La importancia del sueño en los adolescentes: impacto de variables sociodemográficas y de factores personales / The Importance of Sleep in Adolescents: Impact of Sociodemographic Variables and Personal Factors

Resumen Objetivo: Ante la escasez de investigaciones que traten de manera conjunta el conocimiento, la calidad y la higiene del sueño en el adolescente, el objetivo del presente estudio es analizar las diferencias y las relaciones que existen entre estas variables en función de características sociodemográficas y personales. Método: A través de los instrumentos Sleep Beliefs Scale (SBS), Spanish Adolescents and Young Adults Pittsburgh Sleep Quality Index (AYA-PSQI-S) y Adolescents Sleep Hygiene Scale Revied (ASHSr), se midieron las características del sueño de 140 estudiantes (M = 16,75; DE = 0,75). Resultados: El 89,3% de los adolescentes presentaban problemas de sueño, subyacentes de la mejorable higiene del sueño por parte del 62,2% y de un escaso conocimiento general del sueño. El sexo femenino y el alumnado en cursos superiores presentaron mayores problemas para conciliar el sueño, somnolencia y una baja gestión cognitiva-emocional (p < 0,05). La higiene del sueño (β = - 0,344), la edad (β = 0,154) y el autoconcepto (β = -0,349) son los factores que predijeron significativamente (p < 0,05) la calidad del sueño del adolescente. Conclusiones: La adquisición de una adecuada higiene del sueño se vuelve fundamental para mejorar la calidad del descanso y la funcionalidad diurna en adolescentes, destacando su importancia, sobre todo, en niveles académicos avanzados y en el caso específico de las mujeres.

Abstract Objective: Given the scarcity of research addressing the intersection of knowledge, sleep quality, and hygiene among adolescents, the primary objective of this study is to analyse the variations and correlations among these variables based on socio-demographic and personal characteristics. Method: The Sleep Beliefs Scale (SBS), the Spanish Adolescents and Young Adults Pittsburgh Sleep Quality Index (AYA-PSQI-S), the Adolescents Sleep Hygiene Scale Revied (ASHSr) were used to measure the sleep characteristics of the 140 Spanish students (M = 16,75; SD = 0,75). Results: Sleep problems were found in 89,3% of the adolescents, underlying poor sleep hygiene in 62,2% and poor general sleep knowledge (SBS = 12,04). Females and students in higher grades presented greater problems in falling asleep, sleepiness, and poor cognitive-emotional management (p < 0,05). Sleep hygiene (β = - 0,344), age (β = 0,154), and self-concept (β = -0,349) were the factors that significantly (p < 0,05) predicted adolescent sleep quality. Conclusions: The acquisition of proper sleep hygiene becomes crucial to enhance the quality of rest and daytime functionality in adolescents, emphasizing its significance, especially in advanced academic levels and specifically in the case of females.

Sleep Hygiene Intervention Improves Sleep Time and Duration in High School Students.

Objective To evaluate the effects of a sleep hygiene education program for adolescents to address excessive daytime sleepiness, insomnia, and sleep-related behaviors. Materials and Methods The participants were 98 high school students from the 11th and 12th grades. A day-long health promotion action was conducted at their school science fair to disseminate relevant information about sleep disorders. Social status and sleep perception and habits were evaluated through the following validated questionnaires: the Brazilian Economic Classification Criteria, a questionnaire on sleep habits for adolescents, the Pediatric Daytime Sleepiness Scale, the Insomnia Severity Index, and the Sleep Time-Related Information and Communication Technology questionnaire. The questionnaires were administered before the fair and 12 months after participation, and the results before and after the intervention were compared by means of the Student t -test and the Fisher exact test. For the correlations involving the results, the Pearson correlation was used with the level of significance of p < 0.05. Results A qualitative reduction in poor bedtime habits was observed after the intervention, such as watching television and leaving a cell phone on with sound. A higher frequency of use of electronic devices can affect school performance and contribute to later bedtime on weekends ( p < 0.001). Excessive daytime sleepiness was correlated with the excessive use of electronic devices ( p = 0.017). Conclusion Some habits changed after the awareness intervention. There was an impact of the use of electronic devices on academic performance, on the regularity of bedtimes, and on excessive daytime sleepiness. We emphasize the importance of health education programs with sustainable actions following actual changes in behavior.

Relación entre la calidad de sueño y somnolencia diurna en estudiantes universitarios / Sleep quality and daytime sleepiness in university students / Qualidade do sono e sonolência diurna em estudantes universitários

Los estudiantes universitarios están propensos a sufrir alteraciones en el sueño como la somnolencia diurna, lo cual tiene repercusión directa en su calidad de vida y desempeño diario. Objetivo. Determinar la relación entre la calidad de sueño y somnolencia diurna en estudiantes de la Universidad nombre, en Perú. Materiales y Métodos. Se consideró el enfoque cuantitativo, de diseño no experimental, con la aplicación de los instrumentos de calidad del sueño de Pittsburgh y la escala de somnolencia Epworth. La población fue de 446 estudiantes y se obtuvo una muestra de 220 estudiantes universitarios, mediante un muestreo no probabilístico. Resultados. Se presentan severos problemas en relación a la calidad del sueño en un 60,9 %; así como en la calidad subjetiva del sueño en un 49,5 %, duración del sueño en un 54,5 %, uso de medicación hipnótica en un 56,8 %, disfunción diurna 50,5 %; y la latencia del sueño, eficiencia de sueño habitual y alteraciones del sueño en un 57,7 %. Entre tanto, la somnolencia diurna fue alta en un 58,6 %. Conclusiones. Existe relación positiva y significativa entre la calidad del sueño y la somnolencia diurna en los alumnos de la Universidad nombre, alcanzando una ρ = 0.000 (ρ < 0.05); del mismo modo se encontró relación significativa en cada una de las dimensiones de la calidad del sueño y la somnolencia diurna; de lo que se interpreta que la calidad del sueño de problemas de nivel leve, la somnolencia diurna se encuentra en niveles bajos en los universitarios.

