Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.465
Filtrar
1.
Adv Exp Med Biol ; 1297: 163-171, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33537944

RESUMO

Shared neurophysiology of addiction and sleep disorders results in a bidirectional interplay. Diagnosing and treating primary sleep disorders, particularly in adolescents, can prevent the development of addiction in susceptible individuals. Addressing sleep issues in early recovery, and throughout maintenance, can prevent relapse. Cannabis use for insomnia shows mixed results; assisting with onset sleep latency in early use, this subsides with chronic use and holds addiction risk. Insomnia is a primary complaint of cannabis withdrawal syndrome and a primary cause of relapse in cannabis use disorder. An ideal sleep aid would prevent relapse and have low abuse potential. Pharmaceutical and behavioral options include suvorexant, mirtazapine, trazodone, and aerobic exercise, but clinical trials are lacking to demonstrate efficacy.


Assuntos
Comportamento Aditivo , Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Adolescente , Comportamento Aditivo/diagnóstico , Humanos , Sono , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/tratamento farmacológico
2.
Artigo em Russo | MEDLINE | ID: mdl-33580756

RESUMO

OBJECTIVE: To study the features of the emotional status and autonomic regulation in patients with coronary heart disease and sleep disorders. MATERIAL AND METHODS: Patients with angina pectoris of II-IV functional class (n=244), aged 36 to 72 years (average age 56.9±0.5 years), were examined. Emotional status was assessed by the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Inventory, the State-Trait Anxiety Inventory. The vegetative status was studied by heart rate variability based on 5-minute recordings of cardiointervalogram and D.J. Ewing cardiovascular tests and a vegetative disorders questionnaire. Patients were divided into 2 groups depending on the severity of sleep disorders. RESULTS: Sixty-two patients (25.4%) had no sleep disorders (≥22 points on the sleep quality questionnaire), they were included in the 2nd group; 113 patients (46.3%) had severe sleep disorders (≤18 points on the sleep quality questionnaire), these patients were included in the 1st group, 69 patients (28.3%) had sleep disorders assessed as insignificant (from 19 to 21 points on the sleep quality questionnaire). The HADS scores for anxiety and depression were 9.2±0.4 and 7.7±0.4, respectively, in the 1st group; in the 2nd group the levels of anxiety and depression were 5.9±0.4 and 3.9±0.4 points (p<0.001). Clinically expressed autonomic disorders were observed in 100% of patients in the 1st group and in 75.8% in the 2nd group (p<0.001). The average score on the questionnaire of autonomic disorders was 41.8±1.2 in the 1st group, and 25.6±1.6 points in the 2nd group (p<0.001). CONCLUSION: In patients with sleep disorders, a higher level of anxiety, depression, autonomic disorders and lower heart rate variability were detected, which is an unfavourable prognostic sign that should be considered in treatment and rehabilitation of these patients.


Assuntos
Isquemia Miocárdica , Transtornos do Sono-Vigília , Adulto , Idoso , Ansiedade/diagnóstico , Depressão/diagnóstico , Emoções , Humanos , Pessoa de Meia-Idade , Isquemia Miocárdica/complicações , Qualidade de Vida , Transtornos do Sono-Vigília/diagnóstico
3.
Sarcoidosis Vasc Diffuse Lung Dis ; 37(2): 169-178, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33093780

RESUMO

Rationale: An increased incidence of Obstructive Sleep Apnea (OSA) in sarcoidosis has been described in small sample size studies. Fatigue is common in sarcoidosis and OSA could be a relevant, treatable comorbidity. To date, the effect of Continuous Positive Airway Pressure (CPAP) on fatigue has never been assessed. Objectives: To investigate the prevalence of OSA in sarcoidosis, fatigue status and daytime sleepiness in patients of our center. To explore the effect of CPAP in fatigue and daytime sleepiness after 3 months using validated questionnaires. Method: Single group, one center, open-label prospective cohort study. Measurements and main result: We enrolled 68 patients and OSA was diagnosed in 60 (88.2%): 25 (36.8%) were mild while 35 (51.5%) were moderate-to-severe. 38 (55.9%) patients received CPAP but only 20 (30.9%) were compliant at 3-month evaluation. Questionnaires demonstrated fatigue in 34 (50%) and daytime sleepiness in 21 (30.9%). In multivariate regression analysis, Scadding stage and FAS behave as predictors of Apnea-Hypopnea Index (AHI) severity while sleepiness and steroids weren't associated. FAS score (ΔFAS = 6.3; p = 0.001) and ESS score (ΔESS = 2.8; p = 0.005) improved after three months of CPAP. Conclusions: OSA is highly prevalent in patients affected by sarcoidosis. ESS questionnaire is not reliable for OSA screening and other pre-test probability tool should be evaluated in further studies. CPAP leads to a significative reduction of fatigue and daytime sleepiness at three-month. Further studies are needed to confirm the high prevalence of OSA in sarcoidosis and the positive role of CPAP in fatigue. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (2): 169-178).


