A qualidade do sono está associada a determinantes sociodemográficos e clínicos em usuários acompanhados na Atenção Primária à Saúde durante a pandemia de COVID-19 / Sleep quality is associated with sociodemographic and clinical determinants in users attended in Primary Health Care during the COVID-19 pandemic / La calidad del sueño se asocia con determinantes sociodemográficos y clínicos en usuarios monitoreados en Atención Primaria de Salud durante la pandemia de COVID-19

Introdução: O avanço da pandemia de COVID-19 acarretou alterações no sono da população. Os distúrbios do sono têm relação com as principais alterações de saúde mental e também possuem relação com os fatores psicossociais. Objetivo: Estimar a prevalência e fatores associados às alterações na qualidade do sono em usuários acompanhados na Atenção Primária à Saúde durante a pandemia de COVID-19. Métodos: Estudo do tipo transversal, com adultos (idade >18 anos) de ambos os gêneros, acompanhados por uma unidade de saúde. Foram levantadas as informações do prontuário eletrônico da unidade e, durante a visita domiciliar (entre agosto e setembro de 2021), os dados socioeconômicos, fatores de risco, sinais vitais, variáveis antropométricas, hábitos de vida, medicações em uso, uso dos serviços de saúde, internação e consultas no último ano. A qualidade de vida foi avaliada pelo questionário SF-36 e foi usado o Índice de Qualidade do sono Pittsburgh (PSQI). Resultados: A amostra foi formada predominantemente por mulheres (82,9%) com 60,5±11,7 anos de idade, da cor branca (70,7%), com companheiro (61%) e pertencentes à classe C (65,8%). 53,7% da amostra apresentou até duas comorbidades, 87,8% apresentavam sobrepeso/obesidade e 80% faziam uso de anti-hipertensivo. A prevalência de qualidade do sono ruim foi de 87,8% (IC95% 73,1­95,0). Os achados apontam para uma relação entre má qualidade do sono com consumo de álcool, presença de ≥3 comorbidades, níveis de PAS, uso de ansiolíticos, nível de escolaridade e uso de serviços de saúde durante a pandemia. Conclusões: A alta prevalência de qualidade do sono ruim na amostra estudada sugere que determinantes sociodemográficos, presença de comorbidades e hábitos de vida devem ser considerados para minimizar os efeitos das alterações do sono na pandemia.

Introduction: The advancement of the COVID-19 pandemic has resulted in changes in the sleep patterns of the population. Sleep disorders are related to major mental health changes and are also associated with psychosocial factors. Objective: To estimate the prevalence and factors associated with sleep quality changes among users attended in Primary Health Care during the COVID-19 pandemic. Methods: This was a cross-sectional study involving adults (age >18 years) of both genders who were being followed at a healthcare unit. Information was gathered from the unit's electronic medical records, and during home visits (between August and September 2021), socioeconomic data, risk factors, vital signs, anthropometric variables, lifestyle habits, current medications, healthcare service utilization, hospitalization, and consultations in the past year were collected. Quality of life was assessed using the SF-36 questionnaire, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Results: The sample consisted predominantly of women (82.9%) with an average age of 60.5±11.7 years, of white ethnicity (70.7%), with a partner (61%), and belonging to class C (65.8%). 53.7% of the sample had up to two comorbidities, 87.8% were overweight/obese, and 80% were using antihypertensive medication. The prevalence of poor sleep quality was 87.8% (95%CI 73.1­95.0). The findings indicate a relationship between poor sleep quality and alcohol consumption, the presence of ≥3 comorbidities, systolic blood pressure levels, use of anxiolytics, education level, and the use of healthcare services during the pandemic. Conclusions: The high prevalence of poor sleep quality in the study sample suggests that sociodemographic determinants, presence of comorbidities, and lifestyle habits should be considered to minimize the effects of sleep disturbances during the pandemic.

Introducción: El avance de la pandemia de COVID-19 ha ocasionado cambios en el sueño de la población. Los trastornos del sueño están relacionados con los principales cambios en la salud mental y también se asocian con factores psicosociales. Objetivo: Estimar la prevalencia y los factores asociados con alteraciones en la calidad del sueño en usuarios atendidos en la Atención Primaria de Salud durante la pandemia de COVID-19. Métodos: Estudio transversal con adultos (edad >18 años) de ambos géneros que son atendidos en una unidad de salud. Se recopilaron datos del historial clínico electrónico de la unidad y durante la visita domiciliaria (entre agosto y septiembre de 2021) se obtuvieron datos socioeconómicos, factores de riesgo, signos vitales, variables antropométricas, hábitos de vida, medicamentos utilizados, uso de servicios de salud, hospitalización y consultas en el último año. La calidad de vida se evaluó mediante el cuestionario SF-36 y se utilizó el Índice de Calidad del Sueño de Pittsburgh (PSQI). Resultados: La muestra estuvo compuesta predominantemente por mujeres (82,9%) con una edad de 60,5±11,7 años, de raza blanca (70,7%), con pareja (61%) y pertenecientes a la clase C (65,8%). El 53,7% de la muestra presentó hasta dos comorbilidades, el 87,8% tenían sobrepeso/obesidad y el 80% utilizaba medicación antihipertensiva. La prevalencia de mala calidad del sueño fue del 87,8% (IC95% 73,1­95,0). Los hallazgos señalan una relación entre la mala calidad del sueño y el consumo de alcohol, la presencia de ≥3 comorbilidades, los niveles de presión arterial sistólica (PAS), el uso de ansiolíticos, el nivel de escolaridad y el uso de servicios de salud durante la pandemia. Conclusiones: La alta prevalencia de mala calidad del sueño en la muestra estudiada sugiere que se deben considerar los determinantes sociodemográficos, la presencia de comorbilidades y los hábitos de vida para minimizar los efectos de los trastornos del sueño en la pandemia.

