Research progress of circadian rhythm and circadian rhythm sleep-wake disorders / 中华神经科杂志

Circadian rhythm is driven by the suprachiasmatic nucleus biological clock, and many life activities and physiological functions are regulated by circadian rhythm, such as central nervous system activity, autonomic nervous system activity, endocrine function, metabolism and immune function. At the molecular level, circadian rhythm is regulated by molecular mechanisms generated by clock genes′ oscillations. Endogenous circadian rhythm is one of the main processes controlling sleep. Circadian rhythm disorder is the most common cause of abnormal sleep-wake cycle, and can also lead to a series of diseases and adverse consequences such as other sleep disorders, abnormal cognitive function, hypertension, diabetes and tumors. Recently, the relationship between circadian rhythm and sleeping awakening has become a hot topic for researchers. In this paper, the research progress of circadian rhythm and circadian rhythm sleep-wake disorders was reviewed.

Aromatherapy combined with Yin-Yang massage for treatment of insomnia / 中国基层医药

Objective:To investigate the therapeutic effects of aromatherapy combined with Yin-Yang massage on insomnia in patients. Methods:A total of 120 patients with insomnia who received treatment in Zhoushan Hospital of Traditional Chinese Medicine between September 2017 and December 2019 were included in this study. They were randomly assigned to undergo either aromatherapy (control group, n = 60) or aromatherapy combined with Yin-Yang massage (observation group, n = 60) for 7 days. After treatment, response rate and anxiety status were recorded in each group. Before and after treatment, the scores of Pittsburgh Sleep Quality Index, frequency of taking sleeping pills, and the incidence of adverse reactions were compared between the two groups. Results:Response rate in the observation group was significantly higher than that in the control group [90.00% vs. 73.34%, χ2 = 5.57, P < 0.05]. After treatment, Pittsburgh Sleep Quality Index in the observation group was significantly lower than that in the control group [(9.47 ± 3.65) points vs. (12.45 ± 2.17) points, t = 5.44, P < 0.05]. The frequency of taking sleeping pills in the observation group was significantly lower than that in the control group [(1.19 ± 0.41) times vs. (2.07 ± 0.98) times, t = 6.42, P < 0.05]. There were 0, 3 and 57 cases of severe, moderate and mild anxiety in the observation group, and 5, 18 and 37 cases of severe, moderate and mild anxiety in the control group. There was significant difference in anxiety status between the two groups ( Z = 19.78, P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Aromatherapy combined with Yin-Yang massage can effectively alleviate anxiety in patients with insomnia, improve sleep quality and is highly safe.

Sleep health and the circadian rest-activity pattern four months after COVID-19 / Saúde do sono e o padrão circadiano de atividade e repouso quatro meses depois da COVID-19

ABSTRACT Objective: To describe the prevalence and severity of sleep disorders and circadian alterations in COVID-19 patients four months after the acute phase of the disease. Methods: This was a cross-sectional observational prospective study of patients with mild COVID-19, moderate COVID-19 (requiring hospitalization but no mechanical ventilation), or severe COVID-19 (with ARDS) four months after the acute phase of the disease. All patients underwent a home sleep apnea test and seven-day wrist actigraphy, as well as completing questionnaires to assess sleep quality and mental health. Differences among the three groups of patients were evaluated by ANOVA and the chi-square test. Results: A total of 60 patients were included in the study. Of those, 17 were in the mild COVID-19 group, 18 were in the moderate COVID-19 group, and 25 were in the severe COVID-19 group. Sleep quality, as assessed by satisfaction, alertness, timing, efficiency, and duration scale scores, was found to be impaired in all three groups, which also had a high prevalence of unhealthy sleep, as assessed by the Pittsburgh Sleep Quality Index. The prevalence of insomnia was increased in all three groups, as assessed by the Insomnia Severity Index. The home sleep apnea test showed that the overall prevalence of obstructive sleep apnea was 60%, and seven-day wrist actigraphy showed that total sleep time was < 7 h in all three groups. Changes in quality of life and in the circadian rest-activity pattern were observed in all three groups. Conclusions: Sleep-related symptoms, changes in the circadian rest-activity pattern, and impaired mental health appear to be common in COVID-19 patients four months after the acute phase of the disease, severe COVID-19 being associated with a higher prevalence of obstructive sleep apnea.

