Factors Associated With Poor Sleep Quality Among Primary Healthcare Workers During the SARS-CoV-2 Pandemic.

INTRODUCTION: Sleep is one of the most important activities for health and the processes related to the central nervous system. Healthcare workers commonly present alterations in the sleep-wake cycle due to complex work schedules because 24-hour attention to the population is required in public health institutions. The increase in care needs caused by the COVID-19 pandemic caused changes in work schedules; as in Mexico, the number of patients requiring consultation in all public health units increased. Chronic partial sleep deprivation (< 7 hours of sleep in the 24-hour cycle) is the most frequent sleep alteration in Mexican health workers. However, it has not been explored whether work modifications due to the pandemic had an impact on the sleep quality of workers. OBJECTIVE: We aimed to describe the prevalence of poor sleep quality and the associated factors in workers (clinical and non-clinical) of a primary care medical unit. MATERIAL AND METHODS: We conducted an analytical and cross-sectional study during November and December 2022. We used the following tools for studying clinical and non-clinical staff working at a family medicine primary care unit: Pittsburgh Sleep Quality Index, Hamilton Anxiety Scale, Beck Depression Inventory, Maslach Burnout Inventory, and Graffar-Méndez-Castellanos socioeconomic level scale, as well as a data collection sheet and a survey of workers' knowledge, attitudes, fears, and needs regarding COVID-19. RESULTS: A total of 233 workers were surveyed. The prevalence of poor sleep quality was 56.7%. A higher score on the Beck Depression Inventory (OR: 1.21, CI 95%: 1.13-1.29), being a doctor (OR: 3.48, CI 95%: 1.5-8.01), and frequent alcohol consumption (OR: 2.4, CI 95%: 1.13-5.2) were identified as risk factors for poor sleep quality. A lower score in the depersonalization dimension of the Maslach Burnout Inventory (OR: 0.5, CI 95%: 0.26-0.99) was identified as a protective factor for poor sleep quality. CONCLUSIONS: During the pandemic, the stress of health workers increased due to work alterations that were necessary to treat the greatest number of patients, so their quality of sleep decreased. Unfortunately, the mental health of healthcare workers is often under-assessed in many institutions. Thus, it is relevant to identify risk factors for alterations (especially those of sleep), since by identifying the target population, comprehensive interventions can be carried out, which can reduce the prevalence of burnout, anxiety, and depression, but if not addressed, the alterations can lead to inadequate care for users of health units.

Biological Activity of a Coumarin Derivative on Heart Failure Using an Ischemia/Reperfusion Injury Model.

Heart failure is a health problem worldwide. There are some drugs for it, including digoxin, spironolactone, captopril, and valsartan, but some of these drugs can produce secondary effects, such as arrhythmia, cough, hyperkalemia, hyponatremia and hypotension. The aim of this research was to evaluate the biological activity of coumarin (2H-chromen-2-one) and its derivatives (3BrAcet-C, 3-4Br-Ph-C, 4-CN-7D-C, 4-Me-7-Ph-C and 6Br-3-D-C) against ischemia/reperfusion injury as a therapeutic alternative for heart failure. In addition, the biological activity of the coumarin derivative 4-Me-7-Ph-C on left ventricular pressure (LVP) was determined in the absence or presence of ouabain and nifedipine at a dose of 1 nM using an isolated rat heart model. The results showed that i) the coumarin derivative 4-Me-7-Ph-C significantly decreased the infarct area (p+=+0.05) compared with 3BrAcet-C, 3-4Br-Ph-C, 4-CN-7D-C, and 6Br-3-D-C; and ii) 4-Me-7-Ph-C increased LVP in a dose-dependent manner, which effect was inhibited by nifedipine. These data suggest that coumarin 4-Me-7-Ph-C may act as a type-L calcium channel activator, so it could be a good agent to treat heart failure.

Poor quality of sleep in Mexican patients with type 2 diabetes and its association with lack of glycemic control.

