Associação do autorrelato de problemas no sono com morbidades e multimorbidades segundo sexo: Pesquisa Nacional de Saúde 2019 / Asociación de los problemas de sueño autoinformados con morbilidades y multimorbilidades según el sexo: Encuesta Nacional 2019 / Association of self-reported sleep problems with morbidities and multimorbidities according to sex: National Health Survey 2019

Objetivo: Avaliar a associação do autorrelato de problemas no sono com a presença de doenças crônicas não transmissíveis (DCNTs) e multimorbidades, e se essas associações diferem por sexo. Métodos: Estudo transversal realizado com dados da Pesquisa Nacional de Saúde 2019. Razões de prevalências entre morbidades, número de DCNTs e autorrelato de problemas no sono foram estimadas por regressão de Poisson com variância robusta, por sexo. Resultados: Foram analisados 85.531 brasileiros com idade ≥18 anos. Os problemas no sono autorrelados associaram-se a todas as morbidades e multimorbidades. A prevalência dos problemas no sono foi maior nos que declararam uma ou duas (RP = 2,37; IC95% 2,22;2,54) e três ou mais DCNTs (RP = 4,73; IC95% 4,37;5,11). As razões de prevalências da associação com diabetes, doenças pulmonares, mentais, renais e multimorbidades foram mais elevadas entre o sexo masculino. Conclusão: As DCNTs impactaram significativamente a qualidade do sono em ambos os sexos, com associação mais forte para o sexo masculino.

Objetivo: Evaluar la asociación de problemas de sueño con la presencia de enfermedades crónicas no transmisibles (ECNTs) y multimorbilidades, y si estas asociaciones difieren por sexo. Métodos: Estudio transversal con datos de la encuesta epidemiológica Pesquisa Nacional de Saúde 2019. Se estimaron las razones de prevalencia entre morbilidades, número de ECNTs y problemas de sueño por regresión de Poisson con variación robusta, por sexo. Resultados: Se analizaron 85.531 brasileños ≥ 18 años. El autoinforme de problemas de sueño se asoció con todas las morbilidades estudiadas y con multimorbilidades. La prevalencia de problemas de sueño fue mayor en aquellos que informaron uno o dos (PR = 2,37; IC95% 2,22;2,54) y tres o más ECNTs (RP = 4,73; IC95%4,37;5,11). Las razones de prevalencia de la asociación de diabetes con enfermedades pulmonares, mentales, renales y multimorbilidades han sido más fuertes en el sexo masculino. Conclusión: Las ECNTs tienen un impacto significativo en la calidad del sueño con fuerte asociación en ambos sexos, masculino y feminino.

Objective: To evaluate the association between self-reported sleep problems and the presence of non-communicable diseases (NCDs) and multimorbidity, and whether these associations differ by sex. Methods: This is a cross sectional study performed with data from the Brazilian National Health Survey, 2019. Prevalence ratios between morbidities, the number of NCDs, and the self-report of sleep problems were estimated by Poisson regression with robust variance, according to sex. Results: This study analysed data from 85,531 Brazilians age ≥ 18 years. The self-reported sleep problems were associated with all the herein studied morbidities and multimorbidities. The prevalence of sleep problems was higher in those who stated one or two (PR = 2.37; 95%CI 2.22;2.54) and three or more NCDs (PR = 4.73; 95%CI 4.37;5.11). Prevalence ratios of the association with diabetes, lung disease, mental disease, renal disease and multimorbidities were higher among males. Conclusion: NCDs significantly impacted sleep quality, with a particularly stronger association in both, males and females.

Evaluation of Sleep Quality and Daytime Sleepiness in Dentistry Students

Abstract Objective: To evaluate sleep quality and excessive daytime sleepiness in undergraduate dentistry students. Material and Methods: This research is characterized as an observational study of transversal type, having analysed undergraduate students in dentistry from a public university in the State of Pernambuco, Brazil. The sample consisted of 325 students enrolled between the 1st and 10th academic semester. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), while excessive daytime sleepiness was analysed through the Epworth Sleepiness Scale (ESS). The t-Student and Mann-Whitney tests were used for the numerical values, with the F-test (ANOVA) or the Kruskal-Wallis test being used to compare more than two categories. Results: It was observed that 71.1% of students presented a poor sleep quality, with more than half of the students exhibiting excessive daytime sleepiness (58.1%). A relationship between sleep quality and the academic semester was verified. However, gender and age were not associated with sleep quality or with excessive daytime sleepiness. Conclusion: A high prevalence of poor sleep quality and excessive daytime sleepiness was observed among undergraduate students in dentistry. The data suggest that the undergraduate degree in Dentistry can influence the students' quality of sleep, regardless of age or gender.