La importancia del sueño en los adolescentes: impacto de variables sociodemográficas y de factores personales / The Importance of Sleep in Adolescents: Impact of Sociodemographic Variables and Personal Factors

Resumen Objetivo: Ante la escasez de investigaciones que traten de manera conjunta el conocimiento, la calidad y la higiene del sueño en el adolescente, el objetivo del presente estudio es analizar las diferencias y las relaciones que existen entre estas variables en función de características sociodemográficas y personales. Método: A través de los instrumentos Sleep Beliefs Scale (SBS), Spanish Adolescents and Young Adults Pittsburgh Sleep Quality Index (AYA-PSQI-S) y Adolescents Sleep Hygiene Scale Revied (ASHSr), se midieron las características del sueño de 140 estudiantes (M = 16,75; DE = 0,75). Resultados: El 89,3% de los adolescentes presentaban problemas de sueño, subyacentes de la mejorable higiene del sueño por parte del 62,2% y de un escaso conocimiento general del sueño. El sexo femenino y el alumnado en cursos superiores presentaron mayores problemas para conciliar el sueño, somnolencia y una baja gestión cognitiva-emocional (p < 0,05). La higiene del sueño (β = - 0,344), la edad (β = 0,154) y el autoconcepto (β = -0,349) son los factores que predijeron significativamente (p < 0,05) la calidad del sueño del adolescente. Conclusiones: La adquisición de una adecuada higiene del sueño se vuelve fundamental para mejorar la calidad del descanso y la funcionalidad diurna en adolescentes, destacando su importancia, sobre todo, en niveles académicos avanzados y en el caso específico de las mujeres.

Abstract Objective: Given the scarcity of research addressing the intersection of knowledge, sleep quality, and hygiene among adolescents, the primary objective of this study is to analyse the variations and correlations among these variables based on socio-demographic and personal characteristics. Method: The Sleep Beliefs Scale (SBS), the Spanish Adolescents and Young Adults Pittsburgh Sleep Quality Index (AYA-PSQI-S), the Adolescents Sleep Hygiene Scale Revied (ASHSr) were used to measure the sleep characteristics of the 140 Spanish students (M = 16,75; SD = 0,75). Results: Sleep problems were found in 89,3% of the adolescents, underlying poor sleep hygiene in 62,2% and poor general sleep knowledge (SBS = 12,04). Females and students in higher grades presented greater problems in falling asleep, sleepiness, and poor cognitive-emotional management (p < 0,05). Sleep hygiene (β = - 0,344), age (β = 0,154), and self-concept (β = -0,349) were the factors that significantly (p < 0,05) predicted adolescent sleep quality. Conclusions: The acquisition of proper sleep hygiene becomes crucial to enhance the quality of rest and daytime functionality in adolescents, emphasizing its significance, especially in advanced academic levels and specifically in the case of females.

(Dis)satisfaction With Body Image, Lifestyles and Life Satisfaction in Higher Education Students / (In)satisfacción con la imagen corporal, estilos de vida y satisfacción con la vida en estudiantes de enseñanza superior

Abstract Objective: Body image is a predictor of physical, psychological, and social health. Therefore, it can be an indicator for detecting health problems, to be used in the context of higher education. The aim of this study was to assess body image satisfaction in higher education students and to determine whether body image dissatisfaction is related to lifestyle behaviours and life satisfaction. Methodology: This study included 166 Portuguese higher education students. Body image was assessed using the Figure Rating Scale. Active choices during everyday life were assessed using the Active Choice Index. The questionnaire also included questions about sleep behaviour and tobacco and alcohol consumption. Satisfaction with Life was assessed using a five-item scale previously adapted for the Portuguese population. Results: There was a predominance of boys dissatisfied with thinness (26.10%), while the majority of girls revealed that they were dissatisfied due to being overweight (55.70%). The results indicate statistically significant differences between boys and girls in terms of body image categories (p<0.001). However, when we analysed the behaviours separately according to gender, there were no differences. Active behaviours, as well as the other health behaviours analysed (hours of sleep per week and alcohol and tobacco consumption) did not differ between the different levels of body image satisfaction (p>0.05). Conclusion: Most of the students are dissatisfied with their body image, with the majority of girls showing dissatisfaction due to being overweight. Lifestyles and life satisfaction do not differ between students who are satisfied and those who are dissatisfied with their body image.