University students are prone to sleep disturbances such as daytime sleepiness, which has a direct impact on their quality of life and daily performance. Objective. Determine the relationship between sleep quality and daytime sleepiness in students at the Universidad Nombre, in Peru. Materials and methods. The quantitative approach was considered, with a non-experimental design, with the application of the Pittsburgh sleep quality instruments and the Epworth sleepiness scale. The population was 446 students and a sample of 220 university students was obtained, through non-probabilistic sampling. Results. There are severe problems in relation to sleep quality in 60.9 %; as well as in the subjective quality of sleep in 49.5 %, duration of sleep in 54.5 %, use of hypnotic medication in 56.8 %, daytime dysfunction 50.5 %; and sleep latency, habitual sleep efficiency and sleep disturbances by 57.7 %. Meanwhile, daytime sleepiness was high at 58.6 %. Conclusions. There is a positive and significant relationship between sleep quality and daytime sleepiness in the students of the Name University, reaching ρ = 0.000 (ρ < 0.05); Likewise, a significant relationship was found in each of the dimensions of sleep quality and daytime sleepiness; from which it is interpreted that the quality of sleep has mild problems, daytime sleepiness is at low levels in university students.

Os estudantes universitários são propensos a distúrbios do sono, como a sonolência diurna, o que tem impacto direto na sua qualidade de vida e no desempenho diário. Objetivo. Determinar a relação entre qualidade do sono e sonolência diurna em estudantes da Universidad Nombre, no Peru. Materiais e métodos. Considerou-se a abordagem quantitativa, com desenho não experimental, com aplicação dos instrumentos de qualidade do sono de Pittsburgh e da escala de sonolência de Epworth. A população foi de 446 estudantes e obteve-se uma amostra de 220 estudantes universitários, através de amostragem não probabilística. Resultados. Existem problemas graves em relação à qualidade do sono em 60,9 %; bem como na qualidade subjetiva do sono em 49,5 %, duração do sono em 54,5 %, uso de medicação hipnótica em 56,8 %, disfunção diurna 50,5 %; e latência do sono, eficiência habitual do sono e distúrbios do sono em 57,7 %. Enquanto isso, a sonolência diurna foi elevada, 58,6 %. Conclusões. Existe uma relação positiva e significativa entre a qualidade do sono e a sonolência diurna nos estudantes da Universidade do Nome, atingindo ρ = 0,000 (ρ <, 05); Da mesma forma, foi encontrada relação significativa em cada uma das dimensões da qualidade do sono e da sonolência diurna; a partir do qual se interpreta que a qualidade do sono apresenta problemas leves, a sonolência diurna é baixa em estudantes universitários.

Relación entre la calidad de sueño y somnolencia diurna en estudiantes universitarios

Los estudiantes universitarios están propensos a sufrir alteraciones en el sueño como la somnolencia diurna, lo cual tiene repercusión directa en su calidad de vida y desempeño diario. Objetivo. Determinar la relación entre la calidad de sueño y somnolencia diurna en estudiantes de la Universidad nombre, en Perú. Materiales y Métodos. Se consideró el enfoque cuantitativo, de diseño no experimental, con la aplicación de los instrumentos de calidad del sueño de Pittsburgh y la escala de somnolencia Epworth. La población fue de 446 estudiantes y se obtuvo una muestra de 220 estudiantes universitarios, mediante un muestreo no probabilístico. Resultados. Se presentan severos problemas en relación a la calidad del sueño en un 60,9 %; así como en la calidad subjetiva del sueño en un 49,5 %, duración del sueño en un 54,5 %, uso de medicación hipnótica en un 56,8 %, disfunción diurna 50,5 %; y la latencia del sueño, eficiencia de sueño habitual y alteraciones del sueño en un 57,7 %. Entre tanto, la somnolencia diurna fue alta en un 58,6 %. Conclusiones. Existe relación positiva y significativa entre la calidad del sueño y la somnolencia diurna en los alumnos de la Universidad nombre, alcanzando una ρ = 0.000 (ρ < 0.05); del mismo modo se encontró relación significativa en cada una de las dimensiones de la calidad del sueño y la somnolencia diurna; de lo que se interpreta que la calidad del sueño de problemas de nivel leve, la somnolencia diurna se encuentra en niveles bajos en los universitarios.

University students are prone to sleep disturbances such as daytime sleepiness, which has a direct impact on their quality of life and daily performance. Objective. Determine the relationship between sleep quality and daytime sleepiness in students at the Universidad Nombre, in Peru. Materials and methods. The quantitative approach was considered, with a non-experimental design, with the application of the Pittsburgh sleep quality instruments and the Epworth sleepiness scale. The population was 446 students and a sample of 220 university students was obtained, through non-probabilistic sampling. Results. There are severe problems in relation to sleep quality in 60.9 %; as well as in the subjective quality of sleep in 49.5 %, duration of sleep in 54.5 %, use of hypnotic medication in 56.8 %, daytime dysfunction 50.5 %; and sleep latency, habitual sleep efficiency and sleep disturbances by 57.7 %. Meanwhile, daytime sleepiness was high at 58.6 %. Conclusions. There is a positive and significant relationship between sleep quality and daytime sleepiness in the students of the Name University, reaching ρ = 0.000 (ρ < 0.05); Likewise, a significant relationship was found in each of the dimensions of sleep quality and daytime sleepiness; from which it is interpreted that the quality of sleep has mild problems, daytime sleepiness is at low levels in university students.

Os estudantes universitários são propensos a distúrbios do sono, como a sonolência diurna, o que tem impacto direto na sua qualidade de vida e no desempenho diário. Objetivo. Determinar a relação entre qualidade do sono e sonolência diurna em estudantes da Universidad Nombre, no Peru. Materiais e métodos. Considerou-se a abordagem quantitativa, com desenho não experimental, com aplicação dos instrumentos de qualidade do sono de Pittsburgh e da escala de sonolência de Epworth. A população foi de 446 estudantes e obteve-se uma amostra de 220 estudantes universitários, através de amostragem não probabilística. Resultados. Existem problemas graves em relação à qualidade do sono em 60,9 %; bem como na qualidade subjetiva do sono em 49,5 %, duração do sono em 54,5 %, uso de medicação hipnótica em 56,8 %, disfunção diurna 50,5 %; e latência do sono, eficiência habitual do sono e distúrbios do sono em 57,7 %. Enquanto isso, a sonolência diurna foi elevada, 58,6 %. Conclusões. Existe uma relação positiva e significativa entre a qualidade do sono e a sonolência diurna nos estudantes da Universidade do Nome, atingindo ρ = 0,000 (ρ < 0,05); Da mesma forma, foi encontrada relação significativa em cada uma das dimensões da qualidade do sono e da sonolência diurna; a partir do qual se interpreta que a qualidade do sono apresenta problemas leves, a sonolência diurna é baixa em estudantes universitários.

