Strength field tests performance are correlated with isokinetic strength of shoulder rotator muscles in female handball players.

BACKGROUND: The aim of this study was to analyze the relationship between the isokinetic shoulder strength of the athletes and their performance on strength field tests. Data on the balance and functional strength ratios of the internal and external rotator muscles of shoulders of handball players was also investigated. METHODS: Twenty-seven female athletes (23±3.4 years, 71±10.6 kg and 173.3±7.1 cm) underwent an isokinetic assessment of the strength of the shoulder rotator muscles. Athletes also performed the following strength field tests: bench press test, lying bench barbell row test, handgrip test, and medicine ball throwing. RESULTS: The bench press test results and the lying bench barbell row test results were significantly correlated with the concentric internal and external rotator peak torques at 1.05 rad.s-1 and 5.23 rad.s-1, with total work at 1.05 rad.s-1 and with average power at 5.23 rad.s-1 (r=0.51 to 0.81). CONCLUSION: We suggested the use of field test to infer about internal and external rotator muscular strength, but not to infer about isokinetic muscular strength ratios. These findings could be useful to coaches and trainers.

Sleep habits and complaints of adults in the city of São Paulo, Brazil, in 1987 and 1995

This study compares the prevalence of complaints of insomnia, excessive diurnal sleepiness, parasomnias, and sleep habits of the adult population in the city of São Paulo, Brazil, estimated in surveys carried out in 1987 and 1995. Representative samples of 1000 adult residents per survey were interviewed using a validated structured sleep questionnaire, the "UNIFESP Sleep Questionnaire". Difficulty maintaining sleep, difficulty initiating sleep and early morning awakening, occurring at least three times a week, were reported in 1987 and 1995, by 15.8/27.6, 13.9/19.1, and 10.6/14.2 percent of the interviewees, respectively, significantly increasing throughout time. These sleep problems were more often found among women. Frequencies of excessive diurnal sleepiness and sleep attacks were unchanged comparing 1987 with 1995 (4.5 vs 3.8 and 3.1 vs 3.0 percent, respectively). Parasomnia complaints remained unchanged, with the exception of leg cramps, which doubled in prevalence from 1987 to 1995 (2.6 to 5.8 percent). Snoring was the most common parasomnia (21.5 percent in 1995), reported more often by men than by women, and somnambulism was the least common (approximately 1 percent). Besides sleeping slightly less, interviewees went to bed and woke up later in 1995. Approximately 12 percent of the subjects in both surveys had consulted a physician due to sleep problems and 3.0 percent reported habitual use of sleep-promoting substances in 1995. Overall, there was a significant increase in insomnia complaints from 1987 to 1995 in the general population of the city of São Paulo. This major change over a little under a decade should be considered as an important public health issue.

Sleep habits and complaints of adults in the city of São Paulo, Brazil, in 1987 and 1995.

This study compares the prevalence of complaints of insomnia, excessive diurnal sleepiness, parasomnias, and sleep habits of the adult population in the city of São Paulo, Brazil, estimated in surveys carried out in 1987 and 1995. Representative samples of 1000 adult residents per survey were interviewed using a validated structured sleep questionnaire, the "UNIFESP Sleep Questionnaire". Difficulty maintaining sleep, difficulty initiating sleep and early morning awakening, occurring at least three times a week, were reported in 1987 and 1995, by 15.8/27.6, 13.9/19.1, and 10.6/14.2% of the interviewees, respectively, significantly increasing throughout time. These sleep problems were more often found among women. Frequencies of excessive diurnal sleepiness and sleep attacks were unchanged comparing 1987 with 1995 (4.5 vs 3.8 and 3.1 vs 3.0%, respectively). Parasomnia complaints remained unchanged, with the exception of leg cramps, which doubled in prevalence from 1987 to 1995 (2.6 to 5.8%). Snoring was the most common parasomnia (21.5% in 1995), reported more often by men than by women, and somnambulism was the least common (approximately 1%). Besides sleeping slightly less, interviewees went to bed and woke up later in 1995. Approximately 12% of the subjects in both surveys had consulted a physician due to sleep problems and 3.0% reported habitual use of sleep-promoting substances in 1995. Overall, there was a significant increase in insomnia complaints from 1987 to 1995 in the general population of the city of São Paulo. This major change over a little under a decade should be considered as an important public health issue.

