatric age group filter. Additionally, the study also included articles and classic textbooks of the literature on the subject. Data synthesis: During childhood, there is a predominance of behavioral insomnia as a form of sleep-onset association disorder (SOAD) and/or limit-setting sleep disorder. Adolescent insomnia is more associated with sleep hygiene problems and delayed sleep phase. Psychiatric (anxiety, depression) or neurodevelopmental disorders (attention deficit disorder, autism, epilepsy) frequently occur in association with or as a comorbidity of insomnia. Conclusions: Insomnia complaints in children and adolescents should be taken into account and appropriately investigated by the pediatrician, considering the association with several comorbidities, which must also be diagnosed. The main causes of insomnia and triggering factors vary according to age and development level. The therapeutic approach must include sleep hygiene and behavioral techniques and, in individual cases, pharmacological treatment.


Subject(s)
Adolescent , Child , Child, Preschool , Humans , Infant , Sleep Initiation and Maintenance Disorders/etiology , Central Nervous System Diseases/complications , Depression/complications , Neurodevelopmental Disorders/complications , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/physiopathology , Sleep Initiation and Maintenance Disorders/therapy
4.
Arq. neuropsiquiatr ; 73(6): 516-519, 06/2015. tab
Article in English | LILACS | ID: lil-748183

ABSTRACT

Objective To evaluate the association between objective short sleep duration in patients with insomnia and changes in blood parameters related to hypothalamic-pituitary-adrenal (HPA) axis activity.Method A cross-sectional pilot study was conducted in 30 middle-aged adults with chronic insomnia who were divided into 2 groups according to polysomnography (PSG) total sleep time (TST) (TST > 5h and < 5h). All patients underwent subjective analysis of sleep quality, anthropometric measurements, PSG, and determination off asting blood parameters.Results The results revealed lower sleep efficiency and higher sleep latency for those with a TST < 5h. The subjective sleep quality was worse in the TST < 5h. Significantly, higher glucose and cortisol levels were observed with a TST < 5h. Glucose, cortisol and ACTH levels were inversely correlated with the PSG total sleep time.Conclusion Patients with insomnia with objective short sleep duration had HPA-associated endocrine and metabolic imbalances chronically linked to increases in cardiovascular risk observed with this more severe insomnia phenotype.


Objetivo Avaliar a associação entre insônia com tempo de sono curto e alterações sanguíneas relacionados com a atividade do eixo hipotálamo-hipófise-adrenal (HPA).Método Estudo piloto transversal, com 30 adultos de meia-idade, distribuídos em 2 grupos de acordo com o tempo total de sono (TTS) pela polisonografia (PSG) (TTS > 5h e < 5h). Os pacientes foram submetidos a análise subjetiva da qualidade do sono, medidas antropométricas, PSG e parâmetros sanguíneos em jejum.Resultados Revelaram baixa eficiência do sono e maior latência do sono para aqueles com TTS < 5h. A qualidade subjetiva do sono foi pior no TTS < 5h. Significativamente, os níveis de glicose e cortisol mais elevados foram observados no grupo com TTS < 5h. Os níveis de glicose, cortisol e ACTH foram inversamente correlacionados com o TTS da PSG.Conclusão Pacientes com insônia com tempo de sono curto apresentaram desequilíbrios endócrinos e metabólicos associados a atividade do eixo HPA, correlacionados ao aumento do risco cardiovascular observado neste fenótipo mais grave de insônia.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Hypothalamo-Hypophyseal System/physiopathology , Pituitary-Adrenal System/physiopathology , Sleep Initiation and Maintenance Disorders/blood , Sleep Initiation and Maintenance Disorders/physiopathology , Adrenocorticotropic Hormone/blood , Body Mass Index , Blood Glucose/analysis , Chronic Disease , Epidemiologic Methods , Fasting , Growth Hormone/blood , Hydrocortisone/blood , Polysomnography , Reference Values , Time Factors
5.
Arch. argent. pediatr ; 113(3): e164-e167, jun. 2015. ilus, tab
Article in Spanish | LILACS | ID: lil-750477

