Association of Meal Timing with Sleep Quality and Anxiety According to Chronotype: A Study of University Students.

There are several determinants of mental health symptoms, ranging from individual characteristics to social factors. Consistent with patterns in the general population, students with evening characteristics tend to exhibit more anxiety symptoms and poorer sleep quality compared to morning students. Meal timing also appears to affect sleep and may be associated with mental health symptoms. In this context, the aim of the present study was to investigate the association of the timing of the main and last meals of the day with sleep quality and anxiety levels, according to the chronotype of university students. This study was conducted in colleges in São Paulo, Brazil, and involved application of a questionnaire to 162 university students. The questionnaire collected sociodemographic information meal and study times, and included scales assessing eveningness and morningness, sleep quality, and anxiety. Students demonstrating a phase delay in both chronotype and dinner timing exhibited higher levels of anxiety compared to morning-type students. Although no associations were observed between meal timing and sleep quality, sleeping later was associated with poorer sleep quality. The study suggests that evening students and those who eat late at night are more prone to presenting mental health symptoms. More studies are needed to further investigate this association.

Different sleep patterns during the COVID-19 pandemic: association with mood, exercise and light exposure.

The aim was to evaluate the sleep-wake cycle pattern, mood, perceived stress and some behaviors, such as physical exercise and exposure to natural light of college students during the COVID-19 pandemic. This is a cross-sectional study conducted between June and August 2020 using an electronic form provided by Google. The sample consisted of undergraduate students aged between 18 and 30 years old and residents of the northeast region of Brazil. The students generally had sleepiness and poor sleep quality, high levels of anxiety, mild to moderate depressive symptoms and moderate perceived stress. Some of these aspects were worse in women. The college students showed three sleep patterns: one group had good sleep quality without excessive daytime sleepiness; another group had poor sleep quality, but no excessive daytime sleepiness; and a third group had high daytime sleepiness, and less expressive sleep quality impairment. Greater exposure to sunlight and practicing physical exercise predominated in individuals with better sleep quality, suggesting that they are protective factors. In addition, excessive daytime sleepiness and poor sleep quality were separately associated with higher anxiety, depression and stress perception levels, proving to be important aspects for care in order to favor mental health during the pandemic. In conclusion, it is suggested that the COVID-19 pandemic affected the sleep of college students in a heterogeneous way. The differentiated sleep patterns are associated with exposure to natural light and exercising.

Predictors of stress in college students during the COVID-19 pandemic.

Background: College students experience high stress levels during emergency remote classes in the COVID-19 pandemic. However, it is not clear whether this is due to the summation effect of both stressors (classes and pandemic). Therefore, the aim of this study was to investigate predictors of stress in college students before and during remote classes five months after the beginning of the COVID-19 pandemic. Methods: The study was conducted before (BRC, July-August 2020) and during remote classes (DRC, October-November 2020). The sample consisted of 177 individuals (80 in BRC, 97 in DRC). Students were asked to self-collect saliva for cortisol analysis at each moment of the study, and to fill out a form to characterize the individual and assess the chronotype (Morningness-Eveningness Questionnaire), sleep quality (Pittsburgh Sleep Quality Index) and the stress (Perceived Stress Scale-10). Results: There was no difference between the evaluated periods for cortisol, perceived stress or sleep quality. Predictors for cortisol levels were gender, academic semester, chronotype, sleep quality and sadness due to pandemic (p<0.001). Limitations: Short interval between BRC and DRC assessments of perceived stress and salivary cortisol. Conclusions: Age, sex, income, academic semester, chronotype, and the impact of the pandemic on mood are predictors of stress among college students. In addition, emergency remote classes and sleep quality contribute to less stress.

Structural differences between REM and non-REM dream reports assessed by graph analysis.

