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1.
Biomedica ; 44(Sp. 1): 47-62, 2024 05 31.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-39079147

RESUMO

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.


Assuntos
Hipertensão , Humanos , Colômbia/epidemiologia , Hipertensão/epidemiologia , Adulto , Estudos Prospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Longitudinais , Fatores de Risco , Sono , Qualidade do Sono , Fatores de Tempo , Incidência
2.
Rev. Baiana Saúde Pública ; 48(1): 137-154, 20240426.
Artigo em Português | LILACS | ID: biblio-1555798

RESUMO

Durante a pandemia de covid-19, os profissionais de saúde que atuaram na linha de frente viveram um cenário desafiador, com constante risco de infecção pelo SARS-CoV-2, uma demanda de trabalho aumentada e muitas incertezas. O objetivo deste estudo foi analisar as repercussões da covid-19 na saúde de fisioterapeutas baianos atuantes na linha de frente no ambiente hospitalar. Fisioterapeutas baianos participaram deste estudo, respondendo questões referentes aos seus dados sociodemográficos, à qualidade do sono e aos sintomas de ansiedade e depressão, através de um formulário eletrônico (Google Forms). Responderam ao formulário 38 fisioterapeutas residentes em Salvador (BA). A metade deles atua em Unidades de Terapia Intensiva (UTI) e, destes, 65% são trabalhadores do setor privado. Além disso, 68% foram infectados pelo SARS-CoV-2 uma ou mais vezes. O constante medo de infectar seus familiares foi declarado por 77,3% deles e, após o expediente, 36% dos profissionais apresentavam exaustão emocional; 34,2%, estresse psicológico; e 26%, cansaço físico. Os fisioterapeutas baianos relataram que durante a pandemia de covid-19 houve grandes desafios no local de trabalho, como o medo de adoecer e de transmitir a doença e, sobretudo, o medo da morte. O cansaço e o estresse psicológico foram constantes na prática profissional, mas, apesar disso, a maioria dos fisioterapeutas sentiu satisfação por ter atuado de forma tão indispensável em um momento delicado e único.


During COVID-19, health services and professionals who worked on the front line experienced a challenging scenario with a constant risk of infection by SARS-CoV-2, an increased demand for work, and many uncertainties. This study analyzed the repercussions of COVID-19 on the health of Bahian physical therapists working on the hospital front line. Bahian physical therapists participated in this study, answering questions related to their sociodemographic data, sleep quality, and symptoms of anxiety and depression by an electronic form (Google Forms). Overall, 38 physiotherapists living in Salvador (Bahia) answered this form. In total, 50% worked in Intensive Care Units (ICUs); 65%, in the private sector, and 68% suffered infection from SARS-CoV-2 one or more times. This study found that 77.3% of participants reported the constant fear of infecting their family members and 36% showed emotional exhaustion after working hours; 34.2%, psychological stress; and 26%, physical fatigue. Bahian physical therapists reported that COVID-19 brought major confrontations in the workplace, such as the fear of getting sick and transmitting the disease and, above all, death. Fatigue and psychological stress remained constant in the professional practice, but, despite this, most physical therapists felt satisfied for having acted in such an indispensable way in a delicate and unique moment.


Durante la pandemia de la COVID-19, los profesionales de la salud que trabajaban en primera línea vivieron un escenario desafiante, con un riesgo constante de infección por SARS-CoV-2, una mayor demanda de trabajo y muchas incertidumbres. El objetivo de este estudio fue analizar las repercusiones de la COVID-19 en la salud de los fisioterapeutas de Bahía, Brasil, que trabajan en primera línea en el ambiente hospitalario. En este estudio participaron 38 fisioterapeutas residentes en Salvador (Bahía, Brasil) que respondieron a un cuestionario electrónico (Google Forms) con preguntas relacionadas a sus datos sociodemográficos, calidad del sueño y síntomas de ansiedad y depresión. El 50% de ellos trabajan en Unidades de Cuidados Intensivos (UCI) y, de estos, el 65% pertenecen al sector privado. El 68% se ha infectado con el SARS-CoV-2 una o más veces. El miedo constante a contagiar a sus familiares fue declarado por el 77,3% de ellos, y después de la jornada laboral, el 36% de los profesionales presentaron agotamiento emocional; el 34,2%, estrés psicológico; y el 26%, fatiga física. Los fisioterapeutas de Bahía relataron que durante la pandemia de la COVID-19 hubo grandes retos en el lugar de trabajo, como el miedo a enfermarse y transmitir la enfermedad y, sobre todo, el miedo a la muerte. Aunque el cansancio y el estrés psicológico fueron constantes en la práctica profesional, la mayoría de los fisioterapeutas sintieron satisfacción por haber actuado de manera tan indispensable en un momento delicado y único.


