Una Caracterización de la Arquitectura del Sueño en Adultos con Bruxismo del Sueño: Un Estudio Descriptivo Retrospectivo / Characterization of Sleep Architecture in Adults with Sleep Bruxism: A Retrospective Descriptive Study

Objetivo: Caracterizar la arquitectura del sueño en un grupo poblacional de adultos con bruxismo del sueño, en forma general y según sexo.Materiales y método: Estudio descriptivo retrospectivo, con un muestreo por intención de 33 polisomnografías que identificaban sujetos con bruxismo del sueño, según el “cut off” sugerido por Lavigne et al (25 eventos /hora), entre los años 2011-2019. Se consideraron las variables sexo, edad, peso, talla e índice de masa corporal (IMC). Se determinó la arquitectura del sueño en cuanto a duración de las etapas del sueño, micro despertares y eventos de bruxismo. Se realizó un análisis descriptivo de las variables y se compraron los resultados entre los sexos.Resultados: En el grupo poblacional 64% eran mujeres y 36% hombres. El promedio de edad fue de 32.5 años, de talla 1.65, de peso 68 kg, con un IMC promedio de 24.89 (peso normal). Los sujetos tuvieron un promedio de 387.6 horas de sueño, 270 minutos en NMOR y 10.8 en MOR, con un promedio de 50 micro despertares durante la noche y de 48.64 eventos de bruxismo por hora. Según sexo los valores en minutos fueron (p>0.05): NMOR (H: 316.2 – M:256.8); MOR (H: 105 – M:104.4); microdespertares (H :58.9 – M: 45.1); Eventos de BS/hora: (H:48.6 – M: 46.6) Los sujetos con BS durmieron, en promedio, un mayor número de minutos en decúbito lateral (196,59).Conclusión: Los sujetos con BS registran determinadas características en la arquitectura del sueño que deben considerarse. No hubo diferencia en la arquitectura del sueño según sexo. (AU)

Objective: To characterize sleep architecture in a population group of adults with sleep bruxism, in general and by sex. Materials and method: Retrospective descriptive study, with intentional sampling of 33 polysomnographies that identified subjects with sleep bruxism,according to the “cut off” suggested by Lavigne et al (25 events /hour/), between the years 2011-2019. The variables sex, age, weight, height and body mass index (BMI) were considered. Sleep architecture was determined in terms of duration of sleep stages, micro-awakenings, and bruxism events. A descriptive anlysis of the variables was carried out and the results were compared between the sexes.Results: In the population group, 64% were women and 36% men. The average age was 32.5 years, height 1.65 m, weight 68 kg, with an average BMI of 24.89 (normal weight). Subjects had an average of 387.6 minutes of sleep, 270 minutes in non-rapid eye movement (NREM) and 10.8 in rapid eye movement (REM), with an average of 50 micro-awakenings during the night and 48.64 bruxism events per hour. According to sex, the values in minutes were: NMOR (H:316.2 – M:256.8); MOR (H:105 – M:104.4); microawakenings (H:58.9 – M:45.1); BS events/hour: (H:48.6 – M: 46.6), no significant differences were found between them (p>0.05). Subjects with BS slept, on average, a greater number of minutes in the lateral decubitus position (196.59). Conclusion: Subjects with BS register certain characteristics in their sleep architecture that must be considered. There was no difference in sleeparchitecture according to sex.(AU)

La long covid y su impacto en el funcionamiento mental / [The long covid and its impact on mental functioning]

La Covid-19 es una enfermedad causada por el virus SARS-Cov-2. Más allá de los síntomas respiratorios característicos de la enfermedad, se produce una afectación multisistémica, que incluye al Sistema Nervioso Central (SNC). El 15.2% de las personas infectadas experimentan la persistencia de los síntomas o el desarrollo de nuevos síntomas relacionados con la infección tras la recuperación de la fase aguda. La fatiga y el deterioro cognitivo destacan entre los síntomas principales de las personas con Long Covid/Covid Persistente, quienes refieren sobre todo dificultades atencionales, mnésicas y ejecutivas. Este conjunto de síntomas cognitivos ha recibido el término de “niebla mental”. Todo ello, junto a las alteraciones psicopatológicas - ansiedad, depresión y/o trastornos del sueño - tiene un impacto significativo en el funcionamiento diario y en la calidad de vida de las personas afectadas. El progreso en el conocimiento de los síntomas mentales de la Long Covid es imprescindible para diseñar intervenciones terapéuticas. Su reconocimiento también es importante en la valoración de la capacidad laboral. El objetivo de esta revisión es presentar de forma didáctica la información disponible sobre disfunción cognitiva y alteraciones psicopatológicas post Covid-19. (AU)

Covid-19 is a disease caused by the SARSCov-2 virus. Beyond the respiratory symp toms characteristic of the disease, there is multisystem involvement, including the Central Nervous System (CNS). 15.2% of infected people experience persistence of symptoms or development of new infection-related symptoms after recovery from the acute phase. Fatigue and cognitive impairment are among the main symptoms of people with Long Covid/Persistent Covid, who report mainly attentional, memory and executive difficulties. This set of cognitive symptoms has been given the term "brain fog". Together with psychopathological disturbances - anxiety, depression and/or sleep disorders - they have a significant impact on the daily functioning and quality of life of those affected. Progress in the knowledge of the mental symptoms of Long Covid is essential to design therapeutic interventions. Their recognition is also important in the assessment of work capacity. The aim of this review is to present in a didactic way the available information on cognitive dysfunction and psychopathological alterations post Covid-19. (AU)

Melatonina en trastornos del sueño: comparación de distintos productos y revisión bibliográfica / Melatonin in sleep disorders. comparison of different products and literature review

Introducción: los trastornos del sueño en Pediatría son un problema creciente. La melatonina es el producto de elección y es común recibir publicidad de múltiples productos que la contienen. En este texto se lleva a cabo un análisis comparativo de los mismos, examinando la evidencia científica más reciente, con el fin de determinar si está justificado o no su uso. Métodos: se ha realizado un estudio descriptivo de los productos que contenían melatonina comercializados en España, de venta en farmacias y dirigidos a la población pediátrica. Posteriormente, se ha llevado a cabo una revisión de documentos sobre el uso de melatonina en niños y sobre cada componente extra presente en los productos recogidos. Resultados: se analizaron 53 productos. La forma de administración mayoritaria fue en gotas o mililitros. La dosis recomendada habitual de melatonina fue de 1 mg al día. El componente añadido más frecuente registrado fue la vitamina B6, y melisa y pasiflora fueron las plantas más utilizadas. Ninguno de los productos estaba catalogado como fármaco por la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) y tampoco se encontró en la publicidad de ninguno referencias bibliográficas. Conclusiones: aunque es conocida la eficacia de la melatonina en trastornos del sueño, actualmente no hay un consenso sobre su dosis eficaz en edad pediátrica. Las sustancias que más frecuentemente se asocian a melatonina cuentan con poca bibliografía que respalde sus resultados sobre el sueño, además de que para ellas tampoco existen, de momento, dosis estandarizadas para la población infantil. (AU)

