RESUMO

Introdução: O sono é uma função vital e essencial para a sobrevivência humana e tem por objetivo favorecer o reparo corporal e mental. Objetivo: Investigar os fatores associados à autopercepção sobre a qualidade do sono, bem como possíveis alterações das estruturas orofaciais e funções estomatognáticas em indivíduos com queixa de ronco. Material e Método: Trata-se de estudo observacional, analítico e transversal, realizado com 30 indivíduos adultos com queixa de ronco durante o sono, com idade média de 45 anos e 5 meses. Para a avaliação de motricidade oromiofuncional foi utilizado o protocolo AMIOFE. Foram aplicados questionários para investigação do ronco e qualidade de sono dos participantes: Questionário de Berlin, Escala de Sonolência de Epworth e Questionário de qualidade de sono de Pittsburgh. Resultados: Os resultados do questionário de Pittsburgh indicaram disfunção na qualidade do sono em 66,67% dos participantes. A sonolência diurna foi evidenciada em 33,33%, por meio da Escala de Epworth. 60% dos participantes apresentaram alto risco para AOS, por meio dos escores obtidos no instrumento de Berlin. Indivíduos que não praticam exercício físico e com posição habitual de língua no assoalho bucal apresentaram maiores escores no questionário de Berlin. Houve correlação positiva estatisticamente significante e moderada entre as variáveis Índice de massa corporal (IMC) e os escores do Questionário de Berlin. Conclusão: Indivíduos com queixa de ronco apresentam dificuldades relacionadas à qualidade do sono. A autopercepção negativa de qualidade do sono teve relação com dados de motricidade orofacial, hábitos alimentares, composição corporal e hábitos de estilo de vida. (AU)

Introduction: Sleep is a vital and essential function for human survival and aims to promote bodily and mental repair. Objective: To investigate factors associated with self-perception of sleep quality, as well as possible alterations in orofacial structures and stomatognathic functions in individuals with snoring complaints. Material and Method: Observational, analytical and cross-sectional study, conducted with 30 adult individuals complaining of snoring during sleep, with a mean age of 45 years and 5 months. For the evaluation of orofacial myofunctional motricity, the (AMIOFE) was used. Questionnaires were applied to investigate the snoring and sleep quality of the participants: Berlin Questionnaire, Epworth Sleepiness Scale and Pittsburg Sleep Quality Index Questionnaire. Results: The Pittsburgh questionnaire results indicated sleep quality dysfunction in 66.67% of participants. Daytime sleepiness was evidenced in 33.33%, using the Epworth Scale. 60% of the participants presented high risk for obstructive sleep apnea syndrome (OSA), through the scores obtained in the Berlin questionnaire. Individuals who do not practice physical exercise and with usual tongue position on the oral floor presented higher scores in the Berlin questionnaire. There was a statistically significant and moderate positive correlation between the variables Body Mass Index (BMI) and the Berlin questionnaire scores. Conclusion: Individuals complaining of snoring self-reported difficulties related to sleep quality. The sleep quality difficulties self-reported were related to data on orofacial motricity, eating habits, body composition and lifestyle habits. (AU)

Introducción: El sueño es uma función vital y essencial para la supervivência human, tien como objetivo promover la reparación corporal y mental. Objetivo: Investigar los factores asociados con la autopercepción de la calidad del sueño, así como posibles alteraciones en las estructuras orofaciales y funciones estomatognáticas en individuos con quejas de ronquidos. Metodo: Se trata de estudio observacional, analítico, transversal, realizado con 30 individuos adultos con queja de ronquidos durante el sueño y edad media de 45 años y 5 meses. Para la evaluación de la motricidad oromiofuncional se utilizó el protocolo (AMIOFE/OMES). Se aplicaron cuestionarios para investigar el ronquido y la calidad de sueño de los participantes: Cuestionario de Berlín; Escala de Somnolencia de Epworth; Cuestionario de Calidad del Sueño de Pittsburgh. Resultados: Los resultados del cuestionario de Pittsburgh indicaron disfunción en la calidad del sueño en 66,67%. La Escala de Epworth evidenció somnolencia diurna en 33,33%. El 60% presentaron alto riesgo de AOS, conforme las puntuaciones obtenidas en el instrumento de Berlín. Los que no practican ejercicio físico y que tienen la posición habitual de la lengua en el piso de la boca obtuvieron puntuaciones más altas en el cuestionario de Berlín. Hubo correlación positiva estadísticamente significativa y moderada entre las variables del IMC y las puntuaciones del Cuestionario de Berlín. Conclusión: Individuos con quejas de ronquidos refieren dificultades relacionadas con la calidad del sueño. Las dificultades estuvieron relacionadas con datos de motricidad orofacial, hábitos alimentarios, composición corporal y los hábitos de estilo de vida. (AU)