Resumen Objetivo: La imagen corporal es un factor predictivo de la salud psicológica, física y social. Por lo tanto, puede ser un indicador para detectar problemas de salud, para utilizar en el contexto de la educación superior. El objetivo de este estudio fue evaluar la satisfacción con la imagen corporal en estudiantes de enseñanza superior y determinar si la insatisfacción con la imagen corporal está relacionada con los comportamientos de estilo de vida y la satisfacción con la vida. Metodología: En este estudio participaron 166 estudiantes portugueses de enseñanza superior. La imagen corporal se evaluó mediante la escala Figure Rating Scale. Las elecciones activas durante la vida cotidiana se evaluaron mediante el Active Choice Index. El cuestionario también incluía preguntas sobre el comportamiento durante el sueño y el consumo de tabaco y alcohol. La satisfacción con la vida se evaluó mediante una escala de cinco ítems previamente adaptada a la población portuguesa. Resultados: Predominaron los chicos insatisfechos por delgadez (26.10%), mientras que la mayoría de las chicas revelaron estar insatisfechas por sobrepeso (55.70%). Los resultados indican diferencias estadísticamente significativas entre chicos y chicas en cuanto a las categorías de imagen corporal (p<0.001). Sin embargo, al analizar los comportamientos por separado en función del sexo, no se observaron diferencias. Las conductas activas, así como las demás conductas de salud analizadas (horas de sueño semanales y consumo de alcohol y tabaco) no difirieron entre los distintos niveles de satisfacción con la imagen corporal (p>0.05). Conclusiones: La mayoría de los estudiantes están insatisfechos con su imagen corporal, siendo mayoritaria la insatisfacción de las chicas por sobrepeso. Los estilos de vida y la satisfacción vital no difieren entre los alumnos satisfechos y los insatisfechos con su imagen corporal.

Relação entre apoio social e sono de pessoas idosas cuidadoras em vulnerabilidade social / Relationship between social support and sleep of elderly caregivers in social vulnerability / Relación entre apoyo social y sueño de adultos mayores cuidadores con vulnerabilidad social

Objetivo: analisar a relação entre apoio social e qualidade do sono de pessoas idosas que cuidam de outros idosos em ambiente de vulnerabilidade social. Método: estudo transversal realizado com 65 cuidadores entrevistados por meio de instrumento de caracterização, Índice de Katz, Escala de Lawton e Brody, Índice de Qualidade do Sono de Pittsburgh e Escala de Apoio Social do Medical Outcomes Study, com dados analisados com testes de comparação e de correlação. Resultados: a maioria eram mulheres, cônjuges do idoso cuidado e possuíam sono de má qualidade. Observou-se correlação fraca e inversa entre má qualidade do sono e a dimensão interação social positiva (Rho=-0,27; p=0,028). Identificou-se relação significativa entre: apoio material e disfunção diurna (p=0,034); apoio afetivo e eficiência do sono (p=0,026); interação social positiva e qualidade subjetiva do sono (p=0,001) e disfunção diurna (p=0,008). Conclusão: Quanto maior a interação social positiva, melhor é a qualidade do sono.

Objective: to analyze the relationship between social support and sleep quality of elderly individuals who care for other elderly individuals in a socially vulnerable environment. Method: a cross-sectional study conducted with 65 caregivers interviewed using a characterization instrument, Katz Index, Lawton and Brody Scale, Pittsburgh Sleep Quality Index, and Medical Outcomes Study Social Support Scale, with data analyzed using comparison and correlation tests. Results: the majority were women, spouses of the elderly being cared for, and had poor sleep quality. A weak and inverse correlation was observed between poor sleep quality and the positive social interaction dimension (Rho=-0.27; p=0.028). Significant relationships were identified between: material support and daytime dysfunction (p=0.034); emotional support and sleep efficiency (p=0.026); positive social interaction and subjective sleep quality (p=0.001), as well as daytime dysfunction (p=0.008). Conclusion: The higher the positive social interaction, the better the sleep quality.

Objetivo: analizar la relación entre el apoyo social y la calidad del sueño de personas mayores que cuidan de otras personas mayores en entornos socialmente vulnerables. Método: estudio transversal realizado con 65 cuidadores entrevistados mediante un instrumento de caracterización, Índice de Katz, Escala de Lawton y Brody, Índice de Calidad del Sueño de Pittsburgh y Escala de Apoyo Social del Medical Outcomes Study, los datos fueron analizados mediante pruebas de comparación y correlación. Resultados: la mayoría eran mujeres, cónyuges del adulto mayor que recibe el cuidado y tenían mala calidad del sueño. Se observó una correlación débil e inversa entre la mala calidad del sueño y la dimensión de interacción social positiva (Rho=-0,27; p=0,028). Se identificó que había relación significativa entre: apoyo material y disfunción diurna (p=0,034); apoyo afectivo y eficiencia del sueño (p=0,026); interacción social positiva y calidad subjetiva del sueño (p=0,001) y disfunción diurna (p=0,008). Conclusión: Cuanto mayor sea la interacción social positiva, mejor será la calidad del sueño.

