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1.
Rev Saude Publica ; 53: 82, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576942

RESUMO

OBJECTIVE: To estimate the prevalence of poor self-rated sleep and to identify the population subgroups most susceptible to the problem. METHODS: This is a cross-sectional, population-based study developed with data from the Health Survey conducted in the city of Campinas (ISACamp 2014/2015). Data from a sample of 1,998 individuals aged 20 years or older were analyzed. The self-rated quality of sleep was analyzed according to socio-demographic characteristics, morbidities, health behaviors and feeling of well-being. The association of sleep quality with different complaints and characteristics of sleep was also analyzed. Adjusted prevalence ratios were estimed using Poisson multiple regression model allowing for the sample weights. RESULTS: Prevalence of poor self-rated sleep was 29.1% and showed to be significantly higher in women, in individuals aged from 40 to 50 years, migrants, without occupation, physically inactive in leisure context, with common mental disorder (PR = 1.59), with greater number of health problems (PR = 2.33), poor self-rated health (PR = 1.61), and life dissatisfaction. Poor sleep was strongly associated with reports of difficulty in initiating sleep (PR = 4.17), in maintaining sleep (PR = 4.40) and with never or almost never feeling well when waking up (PR = 4.52). CONCLUSIONS: The results identify the population subgroups with poor quality of sleep that deserve greater attention. It also highlight the need to consider, in addition to the presence of comorbidities, mental health and the feeling of well-being in the care of patients with sleep problems and in the interventions planed for promoting healthy sleep.


Assuntos
Qualidade de Vida , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/fisiopatologia , Sono/fisiologia , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Autoimagem , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
2.
Rev. saúde pública (Online) ; 53: 82, jan. 2019. tab
Artigo em Inglês | LILACS-Express | ID: biblio-1043331

RESUMO

ABSTRACT OBJECTIVE To estimate the prevalence of poor self-rated sleep and to identify the population subgroups most susceptible to the problem. METHODS This is a cross-sectional, population-based study developed with data from the Health Survey conducted in the city of Campinas (ISACamp 2014/2015). Data from a sample of 1,998 individuals aged 20 years or older were analyzed. The self-rated quality of sleep was analyzed according to socio-demographic characteristics, morbidities, health behaviors and feeling of well-being. The association of sleep quality with different complaints and characteristics of sleep was also analyzed. Adjusted prevalence ratios were estimed using Poisson multiple regression model allowing for the sample weights. RESULTS Prevalence of poor self-rated sleep was 29.1% and showed to be significantly higher in women, in individuals aged from 40 to 50 years, migrants, without occupation, physically inactive in leisure context, with common mental disorder (PR = 1.59), with greater number of health problems (PR = 2.33), poor self-rated health (PR = 1.61), and life dissatisfaction. Poor sleep was strongly associated with reports of difficulty in initiating sleep (PR = 4.17), in maintaining sleep (PR = 4.40) and with never or almost never feeling well when waking up (PR = 4.52). CONCLUSIONS The results identify the population subgroups with poor quality of sleep that deserve greater attention. It also highlight the need to consider, in addition to the presence of comorbidities, mental health and the feeling of well-being in the care of patients with sleep problems and in the interventions planed for promoting healthy sleep.