Dream reports collected after rapid eye movement sleep (REM) awakenings are, on average, longer, more vivid, bizarre, emotional and story-like compared to those collected after non-REM. However, a comparison of the word-to-word structural organization of dream reports is lacking, and traditional measures that distinguish REM and non-REM dreaming may be confounded by report length. This problem is amenable to the analysis of dream reports as non-semantic directed word graphs, which provide a structural assessment of oral reports, while controlling for individual differences in verbosity. Against this background, the present study had two main aims: Firstly, to investigate differences in graph structure between REM and non-REM dream reports, and secondly, to evaluate how non-semantic directed word graph analysis compares to the widely used measure of report length in dream analysis. To do this, we analyzed a set of 133 dream reports obtained from 20 participants in controlled laboratory awakenings from REM and N2 sleep. We found that: (1) graphs from REM sleep possess a larger connectedness compared to those from N2; (2) measures of graph structure can predict ratings of dream complexity, where increases in connectedness and decreases in randomness are observed in relation to increasing dream report complexity; and (3) measures of the Largest Connected Component of a graph can improve a model containing report length in predicting sleep stage and dream report complexity. These results indicate that dream reports sampled after REM awakening have on average a larger connectedness compared to those sampled after N2 (i.e. words recur with a longer range), a difference which appears to be related to underlying differences in dream complexity. Altogether, graph analysis represents a promising method for dream research, due to its automated nature and potential to complement report length in dream analysis.

Uso da actigrafia na avaliação do ritmo atividade-repouso em pacientes com doença de Parkinson / Use of actigraphy on assessment of activity-rest rhythm in patients with Parkinson's disease

Distúrbios do sono são os mais comuns sintomas não-motores encontrados na doença de Parkinson (DP). OBJETIVOS: Avaliar a relação entre actigrafia e distúrbios do sono mais incidentes na DP. MÉTODOS: Pacientes com e sem DP foram avaliados quanto aos sintomas motores, qualidade do sono, cronotipo e objetivamente através do uso do actímetro. RESULTADOS: Encontrou-se uma significante redução da qualidade do sono entre os pacientes com DP (p = 0.0023), uma pior qualidade subjetiva do sono, maior uso de medicamentos para insônia, mais distúrbios do sono e uma maior fragmentação do ritmo atividade-repouso (IV) (p=0.0271). CONCLUSÃO: Pacientes com DP possuem uma pior qualidade de sono e um ritmo atividade-repouso mais fragmentado. A actigrafia pode ser útil na avaliação da qualidade do sono e do ciclo atividade repouso em pacientes com DP, contribuindo para o rastreio e acompanhamento de eventuais distúrbios do ritmo circadiano a esta doença associados. (AU)

Sleep disorders are the most common non-motor symptom found in Parkinson's Disease (PD). OBJECTIVES: To evaluate the relationship between actigraphy and more incidents sleep disorders in PD. METHODS: Patients with and without PD were assessed regarding motor symptoms, sleep quality, chronotype and objectively through the use of an actimeter. RESULTS: It was found a significant reduction of sleep quality among the patients with PD (p = 0.0023), a worse subjective sleep quality, they used more medications to sleep, they had more sleep disorders and a significantly higher fragmentation of pace (IV) (p = 0.0271). CONCLUSION: Patients with PD have a worse sleep quality and a rest-activity rythm fragmented. Actigraphy can be useful for assessing the quality of sleep and activity/rest cycle in patients with PD, contributing to the screening and follow-up of any circadian rhythm disorders associated to this disease. (AU)

Efeitos agudos do exercício físico no tratamento da dependência química / Acute effects of physical exercise in addiction treatment / Efectos agudos del ejercicio físico en el tratamiento de la adicción

Resumo Foram avaliados os efeitos do exercício físico na capacidade de atenção, na memória, no desejo de usar drogas, na percepção de esforço e prazer e no estado de humor de 16 indivíduos em tratamento para dependência de drogas. Foram usados a escala de Brunel, o teste de cancelamento de números, o teste dos blocos de Corsi, a escala de Borg e escala de valência afetiva ao esforço físico nas situações controle, pré e pós-realização de uma sessão de exercícios físicos (60 min). Foi observada redução no desejo de usar drogas e no tempo de execução do teste de cancelamento de números, e aumento no número de blocos recordados. Os resultados apontam a importância do profissional da educação física nas equipes para tratamento da dependência química.

