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1.
Neurology ; 94(7): e705-e717, 2020 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-31964693

RESUMO

OBJECTIVE: A cross-sectional study was performed to evaluate whether quantitative oculomotor measures correlate with disease severity in late-onset GM2 gangliosidosis (LOGG) and assess cognition and sleep as potential early nonmotor features. METHODS: Ten patients with LOGG underwent quantitative oculomotor recordings, including measurements of the angular vestibulo-ocular reflex (VOR), with results compared to age- and sex-matched controls. Disease severity was assessed by ataxia rating scales. Cognitive/neuropsychiatric features were assessed by the cerebellar cognitive affective syndrome (CCAS) scale, Cerebellar Neuropsychiatric Rating Scale, and sleep quality evaluated using subjective sleep scales. RESULTS: Oculomotor abnormalities were found in all participants, including 3/10 with clinically normal eye movements. Abnormalities involved impaired saccadic accuracy (5/10), abnormal vertical (8/10) and horizontal (4/10) pursuit, reduced optokinetic nystagmus (OKN) responses (7/10), low VOR gain (10/10), and impaired VOR cancellation (2/10). Compared to controls, the LOGG group showed significant differences in saccade, VOR, OKN, and visually enhanced VOR gains. Severity of saccadic dysmetria, OKN, and VOR fixation-suppression impairments correlated with ataxia scales (p < 0.05). Nine out of ten patients with LOGG had evidence of the CCAS (5/10 definite, 2/10 probable, 2/10 possible). Excessive daytime sleepiness was present in 4/10 and 8/10 had poor subjective sleep quality. CONCLUSIONS: Cerebellar oculomotor abnormalities were present in all patients with LOGG, including those with normal clinical oculomotor examinations. Saccade accuracy (dorsal cerebellar vermis localization), fixation suppression, and OKN gain (cerebellar flocculus/paraflocculus localization) correlated with disease severity, suggesting that quantitative oculomotor measurements could be used to track disease progression. We found evidence of the CCAS, suggesting that cerebellar dysfunction may explain the cognitive disorder in LOGG. Sleep impairments were prevalent and require further study.


Assuntos
Movimentos Oculares , Gangliosidoses GM2/diagnóstico , Adulto , Encéfalo/diagnóstico por imagem , Cognição , Estudos de Coortes , Estudos Transversais , Feminino , Gangliosidoses GM2/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Motilidade Ocular/diagnóstico , Transtornos da Motilidade Ocular/etiologia , Transtornos da Motilidade Ocular/fisiopatologia , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Sono , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/fisiopatologia
2.
Nurs Res ; 69(1): 22-30, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31834117

RESUMO

BACKGROUND: Previous studies demonstrated a short-term relationship between infant sleep-wake states and oral feeding performance, with state being an indication of infants' neurobehavioral readiness for feeding. However, the relationship between sleep-wake states and feeding skills has not been evaluated longitudinally during hospitalization. OBJECTIVES: The purpose of this study was to examine preterm infants' sleep-wake state developmental trajectories and their associations with feeding progression during hospitalization. METHODS: This descriptive and exploratory study was a secondary analysis using data from a longitudinal two-group, randomized controlled trial evaluating the effects of early and late cycled light on health and developmental outcomes among extremely preterm infants who were born ≤28 weeks of gestational age. Sleep-wake states were assessed for two 2-hour interfeeding periods per day (day and night hours), 30 weeks postmenstrual age, and every 3 weeks until discharge. Occurrences of active sleep, quiet sleep, and waking were recorded every 10 seconds. Feeding progression was assessed based on an infant's postmenstrual age at five milestones: first enteral feeding, full enteral feeding, first oral feeding, half oral feeding, and full oral feeding. Trajectory analyses were used to describe developmental changes in sleep-wake states, feeding progression patterns, and associations between feeding progression and sleep-wake trajectories. RESULTS: Active sleep decreased while waking, and quiet sleep increased during hospitalization. Two distinct feeding groups were identified: typical and delayed feeding progression. In infants with delayed feeding progression, rates of active and quiet sleep development during the day were delayed compared to those with typical feeding progression. We also found that infants with delayed feeding progression were more likely to be awake more often during the night compared to infants with typical feeding progression. DISCUSSIONS: Findings suggest that delays in sleep-wake state development may be associated with delays in feeding progression during hospitalization. Infants with delayed feeding skill development may require more environmental protection to further support their sleep development.