ABSTRACT

La enfermedad de Lyme es producida por la espiroqueta Borrelia burgdorferi, que se transmite mediante la picadura de las garrapatas del género Ixodes ricinus. Se caracteriza por la aparición de un eritema migratorio en la zona de la picadura en las fases iniciales. Su diagnóstico se retrasa en gran parte de los casos y se presenta con formas diseminadas o tardías. El diagnóstico es fundamentalmente clínico; la serología suele ser negativa en las fases precoces, pero sirve de apoyo en el caso de las formas más avanzadas. El tratamiento se realiza con antibiótico oral durante 14-28 días, salvo en formas recurrentes o con afectación del sistema nervioso central. Presentamos cuatro casos de borreliosis de Lyme en niños con el fin de dar a conocer distintas formas de presentación de esta entidad y su manejo en la población pediátrica.


Lyme disease is caused by Borrelia burgdorferi infection which is transmittedby Ixodes ricinus. Erythema migrans, a rash spreading from the site of a tick bite, is the earliest and most common manifestation of the disease. If untreated, late manifestations of disseminated disease, mainly neurological and musculoskeletal, may occur. Serologic studies are usually negative in early stages and are not necessary to confirm the diagnosis in cases of erythema migrans. Laboratory confirmation is needed for disseminated disease. Most presentations, including facial nerve palsy, can be treated with oral antibiotics. Ceftriaxone is recommended in other cases of neuroborreliosis. Four cases of Lyme disease in children are reported to illustrate the different presentations of this disease and its management in children.


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Cognition/physiology , Sleep/physiology , Age Factors , Chi-Square Distribution , Cognition Disorders/complications , Cognition Disorders/physiopathology , Memory/physiology , Neuropsychological Tests , Prospective Studies , Regression Analysis , Sex Factors , Sleep Initiation and Maintenance Disorders/complications , Sleep Initiation and Maintenance Disorders/physiopathology , Time Factors
6.
Trends psychiatry psychother. (Impr.) ; 37(1): 47-50, Jan-Mar/2015. graf
Article in English | LILACS | ID: lil-742994

ABSTRACT

Objective: Psychiatric symptoms emerge in the early stages of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis, and patients often seek treatment in psychiatric departments before visiting any other general medical services. Numerous articles about anti-NMDAR encephalitis have been published in the scientific community worldwide, but few emphasize the role of psychiatry in symptom management. Case description: We describe the case of a patient with anti- -NMDAR encephalitis seen in our service and discuss the management of behavioral symptoms based on current scientific literature. High doses of atypical antipsychotics and benzodiazepines were used to control agitation, and trazodone was administered to treat insomnia. Comments: Consultation-liaison psychiatry may help the healthcare team adjust the management of neuropsychiatric complications that might affect inpatients with anti-NMDAR encephalitis. .


Objetivo: Sintomas psiquiátricos surgem em estágios precoces da encefalite antirreceptor N-metil-D-aspartato (NMDAR), o que faz muitos pacientes procurarem tratamento em serviços de psiquiatria antes de se dirigirem a unidades de clínica geral. Embora muitos artigos sobre encefalite anti-NMDAR venham sendo publicados na comunidade científica internacional, poucos enfatizam o papel do psiquiatra no seu manejo sintomatológico. Descrição do caso: O presente artigo relata o caso de um paciente que desenvolveu encefalite anti-NMDAR em nosso serviço e discute manejo de alterações comportamentais com base na literatura científica atual. Altas doses de antipsicóticos atípicos e benzodiazepínicos foram usados para controle de agitação, e trazodona foi utilizada para tratar insônia. Comentários: A interconsulta psiquiátrica pode ajudar no ajuste de condutas de toda a equipe assistente para as complicações neuropsiquiátricas que possam surgir na evolução de pacientes internados por encefalite anti-NMDAR. .