Assuntos
Pressão Positiva Contínua nas Vias Aéreas , Fadiga/prevenção & controle , Pulmão/fisiopatologia , Respiração , Sarcoidose/epidemiologia , Apneia Obstrutiva do Sono/terapia , Transtornos do Sono-Vigília/prevenção & controle , Sono , Idoso , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Fadiga/diagnóstico , Fadiga/epidemiologia , Fadiga/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Recuperação de Função Fisiológica , Fatores de Risco , Roma/epidemiologia , Sarcoidose/diagnóstico , Sarcoidose/fisiopatologia , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/fisiopatologia , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
4.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(9. Vyp. 2): 68-73, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33076648

RESUMO

OBJECTIVE: To summarize published data on the prevalence, characteristics and diagnostic criteria of sleep disorders in epilepsy. MATERIAL AND METHODS: A search of published articles was performed in Medline (Pubmed), Scopus, Web of Science and e-library databases. RESULTS: Epidemiologic, clinical and diagnostic aspects of excessive daytime sleepiness, obstructive sleep apnea and central apnea, restless leg syndrome and parasomnias related to slow-wave and REM-sleep in patients with epilepsy were analyzed. CONCLUSIONS: Further studies are needed to gain an insight into the complex associations of sleep disorders in epilepsy to optimize diagnostic and treatment approaches and to improve the quality of life in that patient population.


Assuntos
Epilepsia , Parassonias , Transtornos do Sono-Vigília , Epilepsia/diagnóstico , Epilepsia/epidemiologia , Humanos , Parassonias/diagnóstico , Parassonias/epidemiologia , Qualidade de Vida , Sono , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia
5.
Sleep Med Clin ; 15(3S): e1-e7, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33008491

RESUMO

Prior to the COVID-19 pandemic, few pediatric sleep medicine clinicians routinely engaged in telemedicine visits because thorough examinations were difficult to perform; there was lack of consistent reimbursement; and many clinicians were busy with their in-office practices. This article reviews how telemedicine has been explored in pediatric sleep medicine prior to the pandemic, current applications of telemedicine, challenges, and reimagining pediatric sleep within the realm of telemedicine.


Assuntos
Pediatria , Medicina do Sono , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/terapia , Telemedicina/métodos , Betacoronavirus , Criança , Pressão Positiva Contínua nas Vias Aéreas , Infecções por Coronavirus , Humanos , Otolaringologia , Pandemias , Pneumonia Viral , Polissonografia , Encaminhamento e Consulta , Síndrome das Pernas Inquietas/diagnóstico , Síndrome das Pernas Inquietas/terapia , Sono , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/terapia , Transtornos do Sono do Ritmo Circadiano/diagnóstico , Transtornos do Sono do Ritmo Circadiano/terapia , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/terapia
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4326-4329, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018953

RESUMO

Parkinson's Disease (PD) is the second most common neurodegenerative disorder with the non-motor symptoms preceding the motor impairment that is needed for clinical diagnosis. In the current study, an angle-based analysis that processes activity data during sleep from a smartwatch for quantification of sleep quality, when applied on controls and PD patients, is proposed. Initially, changes in their arm angle due to activity are captured from the smartwatch triaxial accelerometry data and used for the estimation of the corresponding binary state (awake/sleep). Then, sleep metrics (i.e., sleep efficiency index, total sleep time, sleep fragmentation index, sleep onset latency, and wake after sleep onset) are computed and used for the discrimination between controls and PD patients. A process of validation of the proposed approach when compared with the PSG-based ground truth in an in-the-clinic setting, resulted in comparable state estimation. Moreover, data from 15 early PD patients and 11 healthy controls were used as a test set, including 1,376 valid sleep recordings in-the-wild setting. The univariate analysis of the extracted sleep metrics achieved up to 0.77 AUC in early PD patients vs. healthy controls classification and exhibited a statistically significant correlation (up to 0.46) with the clinical PD Sleep Scale 2 counterpart Items. The findings of the proposed method show the potentiality to capture non-motor behavior from users' nocturnal activity to detect PD in the early stage.