Assuntos
Desenvolvimento Infantil/fisiologia , Nutrição Enteral/métodos , Comportamento do Lactente/fisiologia , Lactente Extremamente Prematuro/fisiologia , Doenças do Prematuro/terapia , Transtornos do Sono-Vigília/fisiopatologia , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino
3.
J Food Sci ; 85(1): 5-13, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31856339

RESUMO

Sleep is an essential biological phenomenon, being a physiological and behavioral process necessary for quality of life. Melatonin is a circadian hormone produced at night by the pineal gland, regulated by the light/dark cycle, under the control of the suprachiasmatic nucleus. Melatonin is an indoleamine, synthesized from the essential amino acid tryptophan via serotonin. Melatonin is also found in plants, where it helps fight oxidative stress. To present a systematic review on the ability of food sources of melatonin to promote healthy sleep. A literature search was performed on the PubMed, Scopus, and ScienceDirect databases, including only randomized, placebo-controlled trials published in English between 2005 and 2019. The methodological quality of the trials was assessed by the Jadad scale. Of the 25 eligible articles, eight met the inclusion criteria. They addressed the intake of milk or cherry juice in children, adults, and elderly subjects and evaluated sleep quality by questionnaires, sleep diary, actigraphy, or polysomnography. The analysis of the studies presented limitations, including lack of homogeneity of treatment dosage and duration. Nonetheless, the results indicated that the consumption of milk and sour cherries, sources of melatonin, may improve sleep quality in humans. These results pointed out to the potential suitability of food sources of melatonin as adjuvants in the prevention and treatment of sleep disorders. Further studies are necessary to better ascertain the aspects relevant to their use.


Assuntos
Suplementos Nutricionais/análise , Melatonina/análise , Transtornos do Sono-Vigília/tratamento farmacológico , Sono , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Melatonina/farmacologia , Pessoa de Meia-Idade , Estresse Oxidativo/efeitos dos fármacos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Sono/efeitos dos fármacos , Transtornos do Sono-Vigília/metabolismo , Transtornos do Sono-Vigília/fisiopatologia , Adulto Jovem
4.
Behav Neurol ; 2019: 5202808, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31885726

RESUMO

Fragile X syndrome (FXS) is a genetic syndrome with intellectual disability due to the loss of expression of the FMR1 gene located on chromosome X (Xq27.3). This mutation can suppress the fragile X mental retardation protein (FMRP) with an impact on synaptic functioning and neuronal plasticity. Among associated sign and symptoms of this genetic condition, sleep disturbances have been already described, but few polysomnographic reports in pediatric age have been reported. This multicenter case-control study is aimed at assessing the sleep macrostructure and at analyzing the presence of EEG abnormalities in a cohort of FXS children. We enrolled children with FXS and, as controls, children with typical development. All subjects underwent at least 1 overnight polysomnographic recording (PSG). All recorded data obtained from patients and controls were compared. In children with FXS, all PSG-recorded parameters resulted pathological values compared to those obtained from controls, and in FXS children only, we recorded interictal epileptiform discharges (IEDs), as diffuse or focal spikes and sharp waves, usually singles or in brief runs with intermittent or occasional incidence. A possible link between IEDs and alterations in the circadian sleep-wake cycle may suggest a common dysregulation of the balance between inhibitory and excitatory pathways in these patients. The alteration in sleep pattern in children with FXS may negatively impact the neuropsychological and behavioral functioning, adding increasing burn of the disease on the overall management of these patients. In this regard, treating physicians have to early detect sleep disturbances in their patients for tailored management, in order to prevent adjunctive comorbidities.