Introduction: sleep disorders in paediatrics are a growing problem. Melatonin is the drug of choice and it is common to receive advertising for multiple products containing melatonin in primary care. In this paper, a comparative analysis of these products is carried out, examining the most recent scientific evidence, in order to determine whether their use is justified or not. Methods: a descriptive study was conducted on melatonin-containing products sold in pharmacies in Spain and aimed at the paediatric population. Subsequently, a systematic review of documents on the use of melatonin in children and on each extra component present in the products collected was carried out. Results: fifty-three products were analysed. The most common form of administration was drops or millilitres. The usual recommended dose of melatonin was 1 mg per day. The most frequently reported added component was vitamin B6, and lemon balm and passionflower were the most frequently used herbs. None of the products were specifically listed in the Spanish Agency for Medicines and Health Products, and no bibliographical references were found in the advertising of any of the products. Conclusions: although the efficacy of melatonin in sleep disorders is well known, there is currently no consensus on its effective dose in children. The substances most frequently associated with melatonin have little literature to support their results in sleep, and there are no standardised doses for them either, or doses lower than these are used due to a lack of studies in the paediatric population. (AU)

Sleep disorders in patients with multiple sclerosis in Spain / Trastornos del sueño en pacientes con esclerosis múltiple en España

Objective This study assesses the presence of sleep disturbances and their relationship with clinical and demographic variables in patients with MS, with a view to establishing correlations between the different variables and the frequency of sleep disturbances. Methods The Pittsburgh Sleep Quality Index (PSQI) was used to detect sleep disorders. We contacted patients treated at the MS unit and distributed a questionnaire (PSQI) to 221 patients, receiving 142 usable questionnaires between 8 and 30 September 2019. Results The prevalence of patients with sleep disturbances in our study was 74.7% (73.7% in women and 76.8% in men). Therefore, sleep disorders are pervasive in patients with MS, with 3 out of 4 patients experiencing them, a higher rate than that observed in the population without the disease. The frequency of sleep disorders gradually increased in line with age. In the 2 age groups analyzed, 44–54 years and 55–68 years, the proportion of moderate and severe sleep disorders was 42.8% and 53.9%, respectively. Moderate and severe sleep disturbances were observed in 27.5%, 44.7%, and 58.3% of patients with Expanded Disability Status Scale scores of 0–3, 3–6, and >6, respectively. Conclusion Our results indicate that sleep disorders are more common in patients with MS than in other populations. Patients with secondary progressive forms of MS more frequently present sleep disturbances, while patients with primary progressive forms report them less frequently. Age and degree of disability were positively correlated with the prevalence and severity of sleep disorders in MS patients. (AU)

Objetivo Evaluamos la presencia de alteraciones del sueño en pacientes con EM y su relación con variables clínicas y demográficas en esta población para establecer correlaciones entre diversas variables y la frecuencia de trastornos del sueño. Métodos Se utilizó el Índice de Calidad de Sueño de Pittsburgh para identificar la presencia de trastornos del sueño. Distribuimos el cuestionario a 221 pacientes de nuestra unidad de EM, y recibimos respuesta de 142 de ellos entre el 8 y el 30 de septiembre de 2019. Resultados En nuestra muestra, el 74,7% de los pacientes presentaban trastornos del sueño (73,7% de las mujeres y 76,8% de los hombres). Nuestros resultados muestran que los trastornos del sueño están muy presentes en la EM, detectándose en 3 de cada 4 pacientes, lo que supone una proporción mayor que en la población general. La presencia de trastornos del sueño aumenta con la edad. En los 2 grupos etarios analizados (44-54 años y 55-68 años), la proporción de pacientes con trastornos del sueño moderados o graves fue del 42,8% y el 53,9%, respectivamente. El 27,5%, el 44,7% y el 58,3% de los pacientes con puntuaciones de 0-3, 3-6 y >6 puntos en la Escala Expandida del Estado de Discapacidad, respectivamente, presentaron trastornos del sueño moderados o graves. Conclusión Nuestros resultados indican que los trastornos del sueño son más prevalentes en los pacientes con EM que en otras poblaciones. Dichos trastornos son más frecuentes en pacientes con EM secundaria progresiva que en pacientes con la forma primaria progresiva. La edad y el grado de discapacidad mostraron una correlación positiva con la prevalencia y la gravedad de los trastornos del sueño. (AU)

Sleep disorders in patients with multiple sclerosis in Spain / Trastornos del sueño en pacientes con esclerosis múltiple en España

Objective This study assesses the presence of sleep disturbances and their relationship with clinical and demographic variables in patients with MS, with a view to establishing correlations between the different variables and the frequency of sleep disturbances. Methods The Pittsburgh Sleep Quality Index (PSQI) was used to detect sleep disorders. We contacted patients treated at the MS unit and distributed a questionnaire (PSQI) to 221 patients, receiving 142 usable questionnaires between 8 and 30 September 2019. Results The prevalence of patients with sleep disturbances in our study was 74.7% (73.7% in women and 76.8% in men). Therefore, sleep disorders are pervasive in patients with MS, with 3 out of 4 patients experiencing them, a higher rate than that observed in the population without the disease. The frequency of sleep disorders gradually increased in line with age. In the 2 age groups analyzed, 44–54 years and 55–68 years, the proportion of moderate and severe sleep disorders was 42.8% and 53.9%, respectively. Moderate and severe sleep disturbances were observed in 27.5%, 44.7%, and 58.3% of patients with Expanded Disability Status Scale scores of 0–3, 3–6, and >6, respectively. Conclusion Our results indicate that sleep disorders are more common in patients with MS than in other populations. Patients with secondary progressive forms of MS more frequently present sleep disturbances, while patients with primary progressive forms report them less frequently. Age and degree of disability were positively correlated with the prevalence and severity of sleep disorders in MS patients. (AU)

Objetivo Evaluamos la presencia de alteraciones del sueño en pacientes con EM y su relación con variables clínicas y demográficas en esta población para establecer correlaciones entre diversas variables y la frecuencia de trastornos del sueño. Métodos Se utilizó el Índice de Calidad de Sueño de Pittsburgh para identificar la presencia de trastornos del sueño. Distribuimos el cuestionario a 221 pacientes de nuestra unidad de EM, y recibimos respuesta de 142 de ellos entre el 8 y el 30 de septiembre de 2019. Resultados En nuestra muestra, el 74,7% de los pacientes presentaban trastornos del sueño (73,7% de las mujeres y 76,8% de los hombres). Nuestros resultados muestran que los trastornos del sueño están muy presentes en la EM, detectándose en 3 de cada 4 pacientes, lo que supone una proporción mayor que en la población general. La presencia de trastornos del sueño aumenta con la edad. En los 2 grupos etarios analizados (44-54 años y 55-68 años), la proporción de pacientes con trastornos del sueño moderados o graves fue del 42,8% y el 53,9%, respectivamente. El 27,5%, el 44,7% y el 58,3% de los pacientes con puntuaciones de 0-3, 3-6 y >6 puntos en la Escala Expandida del Estado de Discapacidad, respectivamente, presentaron trastornos del sueño moderados o graves. Conclusión Nuestros resultados indican que los trastornos del sueño son más prevalentes en los pacientes con EM que en otras poblaciones. Dichos trastornos son más frecuentes en pacientes con EM secundaria progresiva que en pacientes con la forma primaria progresiva. La edad y el grado de discapacidad mostraron una correlación positiva con la prevalencia y la gravedad de los trastornos del sueño. (AU)

Sleep disorders in patients with multiple sclerosis in Spain.