Alteraciones del sueño y bruxismo / Sleep alterations and bruxism

El sueño es un requerimiento biológico para la vida, sus alteraciones o su ausencia pueden disminuir la calidad de vida, el estado anímico y funcional, afectando seriamente la salud. Un sueño placentero y reparador implica cursar por facetas de profundidad diversa y actividad neuronal compleja. En este artículo se intentan explicar las generalidades del proceso del sueño y algunos de sus trastornos que lo relacionan con aumento de la actividad de los músculos masticatorios (bruxismo). Son presentados aspectos clínicos y neuronales que inducen a un incremento de microdespertares como alteración del sueño, estimulando bruxismo nocturno y bruxismo asociado a apnea nocturna. Son discutidas las posibles relaciones bidireccionales entre bruxismo diurno y nocturno secundarias a modifi caciones en la cantidad y calidad del proceso del sueño. De la misma manera, son sugeridas algunas consideraciones semiológicas y nosológicas para el mejor manejo y control del bruxismo asociado a las alteraciones del sueño, bajo el diagnóstico, atención y supervisión de equipos de atención multi- e interdisciplinarios (AU)

Sleep is a biological requirement for life, its alterations or privation thereof may reduce a person's quality of life, his or her state of mind and physical functions, which signifi cantly aff ects their health. Pleasant and repairing sleep implies going through variable deepness sleep stages, and a complex neuronal activity. This article intends to explain the generalities of the sleep process and certain disorders, particularly those in connection with the activity of the mastication muscles (bruxism). Clinical and neuronal aspects are presented inducing an increase in micro-awakenings such as sleep alterations stimulating nocturnal and bruxism associated with sleep apnea. Bidirectional connections between diurnal and nocturnal bruxism are argued as secondary to changes in the amount and quality of the sleep process. In the same manner, certain considerations associated to semiology and nosology of the diverse bruxism manifestations are considered for the better handling and control of the bruxism associated with sleep alterations under the diagnosis attention and supervision of multi- and interdisciplinary teams (AU)

Challenges in fibromyalgia diagnosis: from meaning of symptoms to fibromyalgia labeling

Fibromyalgia (FM) is a contested illness with ill-defined boundaries. There is no clearly defined cut-point that separates FM from non-FM. Diagnosis of FM has been faced with several challenges that occur, including patients' health care-seeking behavior, symptoms recognition, and FM labeling by physicians. This review focuses on important but less visible factors that have a profound influence on under- or over-diagnosis of FM. FM shows different phenotypes and disease expression in patients and even in one patient over time. Psychosocial and cultural factors seem to be a contemporary ferment in FM which play a major role in physician diagnosis even more than having severe symptom levels in FM patients. Although the FM criteria are the only current methods which can be used for classification of FM patients in surveys, research, and clinical settings, there are several key pieces missing in the fibromyalgia diagnostic puzzle, such as invalidation, psychosocial factors, and heterogeneous disease expression. Regarding the complex nature of FM, as well as the arbitrary and illusory constructs of the existing FM criteria, FM diagnosis frequently fails to provide a clinical diagnosis fit to reality. A physicians' judgment, obtained in real communicative environments with patients, beyond the existing constructional scores, seems the only reliable way for more valid diagnoses. It plays a pivotal role in the meaning and conceptualization of symptoms and psychosocial factors, making diagnoses and labeling of FM. It is better to see FM as a whole, not as a medical specialty or constructional scores.