Assuntos
Doença de Parkinson , Transtornos do Sono-Vigília , Humanos , Doença de Parkinson/diagnóstico , Polissonografia , Sono , Privação do Sono , Transtornos do Sono-Vigília/diagnóstico
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4982-4985, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019105

RESUMO

Sleep disorders are extremely common in today's society and are greatly affecting the health and safety of every person suffering from one. Over the last decades, Automatic Sleep Stage Classification (ASSC) systems have been developed to assist specialists in the sleep stage scoring process and therefore in the diagnosis of sleep disorders. Binaural beats are auditory phenomena that have been shown to have a positive impact in sleep quality and mental state. This paper introduces a framework that combines an ASSC system and a binaural beats generator in real time. Our goal is to pave the way for developing systems which could reproduce specific binaural beats depending on the detected sleep stage, in order to entrain the brain into a more efficient sleep. For the ASSC stage, different classifiers were evaluated using data signals retrieved from a public sleep stage signals database, corresponding to ten subjects. The complete framework was tested using the database signals and signals from a test subject, captured and processed in real time. Our proposed framework may lead to a fully automated system to improve sleep quality without the need of medication.


Assuntos
Fases do Sono , Transtornos do Sono-Vigília , Bases de Dados Factuais , Humanos , Polissonografia , Transtornos do Sono-Vigília/diagnóstico
8.
Med. intensiva (Madr., Ed. impr.) ; 44(6): 344-350, ago.-sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194813

RESUMO

OBJETIVO: Evaluar las características psicométricas del cuestionario Freedman modificado para la valoración del sueño en el paciente crítico. DISEÑO: Estudio psicométrico. Se exploró la validez de contenido mediante un grupo de expertos y la consistencia interna fue evaluada mediante el coeficiente alfa de Cronbach. Se realizó un análisis factorial para evaluar la validez de constructo; la estabilidad fue medida con análisis test-retest mediante el índice de correlación intraclases. Ámbito: Servicio de Medicina Intensiva de un hospital de referencia. PARTICIPANTES: Pacientes ingresados entre el 23 de febrero de 2016 y el 20 de diciembre de 2017. INTERVENCIONES: Administración de un cuestionario. VARIABLES: Ítems del cuestionario Freedman modificado. RESULTADOS: La pertinencia de los ítems y su definición obtuvieron valores superiores a 3, en una escala tipo Likert con valor máximo de 4 puntos. El alfa de Cronbach indicó un valor global de 0,933. El índice de correlación intraclases obtuvo valores superiores a 0,75 en la mayoría de los ítems del cuestionario. El análisis factorial obtuvo asociación entre las variables analizadas y los 4 factores. CONCLUSIONES: El cuestionario Freedman modificado presentó unas buenas características psicométricas. Puede resultar un instrumento fiable para evaluar la calidad del sueño en el paciente crítico, así como los factores ambientales relacionados


AIM: A study was made of the psychometric characteristics of the modified Freedman questionnaire to assess sleep in critical patients. DESIGN: A psychometric study was carried out, with content validity being explored by a group of experts, and internal consistency based on Cronbach's alpha coefficient. Factor analysis was performed to explore construct validity, and stability was assessed by test-retest analysis. SETTING: The Department of Intensive Care Medicine of a reference hospital. PARTICIPANTS: Patients admitted between 23 February 2016 and 20 December 2017. INTERVENTIONS: Questionnaire administration. VARIABLES: Items of the modified Freedman questionnaire. RESULTS: Item relevance and definition yielded scores > 3 (Likert scale maximum = 4). Cronbach's alpha showed a global value of 0.933. The intraclass correlation index was > 0.75 for most of the items of the questionnaire. Factor analysis allowed the detection of specific associations between the studied variables and the four factors. CONCLUSIONS: The modified Freedman questionnaire showed good psychometric characteristics. It may be a reliable instrument for assessing the quality of sleep in critically ill patients, as well as the environmental factors