Assuntos
Síndrome do Cromossomo X Frágil/diagnóstico por imagem , Síndrome do Cromossomo X Frágil/fisiopatologia , Sono/fisiologia , Adolescente , Estudos de Casos e Controles , Criança , Eletroencefalografia/métodos , Feminino , Proteína do X Frágil de Retardo Mental/genética , Proteína do X Frágil de Retardo Mental/metabolismo , Síndrome do Cromossomo X Frágil/metabolismo , Humanos , Masculino , Plasticidade Neuronal/fisiologia , Polissonografia/métodos , Transtornos do Sono-Vigília/metabolismo , Transtornos do Sono-Vigília/fisiopatologia
5.
Medicine (Baltimore) ; 98(46): e17642, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725607

RESUMO

The sleep allows many psychological processes, such as immune system activity, body metabolism and hormonal balance, emotional and mental health, learning, mnemonic processes. The lack of sleep could undermine mental and physical purposes, causing an alteration in cognitive functions or metabolic disorders. In our study, we have examined the irregular sleep effects with the overweight and obesity risk in children and adults.The sample was composed of 199 subjects, of which 71 adults, (29 males and 42 females), and 128 children (73 males and 55 females). We have measured the weight and height with standard techniques; we also have measured the body mass index dividing the weight in kg with the height square expressed in meters (kg/m). Subjects were divided into underweight, normal weight, overweight, and obese. Were administered some questionnaires to measure the quantity and quality of sleep, and eating habits and individual consumption of food.Analysis of demographic variables not showed significant differences between male and female groups but highlighted a significant trend differences in normal-weight score. The clinical condition has a substantial impact on body mass index score and sleep hours were significant predictor on this.Quantity and quality sleep can also represent a risk factor of overweight and obesity, so sufficient sleep is a factor that influence a normal weight. Adults and children that sleep less, have an increase in obesity and overweight risk with dysfunctional eating behaviors, decreased physical activity, and metabolic changes.


Assuntos
Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Transtornos do Sono-Vigília/fisiopatologia , Sono/fisiologia , Magreza/fisiopatologia , Adulto , Índice de Massa Corporal , Criança , Comportamento Alimentar , Feminino , Humanos , Masculino , Obesidade/complicações , Sobrepeso/complicações , Fatores de Risco , Transtornos do Sono-Vigília/complicações , Inquéritos e Questionários , Magreza/complicações
6.
Medicine (Baltimore) ; 98(41): e17464, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593103

RESUMO

Osteoarthritis (OA) is a common condition of the hip. Patients with hip OA often report nocturnal pain, yet little is known how it affects sleep quality. The purpose of this paper was to assess how hip arthritis affects sleep quality. We hypothesized that hip pain caused by hip OA affects sleep quality in adult patients.This is a prospective, cross-sectional study of patients who were diagnosed with hip OA. Patients were evaluated using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), hip outcome score (HOS), and modified Harris hip score (mHHS). Sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI). A multiple regression model was used to assess factors associated with poor sleep quality.A total of 106 patients were analyzed. All patients had a Tonnis grade of 2 or 3 and American Society of Anesthesiologists (ASA) classification of 2. WOMAC, HOS, and mHHS were significantly and negatively correlated with PSQI. The multiple regression model, WOMAC, short form health survey vitality, ASA classification, and history of obstructive sleep apnea were associated with poor sleep quality (R = 0.60, P < .001).Patients with hip OA, who report a symptomatic hip, are susceptible to reduced sleep quality. There is a correlation between worsening HOSs and sleep quality. The WOMAC score is a significant predictor of poor sleep quality. Patients with poor hip metrics should be screened for sleep disturbance.


Assuntos
Artralgia/fisiopatologia , Osteoartrite do Quadril/fisiopatologia , Transtornos do Sono-Vigília/fisiopatologia , Sono , Adulto , Idoso , Idoso de 80 Anos ou mais , Artralgia/etiologia , Estudos Transversais , Feminino , Articulação do Quadril/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/complicações , Medição da Dor , Estudos Prospectivos , Transtornos do Sono-Vigília/etiologia , Adulto Jovem
7.
Medicina (B Aires) ; 79 Suppl 3: 29-32, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31603840

RESUMO

Recent studies have demonstrated that while we are sleeping, our brain is very busy processing all information we have acquired along the day. Lack of sleep has shown to produce deficits in memory consolidation and plays an important role in brain development and brain plasticity in the several developmental stages of the human brain. At the cellular level, circadian cycles coordinate complex mechanism that "turn on and off" genes and cellular structures regulating individual cell functions to impact global organ and systems physiological activities. At the end a perfect and coordinated equilibrium in the mental, emotional and physiological is the goal of this complex process. Sleep impacts memory, learning, mood, behavior, immunological responses, metabolism, hormone levels, digestive process and many more physiological functions. We present a review of three basic aspects related with sleep: a. brain electrical activity during the sleep and neuroanatomic correlation with mechanism related with memory and learning; b. circadian cycles and impact in several physiological systems; c some examples of clinical disorders associated with sleep disorders and impact in learning and memory.


