Parent-child associations of sleep quality: is physical activity a confounder? The EPI-FAMILY health study.

INTRODUCTION: The incidence of sleep deprivation has increased in pediatric populations, however, the relationship with physical activity (PA) remains uncertain and lacks evidence. Although some studies have shown that parents' lifestyle habits can influence this process, one point that requires further clarification in the literature is whether parents' sleep quality is linked to that of their children and whether parents' physical activity could play an important role in these possible relationships. OBJECTIVES: To investigate the relationship of sleep quality between parents and children and verify the role of physical activity in this association. METHODS: This is a cross-sectional study. Sleep quality was assessed using the Mini Sleep Questionnaire. The amount of sleep was estimated by the number of hours slept. PA domains (occupational activities, leisure, and active commuting) were assessed using the Baecke questionnaire, while moderate to vigorous PA (MVPA) was assessed with an accelerometer. Socioeconomic status was obtained through a questionnaire. The relationship of sleep quality between parents and children was carried out using hierarchical models with Binary Logistic Regression, where the factors were inserted one by one (1. unadjusted model; 2. sociodemographic variables; 3. children's PA; 4. parents' PA). RESULTS: The study sample consisted of 102 children and adolescents (6-17 years), 92 mothers, and 69 fathers. Poor sleep quality of mothers was associated with their children's sleep quality (OR = 3.95; 95%CI = 1.33-11.38; P = 0.013). After inserting mothers' PA intensity into the final model, the associations remained significant (OR = 8.05; 1.33-48.59; P = 0.023). No relationship was observed between poor sleep quality of fathers and their children's sleep quality. CONCLUSION: The relationship between poor sleep quality of mothers and that of their children remained significant, regardless of confounding variables.

Screen time is negatively associated with sleep quality and duration only in insufficiently active adolescents: A Brazilian cross-sectional school-based study.

Background: Time spent on screen devices affects sleep quality and duration leading to several health impairments in youth. Although physical activity (PA) benefits sleep patterns and decreases screen time in adolescents, it is unclear whether the relationship between sleep quality/duration and screen time could be influenced by PA levels. Objective: To analyze the association between sleep quality and duration with screen time in Brazilian adolescents according PA levels. Methods: The sample included 1010 adolescents aged 13.2 ± 2.4 years (n = 556 females - 55 % of the sample). Sleep quality and sleep duration, and PA were assessed by Mini Sleep and Baecke questionnaires, respectively. Participants in the highest quartile were classified as physically active. Screen time was analyzed by the self-reported number of hours spent on different screen devices (i.e., television, computer, videogame, and cellphone/tablet). Participants in the highest tertile were classified as having high screen time. Sex, age, and body mass index were considered covariates in binary logistic regression models. Results: Poor sleep quality was observed in 52.3 % of the sample, whereas 46.6 % reported sleeping less than eight hours/day. High screen time was associated with poor sleep quality (OR = 1.45; 95 %CI = 1.01-2.12) and insufficient sleep duration (OR = 1.52; 95 %CI = 1.01-2.03) in adolescents insufficiently active. There were no associations between screen time and sleep parameters in active adolescents. Conclusion: High screen time was associated with poor sleep quality and insufficient sleep duration only in insufficiently active adolescents. These results suggest that high PA levels may contribute to improving sleep patterns in pediatric population.

Does the Number of Comorbidities Predict Pain and Disability in Older Adults With Chronic Low Back Pain? A Longitudinal Study With 6- and 12-Month Follow-ups.

BACKGROUND AND PURPOSE: People who live longer often live with multimorbidity. Nevertheless, whether the presence of multimorbidity affects pain and disability in older adults with chronic low back pain (LBP) remains unclear. The aim of this study was to investigate whether multimorbidity predicts pain intensity and disability at 6- and 12-month follow-ups in older adults with chronic LBP. METHODS: This was a prospective, longitudinal study with 6- and 12-month follow-ups. Participants with chronic LBP (age ≥ 60 years) were recruited and interviewed at baseline, 6 months, and 12 months. Self-reported measures included the number of comorbidities, assessed through the Self-Administered Comorbidity Questionnaire, pain intensity, assessed with the 11-point Numerical Rating Scale, and disability, assessed with the Roland-Morris Disability Questionnaire. Data were analyzed using univariate and multivariate regression models. RESULTS AND DISCUSSION: A total of 220 participants were included. The number of comorbidities predicted pain intensity at 6-month (ß= 0.31 [95% CI: 0.12 to 0.50]) and 12-month (ß= 0.29 [95% CI: 0.08 to 0.50]) follow-ups. The number of comorbidities predicted disability at 6-month (ß= 0.55 [95% CI: 0.20 to 0.90]) and 12-month (ß= 0.40 [95% CI: 0.03 to 0.77]) follow-ups. CONCLUSION: The number of comorbidities at baseline predicted pain and disability at 6-month and 12-month follow-ups in older adults with chronic LBP. These results highlight the role of comorbidities as a predictive factor of pain and disability in patients with chronic LBP, emphasizing the need for timely and continuous interventions in older adults with multimorbidity to mitigate LBP-related pain and disability.