OBJECTIVE: This study assesses the presence of sleep disturbances and their relationship with clinical and demographic variables in patients with MS, with a view to establishing correlations between the different variables and the frequency of sleep disturbances. METHODS: The Pittsburgh Sleep Quality Index (PSQI) was used to detect sleep disorders. We contacted patients treated at the MS unit and distributed a questionnaire (PSQI) to 221 patients, receiving 142 usable questionnaires between 8 and 30 September 2019. RESULTS: The prevalence of patients with sleep disturbances in our study was 74.7% (73.7% in women and 76.8% in men). Therefore, sleep disorders are pervasive in patients with MS, with 3 out of 4 patients experiencing them, a higher rate than that observed in the population without the disease. The frequency of sleep disorders gradually increased in line with age. In the 2 age groups analyzed, 44-54 years and 55-68 years, the proportion of moderate and severe sleep disorders was 42.8% and 53.9%, respectively. Moderate and severe sleep disturbances were observed in 27.5%, 44.7%, and 58.3% of patients with Expanded Disability Status Scale scores of 0-3, 3-6, and >6, respectively. CONCLUSION: Our results indicate that sleep disorders are more common in patients with MS than in other populations. Patients with secondary progressive forms of MS more frequently present sleep disturbances, while patients with primary progressive forms report them less frequently. Age and degree of disability were positively correlated with the prevalence and severity of sleep disorders in MS patients.

Avaliação da qualidade do sono em profissionais de saúde da emergência / Evaluación de la calidad del sueño en profesionales de la salud de emergencia / Sleep quality assessment in emergency health professionals

Resumo Objetivo Avaliar a qualidade do sono de profissionais dos serviços de emergência e sua associação com o nível de fadiga e qualidade de vida. Métodos Estudo descritivo, transversal e correlacional, realizado nas unidades do Serviço de Atendimento Móvel de Urgência (SAMU) e na Unidade de Pronto Atendimento (UPA), no ano de 2021, com 108 participantes. Para avaliação da qualidade do sono, foi utilizado o Índice de Qualidade do Sono de Pittsburgh versão Brasileira (PSQI-BR); para avaliação da Fadiga, foi utilizada a Escala de Fadiga de Chalder, em conjunto com a Escala de Necessidade de Descanso (ENEDE); e para avaliação da qualidade de vida, foi utilizado o World Health Organization Quality of Life Brief Version (WHOQOL-bref), sendo que os instrumentos utilizados foram adaptados para a língua portuguesa em estudos anteriores. Foram aplicados testes de associação para a análise estatística, tendo sido utilizados o Teste Qui-Quadrado de Pearson, o Teste U Mann-Whitney ou Kruskal Wallis e a correlação de Spearman. Valores de p <0,05 foram considerados como significativos. Resultados Foi identificado que 72,2% dos participantes apresentaram má qualidade do sono e 75,9% estavam fadigados. Foi observada associação significativa entre a qualidade do sono e a fadiga, a necessidade de descanso e a qualidade de vida. Conclusão Foi identificado que os profissionais de saúde que trabalham em serviço de urgência e emergência apresentam má qualidade do sono e de vida e níveis elevados de fadiga e necessidade de descanso, o que pode impactar diretamente suas atividades pessoais e profissionais.

Resumen Objetivo Evaluar la calidad del sueño de profesionales de los servicios de emergencia y su relación con el nivel de fatiga y calidad de vida. Métodos Estudio descriptivo, transversal y correlacional, realizado en las unidades del Servicio de Atención Móbil de Urgencia (SAMU) y en la Unidad de Pronta Atención (UPA), en el año 2021, con 108 participantes. Para evaluar la calidad del sueño, se utilizó el Índice de Calidad del Sueño de Pittsburgh, versión brasileña (PSQI-BR). Para evaluar la fatiga, se utilizó la Escala de Fatiga de Chalder, junto con la Escala de Necesidad de Descanso (ENEDE). Para evaluar la calidad de vida, se utilizó el World Health Organization Quality of Life Brief Version (WHOQOL-bref). Los instrumentos utilizados fueron adaptados al idioma portugués en estudios anteriores. Se aplicaron pruebas de asociación para el análisis estadístico, para lo cual se utilizó la Prueba χ2 de Pearson, la Prueba U de Mann-Whitney o la prueba de Kruskal-Wallis y la correlación de Spearman. Se consideraron valores de p<0,05 como significativos. Resultados Se identificó que el 72,2 % de los participantes presentó una mala calidad de sueño y el 75,9 % tenía fatiga. Se observó una asociación significativa entre la calidad del sueño y la fatiga, la necesidad de descanso y la calidad de vida. Conclusión Se identificó que los profesionales de la salud que trabajan en servicios de urgencia y emergencia presentaron mala calidad de sueño y de vida y niveles elevados de fatiga y necesidad de descanso, lo que puede impactar directamente en sus actividades personales y profesionales.

Abstract Objective To assess emergency service professionals' sleep quality and its association with the level of fatigue and quality of life. Methods A descriptive, cross-sectional and correlational study, carried out in the units of the Mobile Emergency Care Service (SAMU) and in the Emergency Care Unit (ECU), in 2021, with 108 participants. To assess sleep quality, the Pittsburgh Sleep Quality Index, Brazilian version (PSQI-BR), was used; to assess fatigue, the Chalder Fatigue Scale was used, together with the Need for Recovery Scale (NFR); and to assess quality of life, the World Health Organization Quality of Life Brief Version (WHOQOL-bref) was used, and the instruments used were adapted to Portuguese in previous studies. Association tests were applied for statistical analysis, using Pearson's chi-square test, Mann-Whitney U test or Kruskal Wallis and Spearman's correlation. P-values <0.05 were considered significant. Results It was identified that 72.2% of participants had poor sleep quality and 75.9% were fatigued. A significant association was observed between sleep quality and fatigue, the need for recovery and quality of life. Conclusion It was identified that health professionals working in emergency services have poor sleep quality and life, and high levels of fatigue and need for recovery, which can directly impact their personal and professional activities.