Abstract We evaluated the effects of exercise on alertness and memory, the desire to use drugs, the perception of effort and pleasure and mood state, of 16 individuals in treatment for drug addiction. We used tests and scales to assess mood, attention, memory, perceived effort and affect related to exercise, in the situations: Control, Pre and Post completion of an exercise session (60 min). We observed a significant reduction in the desire to use drugs and in the execution time of the test cancellation numbers, and an increase of the number of blocks recalled. The results support the importance of the Professional of Physical Education for treatment of chemical dependency.

Resumen Se evaluaron los efectos del ejercicio físico en el estado de alerta, memoria, el deseo de consumir drogas, la percepción del esfuerzo y placer, y en el estado de ánimo de 16 personas en tratamiento por adicción a las drogas. Se utilizaron pruebas y escalas para evaluar el estado de ánimo, la atención, la memoria visuoespacial, el esfuerzo y el afecto percibido en relación con el ejercicio físico en situaciones de: control, previamente y posteriormente a la finalización de una sesión de ejercicio (60 min). Se observó una reducción del deseo de consumir drogas y del tiempo de ejecución del test de cancelación de números y un aumento del número de bloques recordados. Los resultados indican la importancia de los profesionales de la educación física en el tratamiento de la dependencia química.

A fresh look at the use of nonparametric analysis in actimetry.

Actimetry has been used to estimate the sleep-wake cycle instead of the rest-activity rhythm. Although algorithms for assessing sleep from actimetry data exist, it is useful to analyze the rest-activity rhythm using nonparametric methods. This would then allow rest-activity rhythm stability, fragmentation and amplitude to be quantified. In addition, sleep and wakefulness efficiency can be quantified separately. These variables have been used in studies analyzing the effect of age, diseases and their respective treatments on human circadian rhythmicity. In this study, we carried out a comprehensive analysis of the main results from published articles and devised a functional model of interaction among the several components involved in generating the sleep-wake cycle. The nonparametric variables render it possible to infer the main characteristics of circadian rhythms, such as synchronization with a zeitgeber, and its amplitude and robustness.

Sleep and frailty syndrome in elderly residents of long-stay institutions: a cross-sectional study.

AIM: Aging changes sleep patterns in most elderly people. Frailty shares a number of characteristics with sleep disorders and leads to similar results. However, their relationship in residents of long-stay institutions remains unclear. Thus, the present study aimed to evaluate the relationship between sleep and frailty syndrome in residents of long-stay institutions. METHODS: This was a cross-sectional study of 69 institutionalized elderly in the city of João Pessoa, Brazil. The Pittsburg Sleep Quality Index, actimetry and specific tests for frailty phenotype variables were used. Pearson's χ(2)-test, one-way anova and multiple linear regression were applied in statistical analysis. RESULTS: The sample was characterized as predominantly frail (49.3%), mainly women (62.3%), with a mean age of 77.52 years (± 7.82). Frail elderly exhibited poor sleep quality, when compared with non-frail individuals (P = 0.02). In the multiple linear regression analysis, sleep latency (R(2) = 0.11, P = 0.003) and sleep quality (R(2) = 0.08, P = 0.013) had an influence on frailty, especially sleep quality. No differences were found between rest-activity pattern and frailty phenotype. CONCLUSION: Sleep alterations, including poor sleep quality and prolonged latency, were related to frailty in institutionalized elderly.

Circadian and homeostatic changes of sleep-wake and quality of life in stroke: implications for neurorehabilitation.