Subject(s)
Humans , Male , Adult , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/psychology , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/drug therapy , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/physiopathology , Psychomotor Agitation/drug therapy , Psychomotor Agitation/physiopathology , Psychotropic Drugs/therapeutic use , Sleep Initiation and Maintenance Disorders/drug therapy , Sleep Initiation and Maintenance Disorders/physiopathology
7.
Int. braz. j. urol ; 41(1): 101-109, jan-feb/2015. tab, graf
Article in English | LILACS | ID: lil-742864

ABSTRACT

Objectives To analyze the efficacy of intrarectal ice application as an anesthetic method prior to transrectal ultrasound (TRUS) guided prostate biopsy. Materials and Methods A total of 120 consecutive men were included into the study prospectively. Patients were equally randomized as group 1 and 2 with 60 patients each. Ice was applied as an anesthetic method 5 minutes before procedure to the patients in group 1. Patients in group 2 were applied 10 ml of 2% lidocaine gel 10 minutes before procedure. Twelve core biopsy procedure was performed for all patients. The pain level was evaluated using a visual analogue scale (VAS). Results Median pain score was 3.5 (1-8) in group 1 and 5 (1-8) in group 2. There is significantly difference between groups regarding the mean sense of pain level during the procedure. (p=0.007) There was also no difference in complications between two groups about presence and duration of macroscopic hematuria and rectal bleeding. Conclusions Intrarectal ice application prior to TRUS prostate biopsy has an effect on reducing pain. Development of new techniques about cold effect or ice can make this method more useful and decrease complication rates. .


Subject(s)
Humans , Sleep Initiation and Maintenance Disorders/diagnosis , Hypertension/etiology , Phenotype , Polysomnography , Sleep Initiation and Maintenance Disorders/complications , Sleep Initiation and Maintenance Disorders/mortality , Sleep Initiation and Maintenance Disorders/physiopathology , Sleep/physiology , Time Factors
8.
Rev. ter. ocup ; 25(2): 119-125, maio-ago. 2014. tab, graf
Article in Portuguese | LILACS | ID: lil-745368

ABSTRACT

A insônia é conceituada como a dificuldade de iniciar ou manter o sono ou insatisfação com a qualidade do sono e que pode interferir no desempenho das atividades sociais e cognitivas. Este trabalho teórico buscou estudar a insônia no adulto e suasalterações que acometem o desempenho ocupacional. O estudo desenvolveu revisão bibliográfica do tipo narrativa do período de 2002 a 2012, realizada nas bases de dados eletrônicas utilizando como descritores, em português e em inglês, insônia e desempenho ocupacional. Foram encontrados 398 artigos, e selecionados 16 artigos. As publicações possuem maior frequência no ano de 2012 e apenas artigos científicos na línguainglesa estavam relacionados ao tema de pesquisa. Os principais acometimentos relacionados com o desempenho ocupacional dos indivíduos adultos referem-se aos prejuízos apresentados em diferentes contextos como no ambiente escolar, familiar, social e do trabalho. Dentre esses aspectos que interferem no desempenho ocupacional destacam-se: alterações cognitivas; fadiga duranteo dia; menor produtividade seja no trabalho ou nas atividades diárias de modo geral; absenteísmo, destacando-se esse aspecto relacionado ao trabalho; distúrbios de humor; ansiedade; relações familiares e sociais prejudicadas; e acidentes no trabalho.


Insomnia is conceptualized as a disorder defined by the existence of difficulty initiating or maintaining sleep or dissatisfaction with the quality of sleep and it can interfere with the performance of cognitive and social activities. This theoretical study aimed to study about the insomnia in adults and the changes that affect the occupational performance. The studydeveloped a bibliographic review of narrative’s type of the period 2002 to 2012, held in electronic databases using as descriptors, in Portuguese and in English, insônia and desempenho ocupacional. It was found 398 articles, and selected 16 articles. The publications have a higher frequency in the year 2012 and only scientificarticles in English language were related to the research topic. The main disorders related with the occupational performance of adults relate to losses presented in different contexts such as in the school environment, family, social and work. Among these aspects that interfere in occupational performance stand out: cognitive changes, fatigue during the day; lower productivity at work or in daily activities in general; absenteeism, highlighting related to work; mood disorders; anxiety; family relationshipsand social disadvantage; and accidents at work.