Associations between Sleep Duration and Smoked Cigarettes per Day, Heavy Smoking in Smokers

BACKGROUND: This study was performed to evaluate the associations between sleep duration and smoked cigarettes per day, prevalence of heavy smoking. METHODS: This study was based on the data of 9,893 subjects who are currently smoking, from the 4th to 6th Korea National Health and Nutrition Examination Survey. Based on appropriate sleep duration from National Sleep Foundation, study subjects were categorized into short, appropriate and over sleep group. Multiple regression analysis was performed to evaluate the association between sleep duration and smoked cigarettes per day, prevalence of heavy smoking. Age, gender, household income, education, marital status, occupation, alcohol use, body weight, hypertension, diabetes mellitus, depression, and level of stress were controlled. RESULTS: Compared with appropriate sleep group, smoked cigarettes per day and prevalence of heavy smoking were higher in short sleep group, and lower in over sleep group. CONCLUSIONS: There is association between sleep duration and smoked cigarettes per day, prevalence of heavy smoking.

Vida cotidiana del adulto mayor y la necesidad de sueño-descanso / Daily life of the elderly and the need for sleep-rest

La necesidad de sueño-descanso en el adulto mayor se encuentra seriamente comprometida debido a la presencia de trastornos del sueño, específicamente insomnio y somnolencia excesiva diurna, que en la actualidad representan un problema de salud pública. La etiología de dichos trastornos es multifactorial, ya que además del factor biológico existen otros componentes en su vida cotidiana que los agravan, tales como factores psicológicos, ambientales y económicos. En este sentido, la vida cotidiana del adulto mayor se visualiza como objeto de estudio de esta investigación en relación a la necesidad de sueño-descanso. OBJETIVO: Describir, analizar e interpretar las vivencias de la vida cotidiana del adulto mayor en relación con la necesidad de sueño-descanso. MÉTODO: Se realizó un estudio usando la técnica de investigación cualitativa, fenomenológica, exploratoria y descriptiva. Se eligieron a cinco adultos mayores que presentaran insomnio o somnolencia excesiva diurna y se les aplicó la entrevista en profundidad. El análisis de los datos fue de contenido tipo temático. RESULTADOS: Se encontraron dos categorías y tres subcategorías. 1. Prácticas del adulto mayor: a) Prácticas repetitivas, las cuales realiza de forma involuntaria el adulto mayor en su vida cotidiana, tales como establecer un horario autoimpuesto para dormir y despertar, el cual reduce la cantidad de horas recomendadas de sueño y por consecuencia la eficacia del mismo. b) Tareas agobiantes: Son actividades que realiza el adulto mayor como parte de su cotidianeidad y que responden a necesidades de terceras personas y que le generan una sensación de estrés durante el día, el cual, modifica el ciclo de sueño, presentando insomnio y cansancio emocional y mental, así como una disminución del tiempo que dedican a sí mismos. c) Actividades recreativas, que son regeneradoras de energía, ayudan a liberar el estrés y fomentan un descanso integral en el adulto mayor, sin embargo no hay una consciencia de la importancia que tiene el tiempo de ocio en la vejez, y los adultos mayores no le dan prioridad en su vida cotidiana. 2 Ansiedad nocturna, se refiere a un estado de agitación e inquietud que dificulta la conciliación y mantenimiento del sueño, propiciando la aparición de pensamientos y sentimientos negativos por problemas familiares y económicos principalmente, los cuales provocan síntomas de insomnio, afecto deprimido y somatización de enfermedades. CONCLUSIÓN: Los resultados obtenidos sugieren que el adulto mayor cae en un círculo vicioso que afecta la necesidad de sueño-descanso, pues no distribuye de manera adecuada el tiempo en su vida cotidiana, ya que realiza actividades que son generadoras de estrés que provocan un cambio en el ciclo de sueño-vigilia con la presencia de insomnio, el cual conlleva a un agotamiento y un deterioro en la realización de actividades cotidianas.

