[Healthy sleep: evidence and guidelines for action. Official document of the Spanish Sleep Society]. / Sueño saludable: evidencias y guias de actuacion. Documento oficial de la Sociedad Española de Sueño.

One of the main objectives of the Spanish Sleep Society is to promote healthy sleep in both the general population and in health professionals. This document aims to conduct a review of the current scientific literature on sleep habits that can serve as the basis on which to establish a set of general recommendations, regarding healthy sleep, for use by the general population in Spain as well as to identify the main challenges faced by research into sleep habits. The document has been developed by a multidisciplinary team made up of members of the Spanish Sleep Society who are experts in paediatric sleep medicine, clinical neurophysiology, pulmonology, neurology, chronobiology, physiology and psychology. The existing scientific literature dealing with sleep habits in the general population was reviewed, and the following aspects were addressed: the current state of sleep habits in the Spanish population; a generic review of the optimum number of hours of sleep; the impact of the environmental setting (noise, temperature, illumination, etc.), hours of sleep, diet and sport, together with several specific sections for children and teenagers, shift-workers and drivers of different vehicles. The conclusions from all the aspects addressed in this document have resulted in a set of final general recommendations that will serve as a guide for the general population and health professionals. Likewise, the principal environmental challenges and future lines of research are also discussed.

Trastorno de retraso de la fase del sueño y del despertar. Síndrome de retraso de fase / Delayed sleep wake phase disorder (DSWPD)

El trastorno de retraso de la fase del sueño y del despertar o síndrome de retraso de fase (SRF) es la alteración del ritmo circadiano de sueño más frecuente y suele manifestarse en la adolescencia. Se caracteriza por un retraso estable, habitualmente de más de dos horas, del inicio y del final del sueño respecto a los horarios convencionales. Clínicamente los pacientes presentan insomnio a la hora de acostarse, con gran dificultad para levantarse por la mañana en la hora deseada. Entre semana, debido a las obligaciones escolares o sociales, los niños con SRF duermen pocas horas, generándose una privación crónica de sueño que se manifestará con somnolencia diurna, fatiga, falta de atención, afectación del rendimiento escolar o absentismo escolar. Característicamente, el fin de semana o durante las vacaciones, cuando están libres de horarios, retrasan el sueño, siendo este de características normales y levantándose descansados. Es importante realizar un diagnóstico precoz para iniciar un tratamiento temprano que minimice las consecuencias del SRF. Por la imposibilidad de seguir unos horarios regulares de estudio ni de trabajo, son jóvenes a los que se califica de noctámbulos o de vagos, a pesar de sus esfuerzos repetidos por adaptarse a unos horarios convencionales, lo que aboca en altos índices de depresión, ansiedad y abuso de sustancias. El retraso de fase de sueño se confirma mediante las agendas de sueño, la actigrafía y los marcadores de fase circadianos. La higiene del sueño, la cronoterapia, la fototerapia y la administración de melatonina son los posibles tratamientos del SRF (AU)

Delayed sleep wake phase disorder (DSWPD) or delayed sleep phase disorder is the most frequent circadian rhythm sleep disorder and is commonly seen in adolescents. DSWPD is characterized by habitual by sleep onset and wake times that are usually delayed more than two hours relative to conventional sleep-wake times. Clinically, affected subjects experience difficulty falling asleep and arising at socially acceptable wake time. Enforced conventional wake times (during the school or working days), may result in chronically insufficient sleep manifested as excessive daytime sleepiness, fatigue, repetitive school absences with negative impact on their attention and academic performance. When allowed to follow their preferred schedule (during the weekends or vacation periods), the patient’s timing of sleep is delayed with normal and restoring sleep. It is very important to make an early diagnosis to initiate treatments that minimize consequences of DSWPD. Although their repetitive attempts to adapt to conventional times, their difficulties to maintain regular school or work timings leads these adolescents to be seen as lazy and not motivated, which usually results in an increase in mood disorders and drug abuse. Delay sleep phase is demonstrated by sleep log, actigraphy monitoring and in the timing of other circadian rhythms. Sleep hygiene, chronotherapy, bright light therapy or melatonin administration are the most habitual treatment of the DSWPD (AU)

[A study of parasomnias in the prepubertal age]. / Estudio de las parasomnias en la edad prepuberal.

