Waist-to-height ratio and waist circumference as the main measures to evaluate obstructive sleep apnea in the woman's reproductive life stages.

Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder. In women, the frequency of OSA increases substantially during and after the menopause, as does the prevalence of obesity in this reproductive life stage. This cross-sectional study uses data from the Sao Paulo Epidemiologic Sleep Study (EPISONO, 2007), and comprises a sample of 500 women aged 20-80 years. Multiple logistic regression analysis was used to assess the factors associated with OSA in premenopausal and postmenopausal women. All participants underwent polysomnography, and obesity was assessed using the waist-to-height ratio (WHtR), body mass index, neck and waist circumference, measured using standard methods. WHtR was the factor most associated with a significant increase in risk of OSA in premenopausal women. Waist circumference was the factor most associated with OSA in postmenopausal women, for all severities of the disease. Anthropometric factors presented a high rate of accuracy in the classification of women with OSA. The study found that different obesity-related anthropometric measures should be considered in the diagnosis of OSA, according to the woman's reproductive stage.

Oxygen saturation during sleep as a predictor of inflammation in anovulatory women.

PURPOSE: To evaluate the inflammatory profile of premenopausal women with anovulatory cycles, regular menstrual cycles, or using contraceptives, and the associations with sleep and health-related parameters. METHODS: Subjects completed questionnaires including the Pittsburgh Sleep Quality Index and the Epworth sleepiness scale, underwent whole-night polysomnography, and had blood collected for analysis of inflammatory, cardiovascular, and hormonal parameters. Women of reproductive age were categorized into three groups for comparisons: anovulatory menstrual cycles, regular menstrual cycles, and hormonal contraceptive use. RESULTS: Women with anovulatory menstrual cycles (n = 20) had higher circulating levels of the proinflammatory cytokine IL-6 compared with women who had regular menstrual cycles (n = 191) and those on hormonal contraception (n = 72). No other classical marker of low-grade inflammation was significantly different. Subjective and objective sleep data were similar among groups. However, the mean peripheral oxygen saturation (SpO2) during sleep was reduced in anovulatory women. The analysis of associated variables of the inflammatory profile demonstrated that mean SpO2 during sleep was a predictive factor of IL-6 levels. CONCLUSIONS: Our data suggest that in premenopausal women with anovulation, a proinflammatory condition mediated by IL-6 is associated with lower oxygen levels during sleep. These findings reflect the balance between gynecological status, the immune system, and sleep, pointing to the need to control for these factors in clinical practice and research contexts.

The association of insomnia and quality of life: Sao Paulo epidemiologic sleep study (EPISONO).

OBJECTIVES: Sleep is essential for health and well-being and lack of sleep can have serious physiological consequences. This study aimed to evaluate sleep patterns and the influence of insomnia on quality of life. DESIGN: The epidemiologic sleep study is a population-based study of sleep and risk factors for sleep disturbances. SETTING AND PARTICIPANTS: This cross-sectional study recruited 574 men and 468 women aged 18 years or older randomly, to represent the population of Sao Paulo, according to gender, age, and socioeconomic status. MEASUREMENTS: Data from polysomnography were used to assess sleep objectively and a validate questionnaire to assess quality of life. Validated questionnaires based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, assessed the perception of insomnia and categorized the sample as: without insomnia symptoms, insomnia symptoms, and insomnia syndrome. Anthropometric data, objective sleep parameters and quality of life were assessed and the sample was distributed according to age for both genders. RESULTS: Participants in both insomnia groups presented a worse perception of quality of life compared to without insomnia symptoms group in both genders. Women had a lower percentage of participants without insomnia symptoms (33.3%), and a higher percentage of insomnia symptoms (48.6%), and insomnia syndrome (18.1%) than men (42.1%, 47.2%, and 10.7%, respectively). CONCLUSIONS: Women presented more insomnia complaints and had a lower perceived quality of life compared to men, especially at young ages. Men and women with insomnia symptoms or insomnia syndrome had a lower quality of life score.

Gender differences in the application of anthropometric measures for evaluation of obstructive sleep apnea.