Assuntos
Ritmo Circadiano/fisiologia , Aprendizagem/fisiologia , Memória/fisiologia , Plasticidade Neuronal/fisiologia , Sono/fisiologia , Encéfalo/fisiologia , Emoções/fisiologia , Humanos , Transtornos do Sono-Vigília/fisiopatologia
8.
Rev Saude Publica ; 53: 82, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576942

RESUMO

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


Assuntos
Qualidade de Vida , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/fisiopatologia , Sono/fisiologia , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Autoimagem , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-31581629

RESUMO

Developmental Coordination Disorder (DCD) is considered to be abnormal motor skills learning, identified by clumsiness, slowness, and/or motor inaccuracy impairing the daily-life activities in all ages of life, in the absence of sensory, cognitive, or neurological deficits impairment. The present research focuses on studying DCD sleep structure and Cyclic Alternating Pattern (CAP) parameters with a full overnight polysomnography and to study the putative correlations between sleep architecture and CAP parameters with motor coordination skills. The study was a cross-sectional design involving 42 children (26M/16F; mean age 10.12 ± 1.98) selected as a DCD group compared with 79 children (49M/30F; mean age 9.94 ± 2.84) identified as typical (no-DCD) for motor ability and sleep macrostructural parameters according to the MABC-2 and polysomnographic (PSG) evaluations. The two groups (DCD and non-DCD) were similar for age (p = 0.715) and gender (p = 0.854). More significant differences in sleep architecture and CAP parameters were found between two groups and significant correlations were identified between sleep parameters and motor coordination skills in the study population. In conclusion, our data show relevant abnormalities in sleep structure of DCD children and suggest a role for rapid components of A phases on motor coordination development.


Assuntos
Transtornos das Habilidades Motoras/fisiopatologia , Destreza Motora/fisiologia , Transtornos do Sono-Vigília/fisiopatologia , Sono REM/fisiologia , Sono/fisiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Polissonografia
10.
Sleep Med Clin ; 14(4): 469-478, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31640875

RESUMO

Drowsy driving is common and causes 21% of fatal crashes. Individuals at risk include young men, shift workers, older adults, and people with chronic short sleep duration, untreated obstructive sleep apnea (OSA), and narcolepsy. Untreated OSA is a particular concern in commercial drivers, who are at higher risk for the disorder. Treatment for sleep problems such as sleep extension for chronic short sleep, positive airway pressure (PAP) for OSA, pharmacologic treatments, and drowsy driving countermeasures may reduce the risk of crashes. Implementing screening measures to identify common sleep problems contributing to drowsy driving continues to be of high importance.


Assuntos
Acidentes de Trânsito/prevenção & controle , Condução de Veículo , Transtornos do Sono-Vigília/fisiopatologia , Sonolência , Humanos
11.
J Stroke Cerebrovasc Dis ; 28(11): 104349, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31492629