Assuntos
Humanos
3.
J Med Genet ; 61(6): 586-589, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38350721

RESUMO

Pogo transposable element-derived protein with ZNF domain (POGZ) gene encodes a chromatin regulator and rare variants on this gene have been associated with a broad spectrum of neurodevelopmental disorders, such as White-Sutton syndrome. Patient clinical manifestations frequently include developmental delay, autism spectrum disorder and obesity. Sleep disturbances are also commonly observed in these patients, yet the biological pathways which link sleep traits to the POGZ-associated syndrome remain unclear. We screened for sleep implications among individuals with causative POGZ variants previously described. Sleep disturbances were observed in 52% of patients, and being obese was not observed as a risk factor for sleep problems. Next, we identified genes associated with sleep-associated traits among the POGZ regulatory targets, aiming to uncover the molecular pathways that, when disrupted by POGZ loss of function, contribute to the aetiology of sleep phenotypes in these patients. The intersect between POGZ targets and sleep-related genes was used in a pathway enrichment analysis. Relevant pathways among these overlapping genes are involved in the regulation of circadian rhythm, tau protein binding, ATPase activator activity. This study may represent the beginning for novel functional investigations on shared molecular mechanisms between sleep disturbances and rare developmental syndromes related to POGZ and its regulatory targets.


Assuntos
Transtornos do Neurodesenvolvimento , Fenótipo , Transtornos do Sono-Vigília , Humanos , Transtornos do Neurodesenvolvimento/genética , Transtornos do Sono-Vigília/genética , Masculino , Feminino , Sono/genética , Criança , Pré-Escolar , Ritmo Circadiano/genética , Proteínas de Ligação a DNA , Proteínas de Ciclo Celular
4.
Children (Basel) ; 11(2)2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38397320

RESUMO

Sleep is of vital necessity for health, and it has a restorative and protective function for children and adolescents with chronic conditions and their families. The purpose of this study was to identify the scientific production on sleep patterns in children and adolescents with chronic conditions and their families. This integrative review was conducted between March and June 2022 using the databases of MEDLINE, Web of Science, CINAHL and PsycINFO. The articles included were original papers published between January 2007 and mid-2022. Excluded were review studies that did not evaluate sleep and whose participants did not have chronic conditions or were not children, adolescents and/or their families. The searches returned 814 abstracts. After exclusions, 47 studies were selected to be read in full; of these, 29 were selected and were grouped empirically into four categories: major alterations in the sleep patterns of children and adolescents with chronic conditions; the relationship between sleep disorders and symptoms in children and adolescents with chronic conditions; the impaired sleep patterns of families of children and adolescents with chronic conditions; and sleep alterations and their relationship with other problems in families of children and adolescents with chronic conditions. All studies showed sleep pattern impairment in children and adolescents with chronic conditions as well as their families.

