ABSTRACT
BACKGROUND: Stress has been implicated as a factor in the presence and severity of symptoms during the menopausal transition. Our primary aim was to test the hypothesis that stress-sensitive biological measures and self-reported stress would be positively associated with a greater likelihood and intensity of hot flashes. Our secondary aim was to examine measures of stress in relation to the most often reported symptoms in Campeche, Mexico. We also hypothesized ethnic differences (Maya versus non-Maya) in relation to measures of stress and symptom reports. METHODS: Participants aged 40-60 (n = 305) were drawn from multiple sites across the city of San Francisco de Campeche to achieve a generally representative sample. Measures included C-reactive protein (CRP), an indicator of inflammation; Epstein-Barr virus antibodies (EBV-Ab), an indicator of immune function; the Perceived Stress Scale (PSS); a symptom checklist; anthropometric measures; and a questionnaire that elicited symptoms, ethnicity (based on language, birthplace, and last names of the woman, her parents, and her grandparents) and ten dimensions of socioeconomic status (SES). The relationships between symptoms and stress-sensitive biological and self-reported measures were examined in bivariate analyses, and with logistic and linear regressions. RESULTS: The twelve most common symptoms reported, in descending order of frequency, were tiredness, muscle and joint pain, nervous tension, problems concentrating, feeling depressed, difficulty sleeping, headaches, feeling of ants crawling on the skin, loss of interest in sex, urinary stress incontinence, hot flashes, and night sweats. PSS scores were significantly associated with the likelihood of seven symptoms (yes/no), and with the intensity of ten symptoms after controlling for ethnicity, SES, education, cohabitation status, parity, smoking, body mass index, and menopausal status. The stress-sensitive biological measures of immune function (EBV-Ab and CRP) were not significantly associated with midlife symptoms. The PSS was associated with more symptoms among the Maya (e.g., feeling nervous/tense and having difficulty concentrating) than non-Maya. CONCLUSION: PSS scores were associated with the intensity, but not the likelihood, of hot flashes. Other symptoms were also associated with self-reported stress but not with physiological measures. Maya/non-Maya differences may indicate that either symptoms or stress were experienced and/or reported in culture-specific ways.
ABSTRACT
Las dificultades del sueño son altamente prevalentes en los estudiantes de medicina, por lo que es necesario contar con mayor evidencia acerca de cómo sus hábitos contribuyen sobre la calidad del mismo. Objetivos: Evaluar la asociación entre algunos hábitos de salud y tener dificultad en el sueño en alumnos de medicina de primer año. Diseño: Estudio transversal, descriptivo. Institución: Facultad de Medicina, Universidad Nacional Autónoma de México. Participantes: Alumnos de primer año de medicina. Intervenciones: Estudio en 572 alumnos de primer año de medicina con edad promedio de 18,6 años, 37% hombres, de una institución educativa pública de México, seleccionados a través de un muestreo no probabilístico. Se utilizó tres preguntas de la Symptom Check List (SCL90) para considerar dificultad del sueño y 18 preguntas correspondientes al apartado II del Perfil de Estrés de Nowack para evaluar los hábitos de salud. Mediante regresiones logísticas simples, se obtuvo los odds ratio (OR) de los hábitos de salud con respecto a la presencia/ausencia de dificultad del sueño. Principales medidas de resultados: Hábitos de sueño. Resultados: Los hábitos como alta promoción del descanso-sueño (OR=0,15; IC=0,04 a 0,64) y alta prevención del riesgo (OR=0,59; IC=0,41 a 0,86) se asociaron 95%95% a la ausencia de dificultad del sueño. Conclusiones: Pese a que la promoción del descanso sueño fue el hábito menos comunicado por los estudiantes, estuvo asociado a la ausencia de dificultad del sueño con respecto a otros hábitos de salud.
Medical students have a high percentage of poor sleepers; more evidence on how health habits contribute to sleep better in this population is needed. Objectives: To identify the association of some health habits with presence/absence of sleep difficulties in medical freshmen. Design: Cross-sectional, descriptive study. Setting: Faculty of Medicine, Universidad Nacional Autonoma de Mexico. Participants: Medical students. Interventions: The presence/absence of sleep difficulties was assessed by three items from the Symptom Check List (SCL90) in 572 medical students 18.6 year-old (SD±2.7) average, 37% men and 63% women. Sleep-related habits were determined by 18 items from the Nowack Stress Profile. Main outcome measures: Sleep habits. Results: Simple analyses showed that absence of sleep difficulties was associated with the "high promotion of restsleep" (OR=0.15; CI95%=0.04-0.64) and "high risk prevention" (OR=0.59; CI95%=0.41-0.86). Conclusions: The "promotion of rest-sleep" was the least reported habit by students, but explained absence of sleep difficulties better than other health habits.