Substance use and mental health of Brazilian truck drivers / Consumo de sustancias y salud mental de los camioneros brasileños

Objetivo: evaluar el uso de sustancias y la salud mental de los camioneros brasileños, y cómo estos impactan en sus comportamientos re-lacionados con la conducción. Métodos: estudiotransversal realizado con 235 camioneros en Brasil. Resultados: Los conductores que condujeron des-pués de beber eran fumadores, sufrieron agresiones y experimentaron an-siedad. Las fallas en la conducción se asociaron con la conducción después de beber y han sufrido agresiones. Los errores se asociaron con la altera-ción del sueño y la participación en accidentes que tuvieron víctimas. Las infracciones fueron mayores entre quienes condujeron después de beber, consumieron drogas, tenían ansiedad y problemas de sueño. Conclusión: El uso de sustancias, la salud mental, la somnolencia y la violencia están inter-relacionados para los camioneros brasileños.(AU)

Objective: to evaluate the substance use and mental health of Bra-zilian truck drivers, how these impact on their driving-related behaviors.Methods: cross-sectional study conducted with 235 truck drivers in Brazil. Results: The drivers who drove after drinking were smokers, suffered as-saults and experienced anxiety. Lapses in driving were associated with driv-ing after drinking and have suffered assaults. Errors were associated with impaired sleep and being involved in accidents that had victims. Violations were greater amongst those who drove after drinking, used drugs, had anx-iety and impaired sleep. Conclusion: Substance use, mental health, drowsi-ness and violence are interrelated for Brazilian truck drivers.(AU)

Efficacy of Roncolab mobile application for diagnosing the primary sign of sleep-disordered breathing (snoring) in children / Eficacia de la aplicación móvil Roncolab para el diagnóstico de signo primario de trastorno respiratorio del sueño (ronquido) en niños

ABSTRACT Sleep-disordered breathing (SDB) is a group of disorders associated with breathing anomalies during sleep. Easily detectable by sound, snoring is one of the most common manifestations and the main sign of SDB. Snoring is characteristic of breathing sound during sleep, without apnea, hypoventilation, or interrupted sleep. It may reduce the percentage of sleep and increase microarousals due to breathing effort or gas exchange. A range of questionnaires have been validated and adapted to the pediatric population to screen for patients who require laboratory testing. The Pediatric Sleep Questionnaire (PSQ) screens for SDB and identifies primary signs such as snoring. RoncoLab is a mobile application that records and measures snoring intensity and frequency Aim To compare the RoncoLab app and the PSQ regarding how efficiently they diagnose snoring Materials and Method This was an observational, analytical study of 31 children aged 7 to 11 years who visited the pediatric dental clinic at Benemérita Universidad Autónoma de Puebla, Mexico (BUAP). The PSQ was applied to diagnose SDB. Guardians were then instructed on how to download and use the mobile application to record data while the child was sleeping at home. Agreement between RoncoLab and the PSQ was analyzed statistically by Cohen's Kappa index at 95% confidence level Results The Kappa index for identification of primary snoring was 0.743 (p<0.05). App sensitivity was 0.92, and specificity 0.82 Conclusion There is good agreement between PSQ and RoncoLab for diagnosing primary snoring, with acceptable sensitivity and specificity.

RESUMEN Los trastornos respiratorios del sueño (TRS) son un grupo de padecimientos asociados con anormalidades respiratorias del sueño. Una de las manifestaciones más comunes es el ronquido; signo fácil de detectar por el ruido que emite y se considera como el signo principal. Este trastorno es característico del ruido respiratorio durante el sueño, sin apneas, hipoventilación, ni interrupciones del sueño. Este puede ocasionar disminución del porcentaje del sueño y aumentar los microdespertares, esto debido al esfuerzo respiratorio o al intercambio de gases. En la actualidad existen cuestionarios validados y adaptados para la población pediátrica útiles como herramienta clínica para el tamizaje y selección de pacientes que requieran pruebas de laboratorio. El Pediatric Sleep Questionnaire (PSQ) permite el cribado de TRS e identificación de signos primarios como el ronquido. RoncoLab es una aplicación móvil que registra y mide la intensidad y frecuencia del ronquido. Objetivo Comparar la eficacia del diagnóstico del ronquido por medio del RoncoLab contrastado con el PSQ Materiales y Método Estudio observacional, analítico, en el cual se incluyeron 31 niños de 7 a 11 años, que acudieron a la clínica de odontopediatría de la Benemérita Universidad Autónoma de Puebla, México (BUAP) Se aplicó el PSQ a los 31 niños para el diagnóstico de TRS, después se le instruyó al tutor como descargar y utilizar la aplicación móvil para registrar los datos obtenidos en las horas de sueño en casa. El análisis estadístico de concordancia entre los instrumentos diagnósticos se realizó con el Índice Kappa de Cohen a un nivel de confianza del 95% Resultados El Índice de Kappa para la identificación de los ronquidos primarios fue de 0.743 (p<0.05). La sensibilidad de la aplicación fue de 0.92, mientras la especificidad fue de 0.82 Conclusión Existe buena concordancia entre el PSQ y el RoncoLab en el diagnóstico de ronquido primario, con sensibilidad y especificidad aceptable.

Sleep quality and perinatal depression in pregnant women treated in a primary care centre in Lima, Peru.

OBJECTIVE: The aim is to evaluate the association between sleep quality and perinatal depression in pregnant women between the 12th week of gestation and the 36th week of gestation in a maternity and child centre in Lima. METHODS: Analytical cross-sectional study in pregnant women cared for in a primary care centre between August and December 2019. The data were collected through a self-administered survey. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The evaluation of perinatal depression was performed with the Edinburgh Postnatal Depression Scale (EPDS). For the multivariate analysis, Poisson regression with robust variances was used to calculate the crude and adjusted prevalence ratios and their respective confidence intervals. RESULTS: The sample was composed of 200 participants. The median [IQR] age was 26 [22-32] years, and 111 (55.5%) pregnancies were unplanned. 52% presented a poor quality of sleep and the risk of perinatal depression was 31.5%. Poor quality of sleep was associated with a significantly higher frequency of perinatal depression (aPR = 4.8 for those with poor quality of sleep warranting medical attention, and aPR = 6.6 for those with poor quality of sleep warranting medical attention and treatment). CONCLUSIONS: There is a possible association between poor sleep quality and perinatal depression in pregnant women between weeks 12 and 36 of gestation. Operational research should be promoted to assess whether interventions to improve sleep quality could have a positive impact on reducing perinatal depression.

Impacto de la COVID-19 sobre la salud mental en Uruguay / Impact of COVID-19 on mental health in Uruguay

Introducción. Los antecedentes de cuarentenas han señalado impactos en el corto y largo plazo en la salud mental. Objetivo. Describir las repercusiones generadas en el área de la salud mental en la población uruguaya mayor de 18 años, de las variables ansiedad, tristeza y dificultades para conciliar el sueño, en el periodo comprendido entre el 13 de marzo de 2020 al 10 de junio de 2021. Metodología. Estudio transversal analítico. Se aplicó una encuesta web, auto-administrada. Se analizaron las frecuencias absolutas y relativas porcentuales y sus intervalos de confianza (95 %). Se estimaron modelos logísticos binarios para las variables dicotómicas y modelos logísticos multinomiales para «dificultad para conciliar el sueño¼. Resultados. En relación a los elementos de ansiedad, 27,1 % (IC 95 % 24,8-29,3) y 31,0 % (IC 95 % 28-33,3) respondieron sentirse ansiosos en el primer y segundo corte, respectivamente. El 19,9 % (IC 95 % 17,6 - 21,7) en el primer corte, mientras que el 31,4 % (IC 95 % 20,06-33,89) lo confirmaron en el segundo. El nivel educativo medio se asoció con la presencia de ansiedad (p < 0,001), mientras el bajo se asoció con tristeza (p = 0,005). Se observó un efecto protector en hogares con más de cinco miembros para la variable tristeza con un OR de 0,41 (IC 95 % 0,22 - 0,75). Se encontró relación entre el género femenino y la presencia de ansiedad y tristeza. Los niveles educativos medio y alto se vieron relacionados con la presencia de ansiedad y la tristeza se asoció con el desempleo. Los trastornos del sueño se asociaron al género femenino, desempleo y enfermedades no transmisibles. Conclusión. Los trastornos de ansiedad, la afectación del sueño y los sentimientos de tristeza fueron prevalentes, las familias de mayor número de miembros tuvieron un efecto protector sobre estas manifestaciones