The elderly necessity of sleeping is compromised due to sleep disorders, specifically insomnia and excessive daytime sleepiness (EDS), which are currently an issue in public health. The etiology of said disorders is multifactorial because, besides the biological factor, there are other components in the everyday- life that aggravate them; such as psychological factors, environmental factors and economic factors. Considering this, the elderly everyday-life will be this research object of study in relation to the necessity of sleeping. OBJECTIVE: Describe, analyze and interpret the elderly everday-life experiences in relation to the necessity of sleeping. METHOD: The study was made using a qualitative, phenomenological, exploratory and descriptive research method. Five elderlies suffering from insomnia or EDS were chosen and interviewed. The data was analyzed using thematic analysis. RESULTS: There are two categories and three subcategories. 1. Elderly customs: a) Repetitive customs, which are done unintentionally by the elderly in their everyday-life, such as having a self-imposed schedule to sleep and wake, which, reduces the recommended amount of sleep and therefore the efficacy of it. b) Overwhelming activities, which are activities that the elderly do in their everyday-life in order to fulfil other's needs, which cause them a feeling of stress during the day that affects the sleep cycle, causing insomnia, emotional exhaustion and mental fatigue, as well as a decrease in the amount of time they spend on themselves. c) Recreational activities, which give energy, help to relieve stress and promote complete rest in the elderly. However, there is not awareness of how important this leisure time is at old age, so the elderly do not give it priority in their everyday-life. 2. Sleep anxiety, which refers to a state of turmoil and restlessness that causes problems to fall asleep and stay asleep, leading to negative thoughts and feelings, caused mainly by family and economic problems, which results in insomnia, depression and somatization. CONCLUSION: The results suggest that the elderly falls into a vicious circle that affects the necessity of sleeping. As a result of they not being able to organize their everyday-life time properly; due to the fact that they do activities that cause stress and a change in the sleep-wake cycle in conjunction with the presence of insomnia, which leads to exhaustion and deterioration in the performance of daily activities.

Facing Complaining Customer and Suppressed Emotion at Worksite Related to Sleep Disturbance in Korea

This study aimed to investigate the effect of facing complaining customer and suppressed emotion at worksite on sleep disturbance among working population. We enrolled 13,066 paid workers (male = 6,839, female = 6,227, age < 65 years) in the 3rd Korean Working Condition Survey (2011). The odds ratio (OR) and 95% confidence intervals (CI) for sleep disturbance occurrence were calculated using multiple logistic regression models. Among workers in working environments where they always engage complaining customers had a significantly higher risk for sleep disturbance than rarely group (The OR [95% CI]; 5.46 [3.43–8.68] in male, 5.59 [3.30–9.46] in female workers). The OR (95% CI) for sleep disturbance was 1.78 (1.16–2.73) and 1.63 (1.02–2.63), for the male and female groups always suppressing their emotions at the workplace compared with those rarely group. Compared to those who both rarely engaged complaining customers and rarely suppressed their emotions at work, the OR (CI) for sleep disturbance was 9.66 (4.34–20.80) and 10.17 (4.46–22.07), for men and women always exposed to both factors. Sleep disturbance was affected by interactions of both emotional demands (engaging complaining customers and suppressing emotions at the workplace). The level of emotional demand, including engaging complaining customers and suppressing emotions at the workplace is significantly associated with sleep disturbance among Korean working population.

Assessment of depression, anxiety, sleep disturbance, and quality of life in patients with chronic low back pain in Korea / 대한마취과학회지

BACKGROUND: Chronic low back pain (CLBP) has a significant effect on quality of life and imposes a great economical burden on society. In a number of studies, validated questionnaires had been given to CLBP patients to determine their health-associated quality of life, sleep disturbance, and psychological status. However, such outcome studies had not been performed previously in Korea. METHODS: We used self-report questionnaires to compare CLBP patients with an age- and sex-matched healthy control group. Between September 2012 and August 2013, we enrolled 47 patients who had CLBP for more than 3 months (group P) and 44 healthy age- and sex-matched controls (group C), who completed the following self-report questionnaires: 36-Item Short Form Health Survey (SF-36), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Oswestry Disability Index (ODI), and Pittsburgh Sleep Quality Index (PSQI). RESULTS: The scores from the ODI, BDI, and BAI were significantly higher in group P than in group C. The SF-36 scores were significantly lower in group P than in group C, suggesting lower quality of life in group P. The incidence of depression and anxiety was significantly higher in group P than in group C. However, neither the PSQI score nor the incidence of sleep disturbance was significantly different between the groups. CONCLUSIONS: Patients with CLBP showed considerable functional disability and significant impairment of psychological status with a low quality of life. Hence, it is important to evaluate CLBP patients to provide adequate psychological support.