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Psicometria/métodos , Cuidados Críticos/psicologia , Transtornos do Sono-Vigília/psicologia , Transtornos do Sono-Vigília/diagnóstico , Inquéritos e Questionários , Análise Fatorial , Privação do Sono/psicologia
9.
Sleep Med ; 74: 18-24, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32836181

RESUMO

OBJECTIVE: The COVID-19 pandemic is a large-scale public health emergency that likely precipitated sleep disturbances in the community. This study aimed to investigate the prevalence and correlates of sleep disturbances during the early phase of COVID-19 pandemic. METHODS: This web-based cross-sectional study recruited 1138 Hong Kong adults using convenience sampling over a two-week period from 6th April 2020. The survey collected data on sleep disturbances, mood, stress, stock of infection control supplies, perceived risk of being infected by COVID-19, and sources for acquiring COVID-19 information. The participants were asked to compare their recent sleep and sleep before the outbreak. The Insomnia Severity Index (ISI) was used to assess their current insomnia severity. Prevalence was weighted according to 2016 population census. RESULTS: The weighted prevalence of worsened sleep quality, difficulty in sleep initiation, and shortened sleep duration since the outbreak were 38.3%, 29.8%, and 29.1%, respectively. The prevalence of current insomnia (ISI score of ≥10) was 29.9%. Insufficient stock of masks was significantly associated with worsened sleep quality, impaired sleep initiation, shortened sleep duration, and current insomnia in multivariate logistic regression (adjusted OR = 1.57, 1.72, 1.99, and 1.96 respectively, all p < 0.05). CONCLUSION: A high proportion of people in Hong Kong felt that their sleep had worsened since the COVID-19 outbreak. Insufficient stock of masks was one of the risk factors that were associated with sleep disturbances. Adequate and stable supply of masks may play an important role to maintain the sleep health in the Hong Kong general population during a pandemic outbreak.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Pneumonia Viral/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , População Urbana , Adolescente , Adulto , Idoso , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Estudos Transversais , Surtos de Doenças/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Prevalência , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/terapia , População Urbana/tendências , Adulto Jovem
10.
Sleep Med ; 74: 39-47, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32836185

RESUMO

OBJECTIVE: To assess the prevalence and sociodemographic correlates of insomnia symptoms among Chinese adolescents and young adults affected by the outbreak of coronavirus disease-2019 (COVID-19). METHODS: This cross-sectional study included Chinese adolescents and young adults 12-29 years of age during part of the COVID-19 epidemic period. An online survey was used to collect demographic data, and to assess recognition of COVID-19, insomnia, depression, and anxiety symptoms using the Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder (GAD-7) questionnaires, respectively. The Social Support Rate Scale was used to assess social support. RESULTS: Among 11,835 adolescents and young adults included in the study, the prevalence of insomnia symptoms during part of the COVID-19 epidemic period was 23.2%. Binomial logistic regression analysis revealed that female sex and residing in the city were greater risk factors for insomnia symptoms. Depression or anxiety were risk factors for insomnia symptoms; however, social support, both subjective and objective, was protective factors against insomnia symptoms. Furthermore, anxiety and depression symptoms were mediators of social support and insomnia symptoms. CONCLUSIONS: Results of this study revealed a high prevalence of sleep problems among adolescents and young adults during the COVID-19 epidemic, especially senior high school and college students, which were negatively associated with students' projections of trends in COVID-19. The adverse impact of COVID-19 was a risk factor for insomnia symptoms; as such, the government must devote more attention to sleep disorders in this patient population while combating COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/psicologia , Adolescente , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/psicologia , Criança , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Pneumonia Viral/diagnóstico , Transtornos do Sono-Vigília/diagnóstico , Apoio Social , Inquéritos e Questionários , Adulto Jovem
11.
Chronobiol Int ; 37(8): 1214-1222, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32856947