This study aims to investigate anthropometric measures and their effectiveness as screening method for diagnosing obstructive sleep apnea (OSA) in each gender. We also evaluated which measures were associated with OSA in the adult population of a large metropolitan city, Sao Paulo, Brazil. 552 women and 450 men were submitted to polysomnography (PSG), and the anthropometric measurements as body mass index (BMI), waist-to-height ratio, neck and waist circumference were collected. The measurements were then compared with the OSA classification established by the PSG. In women, waist circumference and waist-to-height ratio were found to be the best predictor, while in men, the factors with great potential for identification varied according to severity of the disease, highlighting waist-to-height ratio, neck circumference and BMI had strongest association. The accuracy of the classification in relation to mild-to-severe OSA based on cut-off values of 92.5cm for waist circumference was greater than 72.9% in men, and 78.9% in women based on cut off values of 95cm. Regarding severe OSA, cut-off values of 116.1cm were greater than 91.3% accurate in the male population, and 95.1% in the female population with a cut-off value of 126.5cm. The study found waist circumference and waist-to-height ratio to be the best measure to assess sleep-disordered breathing in women. Waist-to-height ratio and neck circumferences were the best measures in men with mild OSA, but BMI was more closely associated with severe OSA. The present study identified the anthropometric variables with the highest risk for OSA and their respective cutoff value, according to gender.

Plasma Leptin and Premenstrual Syndrome: A Review.

IMPORTANCE: Premenstrual syndrome (PMS) is characterized by physical and psychological symptoms in the luteal phase. Leptin can influence PMS as it acts on the hypothalamic-pituitary-gonadal axis. OBJECTIVE: The aim of this study was to evaluate data in the literature about the profile of plasma leptin in women with PMS. EVIDENCE ACQUISITION: We performed a search of databases using both descriptors. Three studies were identified. They included 181 participants. Two of these studies found higher leptin levels in women with PMS. RESULTS: Conflicting results were found regarding the leptin levels in the luteal phase and the correlation between leptin, estradiol, and progesterone levels. CONCLUSIONS AND RELEVANCE: Leptin could have a role in the pathophysiology of PMS and indicate degree of severity of PMS. Future studies on the role of leptin in PMS are needed.

Effects of acute physical exercise in the light phase of sleep in rats with temporal lobe epilepsy.

OBJECTIVE: Our aim was to investigate the influence of an acute exercise session on sleep pattern in rats with temporal lobe epilepsy (TLE). METHODS: Twenty male Wistar rats were randomly assigned to 4 groups: control (C); acute exercise (EX); epilepsy (E) and epilepsy acute exercise (EEX). Two sleep electrocorticography recordings were performed during the light phase [baseline and day 2 (after the acute physical exercise session)]. After baseline recording, the exercise groups (EX and EEX) were submitted to an exercise session on a motor-driven treadmill at 12m/min for 30min. Twelve hours later, the rats were submitted to the second sleep recording. RESULTS: At baseline, the E group showed a higher wakefulness and a lower Total sleep time, Slow Wave Sleep and REM sleep compared with the C group. After acute exercise, there was an increase in Total sleep time and Slow Wave Sleep and a decrease of wakefulness in EEX (+11.10%, +20.29% and -11.25%, respectively) and EX (+5.20%, +11.60% and -8.12%, respectively) groups. CONCLUSION: These findings suggest that acute physical exercise positively impacts the sleep pattern of rats with TLE, inducing a more consolidated sleep.

Sleep pattern and spectral analysis of caregiver-mothers of sons with Duchenne muscular dystrophy, and an examination of differences between carriers and non-carriers.

