Free-time physical activity and pain perception: An analysis of daily records from Brazilian teachers.

The sensation of pain is frequent in teachers and its relationship with the practice of free-time physical activity still needs more scientific evidence. This study analyzed the association between free-time physical activity and pain symptoms experienced by teachers during the day and at bedtime. In this cross-sectional study, data were obtained through individual interviews and the fulfillment of an activity diary by teachers from a city located in southern Brazil. Statistical analysis was performed using logistic regression adjusted for sociodemographic, lifestyle and health variables. Among the 141 teachers included, pain perception was reported during the day by 66.7% and at bedtime by 66.0%. Analyses adjusted for sex, age, body mass index and time spent watching television indicated that practicing more than 240 minutes/week of free-time physical activity was associated with a lower likelihood of reported pain during the day (odds ratio, OR=0.18; 95% confidence interval, CI: 0.06-0.54) and at bedtime (OR=0.28; 95% CI: 0.10-0.79) compared to practicing ≤60 minutes/week of free-time physical activity. These associations lost statistical significance after the additional adjustment for depressive symptoms. In summary, this study showed that teachers who practiced more than 240 minutes/week of physical activity in free-time were less likely to report pain during the day and at bedtime. Depressive symptoms had an important confounding effect on this association. A multidisciplinary approach can optimize preventive strategies for pain prevention and management through health education programs in the workplace.

The association of continuous-use medications and sleep parameters in a sample of working adults.

PURPOSE: Although polypharmacy is linked to health outcomes in the elderly, the use of multiple medications is increasing in middle-aged adults. This study analyzed whether or not the increased number of continuous-use medications (C-UM) is associated with objective and subjective sleep parameters in a working population. METHODS: Cross-sectional study with schoolteachers from public schools in Londrina, Brazil. The participants were classified according to the self-reported number of C-UM. Sleep data were obtained with actigraphy and a concomitant sleep diary for 7 days. The analyses were adjusted for socio-demographic, lifestyle, and morbidity variables. RESULTS: A total of 17% of the participants were classified as using ≥3C-UM. In fully adjusted analyses, the use of ≥3C-UM was associated with lower actigraphic sleep duration (<6 h) (odds ratio [OR] = 2.51; 95% confidence interval [CI] = 1.01,6.21), higher actigraphic sleep onset latency (SOL) (OR = 2.65; 95%CI = 1.00,7.02), and with a higher number of awakenings during sleep measured by actigraphy (OR = 3.30; 95%CI = 1.32,8.28). The use of ≥3 C-UM was also associated with higher SOL (OR = 3.76; 95%CI = 1.36,10.5) and lower sleep efficiency (OR = 11.6; 95%CI = 2.92,46.1), as measured with the sleep diary. A 1-unit increment in the number of continuous-use medications was associated with higher self-reported SOL and lower subjective sleep efficiency. CONCLUSION: The continuous use of ≥3 medications is associated with worse objective and subjective parameters of sleep duration and quality in schoolteachers.

Work-related rumination and worry at bedtime are associated with worse sleep indicators in schoolteachers: a study based on actigraphy and sleep diaries.

OBJECTIVE/BACKGROUND: Work-related rumination and worry are indicators of occupational stress which can impact sleep when they occur close to bedtime. This study examined the relationship between these repetitive thoughts before sleep with objective and subjective sleep parameters. METHODS: A microlongitudinal study was carried out with schoolteachers who answered questions on rumination and worry before sleep, wore a wrist actigraph, and completed a sleep diary for 5 to 7 consecutive days. Analysis used mixed-effects repeated measures linear models adjusted for sociodemographic, lifestyle, and health status. RESULTS: Among the 134 schoolteachers studied, 64.9% were women and were aged 41.9 ± 9.5 years. In the fully adjusted analysis, actigraphy indicated that a wake-up time <6:30 a.m. was associated with both rumination (relative risk (RR) = 1.67; 95% confidence interval (CI) = 1.21-2.31) and worry (RR = 2.44; 95%CI = 1.63-3.64). Moreover, actigraphy-measured nighttime sleep duration <7 h (RR = 1.23; 95%CI = 1.03-1.47) and self-reported sleep latency >15 min (RR = 1.43; 95%CI = 1.02-2.02) were associated with work-related worry. CONCLUSIONS: The occurrence of work-related repetitive thoughts before sleep, particularly worry about next-day issues, is associated with an increased risk of impaired objective and subjective sleep indicators. These findings suggest that these cognitive processes related to work should be addressed in strategies aimed at preventing and treating sleep disturbances and their individual and occupational consequences.

Agreement between sleep diary and actigraphy in a highly educated Brazilian population.

OBJECTIVE: This study evaluated the agreement between a sleep diary and actigraphy on the assessment of sleep parameters among school teachers from Brazil. METHODS: A total of 163 teachers (66.3% women; aged 45 ± 9 years) filled out a sleep diary and wore a wrist actigraph device for seven consecutive days. Data were collected from August 2014 to March 2015 in Londrina, a large city in southern Brazil. Intraclass correlation coefficients (ICC) and Pearson correlation coefficients (r) were used to compare self-reported and actigraphic data. RESULTS: Self-reported total sleep time (TST), sleep onset latency (SOL), and sleep efficiency were higher than measured by actigraphy (mean difference: 22.6 ± 46.9 min, 2.6 ± 13.3 min, and 7.3± 5.7%, respectively). Subjective total time in bed (TIB) and wake-up time were lower than measured by actigraphy (mean difference: -10.7 ± 37.6 and -19.7 ± 29.6, respectively). Moderate or good agreement and correlation were found between the sleep diary and the actigraphic data for TST (ICC = 0.70; r = 0.60), TIB (ICC = 0.83; r = 0.73), bedtime (ICC = 0.95; r = 0.91), sleep start time (ICC = 0.94; r = 0.88), and wake-up time (ICC = 0.87; r = 0.78). However, SOL (ICC = 0.49; r = 0.38) and sleep efficiency (ICC = 0.16; r = 0.22) showed only fair or poor agreement and correlation. CONCLUSION: In this highly educated population, the sleep diary and the actigraphy showed moderate or good agreement to assess several sleep parameters. However, these methods seemed to measure different dimensions of sleep regarding sleep onset latency and efficiency. These findings moderately varied according to the individual's subjective sleep quality.

Watching television for more than two hours increases the likelihood of reporting poor sleep quality among Brazilian schoolteachers.

Although time spent watching television and sleep problems have increased in the last few decades, it is unclear whether these conditions are associated in working adults after controlling for lifestyle, job characteristics and other individual aspects. The present study analyzed the association between time spent watching television and sleep quality among teachers from public schools in Londrina, Brazil. In this cross-sectional study, information from the Pittsburgh Sleep Quality Index (PSQI) and about time spent watching television was obtained during personal interviews. Logistic regression models adjusted by the main confounders (sociodemographic, occupational and lifestyle variables) were used in the analyses. Among the 959 studied teachers (68.2% women, median age: 42years), teachers who watched >120min/day had a higher likelihood of reporting poor sleep quality (PSQI>5) (odds ratio=1.41; 95% confidence interval=1.01; 1.98) compared with those who watched television for up to 60min/day, regardless of gender, age, work hours, leisure time physical activity and other lifestyle variables. This association did not remain significant after the adjustment for health conditions, i.e., obesity, anxiety, depression and chronic pain, which may act as confounding variables in the relationship between watching television and poor sleep quality. Watching television for >120min/day was independently associated with poorer sleep quality, which should be considered in the prevention and treatment of sleep disturbances among working population.