RESUMO

This study aimed to investigate the relationship between chronotype preference/sleep problems and symptom severity of children with Attention Deficit Hyperactivity Disorder (ADHD) during the COVID-19 outbreak and to assess the chronotype preference/sleep problems that may play a mediating role in the relationship between the reactions to trauma and severity of ADHD symptoms. The sample of this single-center cross-sectional study consisted of 76 children with ADHD and their parents. Trauma symptoms were evaluated with the Children's Impact of Event Scale (CRIES-8); sleep habits were assessed using the Children's Sleep Habits Questionnaire (CSHQ); and chronotype was assessed using the Children's Chronotype Questionnaire (CCQ). There were significant differences in CRIES-8 and CSHQ scores between the eveningness type group and the non-eveningness type group. The CRIES-8 scores of children with ADHD were related to the CCQ and CSHQ scores and severity of ADHD symptoms. In mediation analyses, sleep problems were found to be the full mediating factor in the relationship between CRIES-8 scores and severity of ADHD symptoms and the relationship between CCQ scores and the severity of ADHD symptoms. Our findings indicate that chronotype plays an important role on the negative effects of home confinement of ADHD children during the COVID-19 outbreak. The role of the full mediator of sleep problems in the path from cognition to the behavior of young ADHD and non-ADHD children confined to the home environment during the pandemic period requires further assessment.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Betacoronavirus , Ritmo Circadiano/fisiologia , Infecções por Coronavirus/virologia , Pneumonia Viral/virologia , Transtornos do Sono-Vigília/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Infecções por Coronavirus/fisiopatologia , Estudos Transversais , Feminino , Humanos , Masculino , Pandemias , Pneumonia Viral/fisiopatologia , Transtornos do Sono-Vigília/diagnóstico
12.
Med Arch ; 74(3): 210-215, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32801438

RESUMO

Introduction: Several research studies have started to investigate the health conditions of medical doctors and nurses in order to find a relationship if any between their work environment, their usually heavy duties and the result of these two parametric on patients' health. Aim: The present research study is an effort to investigate the relationship between the physical activity and sleep disorders among health care professionals, particularly among medical doctors and nurses. Methods: Participants of the study were asked to fill a questionnaire which was a mixture of other internationally accredited questionnaires regarding physical activity level as well as sleeping functions. Data were collected among 204 physicians and nurses. The statistical analysis revealed a correlation between physical activity and some aspects of sleep disorders. Results: A total number of 204 questionnaires have been distributed to medical doctors and nurses working in public hospitals in Athens Greece from the middle of February until the middle of April 2020. The hospitals were assigned by the health authorities to the fight of the pandemic of COVID 19. The majority of the participants were women 71,3% and 28,7% were men. From a total of 204 half of them were medical doctors and half of them were nurses. 43% were married, 49% were single and 8% were divorced and there were no widows. Regarding the participant nurses, 43% had a university degree and 38,4% had a technological education degree. The results of the statistical analysis showed that there are positive correlations between the level of physical activity during the daily work and the free time of the participants with parameters that are related to sleep disorders. Conclusion: The sample of the study was not a large one but nevertheless a stressful situation such as is the epidemic of COVID19 can provide useful information in order to better understand the relationship between physical activity and sleeping disorders in such working conditions.


Assuntos
Infecções por Coronavirus/epidemiologia , Exercício Físico , Médicos Hospitalares , Recursos Humanos de Enfermagem no Hospital , Estresse Ocupacional , Pneumonia Viral/epidemiologia , Transtornos do Sono-Vigília , Adulto , Atitude do Pessoal de Saúde , Betacoronavirus , Exercício Físico/fisiologia , Exercício Físico/psicologia , Feminino , Grécia/epidemiologia , Médicos Hospitalares/psicologia , Médicos Hospitalares/estatística & dados numéricos , Humanos , Masculino , Recursos Humanos de Enfermagem no Hospital/psicologia , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Estresse Ocupacional/etiologia , Estresse Ocupacional/fisiopatologia , Pandemias , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/fisiopatologia , Transtornos do Sono-Vigília/psicologia , Inquéritos e Questionários , Equilíbrio Trabalho-Vida , Carga de Trabalho
13.
Chronobiol Int ; 37(8): 1207-1213, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32746638