OBJECTIVES: Sleep is essential for physical and mental well-being. However, poor sleep is a common complaint among caregivers. The aim of the present study was to determine sleep patterns of caregiver-mothers (CM group) of sons with Duchenne muscular dystrophy (DMD) and also to examine the differences between non-carriers and carriers of the gene related to DMD within the CM group. METHODS: Observational case-control study. PARTICIPANTS: The CM and control (CTRL) groups were matched for age, body mass index and social class. Polysomnography was conducted in a sleep laboratory for one night. The discrete fast Fourier transformation method was used to calculate the electroencephalogram (EEG) power spectrum for the entire night and sleep stages. RESULTS: The CM group presented higher sleep latency and N3 sleep stage compared with the CTRL. When carrier and non-carrier CM subgroups were analyzed, increased sleep latency and time awake, as well as reduced sleep efficiency and N2, were observed in the carrier group. Regarding respiratory parameters, carriers demonstrated higher hypopnea index values compared with non-carriers. Spectral analysis showed that carriers compared with non-carrier DMD caregiver-mothers presented lower spectral power in fast waves, mainly beta, during REM sleep in some EEG derivations. CONCLUSIONS: There was an impairment of sleep pattern in the CM group compared with CTRL mothers; this was possibly associated with difficulty in initiating sleep. Being a DMD gene carrying caregiver further compromised some aspects of sleep microstructure during REM sleep. The data demonstrated the importance of sleep evaluation in caregiver-mothers, and the relationship between sleep and being a carrier of the gene associated with DMD, which was demonstrated as possibly impacting sleep quality.

Scientific research in obstructive sleep apnea syndrome: bibliometric analysis in SCOPUS, 1991-2012.

PURPOSE: The research in obstructive sleep apnea (OSA) may be beneficial from the collaboration between countries and researchers. In this study, we aimed to analyze the scientific research on OSA from 1991 to 2012 and to evaluate the collaboration networks between countries. METHODS: We conducted a bibliometric study in the SCOPUS database. The systematic search was limited to "articles" published from 1991 to 2012. Articles are results of original research; we evaluated the following criteria: number of countries represented, number of authors, number of citations, and journal names. We determined which countries were the most productive (more articles published) and the number of collaborations between these countries. The probability of citation was evaluated using adjusted odds ratios in a logistic regression analysis. RESULTS: We found a total of 6,896 OSA-related articles that had been published in 1,422 journals, 50 % of these articles were concentrated in 41 journals. Of the 74 different countries associated with these articles, the USA had the highest involvement with 23.8 % of all articles published. The probability of citation increased by 1.23 times for each additional author, and by 2.23 times for each additional country represented; these findings were independent of time since publication, journal, or the country of the author. CONCLUSIONS: Scientific production on OSA is increasing with limited international collaboration. The country with the greatest production in this period (1991-2012) was the USA, which concentrated the international collaboration network on OSA. We recommended that articles should be produced with international collaboration to improve the quantity of scientific publications and their chances of publication in high impact journals.

The role of sleep in Juvenile idiopathic arthritis patients and their caregivers.

Juvenile idiopathic arthritis is a chronic disease that may lead to various consequences for patients and caregivers, especially in relation to sleep quality. Sleep is an essential process for homeostasis of the organism. In general, caregivers of children with JIA are more susceptible to these sleep disorders and a lower quality of life. This impairment in sleep can potentially affect the health of caregiver. For this reason, it is very important to continue to evaluate the quality of sleep in caregivers and how to support these JIA children's caregivers more effectively.

Anxiety-like effects of meta-chlorophenylpiperazine in paradoxically sleep-deprived mice.

Chlorophenylpiperazines (CPP) are psychotropic drugs used in nightclub parties and are frequently used in a state of sleep deprivation, a condition which can potentiate the effects of psychoactive drugs. This study aimed to investigate the effects of sleep deprivation and sleep rebound (RB) on anxiety-like measures in mCPP-treated mice using the open field test. We first optimized our procedure by performing dose-effect curves and examining different pretreatment times in naïve male Swiss mice. Subsequently, a separate cohort of mice underwent paradoxical sleep deprivation (PSD) for 24 or 48h. In the last experiment, immediately after the 24h-PSD period, mice received an injection of saline or mCPP, but their general activity was quantified in the open field only after the RB period (24 or 48h). The dose of 5mgmL(-1) of mCPP was the most effective at decreasing rearing behavior, with peak effects 15min after injection. PSD decreased locomotion and rearing behaviors, thereby inhibiting a further impairment induced by mCPP. Plasma concentrations of mCPP were significantly higher in PSD 48h animals compared to the non-PSD control group. Twenty-four hours of RB combined with mCPP administration produced a slight reduction in locomotion. Our results show that mCPP was able to significantly change the behavior of naïve, PSD, and RB mice. When combined with sleep deprivation, there was a higher availability of drug in plasma levels. Taken together, our results suggest that sleep loss can enhance the behavioral effects of the potent psychoactive drug, mCPP, even after a period of rebound sleep.