The present study aimed to assess changes in the circadian and homeostatic control of the sleep-wake pattern in stroke patients and correlations with quality of life. Participants were 22 patients (55 ± 12 years) and 24 healthy subjects (57 ± 11 years). Instruments used were: the Pittsburgh Sleep Quality Index, SF-36 Questionnaire and Actigraphy. Data were analyzed by Mann-Whitney test and Spearman's correlation. Results identified a significant difference in sleep quality and quality of life between patients and healthy subjects, with patients on average exhibiting poor sleep quality (patients: 8.4 ± 3.4; healthy subjects: 6.2 ± 2.5; p = 0.0001) and low quality of life scores (p < 0.001). Correlation analysis detected an association between circadian variables (total activity, start and finish times of activity) and quality of life (p < 0.001). Associations between homeostatic variables (sleep duration, latency and efficiency) and quality of life were also significant (p < 0.001). In conclusion, results in this study showed compromised sleep quality and quality of life in the patients evaluated, associated with circadian and homeostatic alterations. This suggests that complaints regarding poor sleep quality be taken into consideration when planning the rehabilitation of stroke patients.

Sciatic nerve grafting and inoculation of FGF-2 promotes improvement of motor behavior and fiber regrowth in rats with spinal cord transection.

PURPOSE: Failure of severed adult central nervous system (CNS) axons to regenerate could be attributed with a reduced intrinsic growing capacity. Severe spinal cord injury is frequently associated with a permanent loss of function because the surviving neurons are impaired to regrow their fibers and to reestablish functional contacts. Peripheral nerves are known as good substrate for bridging CNS trauma with neurotrophic factor addition. We evaluated whether fibroblastic growth factor 2 (FGF-2) placed in a gap promoted by complete transection of the spinal cord may increase the ability of sciatic nerve graft to enhance motor recovery and fibers regrow. METHODS: We used a complete spinal cord transection model. Rats received a 4 mm-long gap at low thoracic level and were repaired with saline (control) or fragment of the sciatic nerve (Nerve) or FGF-2 was added to nerve fragment (Nerve+FGF-2) to the grafts immediately after complete transection. The hind limbs performance was evaluated weekly for 8 weeks by using motor behavior score (BBB) and sensorimotor tests-linked to the combined behavior score (CBS), which indicate the degree of the motor improvement and the percentage of functional deficit, respectively. Neuronal plasticity were evaluated at the epicenter of the injury using MAP-2 and GAP-43 expression. RESULTS: Spinal cord treatment with sciatic nerve and sciatic nerve plus FGF-2 allowed recovery of hind limb movements compared to control, manifested by significantly higher behavioral scores. Higher amounts of MAP-2 and GAP-43 immunoreactive fibers were found in the epicenter of the graft when FGF-2 was added. CONCLUSIONS: FGF-2 added to the nerve graft favored the motor recovery and fiber regrowth. Thus, these results encourage us to explore autologous transplantation as a novel and promising cell therapy for treatment of spinal cord lesion.

Does the chronotype classification need to be updated? Preliminary findings.

Traditionally, chronotype classification is based on the Morningness-Eveningness Questionnaire (MEQ). It is implicit in the classification that intermediate individuals get intermediate scores to most of the MEQ questions. However, a small group of individuals has a different pattern of answers. In some questions, they answer as "morning-types" and in some others they answer as "evening-types," resulting in an intermediate total score. "Evening-type" and "Morning-type" answers were set as A(1) and A(4), respectively. Intermediate answers were set as A(2) and A(3). The following algorithm was applied: Bimodality Index = (Sigma A(1) x Sigma A(4))(2) - (Sigma A(2) x Sigma A(3))(2). Neither-types that had positive bimodality scores were classified as bimodal. If our hypothesis is validated by objective data, an update of chronotype classification will be required.

The food-entrainable oscillator: a network of interconnected brain structures entrained by humoral signals?

Food is critical for all animal species. Its temporal availability is a relevant signal for organizing behavioral and physiological parameters. When food is restricted to a few hours per day, rats, mice, and other mammals exhibit anticipatory activity before mealtime (food-anticipatory activity). There is considerable evidence suggesting that this anticipation is mediated by a food-entrainable oscillator (FEO) with circadian properties, but located outside the suprachiasmatic nucleus of the hypothalamus (the light-entrainable oscillator). However, the locus of the FEO as well as the mechanisms by which food entrainment occurs is unclear. In this review, we summarize data about the potential input pathways to the FEO and propose a model for understanding it as a network of interconnected brain structures entrained by fluctuation of different humoral signals.