Introduction. The history of quarantines has pointed out impacts in the short and long term on mental health. Objective: Within the framework of the measures decreed to reduce the transmissibility of SarS-Cov2, we propose to analyze the repercussions on the mental health of the Uruguayan population. Methodology. Analytical design. Application of a self-administered web survey. Absolute and relative percentage frequencies and their confidence intervals (95 %) were analyzed. Binary logistic models were estimated for dichotomous variables and multinomial logistic models for «difficulty falling asleep¼. Results. Regarding anxiety elements, 27.1 % (95 % CI, 24.8-29.3) and 31.0 % (95 % CI, 28-33.3) responded feeling anxious in the first and second cut-off, respectively. 19.9 % (95 % CI, 17.6-21.7) and 31.4 % (95 % CI, 20.06-33.89) reported feeling sad in the first and second cut-off. Medium educational level was associated with the presence of anxiety (p < 0.001), while low educational level was associated with sadness (p = 0.005). A protective effect was observed in households with more than five members for the sadness variable with an OR of 0.41 (95 % CI, 0.22-0.75). Female gender was related to the presence of anxiety and sadness. Medium and high educational levels were related to the presence of anxiety and sadness was associated with unemployment. Sleep disorders were associated with female gender, unemployment and non-communicable diseases. Conclusion. The impact on mental health was unequal, especially affecting women from middle socio-educational sectors, between 35 and 59 years of age

Alterações do sono e os fatores associados em gestantes atendidas pela atenção primária em saúde / Sleep alterations and associated factors in pregnant women attended by primary health care / Alteraciones del sueño y factores asociados en gestantes atendidas en atención primaria de salud

Resumo Contexto: A gestação ocasiona diversas mudanças fisiológicas, anatômicas, hormonais e psicológicas na mulher. As modificações gravídicas podem repercutir no sono da gestante, diminuindo sua qualidade e duração. Objetivo: Este estudo tem como objetivo verificar a prevalência de alteração do sono em gestantes e os fatores associados. Métodos: Estudo epidemiológico, transversal e analítico realizado com gestantes cadastradas nas Equipes da Estratégia de Saúde Da Família da zona urbana do município de Montes Claros no ano de 2018. A amostra, probabilística, foi calculada em 1.180 gestantes. Os dados foram coletados a partir de um questionário contendo as informações de interesse com posterior análise das variáveis. Resultados: Verificou-se que 87,5% das participantes apresentavam alterações do sono durante a gestação. O aumento do sono foi relatado por 50,5%, a diminuição por 21,8% e 15,1% ambos. O apoio social (p= 0,032), a qualidade de vida (p< 0,001), o estresse (p= 0,009) e os sintomas de depressão (p= 0,005) associaram-se individualmente com a alteração de sono e a qualidade de vida se manteve associada após ajuste (RP ajustada: 0,482, IC95% 0,482; p=<0,001). Conclusão: É elevada a alteração de sono entre as gestantes, sendo associada ao apoio social, à qualidade de vida, ao estresse e à depressão.

Abstract Background: Pregnancy causes several physiological, anatomical, hormonal and psychological changes in women. Pregnancy changes can affect the pregnant woman's sleep, reducing its quality and duration. Objective: This study aims to verify the prevalence of sleep alterations and associated factors in pregnant women. Methods: Epidemiological, cross-sectional and analytical study carried out with pregnant women registered in the Family Health Strategy Teams of the urban area of the municipality of Montes Claros in 2018. The probabilistic sample was calculated in 1,180 pregnant women. Data were collected from a questionnaire containing the information of interest with subsequent analysis of the variables. Results: It was verified that 87.5% of the participants had sleep alterations during pregnancy. The increase in sleep was reported by 50.5%, the decrease by 21.8% and 15.1% both. Social support (p=0.032), quality of life (p<0.001), stress (p=0.009) and symptoms of depression (p=0.005) were individually associated with sleep disturbance and quality of life was remained associated after adjustment (adjusted PR: 0.482, 95% CI 0.482; p=<0.001). Conclusion: There is a high sleep disturbance among pregnant woman, being associated with social support, quality of life, stress and depression.

Resumen Contexto: El embarazo provoca diversos cambios fisiológicos, anatómicos, hormonales y psicológicos en la mujer. Los cambios del embarazo pueden afectar el sueño de la mujer embarazada, reduciendo su calidad y duración. Objetivo: Este estudio tiene como objetivo verificar la prevalencia de trastornos del sueño en mujeres embarazadas y los factores asociados. Métodos: Estudio epidemiológico, transversal y analítico realizado con gestantes registradas en los Equipos de Estrategia de Salud de la Familia del casco urbano del municipio de Montes Claros en el año 2018. La muestra probabilística se calculó en 1.180 gestantes. Los datos se recogieron a partir de un cuestionario que contenía la información de interés con el posterior análisis de las variables. Resultados: Se encontró que 87,5% de las participantes presentaron trastornos del sueño durante el embarazo. El aumento del sueño fue reportado en un 50,5%, la disminución en un 21,8% y en un 15,1% ambos. El apoyo social (p=0,032), la calidad de vida (p<0,001), el estrés (p=0,009) y los síntomas de depresión (p=0,005) se asociaron individualmente con la alteración del sueño y la calidad de vida se mantuvo asociada después del ajuste (RP ajustado: 0,482, IC 95% 0,482, p=<0,001). Conclusión: Existe una alta alteración del sueño entre las gestantes, siendo asociado al apoyo social, calidad de vida, estrés y depresión.