Subject(s)
Adult/psychology , Sleep Initiation and Maintenance Disorders/physiopathology , Sleep Initiation and Maintenance Disorders/psychology , Sleep Initiation and Maintenance Disorders/therapy , Employment/psychology , Social Environment , Sleep/physiology , Comorbidity
9.
J. bras. med ; 102(2)março-abril 2014. tab
Article in Portuguese | LILACS | ID: lil-712223

ABSTRACT

Estima-se que aproximadamente um quarto dos adultos apresente queixas relacionadas ao sono: dificuldades para iniciar ou manter o sono, despertar precoce, sonolência diurna, pesadelos, terror noturno, entre outras. A maioria dos adultos jovens dorme de sete a oito horas por noite, mas a quantidade de sono oscila ao longo da vida, com tendência à diminuição das horas na medida em que se envelhece.


It is estimated that about a quarter of adults present sleep complaints such as: difficulty to sleep through the night, early-morning awakening, somnolency all day long, nightmares, night terrors, among others symptoms. Most young adults sleep 7 to 8 hours per night, but the sleep amount oscillates lifelong trending towards hours reduction as people grow older.


Subject(s)
Humans , Male , Female , Sleep Initiation and Maintenance Disorders/diagnosis , Cardiovascular Diseases/complications , Sleep Apnea, Obstructive/epidemiology , Caffeine/adverse effects , Depression/diagnosis , Sleep Initiation and Maintenance Disorders/physiopathology , Heart Diseases , Biomarkers/analysis , Psychotropic Drugs/adverse effects , Psychotropic Drugs/therapeutic use , Quality of Life , Sleep Wake Disorders/physiopathology
10.
Arq. neuropsiquiatr ; 72(1): 63-71, 01/2014.
Article in English | LILACS | ID: lil-697596

ABSTRACT

Insomnia involves difficulty in falling asleep, maintaining sleep or having refreshing sleep. This review gathers the existing informations seeking to explain insomnia, including those that focus on psychological aspects and those considered neurobiological. Insomnia has been defined in psychological (cognitive components, such as worries and rumination, and behavioral aspects, such as classic conditioning) and physiological terms (increased metabolic rate, with increased muscle tone, heart rate and temperature). From the neurobiological point of view, there are two perspectives: one which proposes that insomnia occurs in association with a failure to inhibit wakefulness and another that considers hyperarousal as having an important role in the physiology of sleep. The non-pharmacological interventions developed to face different aspects of insomnia are presented.


Insônia é um transtorno que envolve dificuldade em dormir, em manter-se dormindo ou em ter um sono restaurador. Esta revisão reúne informações que buscam explicar a insônia, incluindo aquelas que estudam os aspectos psicológicos e os neurobiológicos. A insônia tem sido definida em termos psicológicos (componentes cognitivos, tais como preocupações e ruminação e aspectos comportamentais, tais como o condicionamento clássico) e em termos fisiológicos (taxa metabólica aumentada, com tônus muscular, frequência cardíaca e temperatura aumentados). Do ponto de vista neurobiológico, há duas perspectivas: uma propondo que a insônia ocorre em associação com uma falha na inibição da vigília e outra que considera o hiperalerta como tendo um papel importante na fisiologia do sono. São apresentadas também as estratégias não farmacológicas desenvolvidas para lidar com os diferentes aspectos da insônia.