RESUMO

This study aimed to investigate the relationship between chronotype preference/sleep problems and symptom severity of children with Autism spectrum disorder (ASD) during the confinement and social isolation of the COVID-19 outbreak. This study included 46 drug-naive children aged 4-17 y diagnosed with ASD. The Autism Behavior Checklist (AuBC), Children's Sleep Habits Questionnaire (CSHQ), and Children's chronotype questionnaire (CCQ) were filled out before and at the end of the COVID-19 mandated home confinement by the children's parents. Children with ASD during the home confinement reported higher chronotype scores, i.e., eveningness chronotype, sleep problems, and autism symptom scores compared to the normal non-hone confinement state. The chronotype score and sleep problems of children with ASD during the home confinement period varied according to the AuBC score. The sleep problems of the children with ASD during the home confinement period mediated the relationship between chronotype score and severity of autism symptoms. It is essential to validate the role of the mediator effect of sleep problems and chronotype in larger samples of children with ASD with restricted to home confinement during the pandemic period. If sleep problems can be controlled with parental education, pharmacotherapy, and psychotherapeutic interventions, the impact on children with ASD of home confinement can be reduced.


Assuntos
Transtorno do Espectro Autista/epidemiologia , Betacoronavirus , Ritmo Circadiano/fisiologia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Sono/fisiologia , Betacoronavirus/patogenicidade , Infecções por Coronavirus/fisiopatologia , Feminino , Humanos , Masculino , Pandemias , Pneumonia Viral/fisiopatologia , Índice de Gravidade de Doença , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/fisiopatologia
14.
J. clin. sleep med ; 16(8): 1377-1381, Aug. 15, 2020.
Artigo em Inglês | BIGG - guias GRADE | ID: biblio-1129889

RESUMO

In 2017 the Veterans Administration (VA) and Department of Defense (DOD) launched development of clinical practice guidelines (CPGs) for the diagnosis and treatment of sleep disorders, with the goal of informing and improving patient care. The guideline development process followed GRADE methodology, considering studies and systematic reviews published over the 10-year period prior to guideline development. A total of 41 recommendations were made,18 related to the diagnosis and treatment of obstructive sleep apnea (OSA) and 23 regarding chronic insomnia disorder. In contrast to other published guidelines, the VA DoD CPGs provide a comprehensive approach to diagnosis and management of the two most common sleep disorders, including a discussion of the sequencing of diagnostic approaches and treatment options. Regarding OSA, strong recommendations were made for follow-up evaluation after non-diagnostic home sleep apnea tests, positive airway pressure therapy as first-line treatment, and the incorporation of supportive, educational and behavioral interventions for patients at high risk for PAP therapy non-adherence due to comorbid conditions. Strong recommendations were also made for the use of cognitive-behavioral therapy for insomnia and against the use of kava (an herbal supplement) in the treatment of chronic insomnia disorder. These guidelines, while intended to directly inform care within VA and DOD, are broadly relevant to the practice of sleep medicine. The majority of scientific evidence was based on studies of non-military, non-veteran populations. The CPG is a major milestone for the VA and DOD in recognizing the importance of evidence-based treatments for sleep disorders in military personnel and veterans.


Assuntos
Humanos , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/terapia , Distúrbios do Início e da Manutenção do Sono/prevenção & controle , Kava , Medicina do Sono/organização & administração , Saúde Militar
17.
BMC Psychiatry ; 20(1): 331, 2020 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-32580724

RESUMO

BACKGROUND: Sleep disorders are a risk factor for developing a variety of mental disorders, have a negative impact on their remission rates and increase the risk of relapse. Early identification and treatment of sleep disorders is therefore of paramount importance. Unfortunately, in mental health care sleep disorders are often poorly recognized and specific treatment frequently occurs late or not at all. This protocol-paper presents a randomized controlled trial investigating the clinical relevance of early detection and treatment of sleep disorders in mental health care. The two aims of this project are 1) to determine the prevalence of sleep disorders in different mental disorders, and 2) to investigate the contribution of early identification and adequate treatment of sleep disorders in individuals with mental disorders to their sleep, mental disorder symptoms, general functioning, and quality of life. METHODS: Patients newly referred to a Dutch mental health institute for psychiatric treatment will be screened for sleep disorders with the self-assessment Holland Sleep Disorders Questionnaire (HSDQ). Patients scoring above the cut-off criteria will be invited for additional diagnostic evaluation and, treatment of the respective sleep disorder. Participants will be randomly assigned to two groups: Immediate sleep diagnostics and intervention (TAU+SI-T0), or delayed start of sleep intervention (TAU+SI-T1; 6 months after inclusion). The effect of sleep treatment as add-on to treatment as usual (TAU) will be tested with regard to sleep disorder symptoms, general functioning, and quality of life (in collaboration with a psychiatric sleep centre). DISCUSSION: This trial will examine the prevalence of different sleep disorders in a broad range of mental disorders, providing information on the co-occurrence of specific sleep and mental disorders. Further, this study is the first to investigate the impact of early treatment of sleep disorders on the outcome of many mental disorders. Moreover, standard sleep interventions will be tailored to specific mental disorders, to increase their efficacy. The results of this trial may contribute considerably to the improvement of mental health care. TRIAL REGISTRATION: This clinical trial has been retrospectively registered in the Netherlands Trial Register (NL8389; https://www.trialregister.nl/trial/8389) on February 2th, 2020.