Psychosocial Factors in Patients with Chronic Kidney Disease / 한양의대학술지

This review article is intended to show and understand psychosocial factors in patients with chronic kidney disease (CKD) including end-stage renal disease (ESRD) on renal replacement therapy. These patients suffered from many psychosocial factors such as depression, sleep disorder, and chronic pain, etc. The prevalence of major depression or a defined psychiatric illness in ESRD patients is not clearly defined, but is roughly estimated between 5% and 50%. Unfortunately many sufferers do not seek treatment, and of those who do, significant numbers are improperly diagnosed or are not appropriately treated. They should be managed by psychiatric medication and interview, because depression could affect medical outcomes in ESRD patients through several mechanisms. Sleep disorders are common in ESRD patients treated with dialysis and are associated with patients' perceptions of quality of life, assessed by diverse measures, as well as depressive mood. Although pain has been considered as a problem for ESRD patients for more than 20 years, few studies exist on this subject. Pain appears to be an undervalued problem for ESRD patients. These psychosocial factors could affect morbidity, mortality and life quality in CKD and ESRD patients. The physicians, especially managing CKD patients, need to consider these factors.

Incidence of and Risk Ractors for Zolpidem-Induced Delirium / 대한내과학회지

BACKGROUND/AIMS: Zolpidem is a safe and effective drug for the treatment of insomnia. However, there are some reports of adverse effects, such as delirium, after administration of zolpidem. The aim of this study was to evaluate the incidence of and risk factors for zolpidem-induced delirium. METHODS: This retrospective study enrolled 481 patients who were admitted to hospital and received zolpidem between January and May 2011. We analyzed the incidence and risk factors associated with zolpidem-induced delirium. RESULTS: Zolpidem-induced delirium occurred in 19 of 481 (4.0%) patients. Zolpidem-induced delirium was significantly associated with old age (> or = 65 years; odds ratio [OR] = 4.35, 95% confidence interval [CI] = 1.52-12.44, p = 0.006) and co-administration of benzodiazepine (OR = 4.30, 95% CI = 1.52-12.12, p = 0.006). When males > 65 years-old took both benzodiazepine and zolpidem simultaneously, the incidence of delirium was notably elevated (OR = 6.04, 95% CI = 1.80-20.20, p = 0.003). Other factors, including dosage, did not influence the occurrence of delirium. CONCLUSIONS: Old age and co-administration of benzodiazepine were independent risk factors for zolpidem-induced delirium. Therefore, a detailed medical history should be taken before prescribing zolpidem to an older person, and zolpidem should be used cautiously, with careful monitoring, in these patients.

Diagnosis and Treatment of Restless Legs Syndrome / 한양의대학술지

Restless legs syndrome (RLS) is a sensorimotor neurologic disorder, in which the primary symptom is a compelling urge to move the legs accompanied by unpleasant and disturbing sensations in the legs. RLS is relatively common, affecting 2.5 to 15% of the general population, with prevalence rates increasing alongside age. Sleep disturbance is the most common symptom owing to RLS leg symptoms. In addition, daytime dysfunction, cognitive decline, and mood disturbance are also common in patients with RLS. Iron and dopamine are implicated in the pathophysiology of RLS, however, the underlying pathophysiology of RLS is still not fully understood. The diagnosis can be made based on the symptom characteristics, differential diagnosis is important because many conditions could mimic RLS symptoms. Dopaminergic agents are recommended for the first line treatment of RLS. Alpha2delta anticonvulsants such as gabapentin and pregabalin are also effective for controlling RLS symptoms.

Sleep disturbance induced by cocaine abstinence involving in A2A receptor over-expression in rat hypothalamus / 生物医学工程学杂志

Adult rats were implanted with sleep-wake recording electrodes in our experiments. Polygraphic signs of undisturbed sleep-wake activities were recorded for 24 h before cocaine administration, cocaine withdrawal day 1 (acute), day 8 (subacute), and day 14 (subchronic). Western blot method was performed to examine the expression levels of adenosine receptor subtypes in hypothalamus and cerebellum. Non rapid eye movement (NREM) sleep was significantly increased during nighttime (P < 0.01) and daytime (P < 0.05) on withdrawal day 8. The increase of NREM sleep was significant during nighttime (P < 0.01) and slight during daytime on withdrawal day 14, whereas both daytime and nighttime rapid eye movement (REM) sleeps were reduced markedly (P < 0.01) on withdrawal day 8 and 14. In addition, A2A receptor level was significantly enhanced on cocaine withdrawal day 8 and day 14 (P < 0.05), whereas A1 receptor level reduced markedly on withdrawal day 14 (P < 0.05). However, compared with that in the control group, no significant changes existed among adenosine A1, A2A and A2B receptors in rat cerebellum on cocaine withdrawal day 1, day 8 and day 14. Our findings suggest that sleep disorder caused by subacute and subchronic cocaine abstinence may be associated with over-expression of adenosine A2A receptor in rat hypothalamus to some extent.