Subject(s)
Humans , Male , Female , Cognition/physiology , Sleep Initiation and Maintenance Disorders/psychology , Sleep Initiation and Maintenance Disorders/therapy , Sleep/physiology , Cognitive Behavioral Therapy/methods , Risk Factors , Depression/physiopathology , Sleep Initiation and Maintenance Disorders/physiopathology
11.
Rev. colomb. biotecnol ; 13(1): 73-79, jul. 2011. graf, ilus
Article in Spanish | LILACS | ID: lil-600576

ABSTRACT

Passiflora caerulea L., al igual que otras especies de la familia Passifloraceae, es utilizada en la medicina popular por sus propiedades antiespasmódicas y para el tratamiento de la ansiedad, el insomnio y el nerviosismo. La belleza de sus flores les otorga valor ornamental, mientras que sus frutos son apreciados por su importancia alimenticia. Se evaluó la respuesta in vitro de diferentes explantos y tres biotipos de P. caerulea: Corral de Bustos (provincia de Córdoba), Zavalla (provincia de Santa Fe) y Neuquén (provincia de Neuquén). Se utilizaron dos tipos de explantos: entrenudos y segmentos nodales, y como medio de cultivo Murashige y Skoog (1962) (MS), suplementado con vitaminas de Gamborg (1976) y 1 mg/L-1 de benciladenina (BA). Las respuestas fueron diferentes según el genotipo y el explanto. Los entrenudos ubicados tanto horizontal como verticalmente en medio de cultivo generaron callos como única respuesta. El biotipo de Neuquén mostró los mayores porcentajes de segmentos nodales con brotes. A través de estudios histológicos se determinó que en medio de cultivo MS con 1 mg/L-1 de BA, los segmentos nodales de P. caerulea originan brotes a partir de las yemas axilares preformadas y raíces que parten de callos en la base de los mismos. En iguales condiciones, los entrenudos originan callo como única respuesta.


As other species of the Passifloraceae family, Passiflora caerulea L. is used in popular medicine for its antispasmodic properties and as a remedy for anxiety, insomnia and nervousness. It is also highly prized for the ornamental value of its beautiful flowers, as well as for the nutritional importance of its fruits. The in vitro response of different explants and three biotypes of P. caerulea: the Corral de Bustos (Province of Córdoba), the Zavalla (Province of Santa Fe) and the Neuquén (Province of Neuquén) genotypes, was evaluated using two types of explants: internodes and nodal segments on Murashige and Skoog (1962) (MS) culture medium supplemented with Gamborg’s vitamins (1976) and 1 mg.L-1 of benzyladenine (BA). There were different responses depending on the genotype and the explant. The internodes placed both horizontally and vertically in the culture medium produced callus as sole response. The Neuquén biotype showed the highest percentages of nodal segments with shoots. Histological tests allowed to establish that in MS culture medium with 1 mg.L-1 of BA, the nodal segments of P. caerulea produce shoots from the preformed axillary buds and roots that develop from the callus situated on its base. Under similar conditions, the internodes produce callus as sole response.


Subject(s)
Passifloraceae/anatomy & histology , Passifloraceae/classification , Passifloraceae/growth & development , Passifloraceae/adverse effects , Passifloraceae/physiology , Passifloraceae/genetics , Passifloraceae/immunology , Passifloraceae/microbiology , Passifloraceae/chemistry , Passifloraceae/ultrastructure , Sleep Initiation and Maintenance Disorders/enzymology , Sleep Initiation and Maintenance Disorders/physiopathology , Sleep Initiation and Maintenance Disorders/immunology
12.
J. pediatr. (Rio J.) ; 87(1): 63-69, jan.-fev. 2011. graf, tab
Article in Portuguese | LILACS | ID: lil-576131