Assuntos

RESUMO

Sleep-disordered breathing (SDB) is a group of disorders associated with breathing anomalies during sleep. Easily detectable by sound, snoring is one of the most common manifestations and the main sign of SDB. Snoring is characteristic of breathing sound during sleep, without apnea, hypoventilation, or interrupted sleep. It may reduce the percentage of sleep and increase microarousals due to breathing effort or gas exchange. A range of questionnaires have been validated and adapted to the pediatric population to screen for patients who require laboratory testing. The Pediatric Sleep Questionnaire (PSQ) screens for SDB and identifies primary signs such as snoring. RoncoLab is a mobile application that records and measures snoring intensity and frequency. Aim: To compare the RoncoLab app and the PSQ regarding how efficiently they diagnose snoring. Materials and Method: This was an observational, analytical study of 31 children aged 7 to 11 years who visited the pediatric dental clinic at Benemérita Universidad Autónoma de Puebla, Mexico (BUAP). The PSQ was applied to diagnose SDB. Guardians were then instructed on how to download and use the mobile application to record data while the child was sleeping at home. Agreement between RoncoLab and the PSQ was analyzed statistically by Cohen's Kappa index at 95% confidence level. Results: The Kappa index for identification of primary snoring was 0.743 (p<0.05). App sensitivity was 0.92, and specificity 0.82. Conclusion: There is good agreement between PSQ and RoncoLab for diagnosing primary snoring, with acceptable sensitivity and specificity.

Los trastornos respiratorios del sueño (TRS) son un grupo de padecimientos asociados con anormalidades respiratorias del sueño. Una de las manifestaciones más comunes es el ronquido; signo fácil de detectar por el ruido que emite y se considera como el signo principal. Este trastorno es característico del ruido respiratorio durante el sueño, sin apneas, hipoventilación, ni interrupciones del sueño. Este puede ocasionar disminución del porcentaje del sueño y aumentar los microdespertares, esto debido al esfuerzo respiratorio o al intercambio de gases. En la actualidad existen cuestionarios validados y adaptados para la población pediátrica útiles como herramienta clínica para el tamizaje y selección de pacientes que requieran pruebas de laboratorio. El Pediatric Sleep Questionnaire (PSQ) permite el cribado de TRS e identificación de signos primarios como el ronquido. RoncoLab es una aplicación móvil que registra y mide la intensidad y frecuencia del ronquido. Objetivo: Comparar la eficacia del diagnóstico del ronquido por medio del RoncoLab contrastado con el PSQ. Materiales y Método: Estudio observacional, analítico, en el cual se incluyeron 31 niños de 7 a 11 años, que acudieron a la clínica de odontopediatría de la Benemérita Universidad Autónoma de Puebla, México (BUAP) Se aplicó el PSQ a los 31 niños para el diagnóstico de TRS, después se le instruyó al tutor como descargar y utilizar la aplicación móvil para registrar los datos obtenidos en las horas de sueño en casa. El análisis estadístico de concordancia entre los instrumentos diagnósticos se realizó con el Índice Kappa de Cohen a un nivel de confianza del 95. Resultados: El Índice de Kappa para la identificación de los ronquidos primarios fue de 0.743 (p<0.05). La sensibilidad de la aplicación fue de 0.92, mientras la especificidad fue de 0.82. Conclusión: Existe buena concordancia entre el PSQ y el RoncoLab en el diagnóstico de ronquido primario, con sensibilidad y especificidad aceptable.