RESUMO Objetivo: Descrever a prevalência e gravidade de transtornos do sono e alterações circadianas em pacientes com COVID-19 quatro meses depois da fase aguda da doença. Métodos: Estudo prospectivo observacional transversal com pacientes com COVID-19 leve, moderada (com necessidade de hospitalização, mas não de ventilação mecânica) ou grave (com SDRA) quatro meses depois da fase aguda da doença. Todos os pacientes foram submetidos a teste domiciliar de apneia do sono e actigrafia de sete dias, além de terem preenchido questionários para avaliar a qualidade do sono e a saúde mental. As diferenças entre os três grupos foram avaliadas por meio de ANOVA e teste do qui-quadrado. Resultados: Foram incluídos no estudo 60 pacientes. Destes, 17 eram do grupo COVID-19 leve, 18 do grupo COVID-19 moderada e 25 do grupo COVID-19 grave. A qualidade do sono, avaliada pela pontuação na escala satisfaction, alertness, timing, efficiency, and duration, foi prejudicada nos três grupos, que também apresentaram alta prevalência de sono não saudável, pelo Índice de Qualidade do Sono de Pittsburgh. A prevalência de insônia, avaliada pelo Insomnia Severity Index, foi elevada nos três grupos. O teste domiciliar de apneia do sono mostrou que a prevalência geral de apneia obstrutiva do sono foi de 60%, e a actigrafia de sete dias mostrou que o tempo total de sono foi < 7 h nos três grupos. Alterações da qualidade de vida e do padrão circadiano de atividade e repouso foram observadas nos três grupos. Conclusões: Sintomas relacionados ao sono, alterações do padrão circadiano de atividade e repouso e comprometimento da saúde mental parecem ser comuns em pacientes com COVID-19 quatro meses depois da fase aguda da doença, sendo a COVID-19 grave associada a uma maior prevalência de apneia obstrutiva do sono.

Viabilidade e validade do índice bispectral para mensurar o sono de pacientes na unidade de terapia intensiva / Viability and validity of the bispectral index to measure sleep in patients in the intensive care unit

RESUMO Objetivo: Investigar a viabilidade do índice bispectral na avaliação do sono de pacientes criticamente enfermos lúcidos e a associação entre os parâmetros do sono aferidos por esse índice, pelo Questionário de Sono de Richards-Campbell e pelo ruído ambiental. Métodos: Estudo observacional transversal que avaliou indivíduos adultos criticamente enfermos com doenças de gravidades baixa ou moderada. Foram aferidos: volume e tempo total de sono, volume e tempo de sono profundo, volume e tempo de sono contínuo, latência para o início do sono e pressão sonora ambiental. A percepção subjetiva do sono foi registrada com o Questionário de Sono de Richards-Campbell nas manhãs subsequentes às noites de observação. Resultados: Os pacientes apresentaram tempo total de sono reduzido (234 minutos), predominância dos estágios superficiais e pouco sono profundo (1,7 minutos). Os volumes de sono total, profundo e contínuo foram 3.679, 9,4 e 3.143 índice bispectral versus minutos, respectivamente. A latência para o sono foi de 94 minutos. O escore médio do Questionário de Sono de Richards-Campbell foi 57,9. Foram observadas correlações de magnitudes fracas entre volume total, tempo total, volume contínuo e os domínios do Questionário de Sono de Richards-Campbell profundidade do sono, qualidade geral de sono e escore total; e correlações de magnitudes moderadas entre volume total, tempo total, volume contínuo e o domínio ocorrência de despertares. Conclusão: O índice bispectral é um instrumento com viabilidade limitada para monitorar o sono de pacientes lúcidos e com enfermidades de gravidades baixa e moderada na unidade de terapia intensiva, e pacientes que apresentaram maior volume, tempo total e volume de sono contínuo tiveram melhor percepção global do sono.