Relationship of quality and duration of sleep with arterial hypertension in a Colombian population / Relación de la calidad y la duración del sueño en población colombiana con hipertensión arterial

Introduction. Alterations in the quality and duration of sleep are risk factors for the development of arterial hypertension in Eastern countries. However, in Latin America there are few studies researching this association. Objective. To analyze the association between the quality and duration of sleep and the rate of arterial hypertension in a Colombian population. Materials and methods. An observational, longitudinal, prospective and analytical study nested in the INEFAC population-based cohort, was conducted with participants over 18 years of age from Bucaramanga (Colombia). Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Sleep duration was assessed using standardized questions. Multivariate analysis was performed with logistic regression models adjusted for possible confounding variables. Results. A total of 1,306 non-hypertensive participants with a mean age of 40 ± 12 years were included. In this population, 92.8% had one or more sleep issues. 45.15% slept 6 hours or less and 28.6% slept 8 hours or more. Multivariate analysis showed a higher risk of hypertension in participants with diabetes (OR = 5.27; 95% CI: 2.27-12.26), obesity (OR = 2.81; 95% CI: 1.11-7.13), active smoking (OR = 2.02; 95% CI: 1.01-4.04) and higher socioeconomic level (OR = 4.94; 95% CI: 1.59-15.38 for level 4), but no higher risk was found in participants with poor sleep quality or short sleep duration. Conclusions. No association was found between the duration or quality of sleep and the rate of arterial hypertension in the Colombian population. More studies are required in this population to reach definitive conclusions.

Introducción: Las alteraciones en la calidad y la duración del sueño son factores de riesgo para el desarrollo de hipertensión arterial sistémica en los países orientales. Sin embargo, hay pocos estudios de los países de Latinoamérica para investigar esta asociación. OBJETIVO: Analizar la asociación entre la calidad y la duración del sueño, y la incidencia de hipertensión arterial sistémica en población colombiana. Materiales y métodos. Se llevó a cabo un estudio observacional, longitudinal, prospectivo y analítico, anidado en la cohorte de base poblacional INEFAC, desarrollado con participantes mayores de 18 años de Bucaramanga (Colombia). El sueño se evaluó mediante el índice de calidad del sueño de Pittsburgh y, su duración, mediante preguntas estandarizadas. Se realizó un análisis multivariado con modelos de regresión logística ajustados por las posibles variables de confusión. RESULTADOS: Se incluyeron 1.306 participantes no hipertensos con edad media de 40 ± 12 años. El 92,8 % de la población presentaba algún problema del sueño, el 45,15 % dormía 6 horas o menos y el 28,6 % dormía 8 horas o más. El análisis multivariado mostró un mayor riesgo de hipertensión en los participantes con diabetes (OR = 5,27) (IC95 %: 2,27-12,26), obesidad (OR = 2,81) (IC95 %: 1,11-7,13), tabaquismo activo (OR = 2,02) (IC95 %: 1,01-4,04) y mayor estrato socioeconómico (OR = 4,94) (IC95 %: 1,59-15,38 para estrato 4), pero no se encontró un mayor riesgo en los participantes con mala calidad o poca duración del sueño. CONCLUSIONES: No se demostró asociación alguna entre la duración o la calidad del sueño y la incidencia de hipertensión arterial sistémica en población colombiana. Se requieren más estudios en esta población para llegar a conclusiones definitivas.

Sleep hygiene measures combined with mindfulness meditation in the management of sleep bruxism in children: A randomized controlled clinical trial.

BACKGROUND: Sleep hygiene measures and meditation may reduce stress and improve sleep quality, but their effect on the occurrence of sleep bruxism in children has not yet been investigated. AIM: To explore the effects of sleep hygiene measures combined with mindfulness meditation (relaxation audio) in the management of probable sleep bruxism (SB) in children. DESIGN: This clinical trial (no. NCT04501237) randomized 36 children with 3-8 years of age. Probable SB detection was performed according to the criteria established by the International Consensus on The Assessment of Bruxism-2018. Intervention group was instructed to practice sleep hygiene measures and mindfulness meditation (i.e., the use of a digital app to broadcast audio relaxation) each night before bedtime for 5 weeks; control group did not receive guidance for therapies. Parents completed a bruxism diary for 5 weeks, and the outcome was the number of SB episodes-day reported in the week (ranging from 0 to 7) in each period. A multilevel mixed-effects Poisson regression model was performed. RESULTS: A total of 32 children (mean age: 6.1 years) completed the study. The children who received the therapies related to sleep hygiene measures and mindfulness meditation had a reduction in the SB incidence rate ratio (IRR) of 46% (IRR = 0.54 [Confidence Interval 95%, 0.45-0.65]) during a 5-week observation period. The sensitivity analyses did not show relevant changes in the measure of the effect. CONCLUSION: Sleep hygiene measures combined with mindfulness meditation reduced the SB in children.

Relación de la calidad y la duración del sueño en población colombiana con hipertensión arterial / Relationship of quality and duration of sleep with arterial hypertension in a Colombian population

Introducción. Las alteraciones en la calidad y la duración del sueño son factores de riesgo para el desarrollo de hipertensión arterial sistémica en los países orientales. Sin embargo, hay pocos estudios de los países de Latinoamérica para investigar esta asociación. Objetivo. Analizar la asociación entre la calidad y la duración del sueño, y la incidencia de hipertensión arterial sistémica en población colombiana. Materiales y métodos. Se llevó a cabo un estudio observacional, longitudinal, prospectivo y analítico, anidado en la cohorte de base poblacional INEFAC, desarrollado con participantes mayores de 18 años de Bucaramanga (Colombia). El sueño se evaluó mediante el índice de calidad del sueño de Pittsburgh y, su duración, mediante preguntas estandarizadas. Se realizó un análisis multivariado con modelos de regresión logística ajustados por las posibles variables de confusión. Resultados. Se incluyeron 1.306 participantes no hipertensos con edad media de 40 ± 12 años. El 92,8 % de la población presentaba algún problema del sueño, el 45,15 % dormía 6 horas o menos y el 28,6 % dormía 8 horas o más. El análisis multivariado mostró un mayor riesgo de hipertensión en los participantes con diabetes (OR = 5,27) (IC95%: 2,27-12,26), obesidad (OR = 2,81) (IC95%: 1,11-7,13), tabaquismo activo (OR = 2,02) (IC95%: 1,01-4,04) y mayor estrato socioeconómico (OR = 4,94) (IC95%: 1,59-15,38 para estrato 4), pero no se encontró un mayor riesgo en los participantes con mala calidad o poca duración del sueño. Conclusiones. No se demostró asociación alguna entre la duración o la calidad del sueño y la incidencia de hipertensión arterial sistémica en población colombiana. Se requieren más estudios en esta población para llegar a conclusiones definitivas.