RESUMO OBJETIVO Estimar a prevalência de sono autoavaliado como ruim e identificar os subgrupos da população mais susceptíveis ao problema. MÉTODOS Trata-se de estudo transversal, de base populacional, desenvolvido com dados de Inquérito de Saúde conduzido no município de Campinas (ISACamp 2014/2015). Foram analisados dados de amostra representativa de 1.998 indivíduos com 20 anos ou mais de idade. A qualidade autoavaliada do sono foi analisada segundo características sóciodemográficas, morbidades, comportamentos de saúde e sentimentos de bem-estar. Analisou-se também a associação da qualidade do sono com diferentes queixas e características do sono. Foram estimadas razões de prevalências e desenvolvido modelo de regressão múltipla de Poisson, considerando-se nas análises os pesos amostrais. RESULTADOS A prevalência de sono autoavaliado como ruim foi 29,1% e mostrou-se significativamente mais elevada nas mulheres, em indivíduos de 40 a 50 anos de idade, migrantes, sem ocupação, fisicamente inativos em contexto de lazer, com transtorno mental comum (RP = 1,59), com maior número de problemas de saúde (RP = 2,33), com saúde autoavaliada como ruim (RP = 1,61) e que manifestavam insatisfação com a vida. Sono ruim esteve fortemente associado com relatos de dificuldade de iniciar o sono (RP = 4,17), de manter o sono (RP = 4,40) e com nunca ou quase nunca se sentir bem-disposto ao acordar (RP = 4,52). CONCLUSÕES Os resultados identificam os segmentos da população com má qualidade do sono que merecem maior atenção e destacam a necessidade de avaliar, além da presença de comorbidades, a saúde mental e a presença de sentimentos de bem-estar no processo de cuidado dos pacientes com problemas de sono e no planejamento de intervenções voltadas à promoção de sono saudável.

3.
Arq Neuropsiquiatr ; 76(8): 507-511, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30231122

RESUMO

Spontaneous intracranial hypotension (SIH) is a syndrome that was unknown until the advent of magnetic resonance imaging (MRI). It is a cause of orthostatic headache, which remains underdiagnosed and, rarely, can result in several complications including dural venous sinus thrombosis, subdural hematoma and subarachnoid hemorrhage. Some of these complications are potentially life-threatening and should be recognized promptly, mainly by imaging studies. We reviewed the MRI of nine patients with SIH and describe the complications observed in three of these patients. Two of them had subdural hematoma and one had a dural venous sinus thrombosis detected by computed tomography and MRI. We concluded that MRI findings are of great importance in the diagnosis of SIH and its complications, which often influence the clinical-surgical treatment of the patient.


Assuntos
Hipotensão Intracraniana/complicações , Hipotensão Intracraniana/diagnóstico por imagem , Adulto , Vazamento de Líquido Cefalorraquidiano/diagnóstico por imagem , Vazamento de Líquido Cefalorraquidiano/etiologia , Angiografia por Tomografia Computadorizada/métodos , Feminino , Cefaleia/etiologia , Hematoma Subdural Intracraniano/diagnóstico por imagem , Hematoma Subdural Intracraniano/etiologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Trombose dos Seios Intracranianos/diagnóstico por imagem , Trombose dos Seios Intracranianos/etiologia
4.
Rev Saude Publica ; 52: 82, 2018 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-30183844

RESUMO

OBJECTIVE: To evaluate, in a population-based approach, the association of extreme sleep duration with sociodemographic factors, health, and well-being. METHODS: We analyzed the data from the 2014/2015 Health Survey in the city of Campinas, State of São Paulo, Brazil (ISACamp), performed with 1,969 individuals (≥ 20 years old). Associations between the independent variable and short (≤ 6 hours) and long (≥ 9 hours) sleep were determined using the Rao-Scott chi-square test. The analyses were adjusted with multinomial logistic regression models. RESULTS: Men, individuals aged 40 to 59, those with higher schooling, those who have one (OR = 1.47, 95%CI 1.02-2.12), two (OR = 1.73, 95%CI 1.07-2.80), or three or more (OR = 1.62, 95%CI 1.16-2.28) chronic diseases, and those with three or more health problems (OR = 1.96, 95%CI 1.22-3.17) were more likely to have a short sleep. The chance of long sleep was higher in widowers and lower in those who have more years of schooling, with higher income, worked, lived with more residents at home, and reported three or more diseases (OR = 0.68, 95%CI 0.48-0.97) and health problems. The chance of either short (OR = 2.41, 95%CI 1.51-3.87) or long sleep (OR = 2.07, 95%CI 1.23-3.48) was higher in unhappy individuals. CONCLUSIONS: These findings highlight the higher chance of short sleep duration among men, among persons in productive age, and among those with a higher level of schooling in a Brazilian city. The association of short sleep with comorbidities and the association of happiness with extremes of sleep duration were also important results to understand the relation of sleep duration with health and well-being.