A comparison of public and private obstructive sleep apnea clinics

The aim of the present study was to compare the clinical findings and polysomnography results obtained at public and private clinics in Brazil, the follow-up after diagnosis, and the therapeutic aspects related to continuous positive airway pressure. Patients who snore and who have obstructive sleep apnea were retrospectively divided into two groups, i.e., public clinic (N = 307) and private clinic (N = 317). Data concerning age, sex, body mass index (BMI), neck circumference, medical history, sleepiness scale, follow-up after diagnosis, and acceptance of continuous positive airway pressure therapy were collected. Mean age was 50 ± 12 (range: 15-80) for public patients and 48 ± 12 years (range: 19-91) for private patients. Mean BMI was 30 ± 6 (range: 19-67) for public patients and 31 ± 6 kg/m² (range: 21-59) for private patients. The public clinic had a significantly higher frequency of women than the private clinic (M:F ratio of 2.0:1 and 6.9:1, respectively). The condition of private patients (apnea-hypopnea index = 31 ± 25) was more severe than that of public patients (apnea-hypopnea index = 25 ± 24 events/h; P = 0.0004). In the public and private clinics, 19 and 15 percent of patients were snorers, respectively, and 81 and 85 percent of them had sleep apnea. After diagnosis, follow-up was longer in the private group. The continuous positive airway pressure acceptance was similar for both groups (32 vs 35 percent), but patients from the public clinic abandoned treatment more than private ones (65 vs 13 percent). Social status was significant in terms of the severity of obstructive sleep apnea age and gender distribution. Private patients look for a diagnosis earlier in the course of the disease than public patients, adhere more to follow-up, and abandon continuous positive airway pressure treatment less than public patients do.

A comparison of public and private obstructive sleep apnea clinics.

The aim of the present study was to compare the clinical findings and polysomnography results obtained at public and private clinics in Brazil, the follow-up after diagnosis, and the therapeutic aspects related to continuous positive airway pressure. Patients who snore and who have obstructive sleep apnea were retrospectively divided into two groups, i.e., public clinic (N=307) and private clinic (N=317). Data concerning age, sex, body mass index (BMI), neck circumference, medical history, sleepiness scale, follow-up after diagnosis, and acceptance of continuous positive airway pressure therapy were collected. Mean age was 50 +/- 12 (range: 15-80) for public patients and 48 +/- 12 years (range: 19-91) for private patients. Mean BMI was 30 +/- 6 (range: 19-67) for public patients and 31 +/- 6 kg/m (range: 21-59) for private patients. The public clinic had a significantly higher frequency of women than the private clinic (M:F ratio of 2.0:1 and 6.9:1, respectively). The condition of private patients (apnea-hypopnea index=31 +/- 25) was more severe than that of public patients (apnea-hypopnea index=25 +/- 24 events/h; P=0.0004). In the public and private clinics, 19 and 15% of patients were snorers, respectively, and 81 and 85% of them had sleep apnea. After diagnosis, follow-up was longer in the private group. The continuous positive airway pressure acceptance was similar for both groups (32 vs 35%), but patients from the public clinic abandoned treatment more than private ones (65 vs 13%). Social status was significant in terms of the severity of obstructive sleep apnea age and gender distribution. Private patients look for a diagnosis earlier in the course of the disease than public patients, adhere more to follow-up, and abandon continuous positive airway pressure treatment less than public patients do.

Biological markers of alcohol consumption in nondrinkers, drinkers, and alcohol-dependent Brazilian patients.

