General low alertness in people with obstructive sleep apnea.

STUDY OBJECTIVES: In patients with obstructive sleep apnea (OSA), a previous study using a Go/No-Go task reported an average attention deficit. However, the temporal dynamics of such a deficit are unknown. Here, we investigated whether attention deficits in different subdomains increased as the test progressed. We also investigated the effect of target frequency and speed of stimulus presentation on performance. METHODS: Twenty-seven untreated people with OSA and 27 age- and sex-matched controls underwent a 15-minute Go/No-Go task, divided into 6 blocks. Each block was subdivided into 3 different interstimulus intervals (1, 2, and 4 seconds). Three blocks had a low and three had a high target probability (20% and 80%, respectively). Reaction time (alertness), variability of reaction time (sustained attention), commission errors (response inhibition), and omission errors (focused attention) were measured. RESULTS: Alertness was lower in the group with OSA compared with controls, as evidenced by a significantly higher average reaction time. This effect was seen from the start of the task and continued until the end but did not increase in test progression. The temporal pattern of intrinsic alertness deficits in patients with OSA was found to be independent of target frequency or interstimulus interval. CONCLUSIONS: The primary attention problem in OSA is on the alertness subdomain irrespective of the number of required responses or speed of stimulus presentation. The present results support the notion that OSA is distinct from other neurological and psychiatric conditions, such as depression or chronic pain. The results also suggest significant concerns regarding daily life activities (eg, driving). CITATION: de Souza Bezerra ML, van Duinkerken E, Simões E, Schmidt SL. General low alertness in people with obstructive sleep apnea. J Clin Sleep Med. 2024;20(5):689-698.

Sleep disorders among undergraduate students in Southern Brazil.

PURPOSE: Sleep disorders are very common in the young, being a result of the typical lifestyle lived by young people or a sleep disease that requires assistance and treatment. Furthermore, according to previous findings, sleep alterations can favor the development of depressive mood disorder. This survey aimed to assess the prevalence and characteristics of sleep disorders in a young population sample and their association with depressive symptoms. METHODS: With a cross-sectional study design, self-administered questionnaires were applied to 1,180 undergraduate students. The Mini-Sleep Questionnaire (MSQ) and the Beck Depression Inventory were used to evaluate sleep disturbances and depressive symptoms, respectively. Bivariate and multivariate analyses were conducted, with the main findings being the presence of disrupted sleep (MSQ > 24), with an alpha error of 5%. The median point of the MSQ was 26 (P25-P75, 21-32 points). RESULTS: Sleep alterations were found in 59.6%. The prevalence of depression was 9.3% (n = 110), mild depression being identified in 5.9% (n = 62), moderate in 3.4% (n = 40), and severe in 0.7% (n = 8) of the students. In logistic regression, female gender (OR, 1.48; CI 95%, 1.09-2.01; P = 0.012) and being depressed (OR, 4.42; CI 95%, 2.30-8.50; P < 0.001) were independent factors for disrupted sleep. CONCLUSIONS: Sleep alterations are prevalent complaints among young people, being present in nearly 60% of the students. Female gender and being depressed are independent factors for having some form of sleep disorder.

Consistency and reliability of the Brazilian Portuguese version of the Mini-Sleep Questionnaire in undergraduate students.

PURPOSE: Questionnaires are indispensable tools in epidemiologic studies and clinical surveys. Many questionnaires focusing on sleep disorders have been described in the literature. This cross-sectional study is aimed to assess the consistency and reliability of the Brazilian Portuguese Version of the Mini-Sleep Questionnaire (MSQ-BR). METHODS: Self-administered questionnaires were given to a sample of 1,108 undergraduate students. The variables collected were age, gender, socioeconomic level, and MSQ-BR scores. A subgroup of 53 students was randomly chosen to test the test-retest reliability of the instrument. Internal consistency of total MSQ-BR and its subscales (i.e., insomnia and hypersomnia) was evaluated using Cronbach's alpha coefficient. RESULTS: Our results showed good internal consistency of total MSQ-BR score, with a Cronbach's alpha value of 0.770. The insomnia subscale had an adequate internal consistency (Cronbach's alpha, 0.749). On the other hand, the hypersomnia subscale had moderate internal consistency (Cronbach's alpha, 0.624). The test-retest analysis showed good reliability of the instrument using Pearson's correlation coefficient. CONCLUSIONS: The MSQ-BR has adequate internal consistency and test-retest reliability. The MSQ-BR insomnia has adequate internal consistency for use as a separate application. However, the MSQ-BR hypersomnia demonstrated only moderate internal consistency for use as a separate application. Our intention was not to introduce modifications to the questionnaire, but to evaluate the reliability of total MSQ-BR and its subscales. Others studies are needed to assess the consistency of MSQ compared to other instruments.