Assuntos

RESUMO

OBJECTIVE: To evaluate the associations of parent-reported sleep-disordered breathing (SDB) and device-assessed sleep behaviors with behavioral and emotional functioning in pediatric patients with overweight/obesity. STUDY DESIGN: A total of 109 children with overweight/obesity (mean age, 10.0 ± 1.1 years) were included in this cross-sectional study. We used the Spanish version of the Pediatric Sleep Questionnaire (PSQ) to assess SDB and its subscales (ie, snoring, daytime sleepiness, and inattention/hyperactivity). Device-assessed sleep behaviors (ie, wake time, sleep onset time, total time in bed, total sleep time, and waking after sleep onset) were estimated using wrist-worn accelerometers. We used the Behavior Assessment System for Children, second edition to assess behavioral and emotional functioning (ie, clinical scale: aggressiveness, hyperactivity, behavior problems, attention problems, atypicality, depression, anxiety, retreat, and somatization; adaptive scale: adaptability, social skills, and leadership). RESULTS: SDB was positively associated with all clinical scale variables (all ß > 0.197, P ≤ .041) and with lower adaptability and leadership (all ß < -0.226, P < .021). Specifically, the PSQ subscale relating to daytime sleepiness was associated with higher attention problems, depression, anxiety, and retreat (all ß > 0.196, P ≤ .045) and lower adaptability (ß = -0.246, P = .011). The inattention/hyperactivity subscale was significantly associated with the entire clinical and adaptive scales (all ß > |0.192|, P ≤ .046) except for somatization. The snoring subscale and device-assessed sleep behaviors were not related to any behavioral or emotional functioning variables. CONCLUSIONS: Our study suggests that SDB symptoms, but not device-assessed sleep behaviors, are associated with behavioral and emotional functioning in children with overweight/obesity. Specifically, daytime sleepiness, a potential SDB symptom, was related to higher attention problems, depression, anxiety, and retreat and lower adaptability.

Assuntos

RESUMO

INTRODUCTION: Obstructive sleep apnea syndrome is a high-prevalence disorder found in the population. Studies have shown a possible association between nasal obstruction and obstructive sleep apnea syndrome, but the existence of a association between the degree of nasal obstruction and obstructive sleep apnea syndrome severity has not yet been proven. OBJECTIVE: To evaluate the internal nasal dimensions of adults with primary snoring and obstructive sleep apnea syndrome by acoustic rhinometry and to correlate the findings with obstructive sleep apnea severity. METHODS: Twenty-one male Caucasian subjects with complaints of snoring and/or respiratory pauses during sleep, aged between 18 and 60 years of age, were evaluated. After clinical evaluation, otorhinolaryngological examination and flexible nasopharyngolaryngoscopy, all patients underwent type III polysomnography. The participants were divided into two groups according to symptom severity: group 1, primary snoring and/or mild obstructive sleep apnea syndrome(n = 9) and group 2, moderate/severe obstructive sleep apnea syndrome (n = 12). Internal nasal dimensions were measured by acoustic rhinometry, analyzing minimum cross sectional area (CSA) and three nasal segment volumes. RESULTS: The respiratory event index corresponded to 8.1 ±â€¯4.0 in group 1 and 47.5 ±â€¯19.1 in group 2. In group 1, the cross-sectional areas values, in cm2, corresponded to: CSA 1 = 1.1 ±â€¯0.4; CSA 2 = 2.1 ±â€¯0.9; CSA 3 = 3.5 ±â€¯1.8 and, in group 2: CSA 1 = 1.2 ±â€¯0.3, CSA 2 = 2.0 ±â€¯0.5; CSA 3 = 2.8 ±â€¯0.7. In group 1, volumes (V), in cm3, corresponded to: V1 = 3.5 ±â€¯1.0; V2 = 9.3 ±â€¯5.0; V3 = 40.2 ±â€¯21.5 and in group 2 a: V1 = 3.6 ±â€¯0.5; V2 = 7.6 ±â€¯1.5; V3 = 31.5 ±â€¯6.7. Cross-sectional area and volume ​​did not differ between groups. CONCLUSION: There were no significant differences in the cross-sectional areas and nasal volumes between individuals with primary snoring-mild obstructive sleep apnea syndrome and moderate-severe obstructive sleep apnea syndrome. Differently to the raised hypothesis, our results suggest that there is no association between internal nasal dimensions and severity of obstructive sleep apnea syndrome.