The impact of different shift work schedules on the levels of anxiety and stress in workers in a petrochemicals company / O impacto dos diferentes esquemas de trabalhos em turnos nos níveis de ansiedade e de stress dos trabalhadores de uma empresa petroquímica

This study evaluated anxiety and stress in workers under different shift work conditions. The sample comprised 239 workers, with an average age of 42.6, standard deviation = 5.7 years, divided into fixed daytime working (n=52) and different working shifts (n=187). Documentation: Free and informed consent form; ID's; State-Trait Anxiety Inventory; Lipp's Stress Symptom Inventory for Adults. We used the t-test for independent samples, ANOVA, Pearson's correlation and the two-sample Comparison of proportions Test. Results showed that shift workers had higher State-Trait Anxiety scores than fixed daytime workers (t=-4.994; p=0.0001; t=-2.816; p=0.005, respectively). Both samples exhibited stress, but there were no statistically significant differences between the groups (t=-1.052; p=0.294). Shift work schedules caused more situational and dispositional anxiety, but did not significantly increase stress levels when compared to fixed daytime working.

Este trabalho avaliou ansiedade e estresse em trabalhadores em diferentes esquemas de trabalhos. Participaram 239 trabalhadores, idade média 42,6, desvio-padrão = 5,7 anos, divididos em trabalho diurno fixo (n=52) e diferentes trabalhos em turno (n=187). Protocolos: Termo de Consentimento Livre e Esclarecido, Ficha de Identificação, Inventário de Ansiedade Traço-Estado, Inventário de Sintomas de Stress para Adultos de Lipp. Foram utilizados teste t para amostras independentes, ANOVA, teste de correlação de Pearson e teste de Comparação de Proporções. Os resultados mostraram que os trabalhadores em turnos apresentaram maiores escores de Ansiedade Traço-Estado quando comparados com os trabalhadores diurnos fixos (t=-4,994, p=0,0001; t=-2,816, p=0,005, respectivamente). As duas amostras apresentaram stress, mas não houve diferenças estatisticamente significativas entre os grupos (t=-1,052; p=0,294). Esquemas de trabalhos em turnos causam mais ansiedade situacional e disposicional, mas não elevam significativamente níveis de stress quando comparados com diurnos fixos.

Circadian pattern of wheel-running activity of a South American subterranean rodent (Ctenomys cf knightii).

Circadian rhythms are regarded as essentially ubiquitous features of animal behavior and are thought to confer important adaptive advantages. However, although circadian systems of rodents have been among the most extensively studied, most comparative biology is restricted to a few related species. In this study, the circadian organization of locomotor activity was studied in the subterranean, solitary north Argentinean rodent, Ctenomys knightii. The genus, Ctenomys, commonly known as Tuco-tucos, comprises more than 50 known species over a range that extends from 12 degrees S latitude into Patagonia, and includes at least one social species. The genus, therefore, is ideal for comparative and ecological studies of circadian rhythms. Ctenomys knightii is the first of these to be studied for its circadian behavior. All animals were wild caught but adapted quickly to laboratory conditions, with clear and precise activity-rest rhythms in a light-dark (LD) cycle and strongly nocturnal wheel running behavior. In constant dark (DD), the rhythm expression persisted with free-running periods always longer than 24 h. Upon reinstatement of the LD cycle, rhythms resynchronized rapidly with large phase advances in 7/8 animals. In constant light (LL), six animals had free-running periods shorter than in DD, and 4/8 showed evidence of "splitting." We conclude that under laboratory conditions, in wheel-running cages, this species shows a clear nocturnal rhythmic organization controlled by an endogenous circadian oscillator that is entrained to 24 h LD cycles, predominantly by light-induced advances, and shows the same interindividual variable responses to constant light as reported in other non-subterranean species. These data are the first step toward understanding the chronobiology of the largest genus of subterranean rodents.

Dissociation of the circadian rhythm of locomotor activity in a 22 h light-dark cycle impairs passive avoidance but not object recognition memory in rats.