Valoración de la higiene del sueño mediante una escala modificada en adultos mayores / An assessment of sleep quality in the elderly by using a modified scale

Objetivo: Modificar el índice desarrollado por Mastin y col, para aplicarlo en Adultos Mayores. Material y método: Se realizó la traducción, validación mediante jueces y la evaluación de la consistencia interna mediante el estadístico alfa de Cronbach del “Índice de Higiene del Sueño modificado para adultos mayores” (IHS-AM), construido a partir del índice desarrollado por Mastin y col. Resultados: Se realizó la traducción del instrumento y la modificación para su aplicación en adultos mayores mediante seis expertos encontrándose una validación del instrumento mediante jueces por coincidencia del 80. Se realizó una prueba preliminar para ajuste de la escala a 50 personas mayores de 60 años, previa autorización mediante consentimiento informado, excluyéndose a aquellos iletrados, con deterioro cognitivo moderado o severo y con déficit severo visual o auditivo. El instrumento IHS-AM elaborado obtuvo una confiabilidad determinada por un alfa de Cronbach de 0,7. Conclusión: El índice de higiene del sueño modificado para adultos mayores (IHS-AM) es un instrumento útil para ser aplicado en adultos mayores.

Objective: To modify the currently used Sleep Hygiene Index by Mastin et al, in order to use it in the elderly. Material and method: An elderly-adapted version of the Sleep Hygiene Index originally proponed by Mastin et al. was translated, peer-validated and had its internal consistency assessed using Cronbach’s Alpha method. Results. The aforementioned instrument was translated and modifications for its use in the elderly were performed by six experts, and the instrument was validated for use in the elderly according to an 80 coincidence. A preliminary test for adjusting the scale was performed in 50 subjects who were more than sixty-years old, after signing an informed consent and excluding the illiterate persons, those with moderate or severe cognitive deterioration, and those with sever visual or auditory deficit. The modified instrument obtained a 0.7 value for reliability according to Cronbach’s alpha test. Conclusion: The modified Sleep Hygiene Index is a useful instrument to be applied in the elderly.

Prevalencia de los trastornos del sueño en niños escolares de Sabaneta, Colombia, 2005 / Prevalence of sleep disorders in school children from Sabaneta, Colombia 2005

El sueño es una de las funciones básicas en la vida del niño y condición esencial para el estado de alerta diurno, por tanto su alteración influye negativamente sobre su desarrollo yel bienestar de la familia. Los trastornos del sueño son muy comunes durante la niñez, la Academia Americana de Pediatría en 2001 informó una tasa global de 20% a 30%. Sin embargo,en Colombia han sido escasamente estudiados. Objetivo: establecer la prevalencia de trastornos del sueño en niños escolares del municipio de Sabaneta, los antecedentes familiaresy las características sociodemográficas asociadas. Métodos: se realizó un estudio de observación descriptivo, aleatorizado y de corte transversal donde se analizaron los resultadosobtenidos de 296 cuestionarios diligenciados por los padres de niños pertenecientes a colegios de las áreas urbana y rural del municipio. Dicho cuestionario contenía criteriosclínicos para la clasificación de los trastornos del sueño según el DSM-IV. Resultados: la prevalencia de los diferentes trastornos del sueño fue como sigue: ronquido 39,2%;somniloquia 35,1%; bruxismo 33,1%; apnea obstructiva del sueño 16,9; colecho 16,9%; insomnio 14,9%; pesadillas 12,8%; enuresis 9,5%; sonambulismo 7,4%; despertares nocturnos 7,4%; terrores nocturnos 6,1%; resistencia/miedo a dormir 4,1%. Los despertares nocturnos fueronsignificativamente más frecuentes en niños de estratos socioeconómicos altos (IC: 0,19-0,97); la enuresis lo fue en varones (IC: 0,14-0,96) y las pesadillas lo fueron en niños mayores de 9años (IC: 0,24-0,91). Conclusión: la prevalencia de trastornos del sueño en la población escolar del municipio de Sabaneta es alta y similar a la reportada en otros países. Estos resultados deben incentivar a los padres de familia y pediatras a estar alerta para poderhacer un diagnóstico precoz, que evite complicaciones a largo plazo de un trastorno de sueño no tratado.