Abstract Objective: To investigate the viability of the bispectral index in the sleep evaluation of critically ill patients and to quantify the associations of sleep parameters measured by this index with the Richards-Campbell Sleep Questionnaire and environmental noise. Methods: This was a cross-sectional observational study that evaluated critically ill adults with diseases of low or moderate severity. The following were measured: total sleep volume and time, deep sleep volume and time, continuous sleep volume and time, sleep onset latency, and environmental sound pressure level. The subjective perception of sleep was evaluated with the Richards-Campbell Sleep Questionnaire the morning after each night of observation. Results: Patients had a low total sleep time (234 minutes), a predominance of superficial sleep stages, and little deep sleep (1.7 minutes). The total, deep, and continuous sleep volumes were 3,679, 9.4, and 3,143 (bispectral index units × minutes), respectively. The sleep latency was 94 minutes. The mean score of the Richards-Campbell Sleep Questionnaire was 57.9. Total sleep volume, total sleep time, and continuous sleep volume were weakly correlated with the Richards-Campbell Sleep Questionnaire depth of sleep domain score, overall sleep quality domain score, and total score. Total volume, total time, and continuous volume were moderately correlated with the occurrence of awakenings domain score. Conclusion: The bispectral index is an instrument with limited viability to monitor the sleep of lucid patients and patients with low to moderate disease severity in the intensive care unit. Patients with higher total sleep volume, total sleep time, and continuous sleep volume had better overall sleep perception.

Distúrbios do sono: escalas subjetivas e fatores associados em profissionais da saúde em jornada de plantões / Sleep disorders: subjective scales and associated factors in healthcare professionals during their duties

Objetivo: Demonstrar fatores envolvidos nos distúrbios do sono em profissionais que fazem plantões. Métodos: Trata-se de estudo transversal, cuja amostra foi composta de 244 voluntários, plantonistas da área da saúde, sendo 191 do sexo feminino, que responderam a um questionário socioeconômico, associado à aplicação da Escala de Sonolência de Epworth e ao Índice de Qualidade do Sono de Pittsburgh. Os dados foram analisados pelos coeficientes de Spearman e de Kendall Tau, com distribuição de probabilidade gama. Resultados: Houve significância (p<0,05) com o Índice de Qualidade do Sono de Pittsburgh e a atividade física (+0,216), ergonomia (+0,148), filhos (-0,146), valor da remuneração (+0,112) e disfunção durante o dia (+0,352). Também houve significância com a Escala de Sonolência de Epworth e atividade física (+0,138), renda familiar (-0,118), trabalho semanal (-0,151), latência do sono (-0,106), duração do sono (-0,107), eficiência do sono (-0,139) e disfunção durante o dia (+0,170). Por fim, a eficiência do sono teve significiância com profissão (-0,209), tabagismo (+0,402), Escala de Sonolência de Epworth (-0,139) e dissonias com a obesidade (índice de massa corporal >30; razão de chance de 1,40; intervalo de confiança de 95% de 1,02-1,94). Conclusão: As medidas autorrelatadas são prontamente obtidas com questionários validados, como a Escala de Sonolência de Epworth e o Índice de Qualidade do Sono de Pittsburgh, encontrando-se correlações com renda familiar, ter ou não filhos, índice de massa corporal, atividade física, ergonomia, condições de trabalho, tabagismo e componentes biopsicossociais. Em virtude do caráter transversal deste estudo é indispensável mais estudos com maior follow-up.