Assuntos

RESUMO

STUDY OBJECTIVES: The association of snoring and sleep-disordered breathing (SDB) with daytime sleepiness is well documented; however, the exact mechanisms, and especially the role of sleep microstructure that may account for this association remain incompletely understood. In a cohort of children with SDB, we aimed to compare sleep spindle activity between children with daytime sleepiness versus those without daytime sleepiness. METHODS: Children with SDB who reported daytime sleepiness were recruited and compared with age- and sex-matched SDB controls. Polysomnographic recordings were analyzed evaluating sleep spindle activity. A statistical comparison was carried out in both groups to assess the association between sleepiness and sleep spindle activity. RESULTS: Thirty-three children with SDB (mean age: 7.5 ± 1.7 years) were included, 10 with and 23 without daytime sleepiness. Spindle activity was lower in children with daytime sleepiness compared with those without; in stage N2, median (interquartile range) sleep spindle indexes were 77.5 (37.3) and 116.9 (71.2) (P = .015), respectively. CONCLUSIONS: Spindles were significantly reduced in children with SDB and daytime sleepiness. The exact mechanisms of this association remain unknown and future research is needed in order to establish the exact role of sleep spindle activity on daytime symptoms in children with SDB.

Assuntos

RESUMO

Objectives: We aimed to determine the prevalence of Obstructive Sleep Apnea (OSA) in children and adolescents from four districts of Santiago, Chile by using a six-question subscale from the Sleep-Related Breathing Disorders (SRBD) scale, which measures respiratory symptoms while sleeping. Material and Methods: Cross-sectional observational study. The six-question subscale of the SRBD scale was applied to the parents or guardians of the children and adolescents from four educational establishments in different districts of Santiago. Convenience sampling was used. This subscale allowed to divide the sample into two groups: one group with OSA and one at low risk of OSA. In addition, statistical tests were applied to evaluate the variation between gender and age range. Results: Of the total number of subjects (n=838, 4-18 years, mean: 11.3±4.2), 681 were included. According to the six-question subscale, 2.2% (CI 95% 1.64-2.76%) of the sample had OSA. There is a slight predominance in males, without statistically significant difference (p=0.083). In relation to the age of the participants, there was no statistically significant difference (p=0.512).Conclusion: The prevalence of OSA in Chilean children and adolescents was similar to previous reports. The results obtained by the analysis of the six-question subscale of the SRBD scale allow a more accurate detection of OSA. Future research should promote the translation of this questionnaire into the Chilean context and its use throughout the country.

Objetivos: Nuestro objetivo fue determinar la prevalencia de la apnea obstructiva del sueño (AOS) en niños y adolescentes de cuatro distritos de Santiago, Chile mediante el uso de una subescala de seis preguntas de la escala de trastornos respiratorios relacionados con el sueño (Sleep-Related Breathing Disorders, SRBD), que mide los síntomas respiratorios mientras dormido. Material y Métodos: estudio observacional transversal. La subescala de seis preguntas de la escala SRBD se aplicó a los padres o tutores de los niños y adolescentes de cuatro establecimientos educativos en diferentes distritos de Santiago. Se utilizó muestreo de conveniencia. Esta subescala permitió dividir la muestra en dos grupos: un grupo con OSA y otro con bajo riesgo de OSA. Además, se aplicaron pruebas estadísticas para evaluar la variación entre el género y el rango de edad. Resultados: Del número total de sujetos (n=838, 4-18 años, media: 11,3±4,2), se incluyeron 681. Según la subescala de seis preguntas, el 2,2% (IC 95% 1,64-2,76%) de la muestra tenía AOS. Hay un ligero predominio en varones, sin diferencia estadísticamente significativa (p=0,083). En relación con la edad de los participantes, no hubo diferencias estadísticamente significativas (p=0,512). Conclusión: La prevalencia de AOS en niños y adolescentes chilenos fue similar a informes anteriores. Los resultados obtenidos mediante el análisis de la subescala de seis preguntas de la escala SRBD permiten una detección más precisa de OSA. Investigaciones futuras deberían promover la adaptación de este cuestionario al contexto chileno y su uso en todo el país