ABSTRACT

OBJETIVOS: Avaliar a arquitetura do sono em crianças e adolescentes com fibrose cística (FC) e com suspeita clínica de distúrbios respiratórios do sono (DRS), e identificar o perfil respiratório polissonográfico desses pacientes. MÉTODOS: Os pais ou responsáveis dos pacientes com FC preencheram um questionário que abordava questões clínicas e relacionadas ao sono. As crianças e adolescentes que foram identificadas com quadro clínico sugestivo de DRS foram submetidas a polissonografia. Após a realização da polissonografia, os pacientes foram agrupados de acordo com o índice de apneia obstrutiva (IA) observado (< 1 ou > 1) e utilizou-se a análise fatorial de correspondência múltipla para análise e identificação dos perfis polissonográficos dos pacientes. RESULTADOS: Dos 74 pacientes que preencheram os critérios de inclusão para este estudo, 67 foram submetidos à polissonografia; observou-se que 38 (56,7 por cento) dos 67 pacientes apresentaram um IA > 1. A mediana das idades foi de 8 anos. O grupo de pacientes com IA > 1 caracterizou-se por apresentar tempo total de sono (TTS) nos estágios 4 e no REM < 21 e 13 por cento, respectivamente, latência do sono REM > 144 minutos, o percentual de TTS com saturação da oxi-hemoglobina medida por oximetria de pulso (SpO2) < 90 por cento maior que 0,28 segundos e o índice de dessaturação de oxigênio maior que 0,92. CONCLUSÃO: Os resultados sugerem que pacientes pediátricos clinicamente estáveis com FC têm uma alta prevalência de DRS e apresentam frequentes queixas relacionadas ao sono, significativas alterações na sua arquitetura, assim como episódios de dessaturação de oxigênio durante o sono.


OBJECTIVES: To evaluate sleep architecture in children and adolescents with both cystic fibrosis (CF) and a clinical suspicion of sleep-disordered breathing (SDB), and to identify the respiratory polysomnographic profile of these patients. METHODS: Parents or guardians of children with CF filled out a questionnaire designed to assess their clinical and sleep conditions. Children who were identified as having behaviors associated with SDB underwent polysomnography. After polysomnography, patients were grouped according to the obstructive apnea index (AI) obtained (either < 1 or > 1), and a multiple correspondence factor analysis was used to analyze and identify the polysomnographic profile of patients. RESULTS: Of the 74 patients who met inclusion criteria for this study, 67 underwent polysomnography, and 38 (56.7 percent) of the 67 patients showed an AI > 1. Median age was 8 years. The group of patients with an AI > 1 was characterized by total sleep time (TST) during stage 4 and rapid eye movement (REM) stage of sleep < 21 and 13 percent, respectively, REM sleep latency > 144 minutes, percentage of TST with pulse oxyhemoglobin saturation (SpO2) < 90 percent higher than 0.28 seconds, and an oxygen desaturation index higher than 0.92. CONCLUSION: Results suggest that clinically stable pediatric patients with CF have a high prevalence of SDB and present frequent sleep complaints, significant changes in sleep architecture, and episodes of oxygen desaturation during sleep.


Subject(s)
Adolescent , Child , Child, Preschool , Humans , Cystic Fibrosis/physiopathology , Disorders of Excessive Somnolence/physiopathology , Polysomnography , Cystic Fibrosis/complications , Disorders of Excessive Somnolence/diagnosis , Disorders of Excessive Somnolence/etiology , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/physiopathology , Sleep Initiation and Maintenance Disorders/complications , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/physiopathology
14.
Article in English | IMSEAR | ID: sea-135441

ABSTRACT

Insomnia is a highly prevalent sleep disorder that frequently occurs in its acute form and occurs at a rate of approximately 10 per cent in its chronic form in many countries. There is a high prevalence of insomnia in a variety of medical and psychiatric conditions for which insomnia often serves as a risk factor. The aetiology and pathophysiology of insomnia is such that several factors may predispose individuals for or precipitate and/or perpetuate the condition. Both sedative-hypnotic and cognitivebehavioural interventions exist for insomnia and each type of intervention have substantial levels of empirical support for their efficacy.