Objective: To demonstrate factors involved in sleep disorders in professionals who take shifts. Methods: This is a cross-sectional study whose sample consists of 244 volunteers, on-duty health workers, 191 females, who answered a socioeconomic questionnaire, associated with application of the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index. Data were analyzed with Spearman's and Kendall Tau coefficients, and gamma probability distribution. Results: There was significance (p<0,05) with the Pittsburgh Sleep Quality Index and physical activity (+0,216), ergonomics (+0,148), children (-0,146), the wage (+0,112), dysfunction during the day (+0,352). Also there was significance with the Epworth Sleepiness Scale and physical activity (+0,138), family income (-0,118), weekly workload (-0,151), sleep latency (-0,106), sleep duration (-0,107), sleep efficiency (-0,139), and dysfunction during the day (+0,170). Finally, sleep efficiency was significant with occupation (-0,209), smoking habits (+0,402), Epworth Sleepiness Scale (-0,139), dyssomnia with obesity (body index mass >30; OR of 1,40; CI 95% 1,02-1,94). Conclusion: Self-reported measures are readily obtained with validated questionnaires such as Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index, with correlations with family income, having children or not, body mass index, physical activity, ergonomics, working conditions, smoking habits, and biopsychosocial components. Due to the cross-sectional nature of this study, further research with longer follow-up is indispensable.

Metabolic syndrome in fixed-shift workers / Síndrome metabólica em trabalhadores de turnos fixos

OBJECTIVE To analyze if metabolic syndrome and its altered components are associated with demographic, socioeconomic and behavioral factors in fixed-shift workers.METHODS A cross-sectional study was conducted on a sample of 902 shift workers of both sexes in a poultry processing plant in Southern Brazil in 2010. The diagnosis of metabolic syndrome was determined according to the recommendations from Harmonizing the Metabolic Syndrome. Its frequency was evaluated according to the demographic (sex, skin color, age and marital status), socioeconomic (educational level, income and work shift), and behavioral characteristics (smoking, alcohol intake, leisure time physical activity, number of meals and sleep duration) of the sample. The multivariate analysis followed a theoretical framework for identifying metabolic syndrome in fixed-shift workers.RESULTS The prevalence of metabolic syndrome in the sample was 9.3% (95%CI 7.4;11.2). The most frequently altered component was waist circumference (PR 48.4%; 95%CI 45.5;51.2), followed by high-density lipoprotein. Work shift was not associated with metabolic syndrome and its altered components. After adjustment, the prevalence of metabolic syndrome was positively associated with women (PR 2.16; 95%CI 1.28;3.64), workers aged over 40 years (PR 3.90; 95%CI 1.78;8.93) and those who reported sleeping five hours or less per day (PR 1.70; 95%CI 1.09;2.24). On the other hand, metabolic syndrome was inversely associated with educational level and having more than three meals per day (PR 0.43; 95%CI 0.26;0.73).CONCLUSIONS Being female, older and deprived of sleep are probable risk factors for metabolic syndrome, whereas higher educational level and higher number of meals per day are protective factors for metabolic syndrome in fixed-shift workers.