Introduction. Alterations in the quality and duration of sleep are risk factors for the development of arterial hypertension in Eastern countries. However, in Latin America there are few studies researching this association. Objective. To analyze the association between the quality and duration of sleep and the rate of arterial hypertension in a Colombian population. Materials and methods. An observational, longitudinal, prospective and analytical study nested in the INEFAC population-based cohort, was conducted with participants over 18 years of age from Bucaramanga (Colombia). Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Sleep duration was assessed using standardized questions. Multivariate analysis was performed with logistic regression models adjusted for possible confounding variables. Results. A total of 1,306 non-hypertensive participants with a mean age of 40 ± 12 years were included. In this population, 92.8% had one or more sleep issues. 45.15% slept 6 hours or less and 28.6% slept 8 hours or more. Multivariate analysis showed a higher risk of hypertension in participants with diabetes (OR = 5.27; 95% CI: 2.27-12.26), obesity (OR = 2.81; 95% CI: 1.11-7.13), active smoking (OR = 2.02; 95% CI: 1.01-4.04) and higher socioeconomic level (OR = 4.94; 95% CI: 1.59-15.38 for level 4), but no higher risk was found in participants with poor sleep quality or short sleep duration. Conclusions. No association was found between the duration or quality of sleep and the rate of arterial hypertension in the Colombian population. More studies are required in this population to reach definitive conclusions.

Impacts of conservative treatment on the clinical manifestations of obstructive sleep apnea-systematic review and meta-analysis.

INTRODUCTION: Obstructive sleep apnea (OSA) is a chronic disease with a high populational prevalence that is characterized as airway closure during sleep. Treatment is multidisciplinary and varies according to each case. Continuous positive airway pressure (CPAP), oral appliances, and surgery are the primary therapeutic options. Non-invasive conservative treatments such as sleep hygiene, positional therapy, physical exercises, and weight loss aim to reduce the worsening of the disease while being complementary to the invasive primary treatment. OBJECTIVE: To analyze the impact of non-invasive conservative therapies on the clinical manifestations of OSA syndrome (OSA), compared with other interventions. METHOD: This was a systematic review with meta-analysis. The searches were performed without filters for the time period, type of publication, or language. Randomized clinical trials on subjects over 18 years of age diagnosed with untreated OSA were included. Responses to non-invasive conservative treatment were compared with responses to the primary intervention. Primary outcomes were assessed using the Epworth Sleepiness Scale and/or Functional Outcomes of Sleep Questionnaire (FOSQ). RESULTS: A total of eight studies were included in the review. The heterogeneity of the effect was estimated at 89.77%. Six studies compared conservative treatment with CPAP, one with oral appliances, and one with oropharyngeal exercises. Using the Epworth Sleepiness Scale measurements, the standardized difference in the estimated means, based on the random-effects model, was 0.457 (95% CI (1.082 to 0.169)) and the mean result did not differ significantly from zero (z = 1.43; p = 0.153). The conservative therapies assessed in this study improved the subjective quality of sleep, although the post-treatment ESE scores did not show significant results. The reduction in AHI and better outcomes in the evaluated domains, as well as in cognition and mood, were superior in the groups that received CPAP and IOD. CONCLUSION: The most commonly used treatments of choice for OSA are invasive, including the use of CPAP, oral appliances, and surgeries, being the most utilized options. This study demonstrated that non-invasive conservative treatments, such as sleep hygiene, yield results as effective as invasive treatments. Further studies are needed to confirm this result and to predict whether invasive treatment can be used as the primary treatment or only as a supplement.

Effects of combined exercise training with sleep education in older adults with obstructive sleep apnea: protocol for a randomized clinical trial.

Background: Obstructive sleep apnea (OSA) is a common disorder that affects approximately 1 billion people worldwide. Advanced age is a significant risk factor. Various treatment options have been explored to reduce the severity of OSA symptoms and physical exercise has emerged as a potential alternative therapy. Therefore, this study aims to investigate the effects of a combined exercise program with sleep education on sleep quality and on the severity of OSA in older adults. Methods: This is a randomized clinical trial with two parallel groups that will involve individuals of both genders aged between 60 and 79 years who have an apnea-hypopnea index (AHI) of more than 15 events per hour and who have not received or are currently undergoing treatment for OSA. Older adults who have engaged in regular exercise in the last six months and individuals with contraindications to exercise will be excluded. The study will assess outcomes related to OSA, including AHI, oxygen desaturation index, minimum and mean oxyhemoglobin saturation, sleep efficiency, sleep latency, and the type of respiratory events. Additionally, sleep quality-related outcomes, daytime sleepiness, physical activity, physical fitness, aerobic capacity, cognitive status, anthropometric measures, and health-related quality of life will be analyzed. Participants will be randomized to two groups: a combined exercise group (involving both resistance and aerobic training) with sleep education, and a control group that will receive only educational recommendations for managing OSA. The intervention will last 12 weeks and will consist of three sessions per week, totaling 36 exercise sessions. Sample size calculation indicates a minimum number of 36 participants. Discussion: If the hypothesis is confirmed, this clinical trial will indicate an effective non-pharmacological intervention for treating OSA in older adults. This intervention could be used as an adjunct to existing approaches designed to improve OSA management. Clinical trail registration: Brazil Clinical Trials Registry (ReBEC), identifier RBR-9hk6pgz.

Effect of a lavender essential oil and sleep hygiene protocol on insomnia in postmenopausal women: A pilot randomized clinical trial.

INTRODUCTION: Insomnia and vasomotor symptoms are frequently experienced during the menopausal transition and in postmenopause, worsening sleep maintenance and quality of life. Our study evaluated the use of lavender essential oil and sleep hygiene guidance on quality of life, sleep patterns and self-reported hot flashes in postmenopausal women with insomnia diagnosis. METHODS: This study is part of a larger experimental, double-blind, randomized controlled trial. We included 35 postmenopausal women with a diagnosis of insomnia who were distributed in two groups: A Placebo group (sunflower oil) and an Aroma group (Lavandula angustifolia essential oil); both inhaled the oils before bedtime for 29 days. The groups received sleep hygiene guidelines and weekly follow-up. Validated questionnaires were used to assess the effect of the intervention, and a sleep diary was used to assess sleep onset latency (SOL), total sleep time (TST), and sleep efficiency (SE) daily. Participants who complained of vasomotor symptoms at baseline kept a daily record of their frequency and intensity. RESULTS: All participants benefited in almost all domains of quality of life and in the self-assessed TST and SE. The Aroma group achieved a significant improvement in their overall quality of life score over time. No differences were observed in respect of the hot flashes record and daytime sleepiness. CONCLUSIONS: The aromatherapy intervention was effective in improving the overall quality of life in the Aroma group. Moreover, the sleep diary and sleep hygiene instructions helped all participants to, respectively, self-assess and improve their sleep patterns.