BACKGROUND: The purpose of this study was to compare the sensitivity and specificity of some new and traditional biological markers and indicators of health among Brazilian nondrinkers, drinkers, and alcohol-dependent patients. MATERIAL AND METHODS: We evaluated 130 nondrinkers, 167 drinkers, and 183 alcohol-dependent drinkers from Brazil who participated in the WHO/ISBRA Study on State and Trait Markers of Alcohol Use and Dependence. A standardized WHO/ISBRA Interview Schedule provided background information on the subjects' characteristics including reported health problems and alcohol consumption. Blood samples were analyzed for aspartate aminotransferase (AST), carbohydrate deficient transferrin (CDT), gamma-glutamyltransferase (GGT), blood alcohol levels (BAL), and platelet adenylate cyclase activity (basal levels [AC] and levels after stimulation with Gpp(NH)p, cesium fluoride, and forskolin). RESULTS: The alcohol-dependent drinkers presented higher levels of AST, GGT, AC, CDT, and BAL than the nondrinkers and drinkers, whose levels were similar. Sex differences in the sensitivity of CDT and AC were found. The alcohol-dependent women presented a lower prevalence of abnormal values of CDT and Gpp(NH)p-stimulated AC than the alcohol-dependent men, despite the fact that they presented similar alcohol consumption levels. The alcohol-dependent drinkers presented a higher prevalence of clinical disorders than the nondrinkers and drinkers. The drinkers and alcohol-dependent patients presented significantly higher rates of gastritis than the nondrinkers. CONCLUSIONS: Sex differences in the sensitivity of CDT and AC suggest that these markers are not as sensitive at detecting excessive alcohol use in women as they are in men. If data from this Brazilian sample are compared with those reported for international samples, relevant differences are detected, which suggests that genetic and cultural differences should be considered in the selection of biological markers of heavy alcohol consumption.

Acute effects of low doses of melatonin on the sleep of young healthy subjects.

This study was undertaken to evaluate the acute effects of single low doses of melatonin given to healthy volunteers in the evening. Six healthy male volunteers (age range 22-24 years) participated in this study, after signing an informed consent form. They received in a double-blind fashion placebo or 0.3 or 1.0 mg melatonin at three fixed times: 18:00, 20:00, and 21:00 hr. Polysomnographic recordings began immediately thereafter, with their being allowed to sleep. Prior to each experimental session and in the following morning, subjects completed a sleep quality questionnaire, the Profile of Mood States, the Stanford Sleepiness Scale, and underwent a visual reaction test. Significant decrease on sleep latencies was found following melatonin treatment at 18:00 and 20:00 hr. In addition, melatonin tended to improve sleep efficiency and to reduce intermittent wakefulness. However, at 21:00 hr, 0.3 mg melatonin increased latency to sleep onset and 1.0 mg melatonin had no effect on sleep variables. Furthermore, melatonin given at different times did not alter subjective sleepiness, mood, and reaction time in the following morning. The results from the present study support the notion that administration of low doses of melatonin, mimicking the nocturnal physiological concentration of this hormone may exert immediate sleep-inducing effects.

Alpha sleep characteristics in fibromyalgia.

OBJECTIVE: To characterize the patterns of alpha electroencephalographic sleep and their associations with pain and sleep in patients with fibromyalgia. METHODS: Pain and sleep symptoms of 40 female patients with fibromyalgia and 43 healthy control subjects were studied before and after overnight polysomnography. Blinded analyses of alpha activity in non-rapid eye movement (non-REM) sleep were performed using time domain, frequency domain, and visual analysis techniques. RESULTS: Three distinct patterns of alpha sleep activity were detected in fibromyalgia: phasic alpha (simultaneous with delta activity) in 50% of patients, tonic alpha (continuous throughout non-REM sleep) in 20% of patients, and low alpha activity in the remaining 30% of patients. Low alpha activity was exhibited by 83.7% of control subjects (P < 0.01). All fibromyalgia patients who displayed phasic alpha sleep, activity reported worsening of pain after sleep, compared with 58.3% of patients with low alpha activity (P < 0.01) and 25.0% of patients with tonic alpha activity (P < 0.01). Postsleep increase in the number of tender points occurred in 90.0% of patients with phasic alpha activity, 41.7% of patients with low alpha activity, and 25.0% of patients with tonic alpha activity (P < 0.01). Self ratings of poor sleep were reported by all patients with phasic alpha activity, 58.3% of patients with low alpha activity (P < 0.01), and 12.5% of patients with tonic alpha activity (P < 0.01). Patients with phasic alpha activity reported longer duration of pain than patients in other subgroups (P < 0.01). Additionally, patients with phasic alpha sleep activity exhibited less total sleep time than patients in other subgroups (P < 0.05), as well as lower sleep efficiency (P < 0.05) and less slow wave sleep (P < 0.05) than patients with a tonic alpha sleep pattern. CONCLUSION: Alpha intrusion during sleep can be of different patterns. Phasic alpha sleep activity was the pattern that correlated better with clinical manifestations of fibromyalgia.

Becoming circadian--A one-year study of the development of the sleep-wake cycle in children.