OBJETIVO Analisar se síndrome metabólica e seus componentes alterados estão associados a fatores demográficos, socioeconômicos e comportamentais em trabalhadores de turnos fixos.MÉTODOS Estudo transversal com amostra de 902 trabalhadores de turnos, de ambos os sexos, de um frigorífico de frango do sul do Brasil, em 2010. O diagnóstico da síndrome metabólica foi determinado pelas recomendações doHarmonizing the Metabolic Syndrome; e sua frequência foi avaliada segundo características demográficas (sexo, cor de pele, idade e estado civil), socioeconômicas (escolaridade, renda e turno de trabalho) e comportamentais (tabagismo, consumo de álcool, atividade física de lazer, número de refeições/dia e duração do sono). A análise multivariada seguiu um modelo conceitual de determinação da síndrome metabólica em trabalhadores de turnos fixos.RESULTADOS A prevalência de síndrome metabólica foi 9,3% (IC95% 7,4;11,2). O componente mais frequentemente alterado foi a circunferência da cintura (RP 48,4%; IC95% 45,5;51,2), seguido pela lipoproteína de alta densidade. O turno de trabalho não esteve associado à síndrome metabólica e aos seus componentes alterados. Após ajustes, a prevalência da síndrome metabólica foi positivamente associada ao sexo feminino (RP 2,16; IC95% 1,28;3,64), a trabalhadores com 40 anos ou mais (RP 3,90; IC95% 1,78;8.93) e àqueles que reportaram dormir cinco horas ou menos por dia (RP 1,70; IC95% 1,09;2,24). Por outro lado, a síndrome metabólica esteve negativamente relacionada à escolaridade e a fazer mais do que três refeições por dia (RP 0,43 IC95% 0,26;0,73).CONCLUSÕES Ser mulher, possuir idade mais avançada e ter privação de sono mostraram-se potenciais fatores de risco para síndrome metabólica, enquanto ter maior escolaridade e realizar maior número de refeições/dia foram fatores de proteção para síndrome metabólica em trabalhadores de turnos fixos.

Influence of shift work in nursing on sleep and circadian blood pressure and rhythm / 心血管康复医学杂志

Objective: To explore influence of shift work in nursing on sleep and circadian blood pressure and rhythm. Methods: A total of 29 shift nurses, who worked in our hospital for a long period, were enrolled as shift nurse group. Another 32 day shift nurses were regarded as day shift nurse control group（control group）. Both groups received Pittsburgh sleep quality index (PSQI) assessment and 24h ambulatory blood pressure monitoring (ABPM). Results: Compared with control group, PSQI assessment showed that most factor scores and PSQI total score [(8.67±2.16) scores vs. (11.98±3.30) scores] significantly increased in shift nurse group（P<0.05~0.01）; 24h ABPM showed that mean nighttime SBP [(106.51±12.94) mmHg vs. (115.74±13.72) mmHg] and nighttime DBP [(71.23±9.76) mmHg vs. (74.96±10.68) mmHg] significantly rose in shift nurse group, P<0.05; Mean SBP decreasing rate [(7.84±1.52)% vs. (3.66±1.47)%] and mean DBP decreasing rate [(6.55±1.39)% vs. (2.83±0.51)%], SBP dipper percentage (59.38% vs. 31.03%) and DBP dipper percentage (68.75% vs. 27.59%) significantly reduced, SBP non-dipper percentage (40.63% vs. 68.97%) and DBP non-dipper percentage (31.25% vs. 72.41%) significantly rose in shift nurses group, P<0.05~0.01.Conclusions: There exists definite somnipathy and significant change of circadian blood pressure and rhythm in shift nurses.

Stroke and sleep-wake disturbance / 国际脑血管病杂志

Sleep-wake disturbance is not only a risk factor for stroke,but also one of the serious complications of stroke.The main clinical manifestations of post-stroke sleep-wake disturbance are insomnia,arousal disorders,sleep-related movement disorders and parasomnias.Its mechanism is mainly associated with the sleep-wake center after stroke injury.

Effects of sleep inertia on cognitive performance following different time course naps after 30 hours sleep deprivation in healthy men / 中华神经科杂志