We analyzed the effect of dissociation of the circadian rhythm of locomotor activity on the performance in two memory tasks in rats. One group of animals was maintained in a normal 24 h light-dark cycle of 12:12 (T24 group, control). A second group was housed in a 22 h cycle of 11:11 (T22 group, experimental), a condition which is known to produce dissociation of the circadian rhythm of locomotor activity in two components. Both groups were tested on two memory tasks: passive avoidance and object recognition. An additional control group, kept under constant darkness (DD group), was used for a passive avoidance task. Testing occurred 30 min (short-term memory--STM) and 24 h (T24 and DD group) or 22 h (T22 group) (long-term memory--LTM) after training. The T22 group showed impairment on the passive avoidance task (STM and LTM) compared with the T24 and DD groups. On the object recognition task, the T22 and T24 groups performed similarly in all the sessions. In conclusion, circadian rhythm dissociation induced a performance deficit in the passive avoidance task but had no effect on the object recognition task. We suggest that dissociation of the circadian rhythm of locomotor activity may selectively affect some emotional component related to fear and risk evaluation.

Perfil cognitivo em idosas de dois serviços públicos em São Luís - MA / Socio-demographic factors affecting cognitive performance in older women

CONTEXTO: Este estudo procurou estabelecer, sob o ponto de vista descritivo, o nível de cognição e variáveis sociodemográficas associadas em mulheres da sétima à nona década, em dois serviços públicos, na cidade de São Luís (MA). OBJETIVOS: Estudar o nível de cognição pelo Miniexame do Estado Mental (MMSE) e variáveis sociodemográficas associadas em mulheres da sétima à nona década, em dois serviços públicos, na cidade de São Luís (MA). MÉTODOS: Durante quatro meses um questionário com as variáveis sociodemográficas e o Miniexame do Estado Mental (MMSE) foram aplicados em pacientes ambulatoriais. As voluntárias foram avaliadas nos ambulatórios de Neurologia do Hospital Universitário Presidente Dutra e do Hospital Estadual Carlos Macieira. RESULTADOS: Oitenta pacientes foram avaliadas - 31,2 por cento foram classificadas com transtorno cognitivo ao MEEM; 71,4 por cento destas tinham entre 81 e 85 anos. Transtorno cognitivo estava presente em 65 por cento das pacientes com nível educacional inferior a sete anos. Em relação ao nível de renda e cognição, foi observado que 30,4 por cento das pacientes que apresentavam nível de renda menor que um a dois salários mínimos eram classificadas com transtorno cognitivo. Das 33 voluntárias que tinham cuidador direto, 57,6 por cento apresentavam transtorno cognitivo. CONCLUSÕES: O estudo torna-se de relevância, pois permite se atentar para o problema na região e serve de estímulo para estudos metodológicos mais complexos, visando promover a saúde pública mental do idoso.

BACKGROUND: This study aims to establish a descriptive study about the cognition level and correlated socio-demographic variables, of the female sex, from the seventh to the nineth decade in two public services in the city of São Luís (MA). OBJECTIVES: Study about the cognition level with Mini Mental State Examination (MMSE) and correlated socio-demographic variables, of the female sex, from the seventh to the nineth decade in two public services in the city of São Luís (MA). METHODS: During four months, a questionnaire with socio-demographic variables and the Mini Mental State Examination (MMSE) were applied in the patients attending. The voluntaries were evaluated in the Neurology clinics of the University Hospitals President Dutra and Statue Carlos Macieira. RESULTS: Eighty patients were evaluated - 31,2 percent were classified by MEEM with the cognitive troubles; 71,4 percent of these were between 81 and 85 years old. Cognitive disorder was present in 65 percent of the patients who had less education up to seven years. As for income and cognition level, it was observed that 30,4 percent of the volunteers who presented an income level lower than one to two minimum wage were classified with cognitive disturbances. From the 33 volunteers that had direct care, 57,6 percent presented cognitive disturbances. DISCUSSION: The study becomes relevant, because it allows to attempt to the problem in that region and it serves as a stimulus for the more complex methodological studies seeking to promote the elderly public mental health.