Sleep quality and falls in middle-aged and older adults: ELSI-Brazil study / Qualidade do sono e quedas em adultos de meia-idade e idosos: Estudo ELSI-Brasil / Calidad del sueño y caídas en adultos de mediana edad y mayores: Estudio ELSI-Brasil

ABSTRACT Objective: To verify the association between low self-reported sleep quality (LSQ) and fall in middle-aged and older adults every half-decade of life. Method: A cross-sectional study was conducted using data from the first wave (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is nationally representative. The sample consisted of 8,950 participants who were allocated into eight age groups: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, and ≥ 85 years. The questionnaires used included self-reported sleep quality and the International Physical Activity Questionnaire short version. Fisher's exact test followed by binary logistic regression analysis was performed to identify the odds ratio of sleep quality for fall occurrence, controlled for confounding variables. Results: Individuals aged 50-105 years (63.6 ± 10.2 years), 57.0% females and 43.0% males, participated in this study. Overall, 21.5% of participants experienced at least one fall. The relative frequency of participants classified as having high or LSQ remained constant across each half-decade of life. The LSQ exhibited a statistically significant OR (p < 0.05) for falls across age groups up to 84, even after accounting for confounding variables. Conclusion: LSQ is significantly associated with an increased occurrence of fall in adults aged >50 years, but not for ≥ 85 years regardless of sex and physical activity level.

RESUMO Objetivo: Verificar a associação entre baixa qualidade do sono autorrelatada (BQS) e quedas em adultos de meia-idade e idosos a cada meia década de vida. Método: Um estudo transversal foi conduzido utilizando dados da primeira onda (2015-2016) do Estudo Longitudinal Brasileiro do Envelhecimento (ELSI-Brasil), que é nacionalmente representativo. A população consistiu em 8.950 participantes que foram alocados em oito grupos etários: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84 e ≥ 85 anos. Os questionários utilizados incluíram qualidade do sono autorrelatada e o Questionário Internacional de Atividade Física versão curta. O teste exato de Fisher seguido pela análise de regressão logística binária foi conduzida para identificar a razão de chances da BQS para ocorrência de queda, controlando por variáveis de confusão. Resultados: Pessoas com idades entre 50 e 105 anos (63,6 ± 10,2 anos), sendo 57,0% do sexo feminino e 43,0% do sexo masculino, participaram deste estudo. No geral, 21,5% dos participantes experimentaram pelo menos uma queda. A frequência relativa de participantes classificados como tendo BQS ou alta permaneceu constante em cada meia década de vida. A BQS exibiu uma OR (p < 0,05) notável para quedas em grupos etários até 84 anos, mesmo após o ajuste para variáveis de confusão. Conclusão: A BQS está significativamente associada a uma maior ocorrência de queda em adultos com mais de 50 anos, mas não para ≥ 85 anos, independentemente do sexo e do nível de atividade física.

RESUMEN Objetivo: Verificar la asociación entre la baja calidad del sueño autorreportada (BCS) y las caídas en adultos de mediana edad y mayores cada media década de vida. Método: Se realizó un estudio transversal utilizando datos de la primera oleada (2015-2016) del Estudio Longitudinal Brasileño sobre el Envejecimiento (ELSI-Brasil), que es representativo a nivel nacional. La muestra consistió en 8,950 participantes que fueron asignados a ocho grupos de edad: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84 y ≥ 85 años. Los cuestionarios utilizados incluyeron calidad del sueño autorreportada y el Cuestionario Internacional de Actividad Física versión corta. Se realizó una prueba exacta de Fisher seguida por un análisis de regresión logística binaria para identificar la razón de probabilidades de la calidad del sueño para la ocurrencia de caídas, controlando las variables de confusión. Resultados: Participaron en este estudio individuos con edades entre 50 y 105 años (63,6 ± 10,2 años), siendo el 57,0% mujeres y el 43,0% hombres. En general, el 21,5% de los participantes experimentaron al menos una caída. La frecuencia relativa de participantes clasificados como con alta calidad de sueño o baja calidad de sueño (BCS) se mantuvo constante a lo largo de cada media década de vida. La BCS mostró un OR (p < 0,05) notable para las caídas en grupos de edad hasta los 84 años, incluso después de ajustar por variables de confusión. Conclusión: La BCS está significativamente asociada con una mayor ocurrencia de caídas en adultos mayores de 50 años, pero no para ≥ 85 años, independientemente del sexo y del nivel de actividad física.

Quality of sleep and excessive daytime sleepiness among medical students in a Brazilian private university

SUMMARY OBJECTIVE: The aim of this study was to assess medical students' quality of sleep and excessive daytime sleepiness in different graduation cycles. METHODS: A cross-sectional study was carried out at a private university in Maceió, Brazil, from August 2021 to March 2022. The sample was composed of medical students aged 18 years and above from years 1-2 (basic cycle), 3-4 (clinical cycle), and 5-6 (internship) of Medical School who were invited to answer two validated questionnaires: the Pittsburgh Sleeping Quality Index and the Epworth Sleepiness Scale. RESULTS: A total of 179 students participated; most of them were female (78.2%), aged 19-25 years (73.7%), and with a body mass index<25 kg/m2 (73.7%), with smaller participation from students from the basic cycle (21.2%). Analyzing the Pittsburgh Sleeping Quality Index, 55.9% of the students were classified as having poor sleep quality, with no difference in sleep category between gender, age, body mass index, and graduation cycle. Students with a body mass index of ≥25 kg/m2 had longer sleep latency (p=0.016) and shorter sleep duration (p=0.027). The Epworth Sleepiness Scale assessment showed that 44.1% of the students exhibit daytime sleepiness. Women had more daytime sleepiness than men (p=0.017), with no difference between age, body mass index, and graduation cycle. CONCLUSION: About half of the medical students experience poor sleep quality and daytime sleepiness, regardless of the graduation cycle. This should trigger a targeted institutional intervention to promote better mental and physical health, as well as sleep hygiene, to reduce future health issues.