Sleep is one of the basic needs in a child’s life and it is essential for day time alert state. Any sleep disturbancehas a negative impact on the child’s development, his/her own well-being and that of the family. Sleep disorders are common in childhood. The AmericanAcademy of Pediatrics showed in 2001 a prevalence of 20-30%. In Colombia these disorders have not been well investigated. Objective: to find out the prevalence of sleep disorders in schoolchildren of Sabaneta, Colombia,as well as their medical histories and sociodemographic characteristics. Methods: an observational, descriptive, randomized, cross sectional studywas carried out, based on the results of 296 questionnaires answered by parents. DSM-IV criteria for the classification of sleep disorders were included in the questionnaire. Results: prevalence of the various disorders was as follows: snoring 39.2%; sleeptalking disorder 35.1%; bruxism 33.1%; obstructive sleep apnea 16.9%; cosleeping 16.9%; insomnia 14.9%;nightmares 12.8%; enuresis 9.5%; sleep walking disorder 7.4%; night awakenings 7.4%; night terrors6.1%; fear to fall asleep 4.1%. Enuresis was significantly more frequent in males (CI: 0.14-0.96), night awakenings in children from higher socioeconomicstrata (CI: 0.19-0.97), and nightmares in those older than 9 years (CI: 0.24-0.91). Conclusion: sleep disorders are frequent in the studied group; theirprevalence is similar to that reported from other countries. These results should motivate parents andpediatricians in order to make early diagnosis and, therefore, to avoid long-term complications.

Detrimental effects of variable work shifts on quality of sleep, general health and work performance

The aim of this study was to explore the detrimental effects of working a varying pattern of 8-hour shifts on quality of sleep, general health and work performance. The Arabic version of the Pittsburgh Sleep Quality Index [PSQI]and 2 self-administered questionnaires were used to assess quality of sleep, work performance and general health in a sample of 200 males on a schedule of varying 8-hour shifts at the Kuwait Oil Company. A matched sample of an equal number of workers on a fixed daytime shift as a control group was enrolled in the study. Compared with men working on a straight daytime shift schedule, those working on 8-hour variable shifts exhibited higher rates of heavy smoking [p < 0.003], coffee/tea consumption [p < 0.0001], constipation [p < 0.002], job stress [p < 0.0001] and poor sexual performance [p < 0.0001]. Variable-shift workers reported persistent sleep disturbances in 3 dimensions of the global score of the PSQI [p < 0.0001]. They also had significantly more complaints of fatigue [p < 0.005], poor level of work performance [p < 0.005] and loss of concentration [p < 0.005]. Shift workers were significantly more prone to making errors and having accidents at work, and were more likely to report absence from work than the controls [p < 0.0001 and p < 0.005, respectively]. These results suggest that the majority of workers on an 8-hour variable-shift schedule experienced various health problems, poor quality of sleep and an increased risk for errors and accidents at work as compared with those workers on a straight daytime shift schedule. There is a need to compare potential benefits of an alternative work shift schedule

Impacto dos transtornos do sono sobre o funcionamento diário e a qualidade de vida / Sleep disorders impact on daily functioning and life quality

Os distúrbios do sono provocam conseqüências adversas na vida das pessoas por diminuir seu funcionamento diário, aumentar a propensão a distúrbios psiquiátricos, déficits cognitivos, surgimento e agravamento de problemas de saúde, riscos de acidentes de tráfego, absenteísmo no trabalho, e por comprometer a qualidade de vida. Este estudo foi realizado com o objetivo de revisar a literatura especializada sobre as características dos distúrbios de sono mais freqüentes na população geral e suas implicações sobre os comportamentos, a rotina diária e a qualidade de vida das pessoas portadoras dessa condição. Os estudos revisados mostram que os distúrbios do sono desencadeiam conseqüências adversas à saúde e ao bem-estar dos indivíduos, afetando o trabalho, a cognição, os relacionamentos e o funcionamento diário, com diferentes desdobramentos a curto, médio e longo prazo.