Impacto del Programa de Rehabilitación Interdisciplinario de Dolor Crónico en pacientes sin y con trastornos del sueño / Impact of the Interdisciplinary Chronic Pain Rehabilitation Programme in patients with and without sleep disorders

Introducción: Los trastornos del sueño y el dolor crónico están relacionados bidireccionalmente. Ambos están relacionados con trastornos afectivos, fatiga, depresión, ansiedad y abuso de fármacos, y afectan significativamente a la calidad de vida. El objetivo del Programa Interdisciplinario de Dolor (PRID) es aliviar el dolor del paciente y mejorar su funcionalidad a través de la incorporación de hábitos posturales, del sueño y nutricionales saludables, técnicas de relajación, ejercicio físico y mecanismos cognitivoconductuales. Pacientes y métodos: Se realizó un estudio retrospectivo, observacional y transversal. Se examinó a 323 pacientes con dolor crónico que completaron el PRID. Se les evaluó al principio y al final del programa con escalas de dolor, depresión, calidad de vida e insomnio, y se les comparó entre grupos con y sin insomnio –índice de gravedad del insomnio (ISI) menor de 15 frente a mayor o igual a 15–. Se estudió a 58 pacientes con polisomnografía. Resultados: Se observó una mejoría significativa (p < 0,0001) del dolor, la depresión y la calidad de vida evaluados mediante la escala analógica visual (EVA), el inventario de Beck y el cuestionario Short Form-36 (SF-36), tanto en pacientes con dolor crónico con ISI menor de 15 como ISI mayor o igual a 15. Los resultados fueron superiores en el grupo de pacientes con insomnio. La presencia de un índice de apneas e hipopneas elevado y movimientos periódicos de los miembros inferiores en los pacientes no se relacionó con la mejoría de las escalas de Beck, SF-36, ISI y EVA. Conclusiones: En conclusión, el PRID beneficia a los pacientes con dolor crónico no oncológico en varias esferas afectadas, además del dolor, mediante un tratamiento integral. La polisomnografía puede ayudar a diagnosticar patologías específicas e individualizar el tratamiento farmacológico.(AU)

Introduction: Sleep disorders and chronic pain are linked to each other bidirectionally. Both are related to affective disorders, fatigue, depression, anxiety and drug abuse, and have a significant effect on quality of life. The Interdisciplinary Pain Programme (IDP) aims to relieve the patients’ pain and improve their functionality by incorporating healthy postural, sleep and nutritional habits, relaxation techniques, physical exercise and cognitive-behavioural mechanisms. Patients and methods: A retrospective, observational, cross-sectional study was conducted. A total of 323 patients with chronic pain who completed the IDP were examined. They were assessed at the beginning and at the end of the programme with pain, depression, quality of life and insomnia scales, and were then compared between groups with and without insomnia, that is, with an insomnia severity index (ISI) less than 15 versus greater than or equal to 15. Fifty-eight patients were studied by means of polysomnography. Results: A significant improvement (p < 0.0001) in pain, depression and quality of life, as assessed by the visual analogue scale (VAS), the Beck inventory and the Short Form-36 (SF-36) questionnaire was observed in chronic pain patients with an ISI below 15 and in those with an ISI greater than or equal to 15. The results were superior in the group of patients with insomnia. The presence of a high apnoea and hypopnoea index and periodic lower limb movements in patients was not related to improvements on the Beck, SF-36, ISI and VAS scales. Conclusions: In conclusion, IDP benefits patients with chronic non-cancer-induced pain in several affected areas, in addition to pain, due to a comprehensive treatment. Polysomnography can help diagnose specific pathologies and individualise pharmacological treatment.(AU)

Uso de móviles, problemas de sueño y obesidad en una zona de exclusión social / Mobile phone use, sleep disorders and obesity in a social exclusion zone

Introducción: Existe poca información del impacto del abuso del teléfono móvil (AM) en zonas con necesidad de transformación social (ZNTS). Nuestro objetivo es estimar la prevalencia de AM en ZNTS, y su asociación con problemas de sueño, rendimiento escolar y obesidad. Pacientes y métodos: Muestreo consecutivo de sujetos entre 10 y 17 años que acuden a consulta de atención primaria en ZNTS entre octubre 2019 y marzo de 2020. Realización de entrevista clínica, antropometría, datos sociodemográficos, de uso de móvil y sueño. Resultados: Se estudiaron 214 sujetos. El AM durante la semana (más de dos horas diarias) fue de 37,5% en el grupo de 10-12 años y de 65,2% en el grupo de 13 a 17 años; durante el fin de semana, las prevalencias fueron de 66,6 y 81,3%, respectivamente. El AM durante la semana se asoció a más obesidad; menor nivel de estudios maternos, mayor dificultad para despertarse, somnolencia diurna y mayor frecuencia de suspensos. El riesgo ajustado se duplica para sobrepeso u obesidad (odds ratio [OR] 1,90; intervalo de confianza del 95% [IC 95%] 1,04 a 3,47), obesidad (OR 2,45; IC 95% 1,23 a 4,89) y problemas de sueño o duración de sueño menor de siete horas (OR 2,26; IC 95% 1,31 a 3,92). El AM durante el fin de semana se asoció a problemas de sueño o duración menor de siete horas (OR 2,68; IC 95% 1,40 a 5,11). Conclusiones: Existe una alta prevalencia de AM en zonas de exclusión social, que se asocia con problemas del sueño, suspensos escolares y obesidad. (AU)

Introduction: There is little information on the impact of mobile phone overuse (MPO) in areas in need of social transformation (ANST). Our objective was to estimate the prevalence of MPO in an ANST and its association with sleep disorders, academic performance and obesity. Patients and methods: Consecutive sampling of patients aged 10–17 years who visited a primary care centre in an ARST between October 2019 and March 2020. The study involved performance of a clinical interview with collection of anthropometric, sociodemographic, mobile phone use and sleep data. Results: The analysis included 214 participants. The prevalence of MPO during weekdays (more than 2 h a day) was 37.5% in children aged 10–12 years and 65.2% in 13- to 17-year-olds; in the weekend, the prevalence increased to 66.6% and 81.3%, respectively. In weekdays, MPO was associated with an increased prevalence of obesity, lower maternal educational attainment, greater difficulty waking up, daytime sleepiness and higher frequency of school failure. The adjusted risk was double for excess weight (odds ratio [OR] 1.90, 95% confidence interval [95% CI] 1.04–3.47), obesity (OR 2.45, 95% CI 1.23–4.89) and sleep disorders or sleep duration of less than 7 h (OR 2.26; 95% CI 1.31–3.92). Weekend MPO was associated with sleep disorders or sleep duration of less than 7 h (OR 2.68; 95% CI 1.40–5.11). Conclusions: The prevalence of mobile phone overuse is high in areas of social exclusion and is associated with sleep disorders, school failure, and obesity. (AU)

Mobile phone use, sleep disorders and obesity in a social exclusion zone.

INTRODUCTION: There is little information on the impact of mobile phone overuse (MPO) in areas in need of social transformation (ANST). Our objective was to estimate the prevalence of MPO in an ANST and its association with sleep disorders, academic performance and obesity. PATIENTS AND METHODS: Consecutive sampling of patients aged 10-17 years who visited a primary care centre in an ARST between October 2019 and March 2020. The study involved performance of a clinical interview with collection of anthropometric, sociodemographic, mobile phone use and sleep data. RESULTS: The analysis included 214 participants. The prevalence of MPO during weekdays (more than 2 h a day) was 37.5% in children aged 10-12 years and 65.2% in 13- to 17-year-olds; in the weekend, the prevalence increased to 66.6% and 81.3%, respectively. In weekdays, MPO was associated with an increased prevalence of obesity, lower maternal educational attainment, greater difficulty waking up, daytime sleepiness and higher frequency of school failure. The adjusted risk was double for excess weight (odds ratio [OR] 1.90, 95% confidence interval [95% CI] 1.04-3.47), obesity (OR 2.45, 95% CI 1.23-4.89) and sleep disorders or sleep duration of less than 7 h (OR 2.26; 95% CI 1.31-3.92). Weekend MPO was associated with sleep disorders or sleep duration of less than 7 h (OR 2.68; 95% CI 1.40-5.11). CONCLUSIONS: The prevalence of mobile phone overuse is high in areas of social exclusion and is associated with sleep disorders, school failure and obesity.