Data on three children's sleep-wake behavior during the first year of life submitted to spectral analysis reveal the presence of several frequencies in the circadian and ultradian ranges. The changes in the resulting spectra as age progresses show both an increase in overall rhythmicity, i.e., more data are explained by regular oscillations, and irregular changes in the circadian component. This circadian component shows an increase in power which appears at different ages among the individuals studied.

Becoming circadian: a one-year study of the development of the sleep-wake cycle in children

Data on three children's sleep-wake behavior during the first year of life submitted to spectral analysis reveal the presence of several frequencies in the circadian and ultradian ranges. The changes in the resulting spectra as age progresses show both an increase in overall rhythmicity, i.e., more data are explained by regular oscillations, and irregular changes in the circadian component. This circadian component shows an increase in power which appears at different ages among the individuals studied.

Sleep characteristics of adolescents: a longitudinal study.

The aim of the present research was to study sleep/wake cycle parameters of adolescents and to examine biologic and social influences on their changing sleep patterns. This was a longitudinal study of sleep characteristics of a group of 66 adolescents (mean age, 13 years and 6 months). The adolescents underwent a physical examination, had their pubertal development classified according to Tanner stages, and answered a sleep questionnaire on three timepoints at 6-month intervals. Sleep onset occurred about 1.0 hr later, wake-up time about 3.0 hr later, and sleep length was 1.0-1.5 hr longer on weekends when compared with weekdays. About 60% of the adolescents reported daytime sleepiness, mainly from 8:00 a.m. to 10:00 a.m. and from 2:00 p.m. to 4:00 p.m. on school days. Morning sleepiness on school days occurred at a time of the day that corresponded to sleep on non-school days. Additionally, there was a displacement toward later hours of the wake-up time and a sleep-length increase during weekends from the first to the third timepoint. Social factors such as home conditions and scheduling of school and non-school activities did not change throughout the period of pubertal development studied. Changes of sleep patterns detected may therefore represent an ontogenetic trend along puberty.

Ultradian components of the sleep-wake cycle in babies.

Behavioral states may be analyzed as expressions of underlying cyclic activity involving several physiological systems. The human sleep-wake cycle in the first year of life shows, in addition to the establishment of circadian rhythmicity around the second month, the dynamics of its ultradian components, as can be seen in the more or less gradual decline of the polyphasic pattern. To detect these changes, we have analyzed the sleep-wake cycle of five babies of different ages (3, 4, 9, 11, and 13 months) observed for 5 consecutive days (Monday through Friday), 10 h (08:00-18:00 h) per day at a kindergarten by the first author, and during the night (18:00-08:00 h) by the parents. Behavioral observations were designed for minimizing interference with the babies' habits. Sleep/wake data were arranged in 60-min intervals, and the relative amount of time spent asleep per interval constituted the time series submitted for statistical analysis. The five resulting time series were submitted to spectral analysis for detecting the composition of frequencies contributing to the observed sleep/wake cycle. Several frequencies were thus obtained for each baby in the ultradian and circadian domain, ranging from one cycle in 2.0 h to one cycle in 24 h. The circadian component was the strongest rhythmic influence for all individuals except for the youngest (3-month-old) baby, who showed a semicircadian component as the main frequency in the power spectrum. Three individuals showed ultradian frequencies in the domain of 3-4 h. Differences in the spectra derive from three possible, and probably not exclusive, causes: 1) ontogenetic changes, 2) different masking effects, and 3) individual differences.

Chronobiologic aspects of a coadaptive process: the interaction of Ludwigia elegans flowers and their more frequent bee visitors.

Field observations spanning 1 year of the visits of two bee species--Tetraglossula bigamica (Hymenoptera: Colletidae) and Pseudagapostemon brasiliensis (Hymenoptera: Halictidae)--to the flowers of Ludwigia elegans (Onagraceae) evinced the existence of circadian and circannual components in the rhythms of activity both of plant and bees. In addition to morphological adaptations to the flower, the bees were temporally adjusted to each other and to the flower's opening and closing mechanisms. At the observation locality (Ribeirão Preto, São Paulo, Brazil--latitude 21 degrees-21 degrees 30S), the plant bloomed year-round. The flowers of the same population open simultaneously at the onset of the photophase, pollen and nectar being available almost immediately. Withering occurs in the afternoon of the same day. Although many bee species visited the flowers, T. bigamica and P. brasiliensis were the most frequent visitors, but their yearly rhythms were phased opposite to one another. Circadian rhythms were detected in pollen and nectar harvest. Comparisons of acrophases showed significant differences for males' and females' nectar collecting rhythm and for females' pollen harvest rhythm. As for the circannual component, acrophases of all rhythms occur at progressively later times from December to July when the migration is reversed until November. These data strongly suggest that the relationship between L. elegans and T. bigamica and P. brasiliensis is in accordance with a clearly temporal pattern and that the two bee species are temporally separated in nature.