Assuntos
Doença Crônica/psicologia , Qualidade de Vida/psicologia , Sono/fisiologia , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Fatores de Tempo , Adulto Jovem
5.
Arq. neuropsiquiatr ; 76(8): 507-511, Aug. 2018. graf
Artigo em Inglês | LILACS-Express | ID: biblio-950575

RESUMO

ABSTRACT Spontaneous intracranial hypotension (SIH) is a syndrome that was unknown until the advent of magnetic resonance imaging (MRI). It is a cause of orthostatic headache, which remains underdiagnosed and, rarely, can result in several complications including dural venous sinus thrombosis, subdural hematoma and subarachnoid hemorrhage. Some of these complications are potentially life-threatening and should be recognized promptly, mainly by imaging studies. We reviewed the MRI of nine patients with SIH and describe the complications observed in three of these patients. Two of them had subdural hematoma and one had a dural venous sinus thrombosis detected by computed tomography and MRI. We concluded that MRI findings are of great importance in the diagnosis of SIH and its complications, which often influence the clinical-surgical treatment of the patient.


RESUMO Hipotensão Intracraniana Espontânea (HIE) é uma síndrome desconhecida até o advento das imagens de Ressonância Magnética (RM). É uma causa de cefaleia ortostática que permanece subdiagnosticada e raramente resulta em complicações, como trombose de seios venosos durais, hematoma subdural e hemorragia subaracnoidea. Algumas dessas complicações são potencialmente ameaçadoras à vida e devem ser prontamente reconhecidas pelos estudos de imagem. Nós revisamos as RM de 9 pacientes com HIE e descrevemos as complicações observadas em 3 casos. Dois deles tiveram hematoma subdural e um teve trombose de seio venoso dural detectados por tomografia computadorizada e RM. Concluímos que achados de RM são de grande importância no diagnóstico de HIE e suas complicações, frequentemente influenciando o tratamento clínico-cirúrgico do paciente.

6.
Artigo em Inglês | LILACS-Express | ID: biblio-962270

RESUMO

ABSTRACT OBJECTIVE To evaluate, in a population-based approach, the association of extreme sleep duration with sociodemographic factors, health, and well-being. METHODS We analyzed the data from the 2014/2015 Health Survey in the city of Campinas, State of São Paulo, Brazil (ISACamp), performed with 1,969 individuals (≥ 20 years old). Associations between the independent variable and short (≤ 6 hours) and long (≥ 9 hours) sleep were determined using the Rao-Scott chi-square test. The analyses were adjusted with multinomial logistic regression models. RESULTS Men, individuals aged 40 to 59, those with higher schooling, those who have one (OR = 1.47, 95%CI 1.02-2.12), two (OR = 1.73, 95%CI 1.07-2.80), or three or more (OR = 1.62, 95%CI 1.16-2.28) chronic diseases, and those with three or more health problems (OR = 1.96, 95%CI 1.22-3.17) were more likely to have a short sleep. The chance of long sleep was higher in widowers and lower in those who have more years of schooling, with higher income, worked, lived with more residents at home, and reported three or more diseases (OR = 0.68, 95%CI 0.48-0.97) and health problems. The chance of either short (OR = 2.41, 95%CI 1.51-3.87) or long sleep (OR = 2.07, 95%CI 1.23-3.48) was higher in unhappy individuals. CONCLUSIONS These findings highlight the higher chance of short sleep duration among men, among persons in productive age, and among those with a higher level of schooling in a Brazilian city. The association of short sleep with comorbidities and the association of happiness with extremes of sleep duration were also important results to understand the relation of sleep duration with health and well-being.

