Delayed sleep phase disorder during the COVID-19 pandemic and its health implications.

Circadian rhythm sleep disorders are alterations that are characterized by a shift in the sleep-wake cycle relative to day and night, such as the delayed sleep phase disorder (DSPD), which is a retard of at least 2 hours in the sleep start. Typically, the patient falls asleep after 2 a.m. and wakes up after 10 a.m. and with symptom of sleep onset insomnia. The prevalence of DSPD in young adults is 0.48%, increasing to 3.3% in adolescents. Interestingly, patients with COVID-19 infection report anxiety due to the intensive care unit lockdown and constant exposure to bright light. In addition, post-COVID patients have an increased risk of developing DSPD. For example, in adolescent post-COVID patients, the prevalence of DSPD increases to 63.3%. Patients with DSPD also have alterations in metabolic health, poor school performance, cognitive impairment, and a higher risk of developing other diseases. The objective of the present review is therefore to describe the characteristics of DSPD during the COVID-19 pandemic and to outline its possible implications for physical health (eg, metabolism) and mental health (eg, anxiety or depression).

Parasomnias in patients with addictions-a systematic review.

Parasomnias are involuntary behaviors or subjective experiences during sleep. Our objective was to review existing information on the presence of parasomnias in patients with addictions or during treatment for addictions. Information about parasomnias related to rapid-eye-movement (REM) and non-REM sleep in patients with addictions, while using substances or in abstinence, was reviewed. A systematic search of published articles reporting parasomnias as a consequence of drug use or abuse was conducted in the PubMed and SciELO databases. The search for the studies was performed in three phases: (1) by title, (2) by abstract, and (3) by complete text. The search was performed independently by two researchers, who then compared their results from each screening phase. Seventeen articles were found. The consumption of alcohol was reported in association with arousal disorders, such as sexsomnia and sleep-related eating disorder; and REM sleep behavior disorder was reported during alcohol withdrawal. Cocaine abuse was associated with REM sleep behavior disorder with drug consumption dream content. Overall, we found that several types of parasomnias were very frequent in patients with addictions. To avoid accidents in bedroom, legal problems, and improve evolution and prognosis; must be mandatory to include security measures related to sleep period; avoid pharmacological therapy described as potential trigger factor; improve sleep hygiene; and give pharmacological and behavioral treatments for patients with these comorbid sleep disorders.

Proposing the Clinical Inventory of Sleep Quality.

INTRODUCTION: The aim of the study was to propose the Clinical Inventory of Sleep Quality (CISQ), and compared it with the Pittsburgh sleep quality index (PSQI). METHODS: We studied 400 subjects with the CISQ. Cronbach's alpha coefficient was calculated to measure the reliability, and to determine the concurrent validity, a Canonical correlation analysis was performed. At next, we used an exploratory and confirmatory Factorial analysis with Varimax rotation for validity construct calculation. RESULTS: Cronbach alpha coefficient of the scale was significantly strong (α=0.81). Canonic correlation was=0.93, suggesting that data proved that the CISQ and PSQI are measuring identical subject. Confirmatory Factorial analysis model grouped items of the scale in four factors: 1. Daytime symptoms, 2. Nocturnal symptoms, 3. Sleep disordered breathing symptoms, and 4. Sleep-related movement disorders symptoms. We proposed five categories to score CISQ in a range of 0-52 points, as follows: Good quality of sleep, Mild bad sleep quality, Moderate bad sleep quality, Severe bad sleep quality, and Profound bad sleep quality. CONCLUSION: CISQ is a promising tool to measure sleep quality and deserve more research to confirm its utility.