Qualidade subjetiva do sono em pacientes com transtorno depressivo / Subjective sleep quality in patients with depressive disorder

O objetivo deste estudo foi avaliar a qualidade subjetiva do sono em pacientes com transtorno depressivo. Setenta pacientes (44 mulheres e 26 homens) ambulatoriais com diagnóstico de transtorno depressivo foram entrevistados e responderam ao Índice de Qualidade de Sono de Pittsburgh (IQSP), ao Questionário de Hábitos do Sono e ao Inventário de Depressão de Beck (BDI). As médias das pontuações globais do IQSP e BDI foram respectivamente 12,80 ± 3,77 e 35,83 ± 8,85, e a correlação foi positiva e significativa entre essas escalas (r = 0,70; p < 0,05). As pontuações globais do IQSP em pacientes com insônia (16,61 ± 4,21) e hipersonia (8,82 ± 2,71) apresentaram diferenças marcantes (p < 0,05). Os resultados da análise multivariada indicaram que apenas a insônia foi significativamente associada à qualidade subjetiva do sono (RC = 4,1; 95 por cento IC = 2,0-4,2). Os resultados sugerem que os pacientes da amostra apresentaram percepção inferior da qualidade subjetiva do sono, principalmente na insônia.

The aim of this study was to evaluate subjective sleep quality in patients with depressive disorder. Seventy outpatients (44 women and 26 men) with diagnosis of depressive disorder were interviewed and answered the Pittsburgh Sleep Quality Index (PSQI), the Sleep Habits questionnaire and the Beck Depression Inventory (BDI). Mean PSQI and BDI global scores were 12.80 ± 3.77 and 35.83 ± 8.85, respectively and correlation was positive and significant between these scales (r = 0.70; p < 0.05). The global PSQI scores of patients with insomnia (16.61 ± 4.21) and excessive sleepiness (8.82 ± 2.71) had marked differences (p < 0.05). The results of multivariate analysis indicated that only insomnia had a significant association with subjective sleep quality (OR = 4.1; 95 percent CI = 2.0-4.2). These results suggest that patients with depressive disorder of the study sample experienced poor subjective sleep quality, particularly in insomnia.

Qualidade subjetiva do sono em pacientes com transtorno depressivo / Subjective sleep quality in patients with depressive disorder

O objetivo deste estudo foi avaliar a qualidade subjetiva do sono em pacientes com transtorno depressivo. Setenta pacientes (44 mulheres e 26 homens) ambulatoriais com diagnóstico de transtorno depressivo foram entrevistados e responderam ao Índice de Qualidade de Sono de Pittsburgh (IQSP), ao Questionário de Hábitos do Sono e ao Inventário de Depressão de Beck (BDI). As médias das pontuações globais do IQSP e BDI foram respectivamente 12,80 ± 3,77 e 35,83 ± 8,85, e a correlação foi positiva e significativa entre essas escalas (r = 0,70; p < 0,05). As pontuações globais do IQSP em pacientes com insônia (16,61 ± 4,21) e hipersonia (8,82 ± 2,71) apresentaram diferenças marcantes (p < 0,05). Os resultados da análise multivariada indicaram que apenas a insônia foi significativamente associada à qualidade subjetiva do sono (RC = 4,1; 95 por cento IC = 2,0-4,2). Os resultados sugerem que os pacientes da amostra apresentaram percepção inferior da qualidade subjetiva do sono, principalmente na insônia.(AU)

The aim of this study was to evaluate subjective sleep quality in patients with depressive disorder. Seventy outpatients (44 women and 26 men) with diagnosis of depressive disorder were interviewed and answered the Pittsburgh Sleep Quality Index (PSQI), the Sleep Habits questionnaire and the Beck Depression Inventory (BDI). Mean PSQI and BDI global scores were 12.80 ± 3.77 and 35.83 ± 8.85, respectively and correlation was positive and significant between these scales (r = 0.70; p < 0.05). The global PSQI scores of patients with insomnia (16.61 ± 4.21) and excessive sleepiness (8.82 ± 2.71) had marked differences (p < 0.05). The results of multivariate analysis indicated that only insomnia had a significant association with subjective sleep quality (OR = 4.1; 95 percent CI = 2.0-4.2). These results suggest that patients with depressive disorder of the study sample experienced poor subjective sleep quality, particularly in insomnia.(AU)

Sleep disorders and suicidal ideation in patients with depressive disorder.