Association between physical activity and sleep indicators among adolescents: a cross-sectional study / Associação entre atividade física e indicadores de sono em adolescentes: um estudo tranversal / Asociación entre actividad física e indicadores de sueño en adolescentes: un estudio transversal

Purpose: The aim of the present study is to analyze the association between physical activity and sleep indicators among adolescents. Methods: Cross-sectional study involving 647 adolescents (53.0% female). Leisure time physical activity at low and at moderate to vigorous intensities (420 min/week) were the independent variables and the outcomes were daytime sleepiness, classroom sleepiness, poor sleep perception, sleep duration, bedtime, and wake up time. The multivariate association was performed by Poisson regression to estimate Prevalence Ratios (PR). Results: Not achieving 420 min/week of physical activity at light and at moderate to vigorous intensities was associated with a higher prevalence ratio for classroom sleepiness (PR=1.79 and 1.64), daytime sleepiness (PR=1.25 and 1.17), and poor sleep perception (PR=1.52 and 1.27), all P<0.05. However, not achieving 420 min/week showed the opposite association and decreased the prevalence ratio for having a sleep duration <8h (PR=0.74 and 0.72), P<0.05. No association was found between physical activity and bedtime or wake up time. Mediation analysis revealed that the association between physical activity and daytime sleepiness was fully mediated by a poor perception of sleep quality, while classroom sleepiness showed a partial mediation. Conclusion: Physical activity seems to have a positive effect on daytime sleepiness, classroom sleepiness, and perceived sleep quality. Poor sleep perception was the pathway through which physical activity was associated to sleepiness in the present sample. Conversely, physical activity reduced the likelihood of students achieving 8h of sleep.

Objetivo: O objetivo do presente estudo é analisar a associação entre atividade física e indicadores de sono em adolescentes. Metodologia: Estudo transversal envolvendo 647 adolescentes. A atividade física no tempo livre nas intensidades leve e moderada a vigorosa (420 min/semana) foram as variáveis independentes e os desfechos foram: sonolência diurna, sonolência em sala de aula, percepção de sono ruim, duração do sono, hora em que se deita e acorda. A associação multivariada foi realizada por meio da regressão de Poisson para estimar as Razões de prevalência (PR). Resultados: Não atingir 420 min/semana de atividade física leve e moderada a vigorosa se associou com a maior razão de prevalência de sonolência em sala de aula (PR=1,79 e 1,64), sonolência diurna (PR=1,25 e 1,17) e percepção de sono ruim (PR=1,52 e 1,27), P<0,05. No entanto, não atingir 420 min/semana demonstrou associação oposta e reduziu a razão de prevalência para duração de sono <8h (PR=0,74 e 0,72), P<0,05. Nenhuma associação foi encontrada entre atividade física e hora de deitar ou acordar. A associação entre atividade física e sonolência diurna foi mediada de forma completa pela percepção de sono ruim, enquanto que a sonolência em sala de aula foi mediada parcialmente. Conclusão: A atividade física parece ter efeito positivo na sonolência diurna, em sala de aula e na percepção de sono. A percepção de sono foi a via pela qual a atividade física associou-se à sonolência na amostra estudada. Por outro lado, a atividade física reduziu a probabilidade de estudantes atingirem 8h de sono.

Objetivos: El objetivo del presente estudio es analizar la asociación entre actividad física e indicadores de sueño en adolescentes. Metodología: Estudio transversal en el que participaron 647 adolescentes. La actividad física en el tiempo libre a intensidades ligera y moderada a vigorosa (420 min/semana) fueron las variables independientes y las dependientes fueron: somnolencia diurna, somnolencia en el aula, mala percepción del sueño, duración del sueño, hora de acostarse y despertarse. La asociación multivariada se realizó mediante regresión de Poisson para estimar las razones de prevalencia (RP). Resultados: No alcanzar 420 min/semana de actividad física ligera y moderada a vigorosa se asoció con una mayor razón de prevalencia de somnolencia en el aula (RP=1,79 y 1,64), somnolencia diurna (RP=1,25 y 1,17) y mala percepción del sueño. (RP=1,52 y 1,27), P<0,05. No alcanzar los 420 min/semana demostró la asociación opuesta y redujo la razón de prevalencia para la duración del sueño <8 h (RP = 0,74 y 0,72), P <0,05. No se encontró asociación entre la actividad física y la hora de acostarse o despertarse. La asociación entre actividad física y somnolencia diurna fue completamente mediada por la mala percepción del sueño, mientras que la somnolencia en el aula fue parcialmente mediada. Conclusión: La actividad física parece tener un efecto positivo sobre la somnolencia diurna, en el aula y sobre la percepción del sueño. La percepción del sueño es la forma en que la actividad física redujo la somnolencia en la muestra estudiada. Por otro lado, la actividad física redujo la probabilidad de que los estudiantes alcanzaran las 8 horas de sueño.

EL SUEÑO EN ESTUDIANTES DE ENFERMERÍA EN UNA UNIVERSIDAD DEL SUR DE CHILE / SLEEP IN NURSING STUDENTS AT A UNIVERSITY IN SOUTHERN CHILE

El sueño es una función y necesidad básica en el ser humano; permite el descanso de la mente y cuerpo, recuperar energías y restablecer funciones para un buen rendimiento. Los trastornos del sueño pueden desencadenar problemas gástricos, cardiovasculares, cognitivas, desequilibrio en el rendimiento académico, alterando negativamente la capacidad de concentración, aprendizaje, memoria; dormir poco se asocia a fatiga y disminución de las capacidades cognitivas y motoras durante el día. Las demandas sociales, familiares y académicas de estudiantes universitarios los hace adoptar patrones de sueño irregulares, dando lugar a cambios en el hábito del sueño, especialmente en el contexto de la pandemia por COVID-19, debido al incremento de horas de conexión tele presencial y el uso de aparatos electrónicos para sus actividades académicas. Por ello el presente estudio evaluado y aprobado por Comité De Ética, certificado ORD: Nº 145- 2021/RevOct.2021, pretende describir la calidad del sueño en estudiantes de Enfermería en una Universidad del sur de Chile durante el segundo semestre del 2021; aplicando el Índice de Calidad de Sueño de Pittsburgh a 165 estudiantes de primero a quinto año, a través de un estudio de tipo cuantitativo, observacional, descriptivo, de secuencia transversal, con muestreo probabilístico estratificado y con afijación simple. Solo el 12% de los estudiantes de Enfermería presentó óptima calidad del sueño; el 64% sugiere problemas de sueño y el 24% se acercan a una peor calidad de sueño. La existencia de una alta prevalencia de la mala calidad del sueño indica la necesidad de adquirir una buena higiene del sueño que permita el descanso adecuado y necesario para realizar sus actividades de manera óptima.