Impact of malocclusion and oral habits on oral health-related quality of life and sleep disturbance in young adults : A cross-sectional study.

PURPOSE: The aim of this study was to investigate the impact of malocclusion and oral habits on oral health-related quality of life and sleep disturbance in young adults. METHODS: A cross-sectional study was conducted with a sample of 213 young adults aged 18-30 years. Dental occlusion data were assessed through clinical examination. A questionnaire was used to collect data on oral habits. Outcomes were collected using the Oral Health Impact Profile (OHIP-14) and Mini Sleep Questionnaire. RESULTS: Anterior open bite (adjusted odds ratio [OR] = 2.41, 95% confidence interval [CI] = 1.02-5.67, p = 0.044), swallowing disorders (adjusted OR = 2.39, 95% CI = 1.13-5.05, p = 0.022), and sleeping on hands were associated with a negative impact on oral health-related quality of life. Females (adjusted OR = 2.61, 95% CI = 1.10-6.17, p = 0.029), teeth grinding (adjusted OR = 2.78, 95% CI = 1.08-7.14, p = 0.034), biting lips or cheeks (adjusted OR = 4.28, 95% CI = 1.49-12.29, p = 0.007), and self-perception of need for orthodontic treatment (adjusted OR = 7.88, 95% CI = 2.12-29.30, p = 0.002) were associated as a risk for sleep disturbances. CONCLUSION: The findings suggest that oral habits and some types of malocclusions can impact oral health-related quality of life. In addition, sleep disturbances were associated with a greater need for orthodontic treatment and a habit of grinding teeth in young adults.

Total dietary antioxidant capacity and food groups and their relationship with the sleep time of Brazilian graduates (CUME Study).

To investigate the association between the Dietary Total Antioxidant Capacity (dTAC) and the Total Antioxidant Capacity of food groups (fgTAC) with the sleep time of Brazilian graduates participating in the Cohort of Universities of Minas Gerais (CUME Study). This cross-sectional study analyzed 6,387 graduates (2,052 men, 4,335 women, 35.3 ± 9.3 years old) from the CUME Study. Data was collected online, and dTAC was obtained by the Ferric Reduction Antioxidant Power (FRAP) method. Daily sleep time was classified as short sleep, normal sleep, and long sleep (≤6, 7-8, and ≥9 h, respectively). Multinomial logistic regression models were used to estimate the Odds Ratio (OR) and its 95% Confidence Interval (95% CI) between short sleep and long sleep with quartiles of dTAC and the fgTAC. Lower odds of short sleep was observed for the third quartile of dTAC and for fourth quartile of fgTAC of fruits, beans, and lentils, and for the third quartile of fgTAC of vegetables and oils and fats. Higher odds of short sleep for the fourth quartile of fgTAC of teas and coffees. For long sleep, inverse associations were observed for the fourth quartile of fgTAC of oilseeds and the third quartile of fgTAC of teas and coffees. Higher odds of long sleep were observed for the third quartile of artificial juices and sodas. We cannot independently assert an association between higher dTAC and sleep time. In turn, the associations between sleep time and fgTAC show the importance of the food matrix that antioxidants are inserted, requiring longitudinal studies to observe the direction of associations.

Screen time, sleep duration, leisure physical activity, obesity, and cardiometabolic risk in children and adolescents: a cross-lagged 2-year study.

BACKGROUND: Considering the previous research that suggested that screen time (ST), sleep duration, physical activity (PA), obesity and cardiometabolic risk factors are related, it is essential to identify how these variables are associated over time, to provide knowledge for the development of intervention strategies to promote health in pediatric populations. Also, there is a lack of studies examining these associations longitudinally. The aims of the present study were: (1) to investigate the longitudinal relationships between ST, sleep duration, leisure PA, body mass index (BMI), and cardiometabolic risk score (cMetS) in children and adolescents; and (2) to verify scores and prevalence of cMetS risk zones at baseline and follow-up. METHODS: This observational longitudinal study included 331 children and adolescents (aged six to 17 years; girls = 57.7%) from schools in a southern city in Brazil. ST, sleep duration, and leisure PA were evaluated by a self-reported questionnaire. BMI was evaluated using the BMI z-scores (Z_BMI). The cMetS was determined by summing sex- and age-specific z-scores of total cholesterol/high-density lipoprotein cholesterol (HDL-C) ratio, triglycerides, glucose, and systolic blood pressure and dividing it by four. A two-wave cross-lagged model was implemented. RESULTS: ST, sleep duration, and leisure PA were not associated with cMetS after 2-years. However, it was observed that higher ST at baseline was associated with shorter sleep duration at follow-up (B=-0.074; 95%IC=-0.130; -0.012), while higher Z_BMI from baseline associated with higher cMetS of follow-up (B = 0.154; 95%CI = 0.083;0.226). The reciprocal model of relationships indicated that the variance of ST, sleep time, leisure PA, Z_BMI, and cMetS explained approximately 9%, 14%, 10%, 67% and 22%, respectively, of the model. Individual change scores and prevalence indicated that cMetS had individual changes from 2014 to 2016. CONCLUSION: Sleep duration, ST and leisure PA were not associated with cMetS after 2 years. ST showed an inverse association with sleep duration, and Z_BMI was positively associated with cMetS after a 2-year follow-up. Finally, the prevalence of no clustering of risk factors increased after two years. These findings suggest the need to promote healthy lifestyle habits from childhood and considering individual factors that can influence cardiometabolic health in children and adolescents.