Assuntos

RESUMO

BACKGROUND: It has been reported that the clinical expression of obstructive sleep apnea (OSA) may differ in women and men. OBJECTIVE: The objective of this study was to evaluate the influence of gender on reported OSA-related symptoms in a large clinical population of patients. METHODS: The database from the sleep laboratory of a tertiary care center was examined. Adult patients who had undergone a diagnostic polysomnography and completed the Berlin questionnaire, a sleep questionnaire, and the Epworth sleepiness scale were selected. Multiple logistic regression analysis was performed to assess the relationship between OSA-associated symptoms and different potential explanatory variables. RESULTS: The study sample included 1084 patients, median age was 53 years, 46.5% (504) were women, 72.7% (788) had OSA (apnea/hypopnea index ≥ 5), and 31.2% were obese. After adjusting for age, body mass index, and apnea/hypopnea index, men were more likely to report snoring (OR 4.06, p < 0.001), habitual or loud snoring (OR 2.34, p < 0.001; 2.14, p < 0.001, respectively) and apneas (OR 2.44, p < 0.001), than women. After controlling for multiple variables, female gender was an independent predictive factor for reported tiredness (OR 0.57, p 0.001), sleep onset insomnia (OR 0.59, p 0.0035), and morning headaches (OR 0.32, p < 0.001). Reports of excessive daytime sleepiness, nocturia, midnight insomnia, and subjective cognitive complaints were not significantly associated with gender. CONCLUSION: Women with OSA were more likely to report tiredness, initial insomnia, and morning headaches, and less likely to complain of typical OSA symptoms (snoring, apneas) than men.

Assuntos

RESUMO

AIMS: To evaluate the relationship between possible sleep bruxism and sleep characteristics in children. METHODOLOGY: A cross-sectional study was conducted through data collection of a pre-tested questionnaire answered by 111 parents on behalf of their children in the waiting room during their appointment at the Pediatric Dentistry Clinic of a public Brazilian university. The diagnosis of possible sleep bruxism was based on the international classification of sleep disorders (ICSD) criteria. The Chi-square test and logistic multinomial regression test were used in the statistical analysis. RESULTS: The final model of logistic multinomial regression demonstrated that children with muscle pain in the mouth region (OR = 19.70 95% IC = 1.82-212.69), snoring (OR = 8.25 95% IC = 2, 56-26, 54), and those with parents with possible sleep bruxism have more of a probability of sleep bruxism. CONCLUSION: Potential sleep bruxism tends to be hereditary. Muscle pain, snoring, and mouth breathing were important signals associated with possible sleep bruxism among children.

Assuntos

RESUMO

Spinocerebellar ataxia type 6 (SCA6) is usually described as a pure ataxia syndrome. However, SCA6 patients may have sleep complaints. In this paper, sleep disorders were investigated in patients with SCA6. Twelve SCA6 patients and 12 subjects matched by gender, age and body mass index (control group) underwent polysomnography and clinical investigation for sleep disorders. SCA6 had a higher frequency of snoring (P = 0.01), a higher index of awakening due to respiratory events (P = 0.003) and central apnea events during sleep (P = 0.024), a longer sleep Stage N1 (P = 0.02) and a lower sleep Stage N3 (P = 0.05) in SCA6 patients than in control subjects. SCA6 patients had a reduction in slow wave sleep and a higher frequency of snoring and respiratory disorders during sleep when compared to the control group.

Assuntos

Assuntos