9.
Braz J Psychiatry ; 32(3): 305-14, 2010 09.
Artigo em Português | MEDLINE | ID: mdl-20945021

RESUMO

This manuscript contains the conclusion of the consensus meeting of the Brazilian Sleep Association with Brazilian sleep specialists on the treatment of narcolepsy based on the review of medical literature from 1980 to 2010. The manuscript objectives were to reinforce the use of agents evaluated in randomized placebo-controlled trials and to issue consensus opinions on the use of other available medications as well as to inform about safety and adverse effects of these medications. Management of narcolepsy relies on several classes of drugs, namely, stimulants for excessive sleepiness, antidepressants for cataplexy and hypnotics for disturbed nocturnal sleep. Behavioral measures are likewise valuable and universally recommended. All therapeutic trials were analyzed according to their class of evidence. Recommendations concerning the treatment of each single symptom of narcolepsy as well as general recommendations were made. Modafinil is the first-line pharmacological treatment of excessive sleepiness. Second-line choices for the treatment of excessive sleepiness are slow-release metylphenidate followed by mazindol. The first-line treatments of cataplexy are the antidepressants, reboxetine, clomipramine, venlafaxine, desvenlafaxine or high doses of selective serotonin reuptake inibitors antidepressants. As for disturbed nocturnal sleep the best option is still hypnotics. Antidepressants and hypnotics are used to treat hypnagogic hallucinations and sleep paralysis.


Assuntos
Antidepressivos/uso terapêutico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Hipnóticos e Sedativos/uso terapêutico , Narcolepsia/terapia , Brasil , Gerenciamento Clínico , Humanos
10.
Rev. bras. psiquiatr ; 32(3): 294-305, Sept. 2010. ilus, tab
Artigo em Inglês | LILACS | ID: lil-560778

RESUMO

Este artigo relata as conclusões da reunião de consenso com médicos especialistas sobre diagnóstico de narcolepsia baseada na revisão dos artigos sobre narcolepsia listados no Medline entre 1980 e 2010. A narcolepsia é uma doença crônica de início entre a primeira e segunda décadas de vida do indivíduo. Os sintomas essenciais são cataplexia e sonolência excessiva. A cataplexia é definida como episódios súbitos, recorrentes e reversíveis de fraqueza da musculatura esquelética desencadeados por situações de conteúdo emocional. Os sintomas acessórios são alucinações hipnagógicas, paralisia do sono e sono fragmentado. Critérios de diagnóstico clínico de acordo com a Classificação Internacional dos Transtornos do Sono são de sonolência excessiva e cataplexia. Recomenda-se a realização de polissonografia seguida do teste de latência múltipla do sono em um laboratório de sono para confirmação e diagnóstico de comorbidades. Quando não houver cataplexia, deve haver duas ou mais sonecas com sono REM no teste de latência múltipla do sono. Tipagem HLA-DQB1*0602 positiva com níveis de hipocretina-1 abaixo de 110pg/mL devem estar presentes para o diagnóstico de narcolepsia sem cataplexia e sem sonecas com sono REM.


This manuscript contains the conclusion of the consensus meeting on the diagnosis of narcolepsy based on the review of Medline publications between 1980-2010. Narcolepsy is a chronic disorder with age at onset between the first and second decade of life. Essential narcolepsy symptoms are cataplexy and excessive sleepiness. Cataplexy is defined as sudden, recurrent and reversible attacks of muscle weakness triggered by emotions. Accessory narcolepsy symptoms are hypnagogic hallucinations, sleep paralysis and nocturnal fragmented sleep. The clinical diagnosis according to the International Classification of Sleep Disorders is the presence of excessive sleepiness and cataplexy. A full in-lab polysomnography followed by a multiple sleep latency test is recommended for the confirmation of the diagnosis and co-morbidities. The presence of two sleep-onset REM period naps in the multiple sleep latency test is diagnostic for cataplexy-free narcolepsy. A positive HLA-DQB1*0602 with lower than 110pg/mL level of hypocretin-1 in the cerebrospinal fluid is required for the final diagnosis of cataplexy- and sleep-onset REM period -free narcolepsy.


Assuntos
Humanos , Narcolepsia/diagnóstico , Brasil , Diagnóstico Diferencial , Narcolepsia/etiologia , Narcolepsia/genética
11.
Rev. bras. psiquiatr ; 32(3): 305-314, Sept. 2010. tab
Artigo em Português | LILACS | ID: lil-560785