RESUMO

INTRODUCTION: Sleep disorders are more prevalent in patients with previous stroke compared to healthy individuals. The main objective of the present study was to investigate the impact of sleep quality on the functional status of patients with a history of stroke, upon admission to inpatient rehabilitation. METHODS: Fifty patients (mean age: 69 ± 11 years) with previous stroke were consecutively included in this single center cross-sectional observational study upon admission to inpatient rehabilitation. Pittsburgh Sleep Questionnaire Index (PSQI) was calculated for all patients and patients were divided into 2 groups according to PSQI scores (PSQI ≤ 5 as good sleepers and PSQI > 5 as poor sleepers). A specialist evaluated the level of muscle spasticity and disability, walking capability, and overall performance of daily activity of all enrolled patients using the functional ambulation scale (FAS) score, modified Brunnstrom Classification, Modified Ashworth scale, and Beck Depression Inventory. RESULTS: The FAS score (3.4 ± 1.3 versus 1.8 ± 1.7, P = .004) and Brunnstrom scores of upper limb (3.8 ± 1.1 versus 2.5 ± 1.6, P = .005), lower limb (4.3 ± 1.4 versus 3.1 ± 1.7, P = .013) and hand (3.6 ± 1.5 versus 2.3 ± 1.6, P = .006) were significantly higher in good sleepers than poor sleepers. Linear regression analysis revealed that PSQI score (coefficient ß = -.360, 95% CI: -.212-.032, P = .009) and age (coefficient ß = -.291, 95% CI: .100-.245, P = .032) were independently associated with FAS score. CONCLUSION: Results of the present study indicate that presence of poor sleep quality is associated with poor functional status which might further impair the outcomes of the rehabilitation and accordingly the health-related quality of life in patients admitted for stroke rehabilitation.


Assuntos
Transtornos do Sono-Vigília/complicações , Sono , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Avaliação da Deficiência , Feminino , Nível de Saúde , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Admissão do Paciente , Recuperação de Função Fisiológica , Fatores de Risco , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/fisiopatologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
12.
Ideggyogy Sz ; 72(7-8): 236-240, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31517455

RESUMO

Introduction - Restless Leg Syndrome (RLS) is a disease, primarily composed of sensational symptoms, caused by the urge to move lower extremities especially at night, and characterized by undesired feelings of the legs. Decreasing of the dopaminergic effect at night is thought to be responsible from these symptoms. RLS patients suffer from low quality of sleep affecting their daily life activities even causing socio-economic loss. Although RLS is a common and treatable disease, it can not be diagnosed easily due to the variability of symptoms. Aim - The purpose of this study is to determine the frequency of RLS among health workers and to define the disease causing factors. Method - A questionnaire was applied to 174 randomly selected health workers at Baskent University Medical Faculty (KA17/285). The demographic information, history of illnesses or usage of drugs, socioeconomic status, working hours and daytime sleepiness were questioned. Included in the questionnaire were diagnostic criteria for RLS, frequency assessment scale, and survey of sleep quality. We used "the diagnostic criteria of international RLS working group" for the diagnosis, and "Pittsburgh sleep quality index survey" to determine the quality of sleep. Reliability and validity studies were performed on both tests. Results - A significant relationship between socio-economic status and RLS was found (p<0.05) as an increase of RLS frequency in parallel with decreased socio-economic status. RLS was found to be common among health workers. We suggest that health workers should be checked regularly, and they should be informed about the disease in order to raise an awareness and hence increase their quality of life.


Assuntos
Qualidade de Vida/psicologia , Síndrome das Pernas Inquietas/psicologia , Transtornos do Sono-Vigília/fisiopatologia , Humanos , Reprodutibilidade dos Testes , Síndrome das Pernas Inquietas/epidemiologia , Sono/fisiologia , Inquéritos e Questionários
13.
Int Tinnitus J ; 23(1): 64-68, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31469531

RESUMO

INTRODUCTION: The high prevalence together with the serious impact of sleep disturbances assessed in tinnitus patients urge the need for effective therapy that could improve patients' sleep quality. OBJECTIVES: The purpose of this study was to assess the reported prevalence and severity of sleep disturbance in chronic tinnitus patients and to extract possible tinnitus specific factors that increase the risk of developing sleep disturbances. DESIGN: Subjects were 165 consecutive patients who came to our clinic from January 2017 to January 2019 for consultations on their tinnitus that persisted for one month or longer. Patients charts, audiogram, and sleep questionnaire were reviewed retrospectively and data from these patients were recorded. RESULTS: Half of the tinnitus patients experienced a poor sleep quality. Cervical pain, the use of benzodiazepines and antidepressants, a higher maximal and a higher mean intensity of tinnitus were associated with a poor sleep quality. Especially, a higher maximal intensity of tinnitus was associated with a poor sleep quality. With a VAS of the maximal intensity of the tinnitus higher than 85 millimeter, 69% of the patients have a poor sleep quality. If the VAS of the maximal intensity of the tinnitus was less than 60 millimeter, none of the patients had a poor sleep quality. CONCLUSIONS: In a cohort of patients with chronic tinnitus, we found that half of the tinnitus patients experienced poor sleep quality. The level of the maximal intensity of tinnitus was associated with the sleep quality. It seems that reduction of the intensity of the tinnitus is essential for improvement of quality and patients' quality of life in patients with tinnitus.