AIMS: To determine the association between sleep quality and lack of glycemic control in a Mexican population of type 2 diabetes patients. METHODS: Cross-sectional study. Two hundred two patients between 20 and 60 years old with a previous diagnosis of diabetes were included. Sleep quality was assessed with the Pittsburgh Sleep Quality Index and lack of glycemic control as a glycated hemoglobin A1c level ≥ 7 %. Univariate and multivariate analyses using logistic regression were performed. RESULTS: The study population showed poor sleep quality and a lack of glycemic control of 70.3 % and 69.8 %, respectively. The prevalence of patients with both conditions was 52.5 %. In multivariate analysis, poor sleep quality was significantly associated with a lack of glycemic control (OR = 2.3, p = 0.030). Other associated variables were napping (p = 0.015), diabetes duration (p = 0.011), insulin use (p = 0.024), and diastolic blood pressure ≥ 85 mmHg (p = 0.029). CONCLUSIONS: The prevalence of lack of glycemic control in the study population is high. Poor sleep quality significantly doubles the risk of lack of glycemic control, even in the presence of other risk factors.

Sleep Recovery Restored Neuroglobin Immunoreactivity in Rat LDTg-PPTg Nuclei.

Neuroglobin (Ngb) is a protein member of the globin family, expressed mainly in the central and peripheral nervous system. It is involved in the transport of oxygen in response to hypoxic/ischemic and oxidative stress-related insults. We recently showed that sleep deprivation reduces the number of Ngb-positive cells in brain areas related to sleep. However, it is poorly understood whether Ngb expression correlates with sleep occurrence. Here, we aimed to study if sleep recovery produced by 24 h of sleep deprivation restores the number of Ngb-positive cells in the pedunculopontine tegmentum (PPTg) and laterodorsal tegmentum (LDTg), brain areas related to sleep-wake regulation. Male Wistar rats were sleep-deprived for 24 h using the gentle handling method. After sleep deprivation, rats were allowed a sleep recovery for three or six hours. After sleep recovery, rats were euthanized, and their brains processed for Ngb immunohistochemistry. We found that a 3 h sleep recovery is enough to restore the number of Ngb-positive cells in all the analyzed areas. A similar result was observed after a 6 h sleep recovery. These results suggest that Ngb expression is sleep dependent. We suggest that Ngb expression is involved in preventing cell damage due to prolonged wakefulness.

Papel de las alteraciones del sueño durante la gestación en la programación del feto para el desarrollo de obesidad y enfermedades crónicas degenerativas.

Sleep disturbances are common in the third trimester of pregnancy and generate changes in the secretion of melatonin in pregnant women who sleep less than eight hours or have sleep disturbances, which promote various physiological changes in the mother that in turn result in low birth weight (LBW) in the fetus. LBW is associated with a phenomenon known as "metabolic programming," in which the fetus is subjected to a stressful situation that results in irreversible metabolic alterations that predispose it to the development of obesity in adulthood.

En el tercer trimestre del embarazo son frecuentes las alteraciones del sueño, las cuales generan cambios en la secreción de melatonina en mujeres gestantes que duermen menos de ocho horas o presentan alteraciones de sueño, promoviendo diversos cambios fisiológicos en la madre, que a su vez derivan en bajo peso al nacimiento (BPN) en el producto. El bajo peso al nacimiento está asociado con un fenómeno conocido como "programación metabólica", en la que el feto es sometido a estrés que tiene como resultado alteraciones metabólicas irreversibles que lo predisponen al desarrollo de obesidad en la edad adulta.

Papel de las alteraciones del sueño durante la gestación en la programación del feto para el desarrollo de obesidad y enfermedades crónicas degenerativas / Role of sleep disturbances during pregnancy in the programming of the fetus for development

Resumen En el tercer trimestre del embarazo son frecuentes las alteraciones del sueño, las cuales generan cambios en la secreción de melatonina en mujeres gestantes que duermen menos de ocho horas o presentan alteraciones de sueño, promoviendo diversos cambios fisiológicos en la madre, que a su vez derivan en bajo peso al nacimiento (BPN) en el producto. El bajo peso al nacimiento está asociado con un fenómeno conocido como "programación metabólica", en la que el feto es sometido a estrés que tiene como resultado alteraciones metabólicas irreversibles que lo predisponen al desarrollo de obesidad en la edad adulta.