5.
Exp Gerontol ; 187: 112370, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38310982

RESUMO

BACKGROUND: Frailty is associated with an increased susceptibility to functional decline, impairment, hospitalization, and mortality among the older adults. However, the potential reversibility of frailty lies in identifying modifiable factors that could prevent, mitigate, or interrupt its progression. While there is a suggestion that sleep disorders may increase the risk of frailty and impairment, the risk stratification of this relationship remains inconclusive. OBJECTIVE: Stratify the risk of frailty and impairment and investigate potential connections with sleep quality, excessive daytime sleepiness, and the risk of obstructive sleep apnea in older adults dwelling in the community. METHODS: This was a quantitative cross-sectional investigation. Frailty risk and impairment were stratified using the Frail Non-disabled Questionnaire (for impairment) and the FRAIL Scale (for Frailty). The assessment of excessive daytime sleepiness, sleep quality, and the risk of obstructive sleep apnea involved the employment of the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and the STOP-BANG questionnaire, respectively. RESULTS: A total of 109 older adults living in the urban area (86 %, p = 0.010), females (61 %; p = 0.030), median age 68 (64-75) years, with overweight (36 %, p < 0.010) and self-identified as belonging to other racial or ethnic categories (71 %, p < 0.010). According to the impairment assessment, 32 % of participants were classified as disable (p < 0.01). Conversely, as per the frailty evaluation, 33 % were pre-frail and 25 % were identified as frail. Additionally, a substantial proportion experienced poor sleep quality (80 %, p = 0.010), exhibited a moderate risk of obstructive sleep apnea (49 %, p < 0.010), and showed no signs of excessive daytime sleepiness (62 %, p < 0.010). There was a modest correlation between frailty and impairment with poor sleep quality (rho = 0.39; p < 0.001) and the risk of obstructive sleep apnea (rho = 0.26; p = 0.000). However, the was no significant relationship was observed between frailty and impairment and excessive daytime sleepiness (rho = 0.04; p = 0.660). Similarly, a modest correlation was observed between sleep quality (rho = 0.33; p < 0.001), the risk of obstructive sleep apnea (rho = 0.27; p = 0.001), and frailty. Conversely, no correlation was found with excessive daytime sleepiness (rho = 0.05; p = 0.590). Also, the poor sleep quality and the risk of obstructive sleep apnea explain 14 % of the risk of frailty in the population of community-dwelling older adults (r2 = 0.14; p = 0.04). CONCLUSION: This study reveals a modest risk of frailty and impairment with sleep quality and the risk of obstructive sleep apnea, but not with excessive daytime sleepiness in community-dwelling older adults.


Assuntos
Distúrbios do Sono por Sonolência Excessiva , Fragilidade , Apneia Obstrutiva do Sono , Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Feminino , Humanos , Idoso , Fragilidade/epidemiologia , Vida Independente , Estudos Transversais , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/diagnóstico , Distúrbios do Sono por Sonolência Excessiva/complicações , Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/epidemiologia , Distúrbios do Início e da Manutenção do Sono/complicações , Medição de Risco
6.
J Public Health Dent ; 84(1): 13-20, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38183329

RESUMO

OBJECTIVE: To evaluate the presence of sleep disorders, obesity and anxiety associated with cavitated carious lesions in children aged 8 to 10 years. MATERIALS AND METHODS: A cross-sectional study was carried out in the Northeast of Brazil. The sample was comprised of 793 schoolchildren randomly selected from public and private schools. Calibrated examiners (Kappa >0.80) performed the clinical examination of dental caries using the International Caries Detection and Assessment System and applied the Revised Children's Manifest Anxiety Scale and the Sleep Disturbance Scale for Children questionnaires. The anthropometric variables evaluated were weight and height. Negative binomial regressions (α ≤ 0.05) were performed. A Directed Acyclic Graph was prepared using DAGitty software (version 3.0), to select the co-variables for the statistical fits. RESULTS: The prevalence of tooth decay was 52.8%. The mean number of tooth surfaces with cavitated caries was 2.2(2.8), 58.9% of the schoolchildren had some type of sleep disorder, while 20.2% were anxious and 29.1% were obese. Sleep disturbance (RR = 1.38; 95% CI: 1.05-1.83), general anxiety (RR = 1.71; 95% CI: 1.32-2.21), obesity (RR = 1.48; 95% CI: 1.17-1.86) were associated with dental caries in the final model. CONCLUSION: The presence of carious lesions was higher in children with sleep disorders, anxiety, obesity, and those who experienced dry mouth.


Assuntos
Cárie Dentária , Criança , Humanos , Cárie Dentária/complicações , Cárie Dentária/epidemiologia , Cárie Dentária/diagnóstico , Estudos Transversais , Obesidade , Prevalência , Ansiedade , Transtornos de Ansiedade , Sono
7.
Acta Paul. Enferm. (Online) ; 37: eAPE01001, 2024. tab
Artigo em Português | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1519817