Assuntos
Qualidade de Vida , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Zumbido/complicações , Zumbido/diagnóstico , Adulto , Doença Crônica , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Transtornos do Sono-Vigília/fisiopatologia , Zumbido/terapia
14.
Pediatr Hematol Oncol ; 36(5): 255-266, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31424297

RESUMO

Medical marijuana (MM) is widespread in many medical fields, including oncology, with limited use in pediatric oncology where research is scarce and often shows conflicting results. This research focuses on alleviating side effects of anticancer treatment as an integral part of supportive and palliative care of children with cancer. We report our experience with MM treatment in 50 children, adolescents, and young adults with different types of cancer during 2010-2017. The main indications for prescriptions were nausea and vomiting, decreased mood, disturbed sleep, and pain. The medication was supplied to 30 patients via oil drops (60%) and 11 via smoking (22%), followed by vaporization, capsules, or combinations of various routes. Positive effects were reported by verbal children and parents in 80% of cases. MM was generally well tolerated with few patients reporting toxicity, with the most common adverse reactions being burning in the throat and anxiety attacks in subjects who chose to smoke the product. We conclude that MM may serve as a potentially useful complementary therapy to conventional supportive treatment of children suffering from cancer at the end of life. Further research is needed on the safety and efficacy and the consequences of prolonged use in pediatric populations.


Assuntos
Maconha Medicinal/administração & dosagem , Náusea/tratamento farmacológico , Neoplasias/tratamento farmacológico , Dor/tratamento farmacológico , Transtornos do Sono-Vigília/tratamento farmacológico , Vômito/tratamento farmacológico , Adolescente , Adulto , Criança , Pré-Escolar , Terapias Complementares , Feminino , Humanos , Masculino , Náusea/patologia , Náusea/fisiopatologia , Neoplasias/patologia , Neoplasias/fisiopatologia , Dor/patologia , Dor/fisiopatologia , Transtornos do Sono-Vigília/patologia , Transtornos do Sono-Vigília/fisiopatologia , Vômito/patologia , Vômito/fisiopatologia
15.
Chin Med J (Engl) ; 132(15): 1788-1795, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31283653

RESUMO

BACKGROUND: Sleep disorders are one of the earliest non-motor symptoms of Parkinson's disease (PD). Sleep disorders could, therefore, have value for recognition and diagnosis in PD. However, no unified classification and diagnostic criteria exist to evaluate sleep disorders by polysomnography (PSG). Utilizing PSG to monitor sleep processes of patients with PD and analyze sleep disorder characteristics and their relationship with demographic parameters could aid in bridging this gap. This preliminary study aimed to evaluate the clinical characteristic of sleep disorders in PD using PSG. METHODS: PSG was used to evaluate sleep disorders in 27 patients with PD and 20 healthy volunteers between August 2015 and July 2018 in Fujian Medical University Union Hospital. Total sleep time (TST), sleep efficiency (SE), total wake time, and other parameters were compared between the two groups. Finally, the correlation between sleep disorders and age, disease duration, Unified Parkinson's Disease Rating Scale-III scores, Hoehn-Yahr stage, and levodopa dose were analyzed. The main statistical methods included Chi-square test, two independent samples t test, Fisher exact test, and Pearson correlation. RESULTS: Sleep fragmentation in the PD group was significantly increased (74.1%) while difficulty falling asleep and early awakening were not, as compared to healthy controls. No significant differences were found in time in bed, sleep latency (SL), non-rapid eye movement (NREM) stage 1 (N1), N1%, N2, N2%, N3%, and NREM% between PD and control groups; but TST (327.96 ±â€Š105.26 min vs. 414.67 ±â€Š78.31 min, P = 0.003), SE (63.26% ±â€Š14.83% vs. 76.8% ±â€Š11.57%, P = 0.001), R N3 (20.00 [39.00] min vs. 61.50 [48.87] min, P = 0.001), NREM (262.59 ±â€Š91.20 min vs. 337.17 ±â€Š63.47 min, P = 0.003), rapid-eye-movement (REM) (32.50 [33.00] min vs. 85.25 [32.12] min, P < 0.001), REM% (9.56 ±â€Š6.01 vs. 15.50 ±â€Š4.81, P = 0.001), REM sleep latency (157.89 ±â€Š99.04 min vs. 103.47 ±â€Š71.70 min, P = 0.034) were significantly reduced in PD group. CONCLUSION: This preliminary study supported that sleep fragmentation was an important clinical characteristic of sleep disorders in PD. Whether sleep fragmentation is a potential quantifiable marker in PD needs to be further investigated in the future study.