Caracterização cinética da enzima catecolase (Polifenol oxidase) em extratos brutos da polpa e da casca de berinjela (Solanum melongena L.) / Kinetic characterization of enzyme catecolase (Polyphenol oxidase) in crude extracts of the pulp and peel of eggplant (Solanum melongena L.)

Objetivo - Foi analisado como material biológico os extratos brutos da polpa e da casca de berinjela (Solanum melongena L.), que é fonte da enzima Polifenol oxidase (PFO) [EC.1.14.18.1] e estes foram estudados como materiais biocatalíticos para a oxidação aeróbica de substratos fenólicos19. Métodos - Extraiu-se a PFO dos extratos por trituração, filtração e centrifugação. Através da medida de absorbância e método do Biureto, obteve-se a atividade e a proteína total. Quantidade e tempo de contato do polímero foram determinados espectrofotometricamente. A caracterização cinética da PFO baseou-se na temperatura ótima, estabilidade ao calor, pH ótimo de atividade e de estabilidade. Os valores obtidos foram comparados com os da polpa e casca de banana nanica. Resultados - A atividade específica da PFO na banana nanica (1056 u/mg da polpa e 1537,5 u/mg da casca) é superior à do extrato de berinjela (376,5 u/mg da polpa e 500 u/mgda casca). Os valores de pH de atividade (pH 5,0) e de estabilidade (pH 7,0), tempo de contato com o polímero (zero) e de armazenamento (34 dias) foram iguais para ambos os extratos. A atividade da PFO foi superior na casca quando comparada a polpa de berinjela. A massa de polímero PVP necessária para adsorção de compostos polifenólicos excedentes foi três vezes maior na polpa do que na casca. A temperatura ótima de atividade para a polpa foi de 40°C e para a casca de 15°C. Conclusões - A caracterização da PFO da berinjela é similar a da banana nanica, porém, a maior atividade específica desta última a torna mais propícia na construção do biossensor para quantificar fenóis/polifenóis em amostras.

Objective - Biological material was analyzed as the crude extracts of the pulp and peel of eggplant (Solanum melongena L.), which is the source of the enzyme Polyphenol oxidase (PPO) [EC.1.14.18.1] and these have been studied as materials for the biocatalytic aerobic oxidation of phenolic substrates19. Methods - Drew to PPO extracts by grinding, filtering and centrifuging. By measuring the absorbance and the Biuret method, we obtained activity and total protein. Amount and contact time of the polymer were determined spectrophotometrically. The kinetic characterization of PPO was based on the study of the optimum temperature, heat stability, pH optimum of activity and stability. The values obtained were compared with those of banana pulp nanica. Results - Results showed that the specific activity of PPO in the banana nanica (1056 u/mg of pulp and 1537.5 u/mg of peel) is higher than in the extract of eggplant (376.5u/mg of pulp and 500 u/mg of peel). The pH values of activity (pH 5.0) and stability (pH 7.0), time of contact with the polymer (zero) and storage (34 days) were similar for both extracts. The activity of PPO was higher in peel compared to the eggplant pulp. The mass of polymer PVP required for adsorption of polyphenolics compounds was three times higher in the pulp than in peel. The optimum temperature for activity of the pulp was 40°C and the peel of 15°C. Conclusions - The characterization of PPO eggplant is similar to the banana, however, the highest specific activity that makes it more conducive to the construction of biosensor to quantify phenols / polyphenols in the samples.