Subject(s)
Acute Disease , Anxiety Disorders , Behavior Therapy/methods , Chronic Disease , Clinical Trials as Topic , Cognitive Behavioral Therapy/methods , Comorbidity , Depression/complications , Humans , Mood Disorders/complications , Phototherapy/methods , Prevalence , Sleep Wake Disorders/complications , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/physiopathology , Sleep Initiation and Maintenance Disorders/therapy
15.
Braz. j. med. biol. res ; 41(8): 722-727, Aug. 2008. tab
Article in English | LILACS | ID: lil-491929

ABSTRACT

To evaluate the effect of smoking habits on sleep, data from 1492 adults referred to the Sleep Institute were accessed and divided into 3 categories of smoking status: current, former and non-smokers. Categories of pack-years (<15 and greater than or equal to 15) defined smoking severity. The association of smoking status and smoking severity with sleep was analyzed for sleep parameters, especially apnea and hypopnea index (AHI) greater than or equal to 5, more than 5 percent of total sleep time (TST) spent with oxyhemoglobin saturation (SaO2) <90 percent, and arousal index. The arousal index was higher among current (21 plus or minus 17) and former smokers (20 plus or minus 17) than non-smokers (17 plus or minus 15; P < 0.04). Former smokers had a higher percent of TST at SaO2 <90 percent than non-smokers (9 more less 18 vs 6 more less 13; P < 0.04). Former smokers with pack-years greater than or equal to 15 compared to <15 exhibited higher AHI (22 plus or minus 24 vs 16 plus or minus 21; P < 0.05) and arousal index (22 plus or minus 19 vs 18 plus or minus 15; P < 0.05). Current smokers with pack-years greater than or equal to 15 compared to <15 exhibited higher arousal index (23 plus or minus 18 vs 18 plus or minus 16; P < 0.05) and percent of TST at SaO2 <90 percent (11 plus or minus 17 vs 6 more less 13; P < 0.05). Smoking status and pack-years were not associated with AHI greater than or equal to 5 on logistic regression analysis, but current smokers with pack-years greater than or equal to 15 were 1.9 times more likely to spend more than 5 percent of TST at SaO2 <90 percent than non-smokers (95 percentCI = 1.21-2.97; P = 0.005). The variability of arousal index was influenced by gender, AHI and current smokers with pack-years greater than or equal to 15 (all P < 0.01). Smoking habits seem to be associated with arousal and oxyhemoglobin desaturation during sleep, but not with AHI. The effect was more pronounced in current than former smokers.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Sleep Apnea Syndromes/etiology , Sleep Initiation and Maintenance Disorders/etiology , Smoking/adverse effects , Body Mass Index , Case-Control Studies , Oxyhemoglobins/metabolism , Polysomnography , Regression Analysis , Sleep Apnea Syndromes/diagnosis , Sleep Apnea Syndromes/physiopathology , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/physiopathology , Time Factors
16.
J. pediatr. (Rio J.) ; 81(4): 277-286, jul.-ago. 2005. tab
Article in Portuguese | LILACS | ID: lil-414397

ABSTRACT

OBJETIVOS: O objetivo deste artigo é revisar as características clínicas, a investigacão e o tratamento da insônia na faixa etária pediátrica. FONTE DOS DADOS: Foi realizada pesquisa na MEDLINE, nos últimos 5 anos (1999-2004), utilizando os unitermos distúrbios do sono, insônia e infância. Foram incluídos artigos e livros textos clássicos sobre o tema, sendo elaborado um roteiro crítico para avaliacão e manejo da insônia em pacientes pediátricos. SíNTESE DOS DADOS: O artigo foi estruturado em tópicos apresentados de forma descritiva, contendo a definicão de insônia, características clínicas e etiologia, de acordo com a faixa etária e manejo terapêutico. CONCLUSÕES: A insônia é uma queixa freqüente no consultório pediátrico, embora muitas vezes subdiagnosticada. A definicão da etiologia é fundamental para a escolha da terapêutica mais adequada. Na maioria dos casos, uma boa anamnese é suficiente para estabelecer o diagnóstico e assegurar aos pais a benignidade do problema.