RESUMO

Este artigo relata as conclusões da reunião de consenso da Associação Brasileira de Sono com médicos especialistas brasileiros sobre o tratamento da narcolepsia, baseado na revisão dos artigos sobre narcolepsia publicados entre 1980 e 2010. Os objetivos do consenso são valorizar o uso de agentes avaliados em estudos randomizados placebo-controlados, emitir recomendações de consenso para o uso de outras medicações e informar pontos importantes a respeito da segurança e efeitos adversos das medicações. O tratamento da narcolepsia é baseado em diversas classes de agentes, estimulantes para sonolência excessiva, agentes antidepressivos para cataplexia e hipnóticos para sono noturno fragmentado. Medidas comportamentais são igualmente importantes e recomendadas universalmente. Todos os ensaios clínicos terapêuticos foram classificados de acordo com o nível de qualidade da evidência. Recomendações terapêuticas individualizadas para cada tipo de sintoma e recomendações gerais foram formuladas pelos autores. Modafinila é indicada como a primeira escolha para o tratamento da sonolência diurna. Agentes de segunda escolha para o tratamento da sonolência excessiva são metilfenidato de liberação lenta seguido pelo mazindol. Reboxetina, clomipramina, venlafaxina, desvenlafaxina e os inibidores seletivos de recaptação de serotonina em doses altas são a primeira escolha para o tratamento da cataplexia. Hipnóticos são utilizados para o tratamento do sono noturno fragmentado. Antidepressivos e hipnóticos são igualmente utilizados para o tratamento das alucinações hipnagógicas e paralisia do sono.


This manuscript contains the conclusion of the consensus meeting of the Brazilian Sleep Association with Brazilian sleep specialists on the treatment of narcolepsy based on the review of medical literature from 1980 to 2010. The manuscript objectives were to reinforce the use of agents evaluated in randomized placebo-controlled trials and to issue consensus opinions on the use of other available medications as well as to inform about safety and adverse effects of these medications. Management of narcolepsy relies on several classes of drugs, namely, stimulants for excessive sleepiness, antidepressants for cataplexy and hypnotics for disturbed nocturnal sleep. Behavioral measures are likewise valuable and universally recommended. All therapeutic trials were analyzed according to their class of evidence. Recommendations concerning the treatment of each single symptom of narcolepsy as well as general recommendations were made. Modafinil is the first-line pharmacological treatment of excessive sleepiness. Second-line choices for the treatment of excessive sleepiness are slow-release metylphenidate followed by mazindol. The first-line treatments of cataplexy are the antidepressants, reboxetine, clomipramine, venlafaxine, desvenlafaxine or high doses of selective serotonin reuptake inibitors antidepressants. As for disturbed nocturnal sleep the best option is still hypnotics. Antidepressants and hypnotics are used to treat hypnagogic hallucinations and sleep paralysis.


Assuntos
Humanos , Antidepressivos/uso terapêutico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Hipnóticos e Sedativos/uso terapêutico , Narcolepsia/terapia , Brasil , Gerenciamento Clínico
12.
Braz J Psychiatry ; 32(3): 294-304, 2010 09.
Artigo em Português | MEDLINE | ID: mdl-20585744

RESUMO

This manuscript contains the conclusion of the consensus meeting on the diagnosis of narcolepsy based on the review of Medline publications between 1980-2010. Narcolepsy is a chronic disorder with age at onset between the first and second decade of life. Essential narcolepsy symptoms are cataplexy and excessive sleepiness. Cataplexy is defined as sudden, recurrent and reversible attacks of muscle weakness triggered by emotions. Accessory narcolepsy symptoms are hypnagogic hallucinations, sleep paralysis and nocturnal fragmented sleep. The clinical diagnosis according to the International Classification of Sleep Disorders is the presence of excessive sleepiness and cataplexy. A full in-lab polysomnography followed by a multiple sleep latency test is recommended for the confirmation of the diagnosis and co-morbidities. The presence of two sleep-onset REM period naps in the multiple sleep latency test is diagnostic for cataplexy-free narcolepsy. A positive HLA-DQB1*0602 with lower than 110pg/mL level of hypocretin-1 in the cerebrospinal fluid is required for the final diagnosis of cataplexy- and sleep-onset REM period -free narcolepsy.


Assuntos
Narcolepsia/diagnóstico , Brasil , Diagnóstico Diferencial , Humanos , Narcolepsia/etiologia , Narcolepsia/genética
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