Survival and Risk Factors Associated with Mortality in Patients with Sleep Apnoea in Colombia: A Retrospective Cohort Study.

Background: Survival in patients with sleep apnoea (SA) can be reduced by variables such as age, sex, and comorbidities. However, survival data in patients with SA in Colombia remains scarce. Methods: This is a retrospective cohort study of patients diagnosed with SA between 2005 and 2022. Five-year survival was assessed using the Kaplan-Meier method, and survival curves were stratified by age, sex, and cardiovascular disease. Risk factors associated with survival were evaluated using Hazard Ratio (HR) by adjusting for confounding variables with a Cox regression model. A minimum sample size of 1537 patients were estimated to be necessary to estimate a survival incidence rate with a 5% precision. Results: The five-year survival rate in the general population was 94.6%, with lower survival in patients over 65 years (88.5% vs 97.9%; p < 0.001) and in patients with cardiovascular disease (89% vs 95.2%; p < 0.001) compared to the control group. In the Cox regression, age showed an HR of 1.05 (95% CI: 1.02-1.07; p < 0.001). Male sex had an HR of 2.31 (95% CI: 1.25-4.25; p = 0.007), congestive heart failure an HR of 4.00 (95% CI: 2.31-6.94; p < 0.001), chronic obstructive pulmonary disease (COPD) an HR of 1.75 (95% CI: 1.04-2.96; p = 0.035), chronic kidney disease (CKD) an HR of 2.23 (95% CI: 1.31-3.78; p = 0.003), and metastatic cancer an HR of 4.96 (95% CI: 1.95-12.60; p = 0.001). Conclusion: The study showed a high five-year survival rate in patients with SA. The risk factors associated with decreased overall five-year survival were age, male sex, cardiovascular disease, COPD, CKD, and metastatic cancer.

Song-like activation of syringeal and respiratory muscles during sleep in canaries.

Sleep replay activity involves the reactivation of brain structures with patterns similar to those observed during waking behavior. In this study, we demonstrate that adult male canaries exhibit spontaneous, song-like peripheral reactivation during night sleep. Our findings include: (1) the presence of activity in respiratory muscles, leading to song-like air sac pressure patterns of low amplitude, (2) the simultaneous occurrence of respiratory replay events and reactivation of syringeal muscles, and (3) the reactivation of syringeal muscles without concurrent respiratory system activity. This song-like reactivation of peripheral motor systems enables the identification of specific motor patterns, with replay events preserving individual morphological and temporal properties. The activation of peripheral motor systems in songbirds and the differences in activation patterns between species give unique insights into the fictive behavioral output of activation of a complex learned motor behavior during sleep, shedding light on the neural control mechanisms and potential functions.

History of symptoms consistent with REM sleep behavior disorder in a population with Parkinson's Disease.

REM Sleep Behavioral Disorder (RBD) is a parasomnia marked by the maintenance of muscle tone during REM sleep. Evidence has placed RBD as one of the possible prodromal stages of Parkinson's Disease (PD), but data on the proportion of people with PD who have had symptoms of RBD are limited. This study aimed to investigate the history of symptoms compatible with RBD in a population with PD. The sample was composed by 73 patients with clinically diagnosed PD being followed up at a reference outpatient setting, compared to 73 age- and sex-matched individuals with no PD. The evaluation of symptoms compatible with RBD was performed using the Brazilian version of the RBD Screening Questionnaire (RBDSQ). The prevalence of symptoms compatible with RBD was 65 % for PD and 10.09 % for controls. The RBDSQ score was significantly higher in the PD group (6.03 ± 0.35) in comparison to the control group (2.38 ± 0.23). The odds ratio for presenting previous RBD-compatible symptoms was 12.09 in favor of positive PD cases. PD diagnosis has the following diagnostic properties in relation to presenting RBD symptoms: sensitivity of 0.65, specificity of 0.86, positive predictive value of 0.82 and negative predictive value of 0.71. In conclusion, the proportion of PD patients showing RBD symptoms is high, corroborating the expected neuroprogression of the disease on a case-control design comprising outpatient PD cases. Clinical practitioners should include evaluations of RBD-compatible symptoms during the PD assessment and, if positive, forward to a sleep specialist.

Temporal bisection task as a predictor of cognitive deficits.