Sleep is a basic function and need in humans; it allows the brain and body to rest, recover energy, and restore functions for good performance. Sleep disorders can trigger gastric, cardiovascular, and cognitive problems, as well as affect academic performanceby negatively altering the ability to concentrate, learn, and recall. Insufficient sleep is associated with fatigue and decreased cognitive and motor skills during the day. The social, family, and academic demands of university students often make them adopt irregular sleep patterns, leading to changes in sleep habits. This was especially true during the COVID-19 pandemic, due to the increase in hours of online connection and the use of electronic devices for academic activities. This study, evaluated and approved by the Ethics Committee, certified ORD: Nº 145- 2021/RevOct.2021, aims to describe the quality of sleep in Nursing students at a university in southern Chile during the second semester of 2021. The Pittsburgh Sleep Quality Index was administered to 165 first-year to fifth-year Nursing students, through a quantitative, observational, descriptive, cross-sectional sequence study, with stratified probabilistic sampling and simple assignment. Only 12% of Nursing students had optimal sleep quality; 64% suggest sleep problems and 24% indicated a worse quality of sleep. The high prevalence of poor sleep quality indicates the need for students to adopt good sleep hygiene that allows adequate and necessary rest for optimal academic performance.

One-week sleep hygiene education improves episodic memory in young but not in older adults during social isolation.

Memory formation is a dynamic process that comprises different phases, such as encoding, consolidation and retrieval. It could be altered by several factors such as sleep quality, anxiety, and depression levels. In the last years, due to COVID-19 pandemic, there was a reduction in sleep quality, an increase in anxiety and depressive symptoms as well as an impairment in emotional episodic memory encoding, especially in young adults. Taking into account the profound impact of sleep quality in daily life a series of rules has been developed that are conducive to consistently achieving good sleep, known as sleep hygiene education. These interventions have been shown to be effective in improving sleep quality and duration and reducing depressive and anxiety symptoms. Here we propose the implementation of a brief sleep hygiene education to improve sleep quality and memory performance as well as to diminish anxiety and depressive scores. For that, participants were divided into two groups: Sleep hygiene education and control group. After that, they were evaluated for anxiety, depression, and sleep quality levels and trained on an episodic memory task. They were tested immediately after (short-term test) and also 1 week later (long-term test). This procedure was also performed before the sleep hygiene education and was taken as baseline level. We found that episodic memory performance for young adults improved for the SHE group after intervention but not for older adults, and no improvements in emotional variables were observed. Despite not observing a significant effect of the intervention for young and older adults regarding the sleep quality scores, we consider that there may be an improvement in sleep physiology that is not subjectively perceived, but would also have a positive impact on memory processes. These results show that even a sleep hygiene education of 1 week could improve cognition in young adults when acute memory and sleep impairment occurs, in this case, due to the isolation by COVID-19 pandemic. However, we suggest that longer interventions should be implemented for older adults who already experience a natural decline in cognitive processes such as episodic memory formation.

Desenvolvimento de aplicativo para higiene do sono em adultos / Development of an application for sleep hygiene in adults / Desarrollo de una aplicación para la higiene del sueño en adultos

Introdução: Diferentes condições clínicas podem afetar a quantidade e a qualidade do sono. As medidas de higiene do sono interferem diretamente na qualidade deste. Elas podem ser propagadas à população por meio de aplicativos. Objetivo: Desenvolver, avaliar e disponibilizar um aplicativo que contemple as medidas de higiene do sono e que seja capaz de gerar mudança e verificar a ocorrência de sonolência diurna excessiva. Metodologia: O aplicativo "Somnum" foi desenvolvido e 26 fonoaudiólogos certificados em Sono pela Associação Brasileira do Sono foram convidados a avaliar usando o questionário Emory e outro questionário elaborado pelas autoras. Após, 38 estudantes usaram o aplicativo e responderam antes e depois do uso o Índice de Qualidade do Sono de Pittsburgh e a Escala de Epworth. Resultados: Após seu desenvolvimento, o aplicativo foi avaliado por 4 fonoaudiólogas que contribuíram com suas sugestões e 38 universitários participaram respondendo os questionários, sendo que 6 deles participaram antes e após o uso do aplicativo. Sobre o Índice de qualidade de sono de Pittsburgh, foi observado na análise estatística, comparando o antes e após o uso do aplicativo, melhora da qualidade de sono (p=0,04). No que se refere ao questionário Epworth, foi verificado na situação após o uso do aplicativo "Somnum", que não houve diferença significativa. Conclusão: Após o uso do aplicativo, verificou-se possível melhora na qualidade de sono. Houve ocorrência de sonolência diurna excessiva. (AU)

Introduction: Different clinical conditions can affect the quantity and quality of sleep. Sleep hygiene measures directly affect the quality of sleep. They can be disseminated to the population by means of applications. Objective: To develop, evaluate and make available an application that approach sleep hygiene and that is able to generate changes and verify the occurrence of excessive daytime sleepiness. Methodology: The application "Somnum" was developed and 26 speech therapists certified in sleep by the Brazilian Sleep Association were invited to evaluate it using the Emory questionnaire and another questionnaire developed by the authors. Afterwards, 38 students used the application and answered before and after the use the Pittsburgh Sleep Quality Index and the Epworth Scale. Results: After its development, the app was evaluated by 4 speech therapists who contributed with their suggestions, and 38 university students participated by answering the questionnaires, 6 of them before and after the use of the application. In the Pittsburgh Sleep Quality Index, it was observed in the statistical analysis, comparing before and after using the application, improvement in sleep quality (p=0.04). In the Epworth questionnaire, it was verified in the situation after using the "Somnum" application, that there was not significant difference. Conclusion: After using the application, there was a possible improvement in sleep quality. There was occurrence of excessive daytime sleepiness. (AU)

Introducción: Diferentes condiciones clínicas pueden afectar a la cantidad y calidad del sueño. Las medidas de higiene del sueño afectan directamente a la calidad del mismo. Pueden propagarse a la población mediante aplicaciones. Objetivo: Desarrollar, evaluar y poner a disposición una aplicación que incluya medidas de higiene del sueño y que sea capaz de generar cambios y verificar la aparición de somnolencia diurna excesiva. Metodología: Se desarrolló la aplicación "Somnum" y se invitó a 26 fonoaudiólogos certificados en soeño por la Asociación Brasileña del Sonido a evaluarla utilizando el cuestionario Emory y otro cuestionario elaborado por los autores. Posteriormente, 38 estudiantes utilizaron la aplicación y respondieron antes y después del uso de la misma al Índice de Calidad del Sueño de Pittsburgh y a la Escala de Epworth. Resultados: Tras su desarrollo, la aplicación fue evaluada por 4 fonoaudiólogos que aportaron sus sugerencias y 38 estudiantes universitarios participaron respondiendo a los cuestionarios, 6 de ellos antes y después del uso de la aplicación. Sobre el Índice de Calidad del Sueño de Pittsburgh, se observó en el análisis estadístico, comparando antes y después del uso de la aplicación, mejoría en la calidad del sueño (p=0,04). Con respecto al cuestionario de Epworth, se verificó en la situación posterior al uso de la aplicación "Somnum", que no hubo diferencia significativa. Conclusión:Después de usar la aplicación, hubo uma posible mejora em la calidad del sueño. Hubo ocurrencia de somnolencia diurna excesiva. (AU)