RESUMO

Resumo Objetivo Avaliar a qualidade do sono de profissionais dos serviços de emergência e sua associação com o nível de fadiga e qualidade de vida. Métodos Estudo descritivo, transversal e correlacional, realizado nas unidades do Serviço de Atendimento Móvel de Urgência (SAMU) e na Unidade de Pronto Atendimento (UPA), no ano de 2021, com 108 participantes. Para avaliação da qualidade do sono, foi utilizado o Índice de Qualidade do Sono de Pittsburgh versão Brasileira (PSQI-BR); para avaliação da Fadiga, foi utilizada a Escala de Fadiga de Chalder, em conjunto com a Escala de Necessidade de Descanso (ENEDE); e para avaliação da qualidade de vida, foi utilizado o World Health Organization Quality of Life Brief Version (WHOQOL-bref), sendo que os instrumentos utilizados foram adaptados para a língua portuguesa em estudos anteriores. Foram aplicados testes de associação para a análise estatística, tendo sido utilizados o Teste Qui-Quadrado de Pearson, o Teste U Mann-Whitney ou Kruskal Wallis e a correlação de Spearman. Valores de p <0,05 foram considerados como significativos. Resultados Foi identificado que 72,2% dos participantes apresentaram má qualidade do sono e 75,9% estavam fadigados. Foi observada associação significativa entre a qualidade do sono e a fadiga, a necessidade de descanso e a qualidade de vida. Conclusão Foi identificado que os profissionais de saúde que trabalham em serviço de urgência e emergência apresentam má qualidade do sono e de vida e níveis elevados de fadiga e necessidade de descanso, o que pode impactar diretamente suas atividades pessoais e profissionais.


Resumen Objetivo Evaluar la calidad del sueño de profesionales de los servicios de emergencia y su relación con el nivel de fatiga y calidad de vida. Métodos Estudio descriptivo, transversal y correlacional, realizado en las unidades del Servicio de Atención Móbil de Urgencia (SAMU) y en la Unidad de Pronta Atención (UPA), en el año 2021, con 108 participantes. Para evaluar la calidad del sueño, se utilizó el Índice de Calidad del Sueño de Pittsburgh, versión brasileña (PSQI-BR). Para evaluar la fatiga, se utilizó la Escala de Fatiga de Chalder, junto con la Escala de Necesidad de Descanso (ENEDE). Para evaluar la calidad de vida, se utilizó el World Health Organization Quality of Life Brief Version (WHOQOL-bref). Los instrumentos utilizados fueron adaptados al idioma portugués en estudios anteriores. Se aplicaron pruebas de asociación para el análisis estadístico, para lo cual se utilizó la Prueba χ2 de Pearson, la Prueba U de Mann-Whitney o la prueba de Kruskal-Wallis y la correlación de Spearman. Se consideraron valores de p<0,05 como significativos. Resultados Se identificó que el 72,2 % de los participantes presentó una mala calidad de sueño y el 75,9 % tenía fatiga. Se observó una asociación significativa entre la calidad del sueño y la fatiga, la necesidad de descanso y la calidad de vida. Conclusión Se identificó que los profesionales de la salud que trabajan en servicios de urgencia y emergencia presentaron mala calidad de sueño y de vida y niveles elevados de fatiga y necesidad de descanso, lo que puede impactar directamente en sus actividades personales y profesionales.


Abstract Objective To assess emergency service professionals' sleep quality and its association with the level of fatigue and quality of life. Methods A descriptive, cross-sectional and correlational study, carried out in the units of the Mobile Emergency Care Service (SAMU) and in the Emergency Care Unit (ECU), in 2021, with 108 participants. To assess sleep quality, the Pittsburgh Sleep Quality Index, Brazilian version (PSQI-BR), was used; to assess fatigue, the Chalder Fatigue Scale was used, together with the Need for Recovery Scale (NFR); and to assess quality of life, the World Health Organization Quality of Life Brief Version (WHOQOL-bref) was used, and the instruments used were adapted to Portuguese in previous studies. Association tests were applied for statistical analysis, using Pearson's chi-square test, Mann-Whitney U test or Kruskal Wallis and Spearman's correlation. P-values <0.05 were considered significant. Results It was identified that 72.2% of participants had poor sleep quality and 75.9% were fatigued. A significant association was observed between sleep quality and fatigue, the need for recovery and quality of life. Conclusion It was identified that health professionals working in emergency services have poor sleep quality and life, and high levels of fatigue and need for recovery, which can directly impact their personal and professional activities.