Subject(s)
Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Humans , Sleep Disorders, Circadian Rhythm/therapy , Sleep Initiation and Maintenance Disorders/therapy , Adolescent Development/physiology , Brazil/epidemiology , Comorbidity , Child Development/physiology , Sleep Disorders, Circadian Rhythm/epidemiology , Sleep Disorders, Circadian Rhythm/physiopathology , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/physiopathology
18.
Rev. bras. med. esporte ; 6(4): 119-124, jul.-ago. 2000. tab
Article in Portuguese | LILACS | ID: lil-325131

ABSTRACT

Estudos epidemiológicos conduzidos em geral ou em populações específicas säo de vital importância para a determinaçäo e implementaçäo de políticas públicas. Um dos problemas de saúde mais comuns que causa grande preocupaçäo é o crescente número de pessoas obesas e, conseqüentemente, os problemas de saúde advindos da obesidade. No entanto, as desordens de sono, como a insônia, e distúrbios no ciclo vigília-sono que resultam de fatores psicológicos, neurológicos e sociais säo também importantes problemas de saúde. Neste estudo, foi realizado um levantamento epidemiológico da prática de atividade física e problemas de sono na populaçäo geral da cidade de Säo Paulo. Mil indivíduos de todas a regiões da cidade, representando todas as classes sociais, responderam a um questionário específico. Os resultados mostraram que somente 31,3 dos entrevistados estäo engajados em algum tipo de atividade física e somente 36,4 desses indivíduos têm supervisäo de um profissional qualificado. Os distúrbios de sono associados com a insônia foram reportados por 27,1 dos indivíduos fisicamente ativos e 35,9 dos näo ativos (p < 0,003). Dados de um estudo nacional em saúde e nutriçäo mostram um aumento na percentagem de indivíduos obesos no Brasil. Isto pode ser parcialmente explicado pelos nossos achados de baixos níveis de atividade física desta populaçäo pesquisada, o que pode levar a um aumento na incidência de doenças cardíacas e metabólicas (diabetes). Os resultados revelaram uma baixa percentagem de indivíduos engajados em atividade física regular


Subject(s)
Adult , Middle Aged , Female , Humans , Male , Exercise , Age Distribution , Brazil , Sleep Initiation and Maintenance Disorders/physiopathology , Health Surveys , Surveys and Questionnaires , Sex Distribution , Sleep Wake Disorders , Social Class
19.
Arch. neurociencias ; 2(3): 191-4, jul.-sept. 1997. tab
Article in Spanish | LILACS | ID: lil-227197

ABSTRACT

Se considera que una de cada cinco personas desarrolla un trastorno mental en el curso de su vida, la manifestación sobresaliente de este problema puede ser el insomnio. Se presentan las características clínicas fundamentales de las principales patologías mentales (trastornos de ansiedad, trastornos de personalidad, esquizofrenia, trastornos somatoformes) y las alteraciones asociadas en el sueño. Se describen aproximaciones básicas de higiene del sueño y la utilidad de los psicofármacos en el insomnio


Subject(s)
Sleep Initiation and Maintenance Disorders/physiopathology , Sleep Initiation and Maintenance Disorders/psychology , Somatoform Disorders/physiopathology , Psychiatry/trends
20.
Arch. neurociencias ; 2(2): 122-7, abr.-jun. 1997. tab
Article in Spanish | LILACS | ID: lil-227184

ABSTRACT

Durante el proceso normal de envejecimiento ocurren una serie de cambios fisiológicos y no fisiológicos, un problema frecuente son los trastornos del sueño. La prevalencia del insomnio en ancianos puede alcanzar desde un 25 a 43 por ciento. Se ha identificado que los ancianos duermen menos profundamente, despiertan con más frecuencia durante la noche y se despiertan más temprano durante la mañana. Sin embargo, la calidad y duración del sueño puede ser igual que en las personas más jóvenes, si el anciano es saludable. Los trastornos del sueño pueden alterar su calidad de vida, su funcionalidad cotidiana y la vida de relación. Dado el rápido aumento de la población que envejece, es necesario que el médico este consciente de los cambios que acompañan al ciclo sueño-vigilia en la vejez, independientemente de cualquier proceso patológico y las implicaciones prácticas del tratamiento


Subject(s)
Aged , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/physiopathology , Sleep Wake Disorders/physiopathology
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