Evidence suggests that neuropsychiatric symptoms and deficits in attentional control and executive function can impair time discrimination, demonstrating the intricate link between cognitive processes, subjective well-being, and perception of time. However, the relationship between sleep quality and time discrimination remains elusive. This study aimed to understand differences in the temporal bisection task (TBT) performance. We expected that individuals with impaired cognition, executive function, quality of life, or sleep quality would have reduced time sensitivity. At the same time, those with stress, anxiety, or depression would show a shift in the point of subjective equality. Data were collected from 97 female participants (ranging from 20 to 72 years of age) in more than one moment, resulting in 163 measurements used for the analysis. Participants' neuropsychiatric status was assessed using a battery of tests and scales, including the Mini-Mental State Examination (MMSE), the Frontal Assessment Battery (FAB), the World Health Organization Quality of Life Questionnaire (WHOQOL), the Pittsburgh Sleep Quality Index (PSQI), and the Depression, Anxiety, and Stress Scale-21 items (DASS-21). The results showed that attention and executive control significantly affect time discrimination. In addition, the research indicated that better sleep quality is associated with improved time discrimination sensitivity.

Estrogen receptor α regulates the IKKs/NF-kB activity involved in the development of mechanical allodynia induced by REM sleep deprivation in rats.

Several signaling pathways that converge in NF-kB activation have been linked to developing and maintaining different types of pathological pain. In addition, some mechanisms implied in the establishment of chronic pain have been demonstrated to have a sex-dependent correlation. This study aimed to determine if the IKKs/NF-kB signaling pathway is involved in establishing REM sleep deprivation (REMSD) induced mechanical allodynia in rats and its possible regulation depending on estradiol and estrogen receptors. Intrathecal administration of BMS-345541 or minocycline, two drugs that reduce the IKKs/NF-kB activity, avoided the development of mechanical allodynia in female but not in male rats subjected to 48 h of REMSD. Ovariectomy in female rats abolished the effect of BMS-345541 and minocycline. Meanwhile, the 17-ß-estradiol restitution restored it. Intrathecal administration of MPP, a selective ERα antagonist, but not PHTPP, a selective ERß antagonist, avoided the effect of BMS-345541 in female rats without hormonal manipulation. In addition, the transient run-down of ERα in female rats abolished the effect of BMS-345541. All data suggest an important role of ERα as a regulator of the IKKs/NF-kB activity. REMSD increased the ERα protein expression in the dorsal root ganglia and the dorsal spinal cord in females but not in male rats. Interestingly, ERα activation or ERα overexpression allowed the effect of BMS-345541 in male rats. Data suggest an important regulatory role of ERα in the IKKs/NF-kB activity on establishing mechanical allodynia induced by REMSD in female rats.

Practices and Perception of Paediatric Obstructive Sleep Apnea Among Orthodontists and Paediatric Dentists in Brazil: A Mixed-Methods Study.

OBJECTIVES: To explore orthodontists' (OTs) and paediatric dentists' (PDs) practices and perceptions regarding the screening and management of paediatric obstructive sleep apnea (OSA). METHODS: This explanatory sequential mixed methods design included OTs and PDs with active clinical practice in Brazil and encompassed a quantitative phase followed by a qualitative phase. In the quantitative phase, a survey assessing OSA screening and management practices was administered to OTs and PDs practicing in Brazil. Information-rich OTs and PDs were interviewed in the qualitative phase. Descriptive statistics and the chi-square test were used to analyse the survey data, while inductive content analysis was applied to the interview data. The results from both phases were integrated and reported narratively. RESULTS: Three hundred eighty-one OTs and PDs completed the survey, and ten of them were interviewed. Nearly half of OTs and PDs administered sleep questionnaires and demonstrated some knowledge about paediatric OSA signs and symptoms. PDs and OTs primarily offered rapid maxillary expansion and functional mandibular advancement for managing selected children with OSA, with OTs being more frequently involved in this task than PDs. OTs and PDs identified several barriers and expressed the need for support regarding access to reliable screening tools and interprofessional care. CONCLUSION: Brazilian OTs and PDs were aware of the main signs and symptoms of paediatric OSA and were somewhat involved in offering oral appliance management options. To further define the role of these professionals, increasing support for dental professionals in OSA management and updating existing clinical guidelines is warranted.

The effect of diets with different inflammatory scores on inflammation and sleep in obese subjects: a randomized controlled trial

SUMMARY OBJECTIVE: The aim of this study was to investigate the effect of different dietary inflammatory index diets on inflammatory markers, anthropometric measurements, and sleep quality in obese subjects. METHODS: This study was conducted in a public hospital in Turkey between November 2021 and May 2022. Participants with pro-inflammatory dietary habits were included in the study. Randomly divided into two groups of 33 participants, they were subjected to an anti-inflammatory diet or a control diet for 8 weeks. The study evaluated the anthropometric parameters, inflammatory biomarkers, and sleep quality indices of the diet groups. RESULTS: Significant reductions in body mass index were observed in both groups, more marked in the anti-inflammatory diet cohort. C-reactive protein levels, indicative of inflammation, also decreased substantially in both groups, with a more marked reduction in the anti-inflammatory diet cohort. Despite the improvement in sleep quality in both groups, the variation was not statistically significant. CONCLUSION: This study demonstrates the importance of anti-inflammatory diets in nutritional strategies for obesity by reducing body mass index and inflammation.

Sleep and quality of life in adults with atopic dermatitis: cross sectional study.