Sleep disorders are responsable for many adverse outcomes on people's lives by reducing their daily functioning, increasing psychiatric disorders susceptibility, cognitive deficits, onset and aggravation of health problems, traffic accident risks, work absenteeism, and by diminishing the quality of life. This study was aimed to review the specialized literature about the characteristics of the sleep disturbances that present greater incidence in the general population, and its implications on affected people's behaviors, daily routine and quality of life. Sleep disorders were found to trigger adverse outcomes to people's health and well being by disturbing their work, cognition, relationship and daily functioning, with multiple unfolding in short, medium and long time.

[Comparison of sleep disorder in myocardial infarction patients with their healthy relatives]

Cardiovascular diseases are among the most common causes of mortality and sleep disturbances are common in today society. The purpose of the present study I to determine relationship between wide spectrum of sleep disorders including dyssomnias and parasomnias and occurrence of myocardial infarction. This is a prospective case control study which was performed on 65 patients with acute myocardial infarction and 65 cases of their healthy relatives. Data were collected by Epworth sleepiness scale and analyzed with SPSS software and using chi square, t-test and variance analysis. For dyssomnias, frequency of early awakening in the morning, sleep duration at night, difficulty in falling asleep, sleep disruption and restless leg syndrome in case group were significantly higher than control group. For parasomnias, frequency of sleep paralysis, nightmare and sleep walking in case group were significantly higher than control group. Sleep disorders are more frequent among patients with myocardial infraction and can be considered as a risk factor for this disorder

Sleep disorders in childhood / 소아과

Sleep disorders are very common among pediatric patients. Its prevalence is between 10% and 45% in preschool- and school-aged children. However parents commonly do not concern about their children's sleeping habits and for many pediatricians, there is not part of the routine office visit about a childs sleep. Sleep disorders were classified by International Classification of Sleep Disorder (ICSD) as dyssomnias, parasomnias, sleep disorders associated with mental, neurologic, or other medical disorders, and proposed sleep disorders. There are lots of differences in the causes, manifestations, and managements of sleep disorders between children and adults. The sleep disorders in childhood may manifest themselves as bedtime resistance, refusal to go to bed at a parentally described time, sleep-onset delay, inability to fall asleep within a reasonable time, prolonged nighttime awakening, and inability to return to sleep without assistance after waking during the night, and so have wide-ranging influences on children's behavior, mood, school performance, and family life. It's very important for pediatrician to concern about the sleep disturbances in childhood and so the problems of sleep in children should be early detected and managed.

Clinical observation on governor vessel Daoqi method for treatment of dyssomnia in the patient of depression / 中国针灸

<p><b>OBJECTIVE</b>To explore clinical therapeutic effects of Governor Vessel Daoqi needling method combined with antidepressants on dyssomnia in the patient of depression.</p><p><b>METHODS</b>depression with dyssomnia were randomly divided into a treatment group (n=23) and a control group (n=22). The treatment group were treated with Governor Vessel Daoqi needling method and oral administration of antidepressants, with Shenting (GV 24), Baihui (GV 20), Dazhui (GV 14), Shendao (GV 11) and Zhiyang (GV 9) selected as main acupoints; and the control group with simple antidepressants. They were treated for 4 weeks. Changes of scores for Hamilton Depression Rating Scale (HAMD) and Pittsburgh Sleep Quality Index (PSQI) were investigated in the two groups.</p><p><b>RESULTS</b>Significant differences before and after treatment in the scores for HAMD (P < 0.01) in both the two groups, and a significant difference before and after treatment in the score for PSQI only in the treatment group (P < 0.01) were found; after treatment, there were significant differences between the two groups in the scores of HAMD and PSQI (P < 0.01).</p><p><b>CONCLUSION</b>The combined therapy of Governor Vessel Daoqi needling method and antidepressants can significantly improve dyssomnia in the patient of depression.</p>