Do nocturnal asthma attacks influence sleep parameters and inflammatory markers? A cross-sectional population-based study.

PURPOSE: To evaluate the effects of nocturnal asthma on sleep parameters and inflammatory markers according to the severity of the condition in participants in the São Paulo Epidemiologic Sleep Study (EPISONO). METHODS: Data from the 2007 and 2018 editions of the EPISONO study were utilized. Subjects completed validated sleep and respiratory questionnaires, underwent nocturnal polysomnography and spirometry tests, and provided blood samples for the assessment of inflammatory parameters. RESULTS: Of 72 participants (67% women), 53% (n = 38) had intermittent nocturnal asthma symptoms and 47% (n = 34) had persistent asthma (mild, moderate, and severe). Individuals with persistent nocturnal symptoms had a higher body mass index (BMI), were more likely to have respiratory symptoms, and had worse lung function, a higher apnea-hypopnea index (AHI), and higher desaturation index than individuals with intermittent nocturnal symptoms. Positive associations were identified between nocturnal asthma and obstructive sleep apnea (OSA). A higher frequency of OSA was observed in participants with persistent asthma and participants with OSA were more likely to have persistent than intermittent asthma. However, there were no significant differences between the immunological parameters of those with intermittent or persistent asthma. CONCLUSIONS: This study highlights the relevance of nocturnal symptoms as a valuable indicator of asthma severity. The findings also add to the existing body of evidence linking nocturnal asthma and OSA.

Sleep Quality Predicts Functional Disability in Older Adults with Low Back Pain: A Longitudinal Study.

Low back pain (LBP) and sleep quality are two very prevalent complaints in the older population. However, little is known about the prognostic relationship between sleep quality and disability in older adults with LBP. The aim of this study was to examine the association between sleep quality and disability in older adults with LBP. This was a longitudinal study over a 6-month period. Older adults with LBP in the last 12 weeks and who had preserved cognitive functions were recruited. The questionnaires used were the Pittsburgh Sleep Quality Index and the Roland Morris Disability Questionnaire. At baseline, we collected information on demographic/anthropometric variables, cognitive status, depression, daytime sleepiness, and comorbidities. Linear regression adjusted for potential covariates were performed. Poor sleep at baseline predicted higher disability after 6 months [ß = 0.30 (CI95%:0.07 to 0.55)]. Our results support the existence of an important relationship between sleep and disability in older adults with LBP.

Could melatonin have a potential adjuvant role in the treatment of the lasting anosmia associated with COVID-19? A review.

INTRODUCTION: Anosmia, the loss of the sense of smell, is usually associated with rhinopathies and has been reported as a common symptom of COVID-19. There is no specific drug to treat this condition, although some evidence suggests that melatonin could promote the recovery of olfactory sensory neurons. METHODS: We set out to perform a narrative review to synthesize the current evidence in this area in respect of our hypothesis that melatonin may be linked with anosmia and play a part in oxidative stress and the regulation of inflammation. The main electronic databases (MEDLINE/PubMed, Embase, and Cochrane) were searched. RESULTS: The search produced 26 articles related to our hypothesis. Some studies examined issues related to melatonin's effects and its use as adjuvant therapy for COVID-19. Despite some studies suggesting that melatonin may have potential in the treatment of COVID-19, to the best of our knowledge, there have been no trials that have used it to treat anosmia associated with the disease. Few articles identified proposed that melatonin might have an effect on olfactory cells. DISCUSSION: Further experimental and clinical research on the role of circadian melatonin in the olfactory system is warranted. This will provide evidence of the use of melatonin in the management of anosmia. A number of identified studies suggest that the imbalanced release of melatonin by the pineal gland associated with sleep disturbance may play a role in anosmia, although the specific pathway is not yet entirely clear. This may be a base for further research into the potential role of melatonin as adjuvant treatment of anosmia.

Fear of falling does not predict self-reported physical activity: an observational study with community-dwelling older adults.

OBJECTIVES: To investigate the relationship between FOF and self-reported physical activity levels among older adults. DESIGN: Observational cross-sectional. SETTING AND PARTICIPANTS: Community-dwelling older adults aged 60 years and over and without cognitive deficits were recruited. MAIN OUTCOME MEASURES: Data collected included cognitive function [i.e., Mini Mental Status Examination (MMSE)], FOF [i.e., Iconographic Falls Efficacy Scale (Icon-FES); Falls Efficacy Scale - International (FES-I)], self-reported physical activity (i.e., Modified Baecke Questionnaire for Elderly People), history of falls, number of comorbidities and clinical tests of balance and mobility (i.e., Short Physical Performance Battery and the single leg stance test with closed and opened eyes). Multivariable linear regression was used to test whether FOF predicts self-reported physical activity levels. RESULTS: A total of 200 older adults living in the community were enrolled in this study. Our results showed that FOF, as measured by FES-I or Icon-FES, did not predict self-reported physical activity levels in community-dwelling older adults. CONCLUSION: Our results did not support previous evidence that higher FOF predicts lower levels of self-reported physical activity. These results question the role of FOF in influencing self-reported physical activity levels among community-dwelling older adults.