ABSTRACT
The purpose of this study was to describe sleep difficulties in first year medical students associated with psychopathological symptoms. A cross-sectional study in 572 Medicine students, who were assessed by the Symptom Check List-90 (SCL-90), was performed. A 3.5% of students reported having a hard time sleeping, 6.3% had difficulty staying asleep and 11.4% waking up very early. Sleep difficulties were significantly associated with all psychopathological symptoms. The best predictors of sleep difficulties were anxiety, hostility and interpersonal sensitivity. In conclusion, the symptoms associated with stress, anger, worry, cognitive hyperarousal and hypervigilance are the best predictors for sleep difficulties in this population.
Subject(s)
Emotions , Sleep Wake Disorders/psychology , Stress, Psychological , Students, Medical/psychology , Adolescent , Anger , Cross-Sectional Studies , Female , France , Hostility , Humans , Male , Mental Disorders/psychology , Mexico/epidemiology , Sex Factors , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/psychology , Sleep Wake Disorders/epidemiology , Stress, Psychological/epidemiology , Young AdultABSTRACT
El objetivo del estudio fue describir las dificultades del sueño en estudiantes de Medicina de primer año de una institución pública en la Ciudad de México, en relación con algunos síntomas psicológicos. Se realizó un estudio transversal en 572 alumnos de primer año de Medicina, quienes fueron evaluados mediante la Symptom Check List-90 (SCL-90). Un 3.5% de los estudiantes manifestó tener muchas dificultades para conciliar el sueño, 6.3% para mantenerlo y 11.4% despertaban muy temprano. Las dificultades del sueño se asociaron en forma significativa con todas las dimensiones de psicopatología. Sus mejores predictores fueron la ansiedad, la hostilidad y la sensibilidad interpersonal. Se concluye que los síntomas asociados a tensión, enojo, preocupación, hiperactivación cognitiva e hipervigilancia son los mejores predictores para las dificultades del sueño en esta población.
The purpose of this study was to describe sleep difficulties in first year medical students associated with psychopathological symptoms. A cross-sectional study in 572 Medicine students, who were assessed by the Symptom Check List-90 (SCL-90), was performed. A 3.5% of students reported having a hard time sleeping, 6.3% had difficulty staying asleep and 11.4% waking up very early. Sleep difficulties were significantly associated with all psychopathological symptoms. The best predictors of sleep difficulties were anxiety, hostility and interpersonal sensitivity. In conclusion, the symptoms associated with stress, anger, worry, cognitive hyperarousal and hypervigilance are the best predictors for sleep difficulties in this population.
Subject(s)
Adolescent , Female , Humans , Male , Young Adult , Emotions , Stress, Psychological , Sleep Wake Disorders/psychology , Students, Medical/psychology , Anger , Cross-Sectional Studies , France , Hostility , Mental Disorders/psychology , Mexico/epidemiology , Sex Factors , Sleep Wake Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/psychology , Stress, Psychological/epidemiologyABSTRACT
El objetivo del estudio fue describir las dificultades del sueño en estudiantes de Medicina de primer año de una institución pública en la Ciudad de México, en relación con algunos síntomas psicológicos. Se realizó un estudio transversal en 572 alumnos de primer año de Medicina, quienes fueron evaluados mediante la Symptom Check List-90 (SCL-90). Un 3.5% de los estudiantes manifestó tener muchas dificultades para conciliar el sueño, 6.3% para mantenerlo y 11.4% despertaban muy temprano. Las dificultades del sueño se asociaron en forma significativa con todas las dimensiones de psicopatología. Sus mejores predictores fueron la ansiedad, la hostilidad y la sensibilidad interpersonal. Se concluye que los síntomas asociados a tensión, enojo, preocupación, hiperactivación cognitiva e hipervigilancia son los mejores predictores para las dificultades del sueño en esta población.(AU)
The purpose of this study was to describe sleep difficulties in first year medical students associated with psychopathological symptoms. A cross-sectional study in 572 Medicine students, who were assessed by the Symptom Check List-90 (SCL-90), was performed. A 3.5% of students reported having a hard time sleeping, 6.3% had difficulty staying asleep and 11.4% waking up very early. Sleep difficulties were significantly associated with all psychopathological symptoms. The best predictors of sleep difficulties were anxiety, hostility and interpersonal sensitivity. In conclusion, the symptoms associated with stress, anger, worry, cognitive hyperarousal and hypervigilance are the best predictors for sleep difficulties in this population.(AU)