Objective To study the effects of sleep inertia (SI) of different time course sleeps on sleep stages and cognitions in healthy men after 30 h sleep deprivation,and also to investigate the mechanism of cognitive functions impairment in sleep inertia stages and the influential factors of sleep inertia.Methods Ten healthy men (age,(20.8 ±2.1) years) participated in the program.The program was divided into 2 stages.First,participants attended a series of tests after 20 min nap(20 min nap group)after 30 h sleep deprivation.The testing series included 3 parts:the continuous performance task,the Stroop Tests,and the Addition Tests.The series of tests were done 3 times immediately after the volunteers were awoken and each lasted about 15 minutes with an interval of 10 minutes between each test.The polysomnogram (PSG) was recorded during the nap.The following 7 days was set as washing-out period to ensure a complete recovery.Participants repeated the similar processes with 2 h nap(2 h nap group) instead of 20 min nap.The cognitive performance of each group was compared with each other along with the best cognitive performance in awakening to estimate whether or not the cognitive abilities regained the normal condition.Results ( 1 ) Sleep latency became shortened in both groups after 30 h sleep deprivation.There were no slow wave sleep (SWS) and rapid eye movement sleep (REM) sleep stages in the 20 min naps,while the percentage of SWS was increased and percentage of REM declined in 2 h naps.(2)In the early of SI (5 min after awaking),cognitive tasks showed that the abilities of continuous attention,selected attention and addition ability were all impaired (continuous performance task:(371.8 ± 21.3 ) times/3 min vs (334.4 ± 22.4) times/3 min,( 373.2 ± 19.0) times/3 min vs ( 323.7 ± 23.8) times/3 min,t =10.443,7.774,both P＜0.01; Stroop tests:(20.3 ±1.5) points vs(17.3 ± 1.0) points,(21.5 ±0.8)points vs( 16.1 ± 1.4 ) points,t =8.478,4.934,both P ＜ 0.05 ; Addition Tests:( 222.2 ± 13.2 ) s vs ( 266.6 ±23.7 ) s,( 226.3 ± 10.9) s vs ( 267.6 ± 23.4 ) s,t =5.748,6.685,both P ＜ 0.01 ).The cognitive functions impairments of 2 h nap group were more severe at the initiation of sleep inertia,but regained the normal condition more quickly.Different cognitive tasks recovered at different speeds.The dispersion of SI needed 30 min.Conclusions ( 1 ) There are difference in the sleep construction and awaked sleep stage between 20 min nap and 2 h nap groups.(2) SI exerts negative influences on cognitive performances of continuous attention,selected attention and addition after sleep deprivation.Many factors may influence the dispersion of SI,including sleep debt,compensation of sleep debt and others.(3) Fragments of sleep are unfavorable to the recovery of body.

Impacto da sonolência excessiva na qualidade de vida e a influência do regime de turno de trabalho / Impact of excessive sleepiness on quality of life and the influence of the work shift regime

Objetivo: verificar a qualidade do sono de população que, além das atividades cotidianas, possui alteração em seu ciclo sono-vigília e quais as consequências dessas mudanças para a saúde e o desempenho cognitivo. Métodos: aplicaram-se 620 questionários em trabalhadores de turno fixo diurno de Belo Horizonte e nos de turno ininterrupto de revezamento da empresa Minerações Brasileiras Reunidas (MBR). Realizou-se o inquérito por meio do questionário desenvolvido pelo Serviço de Distúrbios do Sono do Hospital Saint-Antoine, França. Incluiu-se no questionário a Escala de Sonolência de Epworth (ESE). Resultados: em ambas as populações evidenciou-se alta incidência de alterações do sono, como: ronco (58,21%), irritabilidade (50,40%), paradas respiratóriasdurante o sono (12,66%), comprometimento da memória recente (40,61%), sonolência excessiva diurna (63,48%), diminuição da atenção (34,30%) e ESE ? 10 (30,08%). Entre os que apresentavam queixa de sonolência diurna (63,69%), 47,33% tinham também dificuldade de memória, 42,60% déficit de atenção e 57,50%, irritabilidade. Foram mais evidentes a queixa de ronco e paradas respiratórias entre portadores de sobrepeso do que entre os com IMC < 25 kg/m2 - ronco (70,24 vs 43,70%) e parada respiratória (17,86 vs 6,64%), p<0,01 para as duas variáveis. Conclusão: as alterações no sono não estão restritas aos trabalhadores de turno. A inversão do ritmo circadiano não é a única causa de comprometimento da qualidade do sono, pois este se mostra alterado e algumas vezes com qualidade inferior também nos trabalhadores da população com turno fixodiurno. É importante a conscientização da população sobre o impacto do sono na qualidade de vida.