Summary: Background.Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease that causes sleep disturbances and worsens quality of life. However, few studies have been conducted on sleep in adults with atopic dermatitis. This study aimed to evaluate sleep and quality of life in adults with AD. Methods. A cross-sectional study was conducted with 36 adults diagnosed with AD and 21 healthy volunteers (controls), who completed questionnaires on sleep, itching, and quality of life. Disease severity was estimated using SCORing Atopic Dermatitis (SCORAD). All participants wore actigraphy watches for one week to objectively assess sleep quality. Results. Adults with AD slept worse than controls as measured by self-report (Global Pittsburgh Sleep Quality Index, mean ± SD, 9.33 ± 3.59 vs 5.00 ± 2.30, p < 0.001) and by actigraphy (sleep efficiency, SE), mean ± SD, 74.48 ± 11.63 vs 85.6 ± 6.53, p < 0.001). Actigraphy showed that adults with AD slept, on average, almost one hour less (p = 0.010), stayed awake during sleep for almost 44 minutes more (p < 0.001), and woke up 25% more than the controls (p = 0.047). In the AD group, SE and total sleep time were significantly inversely correlated with SCORAD (rs = -0.601, p < 0.001 and rs = -0.604, p < 0.001, respectively), but no significant correlation was found between itch and SE. A decreased quality of life was observed in adults with AD (DLQI, mean ± SD, 8.75 ± 6.7). Conclusions. Adults with AD slept worse than the controls and had a diminished quality of life. Actigraphy is a useful tool to objectively measure sleep quality in adults with AD especially those with moderate to severe disease.

Prevalence and impact of vasomotor symptoms associated with menopause among women in Brazil: Subgroup analysis from an international cross-sectional survey.

OBJECTIVE: This study assessed the prevalence and impact of moderate and/or severe vasomotor symptoms and related treatment patterns in midlife women in Brazil. STUDY DESIGN: Brazilian women aged 40 to 65 years completed an online survey. The prevalence of moderate to severe vasomotor symptoms was assessed in postmenopausal women who completed a series of questionnaires to elicit responses regarding their treatment patterns and attitudes to treatments. MAIN OUTCOME MEASURES: Perimenopausal and postmenopausal women with moderate to severe vasomotor symptoms completed three standardized questionnaires (Menopause-Specific Quality of Life questionnaire, Work Productivity and Activity Impairment questionnaire, and the Patient-Reported Outcomes Measurement Information System Sleep Disturbances Short Form 8b) and answered open-ended questions. RESULTS: Of 1244 postmenopausal women who accessed the survey, 36.2 % had experienced moderate to severe vasomotor symptoms in the previous month. Moderate to severe vasomotor symptoms among 501 perimenopausal and postmenopausal women negatively affected overall quality of life (mean total score on the Menopause-Specific Quality of Life questionnaire was 3.6/8). On the Work Productivity and Activity Impairment questionnaire, women's scores for impairments in overall work and daily activities due to vasomotor symptoms were 50.3 % and 60.0 %, respectively. Overall mean (standard deviation) score on the Patient-Reported Outcomes Measurement Information System Sleep Disturbances Short Form 8b was 25.5 (5.8) on a scale of 8 to 40. Most women sought medical advice (65.5 %), but over half were not receiving treatment. Those who received treatment reported moderately favorable attitudes to hormone and nonhormone prescription medicines, but safety concerns remained. CONCLUSION: Brazilian women experienced a relatively high prevalence and burden of moderate to severe vasomotor symptoms.

Diet and sleep quality in chilean university students.

OBJECTIVES: To evaluate an association between eating patterns and sleep quality in Chilean university students. METHODS: A cross-sectional analytical study was conducted. Participants included students from 4 Chilean universities. Each student was administered survey Questionnaire on the frequency of healthy and unhealthy eating habits and Pittsburgh Sleep Quality Index and their weight and height were taken to obtain the Body Mass Index (BMI). RESULTS: A total of 1,079 young university students, 80.26 % were women and the average age was 21.7 years. The 73.68 % have inadequate sleep quality. There is a significant differences in frequency between sleep quality and the intake of breakfast (p<0.001), fish (p<0.05) and dinner (p<0.05), that is, university students who reported optimal sleep consume breakfast and dinner on a daily basis and their fish intake is in line with nutritional recommendations. With respect to the association between sleep quality and healthy dietary patterns, it is observed a significant association (p<0.01) between optimal sleep and daily breakfast consumption in model 3 (Odds Ratio (OR): 0.61 (0.46-0.82)). Regarding unhealthy dietary patterns, a significant association (p<0.05) is observed in model 3 between sleep quality and alcohol consumption (OR: 1.42 (1.02-1.96)). Furthermore, a significant association between optimal sleep and salt consumption is observed in both model 2 (OR: 0.73 (0.54-0.99)) and model 3 (OR: 0.72 (0.53-0.97)). Finally, a significant relationship between not tobacco use and optimal sleep is observed (OR: 0.68 (0.48-0.96)). CONCLUSION: A positive relationship between healthy diet and sleep quality was observed in university students, which certain dietary patterns, such as the consumption of breakfast and low salt consumption and alcohol, are crucial to talk about a good sleep quality in this population group.

Association between sleep bruxism and snoring in adults: An observational study.

OBJECTIVE: This study evaluated the association between sleep bruxism and snoring. Additionally, the associations between sleep bruxism and age, sex, body mass index, sleep structure, sleep quality, and sleepiness were evaluated. METHODS: Adults suspected of having sleep disorders (n = 61) underwent single-night video polysomnography according to the American Academy of Sleep Medicine criteria. Validated questionnaires were used to assess sleepiness and sleep quality, and clinical examinations were performed to document weight and height. Jamovi software was used for statistical analysis. Logistic regression analyses of the different sleep stages-REM sleep, NREM sleep, and total sleep time-were conducted. RESULTS: No association was found between sleep bruxism and snoring (P > 0.31), with a small effect size (V = 0.171). However, the snore index was found to influence the rhythmic masticatory muscle activity index during REM sleep, with an odds ratio of 1.018 (95 % CI: 1.005 to 1.03; P = 0.05). Moreover, logistic regression showed that the desaturation index presented an odds ratio of 5.01 (95 % CI: 0.96 to 26.13; p = 0.056), with a medium effect size (>3.5). Sleep bruxism was not associated with age, sex, body mass index, or other sleep variables. CONCLUSION: Snoring appears to be associated with bruxism during REM sleep. No associations were found between sleep bruxism and sex, age, or body mass index. This lack of association underscores the complexity of sleep bruxism and snoring and highlights the need for further research. Concerning sleep architecture, only desaturation episodes were associated with bruxism during REM sleep. Neither sleep quality nor sleepiness was associated with sleep bruxism.

Impact of a mandibular advancement device on corticomotor plasticity in patients with obstructive sleep apnea.

BACKGROUND: Neuroplasticity induced by mandibular advancement appliance (MAD) in patients with obstructive sleep apnoea (OSA) is poorly documented. OBJECTIVE: This randomised placebo-controlled crossover mechanistic study assessed the effects of short-term use of a MAD on corticomotor excitability of the masseter and tongue in patients with OSA. METHODS: Adults (n = 28) with mild or moderate OSA were randomly allocated to sleep with a MAD for 2-weeks with 40% of the maximal protrusion (MAD active position) and without any jaw protrusion (MAD placebo position). The outcomes were assessed at baseline, and after 2 and 6 weeks, with a 2-week washout period. The primary outcome was the amplitude of motor evoked potential (MEP) assessed on the right masseter, right side of tongue and right first dorsal interosseous with transcranial magnetic stimulation. Corticomotor map volume of the same muscles was also assessed. Repeated-measures ANOVAs followed by Tukey test were applied to the data (p < .050). RESULTS: There was a significant increase in the MEP amplitude of the masseter and tongue following the MAD active position compared with the baseline and MAD placebo (Tukey: p < .001). There were no significant MEP amplitude differences between the baseline and placebo positions (p > .050). Moreover, there was a significant increase in corticomotor map volume for the masseter and tongue muscles following the MAD active position compared with baseline and MAD placebo (Tukey: p < .003). CONCLUSION: Excitability of the masseter and tongue motor pathways is, at least transiently, increased in patients with OSA following a short-term use of MAD. This novel finding of MAD-induced neuroplasticity in corticomotor pathways may contribute to a further understanding of the mechanisms of oral appliances for treating OSA.

Impact of adenotonsillectomy and palatal expansion on the apnea-hypopnea index and minimum oxygen saturation in nonobese pediatric obstructive sleep apnea with balanced maxillomandibular relationship: A cross-over randomized controlled trial.

OBJECTIVE: To determine the impact and best management sequence between adenotonsillectomy (AT) and rapid palatal expansion (RPE) on the apnea-hypopnea index (AHI) and minimum oxygen saturation (MinSaO2) in nonobese pediatric obstructive sleep apnea (OSA) patients presenting balanced maxillomandibular relationship. STUDY DESIGN/METHODS: Thirty-two nonobese children with balanced maxillomandibular relationship and a mean age of 8.8 years, with a graded III/IV tonsillar hypertrophy and maxillary constriction, participated in a cross-over randomized controlled trial. As the first intervention, one group underwent AT while the other underwent RPE. After 6 months, interventions were switched in those groups, but only to participants with an AHI > 1 after the first intervention. OSA medical diagnosis with the support of Polysomnography (PSG) was conducted before (T0), 6 months after the first (T1) and the second (T2) intervention. The influence of sex, adenotonsillar hypertrophy degree, initial AHI and MinSaO2 severity, and intervention sequence were evaluated using linear regression analysis. Intra- and intergroup comparisons for AHI and MinSaO2 were performed using ANOVA and Tukey's test. RESULTS: The initial AHI severity and intervention sequence (AT first) explained 94.9% of AHI improvement. The initial MinSaO2 severity accounted for 83.1% of MinSaO2 improvement changes. Most AHI reductions and MinSaO2 improvements were due to AT. CONCLUSIONS: Initial AHI severity and AT as the first intervention accounted for most of the AHI improvement. The initial MinSaO2 severity alone accounted for the most changes in MinSaO2 increase. In most cases, RPE had a marginal effect on AHI and MinSaO2 when adjusted for confounders.