Technologies and Mental Health in University Students: An Unhealthy Combination

Abstract Introduction The exposure of medical students to a full-time schedule that includes classes, extracurricular activities, patients' lives responsibility, and great competition between classmates can interfere in emotional issues and in the sleep time. Objective The aim of the present study was to evaluate the sleep quality, and the incidence of anxiety and depression in medical school undergraduates as well as the relationship of these parameters with the intense use of technologies. Methods Fifty-five medical school undergraduates in their second year participated in the present study, answering questionnaires to evaluate sleep quality (Pittsburgh sleep quality index - PSQI), night-time use of technology (sleep time-related information and communication technology - STRICT), and signs of anxiety or depression (hospital anxiety and depression scale - HADS). Results The results showed 31 students (56.4%) with poor sleep quality (PSQI > 5). Based on the STRICT questionnaire, 36 (65.4%) of the participants referred to making use of technology at night-time; and 34 (61.8%) students had compatible anxiety score, while 14 (25.4%) had a compatible score for depression on the HADS questionnaire. There has been a correlation between poor sleep quality, the abuse of technologies before sleep time, and the presence of anxiety or depression. Conclusion The abuse of technology before sleep time reduced the sleep quality in the studied population, besides increasing the symptoms of anxiety and depression.

Multimorbidity and Sleep Patterns among Adults in a Peruvian Semi-Urban Area.

Objective To assess if the duration and quality of sleep vary due to the presence of multimorbidity. Materials and Methods We performed a secondary analysis using data from a population-based study involving adult subjects aged between 30 and 69 years residing in a semi-urban area of Tumbes, Peru. The duration (normal, short or prolonged) and quality (good or poor) of sleep were our outcome variables, whereas the exposure was multimorbidity (two or more chronic conditions). Crude and adjusted Poisson regression models were built to assess the association of interest, and prevalence ratios (PRs) and 95% confidence intervals (95%CIs) were reported. Results We analyzed data from 1,607 subjects with a mean age of 48.2 (standard deviation [SD]: ± 10.6) years, 809 (50.3%) of whom were women. Multimorbidity was present in 634 (39.5%; 95%CI: 37.1-41.9%) subjects, and 193 (12.1%; 95%CI: 10.5-13.7%) were short sleepers, 131 (8.2%; 95%CI: 6.9-9.6%) were long sleepers, and 312 (19.5%; 95%CI: 17.5-21.5%) had poor sleep quality. In the multivariable model, multimorbidity was associated with prolonged sleep duration (PR = 1.45; 95%CI: 1.03-2.04) and poor sleep quality (PR = 2.04; 95%CI: 1.65-2.52). Conclusions Multimorbidity was associated with prolonged, but not short, sleep duration, as well as with poor sleep quality. Our results suggest the need of assessing sleep patterns among adults with multimorbidity.

Technologies and Mental Health in University Students: An Unhealthy Combination.

Introduction The exposure of medical students to a full-time schedule that includes classes, extracurricular activities, patients' lives responsibility, and great competition between classmates can interfere in emotional issues and in the sleep time. Objective The aim of the present study was to evaluate the sleep quality, and the incidence of anxiety and depression in medical school undergraduates as well as the relationship of these parameters with the intense use of technologies. Methods Fifty-five medical school undergraduates in their second year participated in the present study, answering questionnaires to evaluate sleep quality (Pittsburgh sleep quality index - PSQI), night-time use of technology (sleep time-related information and communication technology - STRICT), and signs of anxiety or depression (hospital anxiety and depression scale - HADS). Results The results showed 31 students (56.4%) with poor sleep quality (PSQI > 5). Based on the STRICT questionnaire, 36 (65.4%) of the participants referred to making use of technology at night-time; and 34 (61.8%) students had compatible anxiety score, while 14 (25.4%) had a compatible score for depression on the HADS questionnaire. There has been a correlation between poor sleep quality, the abuse of technologies before sleep time, and the presence of anxiety or depression. Conclusion The abuse of technology before sleep time reduced the sleep quality in the studied population, besides increasing the symptoms of anxiety and depression.

The Sleep Parameters of Paralympic Athletes: Characteristics and Assessment Instruments.

CONTEXT: Sleep serves many important functions for athletes, particularly in the processes of learning, memory, recovery, and cognition. OBJECTIVES: Define the sleep parameters of Paralympic athletes and identify the instruments used to assess and monitor sleep Paralympic athletes. EVIDENCE ACQUISITION: This systematic review was carried out based on the PRISMA guidelines. The survey was conducted in April 2020, the searches were carried out again in September 2021 to check whether there were new scientific publications in the area of sleep and Paralympic sport, searches were performed in the following databases: PubMed, Web of Science, Scopus, SPORTDiscus, Virtual Health Library (BIREME), and SciELO. This systematic review has included studies that investigated at least one of the following sleep parameters: total sleep time, sleep latency, sleep efficiency, number of awakenings, quality of sleep, daytime sleepiness, and chronotype; the participants were comprised of athletes with disabilities. Studies published at any time in English, Portuguese, and Spanish, were included. EVIDENCE SYNTHESIS: Data extraction and study selection were performed by 2 researchers independently, and a third author was consulted as necessary. The search returned a total of 407 studies. Following the screening based on exclusion and inclusion criteria, a total of 13 studies were considered. Paralympic athletes have a low amount (7.06 h) of sleep with poor quality and sleep latency (28.05 min), and 57.2% have daytime sleepiness, with the majority belonging to the indifferent chronotype (53, 5%). Moreover, 11 studies assess sleep using subjective instruments (questionnaires), and 2 studies used an objective instrument (actigraphy). CONCLUSIONS: Sleep disorders are common among Paralympic athletes, poor sleep quality and quantity, and high rates of daytime sleepiness. Subjective methods are most commonly used to assess sleep.