Objective: to check the sleep quality of the population that, in addition to daily activities, has changes in the sleep-wake cycle and the consequences of these changes for health and cognitive performance. Method: 620 questionnaires were applied to workers of regular daily shift in Belo Horizonte and to those with continuous alternation shift of theCompany Minerações Brasileiras Reunidas (MBR). The survey was carried out through questionnaire developed by the Sleep Disturbance Service of Hospital Saint-Antoine, France. In the questionnaire it was included the Epworth Sleepiness Scale (ESS). Results: high incidence of sleep alteration was proved in both population groups, such as: snoring(58,21%), irritability (50,40%), respiratory failure during sleep (12,66%), impairment of recent memory (40,61%), excessive daytime sleepiness (63,48%), attention decrease (34,30%) and ESS ?10 (30,08%). Among those with daytime sleepiness complaint (63,69%), 47,33% also had memory impairment, 42,60% had attention decrease and 57,50% had irritability. Snoring and breathing failure were more evident complaints among those with overweight than among those with IMC <25 kg/m2 - snoring (70.24 vs. 43.70%) and respiratory failure (17.86 vs 6.64%), p <0.01 for both variables. Conclusion: sleep changes are not restricted to workers on duty. The inversion of the circadian rhythm is not the only cause of impaired sleep quality, as it is changed and sometimes with lower quality of life also among workers in the population with fixed daytime shift. It is important the public awareness of the impact of sleep on quality of life.

Sonolência diurna excessiva em adolescentes: prevalência e fatores associados: [revisão] / Daytime sleepiness in adolescents: prevalence and associated factors: [review]

OBJETIVO: Analisar pesquisas sobre sonolência diurna excessiva em adolescentes e apresentar, por meio de revisão sistemática, as prevalências e os fatores associados. FONTES DE DADOS: Foram analisados estudos encontrados nas bases de dados PubMed e SciELO, que apresentassem resultados originais, sem restrições de período e idioma na pesquisa. SÍNTESE DOS DADOS: A prevalência de sonolência diurna excessiva encontrada variou entre 7,8 e 55,8 por cento. As escalas Epworth Sleepiness Scale e a School Sleep Habits Survey foram os principais instrumentos utilizados. Associações da sonolência diurna excessiva com problemas relacionados ao sono, como o ranger de dentes, apneia e insônia, dentre outros, foram descritas com maior frequência nos estudos analisados. A associação de outros possíveis fatores de cunho biológico, ambiental e comportamental com a sonolência diurna excessiva não foi descrita com clareza. CONCLUSÕES: Vários fatores, como o comportamento sedentário e hábitos alimentares, foram pouco investigados e apresentaram resultados divergentes quando analisados como variáveis associadas à sonolência diurna excessiva. Uma carência de investigações epidemiológicas com amostras brasileiras foi identificada.

OBJECTIVE: To assess studies on excessive daytime sleepiness in adolescents and to present a systematic review the prevalence and associated factors. DATA SOURCES: Papers found on PubMed and SciELO databases presenting original results without restriction of time and language were evaluated. DATA SYNTHESIS: The prevalence of excessive daytime sleepiness ranged from 7.8 to 55.8 percent. The Epworth Sleepiness Scale and the School Sleep Habits Survey were the main tools used in the studies. Associations of excessive daytime sleepiness with sleeping-related problems, such as teeth gnashing, sleep apnea and insomnia, among others, were frequently described. The association of other biological, environmental and behavioral factors with excessive daytime sleepiness was not clearly assessed. CONCLUSIONS: Many factors, such as sedentary behavior and alimentary habits, were poorly investigated so far and presented controversial results when analyzed as variables related to excessive daytime sleepiness. A lack of epidemiological studies with Brazilian adolescents was identified.