8.
Rev. Esc. Enferm. USP ; 58: e20230363, 2024. tab
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1559052

RESUMO

ABSTRACT Objective: To evaluate the sleep pattern of children and adolescents with chronic conditions during hospitalization and correlate it with resilience, quality of life, clinical and sociodemographic data. Method: Quantitative, descriptive and cross-sectional study. Data collection took place between May 2022 and January 2023, with children and adolescents with chronic conditions from two hospitals in Rio de Janeiro. The instruments used were the Actigraph, Sandra Prince-Embury's Resilience Scale for Children and Adolescents and the Pediatric Quality of Life Inventory. Data analysis involved descriptive statistics and correlation tests. Results: 40 hospitalized children and adolescents between the ages of nine and 18 took part. The results showed compromised sleep, especially in terms of duration and time awake after sleep onset. Quality of life scores were low and resilience levels were classified as medium to high. Correlations were found between resilience and sleep. In addition, sleep was influenced by diagnosis and treatment. Conclusion: Children and adolescents hospitalized with chronic conditions experience significant sleep disturbances and have a low quality of life, but have satisfactory levels of resilience.


RESUMEN Objetivo: Evaluar el patrón de sueño de niños y adolescentes con enfermedades crónicas durante la hospitalización y correlacionarlo con la resiliencia, la calidad de vida y los datos clínicos y sociodemográficos. Método: Estudio cuantitativo, descriptivo y transversal. La recolección de datos se realizó entre mayo de 2022 y enero de 2023, con niños y adolescentes con condiciones crónicas de dos hospitales de Río de Janeiro. Los instrumentos utilizados fueron el Actigraph, la Escala de Resiliencia para Niños y Adolescentes de Sandra Prince-Embury y el Inventario Pediátrico de Calidad de Vida. El análisis de los datos incluyó estadística descriptiva y pruebas de correlación. Resultados: Participaron 40 niños y adolescentes hospitalizados de entre 9 y 18 años. Los resultados mostraron un sueño comprometido, especialmente en términos de duración y tiempo despierto tras el inicio del sueño. Las puntuaciones de calidad de vida fueron bajas y los niveles de resiliencia se clasificaron entre medios y altos. Se hallaron correlaciones entre la resiliencia y el sueño. Además, el diagnóstico y el tratamiento influyeron en el sueño. Conclusión: Los niños y adolescentes hospitalizados con enfermedades crónicas experimentan alteraciones significativas del sueño y tienen una baja calidad de vida, pero presentan niveles satisfactorios de resiliencia.


RESUMO Objetivo: Avaliar o padrão de sono de crianças e adolescentes com condições crônicas durante a hospitalização e correlacioná-lo com resiliência, qualidade de vida, dados clínicos e sociodemográficos. Método: Estudo quantitativo, descrito e transversal. A coleta de dados ocorreu entre maio de 2022 e janeiro de 2023, com crianças e adolescentes com condições crônicas de dois hospitais do Rio de Janeiro. Os instrumentos utilizados foram o Actigraph, Escala de Resiliência para Crianças e Adolescentes de Sandra Prince-Embury e Inventário Pediátrico de Qualidade de Vida. A análise dos dados envolveu estatística descritiva e teste de correlação. Resultados: Participaram 40 crianças e adolescentes hospitalizados entre nove e 18 anos. Os resultados mostraram sono comprometido, principalmente nos quesitos duração e tempo acordado após início do sono. Os escores para qualidade de vida foram baixos e níveis de resiliência classificados entre médio e alto. Foram encontradas correlações entre resiliência e sono. Além disso, o sono foi influenciado pelo diagnóstico e pelo tratamento. Conclusão: Crianças e adolescentes hospitalizados com condições crônicas vivenciam importantes distúrbios do sono e possuem baixa qualidade de vida, mas apresentam níveis satisfatórios de resiliência.


Assuntos
Humanos , Criança , Adolescente , Enfermagem Pediátrica , Transtornos do Sono-Vigília , Criança , Doença Crônica , Adolescente
9.
Arq. neuropsiquiatr ; 81(12): 1179-1193, Dec. 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1527900