INTRODUCTION AND AIMS: Parasomnias have been little studied in prepubertal age children. When it happens often they can alter the continuity of the sleep and reduce the value restorer of this affecting the academic functioning and daytime behavioural in younger children. We study the total frequency of the parasomnias, the individual frequency of every parasomnia and the association between them in primary education children. PATIENTS AND METHODS: We distribute to children's parents (358) of third through sixth grade of Primary Education of one college of Alcoy the Owens Children's Sleep Habits Questionnaire of for parents to answer. RESULTS: Rate of response was 58 %. Total frequency of the parasomnias was 6.2 %. The most frequent parasomnia of the research was the periodic limb movements (PLM) (7.7 %) followed of bruxism (6.7%), nightmares (1.9%), enuresis (1.9%) and sleepwalking (1.4%). We did not find any case of night terror. There is a major frequency of enuresis, sleepwalking and nightmares in male children and of PLM in the girls though we have not obtained statistical significance. The PLM associated with nightmares (75%, p < 0.005), sleepwalking (66%, p < 0.05) and bruxism (40%, p < 0.005). CONCLUSIONS: Parasomnias happen with a frequency raised in the children in prepubertal age. Following the repercussion that a parasomnia can suppose to the child as well as to his environment, it is important to detect it as soon as possible in order to prevent its consequences and not let them continua once the child gets older.

Estudio de las parasomnias en la edad prepuberal / A study of parasomnias in the prepubertal age

Introducción y objetivos. Las parasomnias se han estudiado poco en niños de edad prepuberal. Cuando ocurren, a menudo pueden alterar la continuidad del sueño y reducir el valor restaurador de éste, afectando al rendimiento escolar y el comportamiento del niño. Estudiamos la frecuencia total de las parasomnias, la frecuencia individual de cada parasomnia y la asociación entre ellas en niños de educación primaria. Pacientes y métodos. Distribuimos a los padres de los niños (358) de 3.º a 6.º de educación primaria de un colegio de Alcoy el cuestionario validado para hábitos del sueño de los niños de Owens, para su cumplimentación. Resultados. La tasa de respuesta fue del 58%. La frecuencia total de las parasomnias fue del 6,2%. La parasomnia más frecuente de las estudiadas fue los movimientos periódicos de las piernas (MPP) (7,7%) seguida del bruxismo (6,7%), las pesadillas (1,9%), la enuresis (1,9%) y el sonambulismo (1,4%). No encontramos ningún caso de terror nocturno. Hay una mayor frecuencia de enuresis, sonambulismo y pesadillas en los niños varones y de MPP en las niñas,aunque no hemos obtenido significación estadística. Los MPP se asociaron con pesadillas (75%, p < 0,005), sonambulismo (66%, p < 0,05) y bruxismo (40%, p < 0,005). Conclusiones. Las parasomnias ocurren con una frecuencia elevada en los niños en edad prepuberal. Dada la repercusión que el padecimiento de una parasomnia puede suponer para el niño y su entorno es importante detectarlas para subsanarlas precozmente en estas edades, para evitar que sus consecuencias trasciendan en edades posteriores (AU)

Introduction and aims. Parasomnias have been little studied in prepubertal age children. When it happens often they can alter the continuity of the sleep and reduce the value restorer of this affecting the academic functioning and daytime behavioural in younger children. We study the total frequency of the parasomnias, the individual frequency of every parasomnia and the association between them in primary education children. Patients and methods.We distribute to children’s parents (358) of third through sixth grade of Primary Education of one college of Alcoy the Owens Children’s Sleep Habits Questionnaire of for parents to answer. Results. Rate of response was 58 %. Total frequency of the parasomnias was 6.2 %. The most frequent parasomnia of the research was the periodic limb movements (PLM) (7.7 %) followed of bruxism (6.7%), nightmares (1.9%), enuresis (1.9%) and sleepwalking (1.4%). We did not find any case of night terror. There is a major frequency of enuresis, sleepwalking and nightmares in male children and of PLM in the girls though we have not obtained statistical significance. The PLM associated with nightmares (75%, p < 0.005), sleepwalking (66%, p < 0.05) and bruxism (40%, p < 0.005). Conclusions. Parasomnias happen with a frequency raised in the children in prepubertal age. Following the repercussion that a parasomnia can suppose to the child as well as to his environment, it is important to detect it as soon as possible in order to prevent itsconsequences and not let them continua once the child gets older (AU)