Relación entre los síntomas de déficit de atención/hiperactividad y el sueño en preescolares / Association between attention-deficit/hyperactivity symptoms and sleep in preschoolers

Introducción: Los problemas de sueño son frecuentes en niños con trastorno por déficit de atención/hiperactividad (TDAH). Algunos autores han tratado de caracterizar los hábitos de sueño pediátricos en Portugal, pero ninguno se ha centrado en los niños en edad preescolar ni ha intentado correlacionarlos con el TDAH. El objetivo fue evaluar la prevalencia de los síntomas del TDAH en niños en edad preescolar y estudiar su asociación con los hábitos de sueño. Material y métodos: Estudio transversal mediante la administración de un cuestionario a una muestra aleatoria de cuidadores de niños matriculados en guarderías en Oporto. Se recogieron datos de características sociodemográficas, consumo de televisión y actividades al aire libre. Los síntomas del TDAH y los hábitos de sueño fueron evaluados mediante las versiones portuguesas del Conners’ Parents Rating Scale-Revised y el Children's Sleep Habits Questionnaire (CSHQ-PT), respectivamente. Resultados: El estudio incluyó 381 preescolares (50,90% varones). Se encontraron niveles altos de síntomas de TDAH en el 13,10%, con una prevalencia mayor en las niñas (14,40% vs. 11,85%; p=0,276). El 45,70% tenían una puntuación total en el CSQH-PT superior a 48, que es el punto de corte establecido para el cribado de los trastornos del sueño en la población portuguesa. Se encontró una asociación significativa entre niveles altos de síntomas de TDAH y un nivel educativo materno más bajo (p<0,001), una menor duración del sueño (p=0,049) y mayores puntuaciones en las subescalas de parasomnias (p=0,019) y de trastornos respiratorios del sueño (p=0,002). (AU)

Introduction: Sleep problems are frequent in children with attention-deficit/hyperactivity disorder (ADHD). Some authors have tried to characterize paediatric sleep habits in Portugal, but none has focused on preschool-age children nor attempted to establish their association with ADHD. We aimed to assess the prevalence of ADHD symptoms in preschool-age children and to study their association with sleep habits. Material and methods: We conducted a cross-sectional study. We distributed questionnaires to a random sample of caregivers of children enrolled in early childhood education centres in Porto. We collected data on sociodemographic characteristics, television watching and outdoor activities. We assessed ADHD symptoms and sleep habits with the Portuguese versions of the Conners’ Parents Rating Scale, Revised and the Children's Sleep Habits Questionnaire (CSHQ-PT), respectively. Results: The study included 381 preschoolers (50.90% male). We found high scores for ADHD symptoms in 13.10%, with a higher prevalence in girls (14.40% vs. 11.85%; P=.276). In the CSHQ-PT, 45.70% of participants had a mean total score greater than 48, which is the cut-off point applied in the screening of sleep disturbances in the Portuguese population. There was a significant association between high scores for ADHD symptoms and a lower maternal education level (P<.001), a shorter sleep duration (P=.049), and higher scores on parasomnias (P=.019) and sleep disordered breathing (P=.002) in CSHQ-PT subscales. (AU)

Cambios en la calidad del sueño durante el semestre académico en estudiantes de la salud / Changes in sleep quality during an academic semester in health careers students / Alterações na qualidade do sono durante o semestre letivo em estudantes da área da saúde

Introducción: La calidad del sueño tiene efectos en la salud física y mental, su alteración en estudiantes universitarios dificulta los procesos de memoria, concentración y capacidad de aprendizaje. En Colombia los estudios de sueño se centran principalmente en estudiantes de medicina y enfermería, y muy pocos identifican su relación con la carga académica. Objetivo: Describir los cambios en la calidad del sueño durante un semestre académico y acorde al ciclo de formación en universitarios de una facultad de salud y rehabilitación de Cali, Colombia. Materiales y métodos: Estudio descriptivo, prospectivo mediante la aplicación del Índice de calidad del sueño de Pittsburgh al inicio y cierre del semestre a 241 estudiantes de Fisioterapia, Nutrición y Terapia ocupacional. Resultados: La mayoría de participantes eran mujeres, de 20 años o menos y de estratos socioeconómicos medio y bajo. Al inicio del semestre el 76,35% de estudiantes dormían 7 horas o más y al final se redujo al 49,79%. Al inicio del estudio el 24,90% presentaban mala calidad del sueño y al final la cifra ascendió a 54,36%. Conclusiones: Se presentó un incremento significativo de mala calidad del sueño al final del semestre académico, siendo mayor el cambio en los estudiantes del ciclo profesional.

Introduction: Sleep quality affects physical and mental health and its alteration in university students hinders memory processes, concentration, and learning capacity. In Colombia, studies on sleep patterns focus mainly on medical and nursing students and few of them identify its relationship with academic load. Objective: To describe sleep quality changes during an academic semester and according to education cycles in university students from a health and rehabilitation program in Cali, Colombia. Materials and methods: Descriptive prospective study, which applied the Pittsburg Sleep Quality Index at the beginning and end of the semester to 241 Physiotherapy, Nutrition, and Occupational Therapy students. Results: Most participants were women, aged 20 years old or younger, and belonged to medium to low socioeconomic strata. At the beginning of the semester, 76.35% of students were able to sleep 7 hours or more and at the end this population decreased to 49.79%. At the beginning of the study, 24.9% displayed poor sleep quality, whereas this group increased to 54.36% at the end. Conclusions: There was a significant increase in poor sleep quality at the end of the academic semester, the change being greater in students from the professional cycle.

Introdução: A qualidade do sono tem efeitos na saúde física e mental, sua alteração em estudantes universitários dificulta os processos de memória, concentração e capacidade do aprendizagem. Na Colômbia, os estudos do sono se concentram basicamente em estudantes de medicina e enfermería, e poucos identificam sua relação com a carga acadêmica. Objetivo: Descrever as alterações na qualidade do sono durante um semestre letivo de acordo com o ciclo de formação em estudantes universitários de uma escola de saúde e reabilitação em Cali, Colômbia. Materiais e métodos: Estudo descritivo, prospectivo por meio da aplicação do Índice de Qualidade do Sono de Pittsburgh no início e final do semestre em 241 alunos de Fisioterapia, Nutrição e Terapia Ocupacional. Resultados: A maioria dos participantes foram mulheres, com idade igual ou inferior a 20 anos e de estratos socioeconômicos médio e baixo. No início do semestre, 76,35% dos alunos dormiam 7 horas ou mais, e no final diminuiu para 49,79%. No início do estudo, 24,90% tinham má qualidade do sono e no final o número subiu para 54,36%. Conclusões: Houve um aumento significativo da má qualidade do sono no final do semestre letivo, sendo a alteração maior nos estudantes do ciclo profissional.

Association between attention-deficit/hyperactivity symptoms and sleep in preschoolers.