Occupational Physical Activity Was Associated With Disability Levels at 6-Month Follow-Up of Patients With Chronic Nonspecific Low Back Pain: A Prospective Cohort Study.

BACKGROUND: Physical activity plays an important role in the prognosis of chronic low back pain (LBP); however, whether physical activity predicts pain intensity and disability remains unknown. This study investigated whether objective and subjective physical activity measures predict pain intensity and disability levels 6 months later in patients with chronic LBP. METHODS: Patients with chronic LBP seeking care at 2 outpatient physiotherapy clinics were recruited. At baseline assessment, we collected anthropometric/sociodemographic data, duration of symptoms, pain intensity, disability, and physical activity (accelerometer and questionnaire). After 6 months, we reassessed pain and disability. Multivariable regression analyses were performed to investigate the association of physical activity measures with pain and disability at follow-up. RESULTS: A total of 179 patients with chronic LBP were included. High occupational physical activity at baseline predicted disability at 6-month follow-up (B = 1.22; 95% confidence interval, 0.21 to 2.21) after controlling for age and baseline disability, meaning that for every 1-point increase in occupational physical activity, disability increased on average by 1.22 point. The remaining physical activity measures showed no association with pain intensity or disability at follow-up. CONCLUSION: Higher perceived levels of occupational physical activity predicted higher disability levels at 6-month follow-up in patients with chronic LBP.

Does sedentary behaviour contribute to the development of a new episode of low back pain? A systematic review of prospective cohort studies.

OBJECTIVE: To investigate whether the sedentary behaviour contributes to the development of new episodes of low back pain in adults. METHODS: Searches were performed in five electronic databases from their inception to March 2022. Prospective cohort studies with people without low back pain at baseline investigating the effect of sedentary behaviour on the development of new episodes of low back pain at follow-up were considered eligible. Two independent authors screened, extracted the data and assessed the risk of bias of included studies. An adapted version of the Quality In Prognosis Studies (QUIPS) tool was used to assess the risk of bias. Meta-analyses were performed using random effect models to obtain a pooled risk ratio (RR) and 95% confidence intervals (CIs). Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the overall certainty of the evidence. RESULTS: Ten studies were included in this review, with a total sample ranging from 107 to 57,504 participants and mean age ranging from 21.7 to 53.6 years. Most studies (n = 9) assessed sedentary behaviour using self-reported methods, including validated questionnaires or single questions, except for one study that used video recording. The overall risk of bias of the included studies was low. Pooled analysis showed that people classified as sedentary or spending more time in sedentary activities were not likely to develop a new episode of low back pain (RR 1.01, 95% CI 0.98-1.04, I2  = 9%, n = 9 studies, moderate evidence). CONCLUSION: Sedentary behaviour probably does not contribute to the development of new episodes of low back pain in an adult population. SIGNIFICANCE: Sedentary behaviour does not appear to increase the chances of developing a new episode of low back pain. This might imply that health lifestyle contributors seem to be more related to the amount and type of physical activity, but not the amount of sedentary time. However, studies evaluating the relationship of the sedentary and physical activity with the development of a new episode of low back pain are still needed.

Relationship of sleep quality with screen-based sedentary time and physical activity in adolescents - the moderating effect of body mass index.

OBJECTIVE: To analyze the association of sleep quality with reported screen-based sedentary time and reported physical activity, among overweight adolescents. METHODS: Adolescents aged 10 to 17 years enrolled in public and private schools were included. Data collection was carried out during the school semesters of 2014-2015 and participants who did not participate in all evaluations were excluded. Sleep quality and physical activity were assessed by validated questionnaires. Screen-based sedentary time was assessed by self-reported mean daily hours spent on television, computer, smartphone/tablet, and videogames. Body mass index was objectively measured and adolescents were classified into normal weight and overweight according to cutoff points for age and sex. Multiple linear regression models adjusted by covariates (age, sex, ethnicity, and socioeconomic status) were used to analyze the relationship between variables. RESULTS: A total of 1008 adolescents were assessed, with a mean age of 13.2 ± 2.4 years and a mean body mass index of 20.4 ± 4.3 kg/m2. Overweight was observed in 28.0% of sample, while 53.0% reported non-white ethnicity. Self-reported screen-based sedentary time was significantly related to poor sleep quality in adolescents (ß = 0.116, p = 0.005), remaining significant only in those who were normal weight (ß = 0.101, p = 0.007) in sensitivity analysis. Self-reported physical activity showed no relationship with sleep quality in both normal weight and overweight adolescents. CONCLUSION: Self-reported screen-based sedentary time was associated with poor sleep quality in adolescents, mainly among those with normal weight. The time spent on screen-based sedentary activities can impair sleep quality even in normal weight adolescents.