Assuntos
Diagnóstico Precoce , Saúde Mental , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/terapia , Humanos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos do Sono-Vigília/psicologia
19.
Cardiovasc Diabetol ; 19(1): 61, 2020 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-32404104

RESUMO

BACKGROUND: Sleep disturbance has been significantly associated with the incidence of cardiovascular disease (CVD) in the general population. However, despite the common prevalence of sleep disturbance in patients with type 2 diabetes, its relationship with the risk of CVD remains unclear. Here, we have examined the association of sleep disturbance with the incidence of all CVD and all-cause mortality in patients with newly-diagnosed type 2 diabetes. METHODS: We used the Korean National Health Insurance Service-Health Screening Cohort data and included 36,058 patients with new-onset type 2 diabetes aged ≥ 40 years between 2004 and 2007, along with follow-up examinations to 2013. We used the ICD-10 code to measure sleep disturbance as a primary diagnosis and the multivariable Cox proportional hazards regression models to estimate the adjusted hazard ratio (AHR) and 95% confidence interval (CI) of all CVD, coronary heart disease (CHD), stroke, and all-cause mortality. RESULTS: We identified 6897 cases of all CVD (CHD, n = 4138; stroke, n = 2759) and 2890 events of all-cause mortality during a mean follow-up period of 7.0 years. Sleep disturbance was associated with an increased risk of All CVD (AHR, 1.24; 95% CI, 1.06-1.46), CHD events (AHR, 1.24; 95% CI, 1.00-1.53), and all-cause mortality (AHR, 1.47; 95% CI, 1.15-1.87) in patients with new-onset type 2 diabetes. Furthermore, women (AHR, 1.33; 95% CI, 1.06-1.67) and middle-aged adults (AHR, 1.29; 95% CI, 1.02-1.64) with sleep disturbance had a significantly increased risk of CVD than those without; contrarily, men (AHR, 1.45; 95% CI, 1.09-1.95) and older adults (AHR, 1.51; 95% CI, 1.15-1.99) with sleep disturbance were associated with a significantly increased risk of all-cause mortality than those without. CONCLUSIONS: Our findings suggest that sleep disturbance is significantly associated with an increased risk of CVD and all-cause mortality in patients with new-onset type 2 diabetes.


Assuntos
Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Adulto , Idoso , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/mortalidade , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/mortalidade , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , República da Coreia/epidemiologia , Medição de Risco , Fatores de Risco , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/mortalidade , Fatores de Tempo
20.
Sleep Med Clin ; 15(2): 155-166, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32386691

RESUMO

Excessive daytime sleepiness is defined as the inability to maintain wakefulness during waking hours, resulting in unintended lapses into sleep. It is important to distinguish sleepiness from fatigue. The evaluation of a sleep patient begins with a careful clinical assessment that includes a detailed sleep history, medical and psychiatric history, a review of medications, as well as a social and family history. Physical examination should include a general medical examination with careful attention to the upper airway and the neurologic examination. Appropriate objective testing with a polysomnogram and a multiple sleep latency test if needed will help confirm the diagnosis and direct the appropriate treatment plan.


Assuntos
Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Transtornos do Sono-Vigília/diagnóstico , Sono/fisiologia , Diagnóstico Diferencial , Distúrbios do Sono por Sonolência Excessiva/fisiopatologia , Humanos , Polissonografia/métodos , Transtornos do Sono-Vigília/fisiopatologia , Vigília/fisiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA