Calidad del sueño y factores que lo alteran en los pacientes críticos en la uti en una institución privada de córdoba 2022 / Sleep quality and factors that alter it in critical patients in the icu in a private institution in Córdoba 2022

Los pacientes que están hospitalizados tienen un desequilibrio en de sus necesidades, más si hablamos de los pacientes que se encuentran en una unidad de terapia intensiva donde el movimiento es dinámico segundo a segundo debido a la inestabilidad hemodinámica de cada paciente. Una vez que se haya estabilizado la salud del paciente orientado, aparece la dificultad de poder dormir, por diversos factores que rodean al paciente ya sea intrínsecos, lo que siente la misma persona o ambientales propiamente de la terapia. Objetivo: determinar la calidad del sueño y los factores que lo alteran los pacientes orientados críticos en la Unidad de Terapia Intensiva. Metodología: estudio descriptivo y transversal, como instrumento se utilizó el cuestionario de Richard Campbell que correspondía 5 preguntas sobre la calidad del sueño y la 6ta pregunta que corresponde al Cuestionario de Freedman sobre los factores que impide obtener un sueño óptimo. Resultado: Se realizó 40 entrevistas a los pacientes orientados de la unidad intensiva de diferentes edades, sexo y patología. Conclusión: El sueño en los pacientes orientados en la unidad de terapia intensiva dio una mala calidad de sueño, es decir un sueño superficial con despertares intermitentes. Los pacientes que tuvieron más dificultad para conciliar el sueño son lo que sufrieron enfermedades respiratorias y oncológicas en los cuales influyo los factores intrínsecos la ansiedad y el extrínseco la postura corporal y el ruido[AU]

The patients who are hospitalized have an imbalance in all their needs, more so if we talk about patients who are in an intensive care unit where movement is dynamic second by second due to the hemodynamic instability of each patient. Once the health of the oriented patient has stabilized, the deficit of being able to sleep appears, due to various factors that surround the patient, whether intrinsic, what the person feels, or the environment of the therapy itself. Objective: to determine the quality of sleep and the factors that alter it in critically oriented patients in the Intensive Care Unit.Methodology: descriptive and cross-sectional study, the Richard Campbell questionnaire was used as an instrument, corresponding to 5 questions on sleep quality and the 6th question corresponding to the Freedman Question-naire on the factors that prevent optimal sleep. Result: 40 interviews were con-ducted with oriented patients from the intensive unit of different ages, sex and pathology. Conclusion: The sleep in the patients oriented in the intensive care unit gave a poor quality of sleep, that is, a superficial sleep with intermittent awakenings. The patients who had more difficulty falling asleep are those who suffered respiratory and oncological diseases in which the intrinsic factors influ-ence anxiety and the extrinsic body posture and noise[AU]

X-Chromosome Dependent Differences in the Neuronal Molecular Signatures and Their Implications in Sleep Patterns.

Biological factors and mechanisms that drive sex differences observed in sleep disturbances are understudied and poorly understood. The extent to which sex chromosome constitution impacts on sex differences in circadian patterns is still a knowledge void in the sleep medicine field. Here we focus on the neurological consequences of X-chromosome functional imbalances between males and females and how this molecular inequality might affect sex divergencies on sleep. In light of the X-chromosome inactivation mechanism in females and its implications in gene regulation, we describe sleep-related neuronal circuits and brain regions impacted by sex-biased modulations of the transcriptome and the epigenome. Benefited from recent large-scale genetic studies on the interplay between X-chromosome and brain function, we list clinically relevant genes that might play a role in sex differences in neuronal pathways. Those molecular signatures are put into the context of sleep and sleep-associated neurological phenotypes, aiming to identify biological mechanisms that link X-chromosome gene regulation to sex-biased human traits. These findings are a significant step forward in understanding how X-linked genes manifest in sleep-associated transcriptional networks and point to future research opportunities to address female-specific clinical manifestations and therapeutic responses.

Short Sleep Duration and Extremely Delayed Chronotypes in Uruguayan Youth: The Role of School Start Times and Social Constraints.

During adolescence, biological, psychosocial, and contextual factors converge in a "perfect storm" and have been put forward to explain the delay in chronotype observed at this age and the prevalence of disrupted sleep. This study provides evidence to support that chronotype and sleep patterns (particularly sleep duration) are socially constrained and to identify novel significant social predictors. Uruguayan public school activities are arranged in up to 4 shifts, creating a natural experiment to examine the effect of school timing on questionnaire-based assessments of sleep and chronotype. In this study, 268 high school students (15-18 years old) who attended school either on morning (0730 to 1130 h) or afternoon shifts (1130 h to 1530 h) responded to an adapted School Sleep Habits Survey. Students attending afternoon shifts had later chronotypes (a 1.5-h later midpoint of sleep on free days adjusted for sleep debt) than those attending the morning shift. Besides shift, evening social activities (including dinner time) were further identified as key predictors of late chronotypes, whereas age and gender were not. Sleep on school days was overall advanced and reduced with respect to weekends, and these effects were stronger in morning-shift students. Weekend sleep duration was similar between shifts, which probably caused the prevalence of reduced sleep durations (average weekly sleep duration, SDweek <8 h) to be higher in morning-shift students (almost 80%) than in afternoon-shift ones (34%). Reduced sleep duration was significantly higher in morning-shift students. In addition, age, chronotype, and dinner time became relevant determinants of sleep deficit only in the morning-shift students. Besides the important social constraint of early school start time, this is the first study to confirm the significance of other types of social pressures on both adolescents' chronotype and sleep deficit, which can be useful as potential new targets for effective policies to protect adolescent sleep.

Sleep pattern and decision-making in physicians from mobile emergency care service with 12-h work schedules.

INTRODUCTION: Shift work schedules are biological standpoint worse because compel the body to anticipate periods of wakefulness and sleep and thus eventually cause a disruption of biological rhythms. OBJECTIVE: The objective of this study is to evaluate the sleep pattern and decision-making in physicians working in mobile units of emergency attention undergoing day shift and rotating shift. METHODS: The study included 26 physicians. The instruments utilized were a sociodemographic questionnaire, the Pittsburgh Sleep Quality Index, the Sleep Habits Questionnaire, the Epworth Sleepiness Scale and Chronotype Identification Questionnaire of Horne-Ostberg, the Iowa Gambling Task (IGT) and hypothetical scenarios of decision-making created according to the Policy-Capturing Technique. For inclusion and exclusion criteria, the participants answered the Chalder Fatigue Scale, the Beck Anxiety Inventory, the Beck Depression Inventory and the Inventory of Stress Symptoms for adults of Lipp. RESULTS: It was found good sleep quality for physicians on day shift schedule and bad sleep quality for physicians on rotating shift schedule. The IGT measure showed no impairment in decision-making, but the hypothetical scenarios revealed impairment decision-making during the shift for both schedules. Good sleep quality was related to a better performance in decision-making. CONCLUSION: Good sleep quality seems to influence a better performance in decision-making.

Chronotype, social jetlag and sleep debt are associated with dietary intake among Brazilian undergraduate students.

Undergraduate students experience a form of circadian misalignment - known as "social jetlag" - that represents the discrepancy in timing between their circadian and social clocks. Whilst social jetlag is not dependent upon chronotype, the two phenomena tend to be related; evening types show a tendency to have a greater social jetlag, for example. Moreover, evening types have been found to be more likely to have inadequate eating habits than do morning types. The objective of this study was to examine the relationship between chronotype, social jetlag, perceived sleep debt and dietary intake in Brazilian undergraduate students. The chronotype was derived from mid-sleep time on free days (MSF) at the weekend. Social jetlag was calculated as the absolute difference between mid-sleep time on weekdays and weekends. Perceived sleep debt was calculated using the difference between students' preferred weekday sleep duration and their self-reported actual weekday sleep duration. Correlations were found between chronotype and breakfast time (r = 0.24, p = 0.003) and lunch time (r = 0.19, p = 0.01). Multiple regression analyses showed that chronotype was positively associated with consumption of meat (ß = 0.21; p = 0.003); social jetlag was negatively associated with consumption of beans (ß = -0.16; p = 0.02) and perceived sleep debt was positively associated with consumption of beverages (ß = 0.15; p = 0.02) and dairy products (ß = 0.17; p = 0.01) and negatively associated with consumption of cereals and pasta (ß = -0.16; p = 0.02). It is concluded that, in undergraduate students, chronotype (MSF), social jetlag and perceived sleep debt can influence the type and amount of some food groups consumed at mealtimes.