INTRODUCTION: Sleep problems are frequent in children with attention-deficit/hyperactivity disorder (ADHD). Some authors have tried to characterize paediatric sleep habits in Portugal, but none has focused on preschool-age children nor attempted to establish their association with ADHD. We aimed to assess the prevalence of ADHD symptoms in preschool-age children and to study their association with sleep habits. MATERIAL AND METHODS: We conducted a cross-sectional study. We distributed questionnaires to a random sample of caregivers of children enrolled in early childhood education centres in Porto. We collected data on sociodemographic characteristics, television watching and outdoor activities. We assessed ADHD symptoms and sleep habits with the Portuguese versions of the Conners' Parents Rating Scale, Revised and the Children's Sleep Habits Questionnaire (CSHQ-PT), respectively. RESULTS: The study included 381 preschoolers (50.90% male). We found high scores for ADHD symptoms in 13.10%, with a higher prevalence in girls (14.40% vs. 11.85%; P = 0.276). In the CSHQ-PT, 45.70% of participants had a mean total score greater than 48, which is the cut-off point applied in the screening of sleep disturbances in the Portuguese population. There was a significant association between high scores for ADHD symptoms and a lower maternal education level (P < 0.001), a shorter sleep duration (P = 0.049), and higher scores on parasomnias (P = 0.019) and sleep disordered breathing (P = 0.002) in CSHQ-PT subscales. CONCLUSIONS: ADHD and sleep disorders are common in preschoolers, in Porto, and this study suggests some clinical correlations between them. Since these interactions are complex and far from being elucidated, further studies are paramount to provide guidance for prevention and managing strategies in younger children at risk for ADHD.

Sleep impairments in refugees diagnosed with post-traumatic stress disorder: a polysomnographic and self-report study.

Background: Post-traumatic stress disorder (PTSD) is the clinical manifestation of traumatic events and is associated with sleep disturbances. Sleep disturbances, if left untreated, may perpetuate or even worsen symptoms of PTSD. Previous studies of other PTSD populations show a higher incidence of sleep impairments and sleep disorders compared to healthy controls (HCs); however, this has never been investigated in trauma-affected refugees diagnosed with PTSD.Objectives: To examine subjective sleep quality, measure sleep architecture, and identify latent sleep disorders in refugees diagnosed with PTSD compared to HCs.Method: This comparative study included 20 trauma-affected refugees diagnosed with PTSD and 20 HC matched on age, sex, and body mass index. All participants completed self-report questionnaires assessing sleep quality, insomnia severity, and disturbing nocturnal behaviour, and all took part in a one-night polysomnography (PSG) assessment.Results: Patients reported significantly poorer subjective sleep quality, sleep latency, sleep duration, and sleep efficiency compared to HCs. Subjective reports on hours spent in bed were not significantly different between patients and HCs. Patients reported significantly higher nightmare frequency and severity compared to HCs. PSG measures showed that patients had significantly reduced sleep efficiency, more awakenings, and longer REM sleep latency, and spent more time awake, whereas there was no significant differences regarding total time in bed, total sleep time, or sleep latency. The prevalence of sleep disorders was equal between groups.Conclusions: The study identified significant impairments in several sleep domains, with a preponderance of disturbed regulation of sleep resulting in awakenings. These results indicate a need for more focus on hyperarousal and nightmares as key elements of disturbed sleep in PTSD. Furthermore, the study identified a discrepancy between subjective and objective measures concerning total sleep time, raising questions regarding the causes of 'sleep state misperception'.Trial registration: ClinicalTrials.gov identifier: NCT03535636..Trial registration: Sleep Impairments in Refugees Diagnosed with PTSD (PSG-PTSD). URL: https://clinicaltrials.gov/ct2/show/NCT03535636. ClinicalTrials.gov NCT03535636. Date of registration: 24/05/2018.

This is the first study assessing sleep impairments and sleep disorders in refugees diagnosed with post-traumatic stress disorder (PTSD) compared to healthy controls.The main finding is that both subjectively and objectively measured sleep is disrupted in refugees diagnosed with PTSD compared to healthy controls.The results suggest that these disturbances of sleep are significant targets in treatment of PTSD and stress the importance of focusing on treatment of sleep disturbances in PTSD.

Estimulação Transcraniana para Transtornos do Sono: uma revisão sistemática / Transcranial Stimulation in Sleep Disorders: a systematic review / Estimulación Transcraneal para los Trastornos del Sueño: una revisión sistemática

Os transtornos do sono podem ter várias consequências para a cognição, comportamento e vida social das pessoas. No entanto, a terapia utilizada para avaliar e intervir nesses transtornos ainda não está consolidada. Nesse contexto, o objetivo deste estudo foi verificar a aplicabilidade e eficácia da estimulação transcraniana (ETCA / ETCC / EMTr) nos transtornos do sono. Foi realizada uma busca sistemática de acordo com as diretrizes do PRISMA nas bases de dados Web of Science, PubMed, LILACS e SciELO. Inicialmente, foram encontrados 448 artigos, de acordo com os critérios de elegibilidade. O banco de dados de evidências de fisioterapia (PEDro) foi utilizado para avaliar a qualidade metodológica dos 11 artigos finais. Em geral, os resultados indicam que há tanto relatos favoráveis quanto desfavoráveis à eficácia do uso terapêutico das técnicas de estimulação transcraniana nos transtornos do sono e, portanto, ainda se configura como uma questão em aberto, dependendo de múltiplos fatores metodológicos e conceituais.

Sleep disorders can have several consequences on people's cognition, behavior and social life. However, the therapy used to assess and intervene in these disorders is not yet consolidated. In this context, the aim of this study was to verify the applicability and effectiveness of transcranial stimulation (tACS / tDCS / rTMS) in sleep disorders. A systematic search was performed according to PRISMA guidelines in the Web of Science, PubMed, LILACS, and SciELO databases. Initially, 448 articles were found, according to the eligibility criteria. The physiotherapy evidence database (PEDro) was used to assess the methodological quality of the 11 final articles. In general, the results indicate that there are both favorable and unfavorable reports on the effectiveness of the therapeutic use of transcranial stimulation techniques in sleep disorders and, therefore, it is still an open question, depending on multiple methodological and conceptual factors.

Trastornos del sueño pueden tener varias consecuencias para la cognición, el comportamiento y la vida social de las personas. La terapia utilizada para evaluar e intervenir en estos trastornos aún no está consolidada. En este contexto, el objetivo de este estudio fue verificar la aplicabilidad y efectividad de la estimulación transcraneal (ETCA / ETCC / EMTr) en los trastornos del sueño. Se realizó una búsqueda sistemática según las guías PRISMA en las bases de datos Web of Science, PubMed, LILACS y SciELO. Inicialmente se encontraron 448 artículos, según los criterios de elegibilidad. Se utilizó la base de datos PEDro para evaluar la calidad metodológica de los 11 artículos finales. En general, los resultados indican que existen informes tanto favorables como desfavorables sobre la efectividad del uso terapéutico de las técnicas de estimulación transcraneal en los trastornos del sueño y, por tanto, sigue siendo una cuestión abierta, dependiendo de múltiples factores metodológicos y conceptuales.