Individual differences in night and continuously-rotating shiftwork: seeking anticipatory rather than compensatory strategy.

Individual differences in adaptation to night or continuously-rotating shiftwork may reflect distinct strategies of coping with temporal challenges of the environment. Rather than studying compensatory mechanisms, we have chosen the anticipatory response of the sleep onset time preceding work in order to reveal the strategy used by workers submitted to those shift systems including night work. Comprehensive interviews, taking into account several aspects of the workers' lives, allowed for a classification of the subjects in terms of adaptation to their working schedules. Night workers go to bed once a day, whereas shiftworkers prefer to allocate their sleep onsets to two different periods of the day. For both cases, the more well-adapted an individual is, according to the classification obtained by the interviews, the more regular will be the choice of sleep onset times.

Correlations between morningness-eveningness character, sleep habits and temperature rhythm in adolescents.

The correlations between morningness-eveningness character (Horne & Ostberg score), sleep habits and temperature acrophase of 62 adolescents (mean age 13 years and 6 months) were investigated on three occasions at 6-month intervals. Horne & Ostberg scores ranged from 29 to 74 with a similar distribution on the three occasions. Temperature acrophase mode occurred around 15:00 p.m. Earlier sleep onset time and wake-up time and earlier temperature acrophase were associated with morningness. The more evening type the adolescent was, the shorter was the sleep length on schools days and the longer was the sleep length on non-school days. Correlations between temperature acrophase and morningness-eveningness character were found in a subgroup of adolescents and require further confirmation. The correlations between morningness-eveningness and sleep habits were present on the three occasions investigated, indicating that these are stable correlations and that morningness-eveningness questionnaires can provide suitable information for studies of this age group.

Biological aspects and self-evaluation of shiftwork adaptation.

Two male truck drivers working in a Brazilian cellulose plant and classifying themselves as "well-" and "ill-adapted" to a shiftwork schedule of 4 days-on and 1 day-off, participated in an autorhythmometric study. Psychophysiological self-ratings (calmness, stress and alertness), oral temperature measurements and urine collections (detection of K+,Na+ and 17-OH concentrations) were performed regularly during the waking period for 15 consecutive days during the shift schedule--the midday shift (11:00 to 19:00 h), early-morning shift (03:00 to 11:00 h) and evening shift (18:00 to 02:00 h), including days-off. Cosine fitting of the data to a successive running one-day window revealed different individual temporal patterns, with the "well-adapted" subject showing a relatively stable phase relationship of the variables under study and the "ill-adapted" subject showing a less stable relationship. The different patterns could explain, at least partially, the fact that one subject feels "adapted" to shiftwork and the other not.

Chronobiology courses at the University of São Paulo/Brazil: a four-year experience.

We describe the didactic experience of graduate and post-graduate courses on chronobiology in São Paulo, Brazil.

Remarkable similarities between the temporal organization of neocortical electrographic sleep patterns of rats and humans.

Electrocorticographic activity was automatically recorded in albino rats for 72 consecutive h and analyzed by procedures suitable to detect 24-h rhythms. Beta (alert wakefulness), theta (somnolence), delta (slow wave sleep) and sigma 1 (superficial synchronized sleep) activities showed a robust circadian rhythmic distribution. The acrophases (maxima of the adjusted cosine curve) occurred at 23:39, 07:59, 08:37 and 13:25 h, respectively. EMG atonia and extreme hypotonia (less than 10% of mean EMG level) episodes showed a 24-h rhythm peaking at 14:18 h. The temporal sequence within the circadian rest period, i.e., somnolence, slow wave sleep, superficial synchronized sleep and paradoxical sleep, is very similar to that known to occur during the nocturnal sleep of humans.