RESUMO

Abstract REM sleep behavior disorder (RBD) is characterized by a loss of atonia of skeletal muscles during REM sleep, associated with acting out behaviors during dreams. Knowledge of this pathology is important to predict neurodegenerative diseases since there is a strong association of RBD with diseases caused by the deposition of alpha-synuclein in neurons (synucleinopathies), such as Parkinson's disease (PD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB). Proper diagnosis of this condition will enable the use of future neuroprotective strategies before motor and cognitive symptoms. Diagnostic assessment should begin with a detailed clinical history with the patient and bed partner or roommate and the examination of any recorded home videos. Polysomnography (PSG) is necessary to verify the loss of sleep atonia and, when documented, the behaviors during sleep. Technical recommendations for PSG acquisition and analysis are defined in the AASM Manual for the scoring of sleep and associated events, and the PSG report should describe the percentage of REM sleep epochs that meet the criteria for RWA (REM without atonia) to better distinguish patients with and without RBD. Additionally, PSG helps rule out conditions that may mimic RBD, such as obstructive sleep apnea, non-REM sleep parasomnias, nocturnal epileptic seizures, periodic limb movements, and psychiatric disorders. Treatment of RBD involves guidance on protecting the environment and avoiding injuries to the patient and bed partner/roommate. Use of medications are also reviewed in the article. The development of neuroprotective medications will be crucial for future RBD therapy.


Resumo O transtorno comportamental do sono REM (TCSREM) é caracterizado por uma perda de atonia dos músculos esqueléticos durante o sono REM, associada a comportamentos de atuação durante os sonhos. O conhecimento desse transtorno é importante como preditor de doenças neurodegenerativas, uma vez que existe uma forte associação de TCSREM com doenças causadas pela deposição de alfa-sinucleína nos neurônios, como a doença de Parkinson (DP), atrofia de múltiplos sistemas (MSA) e demência com corpos de Lewy (DLB). O diagnóstico adequado dessa condição permitirá o uso de futuras estratégias neuroprotetoras antes do aparecimento dos sintomas motores e cognitivos. A avaliação diagnóstica deve começar com uma história clínica detalhada com o paciente e acompanhante, além de exame de vídeos. A polissonografia (PSG) é necessária para verificar a perda da atonia do sono e, quando documentados, os comportamentos durante o sono. As recomendações técnicas para aquisição e análise de PSG são definidas no Manual da AASM (Scoring of sleep and associated events) e o relatório de PSG deve descrever a porcentagem de períodos de sono REM que atendem aos critérios para REM sem atonia. Além disso, a PSG ajuda a descartar condições que podem mimetizar o TCSREM, como apneia obstrutiva do sono, parassonias do sono não REM, crises epilépticas noturnas, movimentos periódicos dos membros e transtornos psiquiátricos. O tratamento do TCSREM envolve orientações sobre adaptações do ambiente para evitar lesões ao paciente e ao colega de quarto. Medicamentos utilizados são revistos no artigo, assim como o crucial desenvolvimento de medicamentos neuroprotetores.

10.
Dement Neuropsychol ; 17: e20230030, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38111593

RESUMO

Caregivers of people living with dementia (PLwD) have a high burden degree that leads to health issues, including sleep. Objective: This study aimed to analyze the impacts of the caregiving burden on caregiver's sleep disturbances. Methods: This systematic review involved a qualitative analysis of publications on Web of Science and Pubmed/Medline databases published between February 2018 and August 2022. Results: A total of 27 studies were identified and analyzed. Caregiver's sleep presents impairments in sleep latency, sleep fragmentation, sleep duration, subjective sleep quality, daytime dysfunction, and insomnia. Caregiver's distress and depressive symptoms have a dual relationship with sleep problems. Conclusion: Sleep disturbances presented by caregivers are correlated with higher burden levels and lead to more vulnerability to psychiatric symptoms and health issues.


Cuidadores de pessoas com demência possuem alto grau de sobrecarga que impacta de forma objetiva o sono e suas dimensões. Objetivo: Este estudo teve o objetivo de analisar o impacto da sobrecarga nas alterações do sono do cuidador. Métodos: Esta revisão sistemática envolveu a análise de resultados quantitativos e qualitativos de publicações das bases de dados Web of Science e PubMed/ Medical Literature Analysis and Retrieval System Online (Medline) publicadas entre fevereiro de 2018 e agosto de 2022. Resultados: O total de 27 estudos foi identificado e analisado. Cuidadores apresentam prejuízos na latência, fragmentação, duração e qualidade subjetiva do sono, disfunção diurna e insônia. O estresse e sintomas depressivos apresentados pelo cuidador possuem com o sono uma relação bidirecional. Conclusão: Os distúrbios do sono apresentados pelos cuidadores estão correlacionados com o alto nível de sobrecarga e geram maior vulnerabilidade para sintomas psiquiátricos e problemas de saúde.

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