Consecuencia del fraccionamiento del sueño en un navegante solitario / Sailor's slepp patterns

Introducción. Es muy escasa la información sobre el sueño de los navegantes solitarios durante largas travesías transoceánicas y sus consecuencias, tanto en su sueño como cognitivas. Hemos podido estudiar los patrones de sueño de un sujeto durante 3 travesías transoceánicas que realizó en solitario con un velero y examinar si los fraccionamientos del sueño afectaban a distintos parámetros subjetivos relacionados con el sueño. Material y método. Mediante escalas analógicas visuales (EAV) se estudiaron el grado subjetivo de alerta y somnolencia, la sensación de descanso, el estado de ánimo y el grado de vigor. El patrón de sueño se estudió mediante diarios de sueño y estudio actimétrico continuo. Resultados. En el primer trayecto, entre Barcelona y Las Palmas, se observó una moderada desestructuración del ritmo vigilia-sueño. En el segundo trayecto, de 34 días, entre Las Palmas y Fortaleza, se observó una mínima intromisión de períodos de vigilia durante el período nocturno, inferiores a los del trayecto anterior, así como períodos de siesta en el horario diurno. En el tercer trayecto, de 21 días de duración, de Jamaica a Martinica, se observó un aceptable mantenimiento del ritmo vigilia-sueño, a pesar de los pequeños períodos de vigilia que se observaron en el período nocturno. En cuanto a los aspectos neurocognitivos estudiados, las EAV no mostraron cambios significativos con respecto al nivel inicial, con excepción del tercer trayecto, donde se observó una disminución significativa de la somnolencia (p > 0,05). Conclusión. Contrariamente a lo esperado, la instauración voluntaria del fraccionamiento del sueño y de ritmos ultradianos de vigilia-sueño en este navegante no contribuyó a alterar, de forma estadísticamente significativa, ninguna de las variables estudiadas. Sólo la somnolencia mejoró al final del trayecto realizado, ya que presentó una disminución significativa (p > 0,05) (AU)

Introduction. There is very little information regarding sailors' sleep patterns and cognitive functions while performing solo-transoceanic long passages. We have studied the sleep patterns of a subject during three solo-transoceanic trips made in a sailboat to detect whether or not disrupted sleep affected different subjective parameters related to sleep. Material and method. Alertness, rest, somnolence, mood, and energy level were studied by means of visual analogical scales (EAV). Sleep patterns were studied by means of a sleep diary and continuous actimetric study. Results. In the first 20-day trip -between Barcelona and Las Palmas (Spain)- a moderate change in wakefulness-sleep patterns was observed. In the second 34-day trip -between Las Palmas and Fortaleza (Brazil)- a minimum interference of periods of wakefulness during the nocturnal period, (inferior to those of the previous journey) as well as periods of "siesta" in the diurnal schedule were observed. The third 21-day trip -from Jamaica to Martinica- an acceptable maintenance of the wakefulness-sleep rate was observed, in spite of the short periods of wakefulness presented in the nocturnal period. The EAV did not show significant changes with respect to the basal ones, with exception of the third passage, where improvement of the somnolence was observed with a significant decrease (P>.05). Conclusion. Contrary to expectations, and with the exception of limited periods of time, the voluntary sleep disruption and ultradian sleep-wakefulness schedule of this sailor did not contribute to altering, in a statistically significant way, any of the variables studied, only somnolence displayed an improvement at the end of the trip significantly decreasing (P>.05) (AU)

[Obstructive sleep apnea syndrome in children: the responsibility of pediatricians]. / Síndrome de apnea obstructiva del sueño en el niño: una responsabilidad del pediatra.

Although obstructive sleep apnea syndrome (OSAS) in children is a frequent and potentially serious respiratory disorder, it has a reliable diagnosis and treatment is highly effective. OSAS is a respiratory sleep-related disorder that forms part of sleep apnea-hypoapnea syndrome. The syndrome affects between 1 % and 3 % of children. In addition to its cardiopulmonary complications, it can retard growth and increase the risk of hyperactivity and learning difficulties. It has also been associated with attention deficit disorder and hyperactivity. When OSAS is suspected, up-to-date nocturnal polysomnography is the gold standard for the diagnosis and quantification of severity of childhood OSAS. In most children the treatment of choice is adenotonsillectomy, which has a success rate of more than 85 %. We provide an up-to-date review of the evidence on the clinical features, etiology, complications and treatment of OSAS in children. The main objective of this review is to alert pediatricians to their essential role in the early detection of this syndrome, especially among children who snore, and to provide a clinical practice guideline for the diagnosis and definitive treatment of these children.