An intrinsic association between suicidal ideation and sleep disorders in patients with depressive disorder has been observed in recent studies. This study was conducted in order to examine the relationship between suicidal ideation and sleep disorders, such as insomnia and excessive sleepiness, in outpatients with major depressive disorder. Seventy patients with diagnoses of major depressive disorder were interviewed and assessed with the Sleep Habits Questionnaire and the Beck Scale for Suicidal Ideation (SSI). Data analyses were performed through descriptive analysis, Students t-test, Chi-square test and logistic regression model, with a statistical significance of 5%. In this study, depressed patients had high SSI scores (6.12+/-2.67), particularly for active suicidal ideation (1.61+/-0.39) and specific plans for suicide components (1.51+/-0.40). Depressed patients with insomnia had significantly higher SSI scores (7.39+/-2.84), in relation to patients with excessive sleepiness (3.68+/-1.73). Furthermore it was observed that insomniac patients had significantly higher scores on the following components: active suicide ideation, specific plans for suicide and previous suicide attempts. The results of multivariate analysis showed that only insomnia had a significant association with suicidal ideation. Thus, sleep disturbances, particularly insomnia, should be considered in the assessment of suicidal risk in outpatients with depressive disorder.

Confiabilidade e reprodutibilidade do Questionário de Hábitos do Sono em pacientes depressivos ambulatoriais / Reability and reproducibility of the Sleep Habits Questionnaire in depressed outpatients

CONTEXTO: Estudos recentes sugerem que, em concomitância com a avaliação clínica, a utilização de questionários do sono permite melhor caracterizar as queixas de sono alterado em pacientes depressivos. OBJETIVO: Determinar a confiabilidade e a reprodutibilidade do Questionário de Hábitos do Sono na identificação das queixas de transtornos do sono, como a insônia e a sonolência excessiva, em pacientes ambulatoriais com transtorno depressivo. MÉTODOS: Realizou-se um estudo transversal com uma amostra de 70 pacientes depressivos no ambulatório de psiquiatria de um hospital geral. Os pacientes foram entrevistados e avaliados por meio do Questionário de Hábitos do Sono em dois momentos, sendo utilizado um desenho de estudo de confiabilidade teste-reteste das respostas que foram analisadas e estimadas pelo coeficiente Kappa. RESULTADOS: Na análise de confiabilidade e de reprodutibilidade, o coeficiente Kappa obteve um nível de concordância forte (0,73 a 0,80) em grande parte das questões, com a maioria dos coeficientes acima de 0,75. CONCLUSÕES: O Questionário de Hábitos do Sono mostrou ser confiável na avaliação das queixas de insônia e de sonolência excessiva em pacientes depressivos ambulatoriais.

BACKGROUND: Recent studies suggest that, together with clinical assessment, sleep questionnaires can adequately characterize sleep complaints in depressed patients. OBJECTIVE: To determine reability and reproducibility of the Sleep Habits Questionnaire in the identification of sleep disorder complaints, such as insomnia and excessive sleepiness, in depressed outpatients. METHODS: A cross-sectional study with a study sample of 70 depressed patients was conducted in the psychiatry outpatient unit of a general hospital. Patients were interviewed and evaluated by the Sleep Habits in two moments and the study design included a test-retest reliability of the answers, which were analyzed and estimated by means of Kappa coefficient. RESULTS: In the reliability and reproducibility analysis, the Kappa coefficient showed high levels of concordance (0.73 a 0.80) for most questions, and in most of the items coefficients were above 0.75. CONCLUSIONS: The Sleep Habits Questionnaire proved to be reliable for the evaluation of insomnia and excessive sleepiness complaints in depressed outpatients.