Abstract Sleep disturbances are common in the third trimester of pregnancy and generate changes in the secretion of melatonin in pregnant women who sleep less than eight hours or have sleep disturbances, which promote various physiological changes in the mother that in turn result in low birth weight (LBW) in the fetus. LBW is associated with a phenomenon known as "metabolic programming," in which the fetus is subjected to a stressful situation that results in irreversible metabolic alterations that predispose it to the development of obesity in adulthood.

Sleep deprivation induces differential morphological changes in the hippocampus and prefrontal cortex in young and old rats.

Sleep is a fundamental state necessary for maintenance of physical and neurological homeostasis throughout life. Several studies regarding the functions of sleep have been focused on effects of sleep deprivation on synaptic plasticity at a molecular and electrophysiological level, and only a few studies have studied sleep function from a structural perspective. Moreover, during normal aging, sleep architecture displays some changes that could affect normal development in the elderly. In this study, using a Golgi-Cox staining followed by Sholl analysis, we evaluate the effects of 24 h of total sleep deprivation on neuronal morphology of pyramidal neurons from Layer III of the prefrontal cortex (PFC) and the dorsal hippocampal CA1 region from male Wistar rats at two different ages (3 and 22 months). We found no differences in total dendritic length and branching length in both analyzed regions after sleep deprivation. Spine density was reduced in the CA1 of young-adults, and interestingly, sleep deprivation increased spine density in PFC of aged animals. Taken together, our results show that 24 h of total sleep deprivation have different effects on synaptic plasticity and could play a beneficial role in cognition during aging.

Enriched environment attenuates nicotine self-administration and induces changes in ΔFosB expression in the rat prefrontal cortex and nucleus accumbens.

Environment enrichment conditions have important consequences on subsequent vulnerability to drugs of abuse. The present work examined whether exposure to an enriched environment (EE) decreases oral self-consumption of nicotine. Wistar rats were housed either in a standard environment (SE, four rats per standard cage) or in an EE during 60 days after weaning. EE consisted of eight animals housed in larger cages containing a variety of objects such as boxes, toys, and burrowing material that were changed three times a week. After this period, animals were exposed to nicotine for 3 weeks, where animals chose freely between water and a nicotine solution (0.006% in water). Fluid consumption was evaluated on a daily basis. ΔFosB immunohistochemistry in the prefrontal cortex and nucleus accumbens was also performed. Rats of the EE group consumed less nicotine solution (0.25±0.04 mg/kg/day) than SE rats (0.54±0.05 mg/kg/day). EE increased the number of ΔFos-immunoreactive (ΔFos-ir) cells in the nucleus accumbens core and shell and in the prefrontal cortex, compared with animals in the standard condition. However, rats exposed to nicotine in the SE showed higher ΔFos-ir cells in the nucleus accumbens core and shell than nonexposed rats. Nicotine consumption did not modify ΔFos-ir cells in these brain areas in EE animals. These results support the idea of a possible protective effect of the EE on reward sensitivity and the development of an addictive behavior to nicotine.

Sleep deprivation reduces neuroglobin immunoreactivity in the rat brain.

Neuroglobin (Ngb), a protein located in the mammal's brain, is involved in oxygen transport and free radical scavenging inside the neurons. Ngb colocalizes with choline acetyltransferase in the laterodorsal tegmental nucleus and in the pontine tegmental nucleus, both involved in the sleep-wake cycle regulation. Some studies have shown that free radicals accumulated during prolonged wakefulness are removed during sleep. Therefore, Ngb could act as a regulator of free radicals generated during prolonged wakefulness in the brain. The aim of this study was to determine whether prolonged wakefulness affects Ngb immunoreactivity because of increases in the oxidative stress induced by continuous neuronal activity. For this purpose, male adult Wistar rats were implanted with electrodes for sleep recordings and were divided into control and sleep-deprived groups. Sleep deprivation was carried out for 24 h by gentle handling of the animals. Sleep-wake activity was determined during the deprivation period or 24 h of control conditions. Subsequently, both groups of animals were killed and their brains were obtained and processed for Ngb immunohistochemical analysis and detection of lipid peroxidation. Our data found no evidence of increased oxidative stress in the brains of sleep-deprived animals compared with the controls. The number of Ngb-positive cells was decreased in the sleep-deprived animals in all analyzed areas of the brain compared with the control group. Our results suggest that Ngb could be involved in sleep regulation, independent of its role in the control of oxidative stress.