Assuntos
Doença de Parkinson/patologia , Privação do Sono/patologia , Transtornos do Sono-Vigília/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Polissonografia , Privação do Sono/fisiopatologia , Transtornos do Sono-Vigília/fisiopatologia , Sono REM/fisiologia
16.
Isr Med Assoc J ; 21(6): 408-411, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31280511

RESUMO

BACKGROUND: Erectile dysfunction (ED) is a syndrome associated with endothelial dysfunction, which may predict cardiovascular events in men presenting with this syndrome. It has been shown to be associated with a higher rate of acute myocardial infarction and cardiovascular mortality, vascular inflammation, and impaired endothelial function. In this review we present the literature findings and describe the mechanistic pathways that are known to be involved in this syndrome and its related clinical consequences.


Assuntos
Doenças Cardiovasculares/complicações , Endotélio Vascular/fisiopatologia , Disfunção Erétil/complicações , Transtornos do Sono-Vigília/complicações , Adulto , Animais , Doenças Cardiovasculares/fisiopatologia , Disfunção Erétil/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Ratos , Transtornos do Sono-Vigília/fisiopatologia
17.
Handb Clin Neurol ; 160: 371-379, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31277861

RESUMO

Actigraphy involves acquisition of data using a movement sensor worn continuously on the nondominant wrist, typically for a week or more. Computer-based algorithms estimate sleep episodes by analysis of continuous minutes of no to low movement, or spans of time when movement is relatively low compared with movements during presumed ambulatory wakefulness. Inherent advantages of actigraphy over polysomnography include its noninvasive nature, cost-effectiveness, lesser burden on patients/research participants, and ability to collect data over multiple days/nights, thereby allowing examination of sleep-wake patterning. Therefore, actigraphy is emerging as a common method to objectively assess sleep parameters providing estimates of sleep duration and continuity. Modes of actigraphy data collection, scoring algorithms, sleep quality/disturbance measures, validation studies, and clinical and research applications are discussed.


Assuntos
Actigrafia/métodos , Polissonografia/métodos , Fases do Sono/fisiologia , Transtornos do Sono-Vigília/fisiopatologia , Actigrafia/tendências , Humanos , Polissonografia/tendências , Transtornos do Sono-Vigília/diagnóstico
18.
Handb Clin Neurol ; 160: 381-392, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31277862

RESUMO

Polysomnography refers to a systematic process used to collect physiologic parameters during sleep. A polysomnogram (PSG) is a procedure that utilizes electroencephalogram, electro-oculogram, electromyogram, electrocardiogram, and pulse oximetry, as well as airflow and respiratory effort, to evaluate for underlying causes of sleep disturbances. PSG is considered to be the gold standard for diagnosing sleep-related breathing disorders, which include obstructive sleep apnea (OSA), central sleep apnea, and sleep-related hypoventilation/hypoxia. PSG can also be utilized to evaluate for other sleep disorders, including nocturnal seizures, narcolepsy, periodic limb movement disorder, and rapid eye movement sleep behavior disorder. With recent technological developments, home sleep apnea testing can be done to confirm a diagnosis in patients with a high risk for moderate to severe OSA in the absence of comorbid medical conditions or other suspected sleep disorders.


Assuntos
Polissonografia/métodos , Transtornos do Sono-Vigília/fisiopatologia , Sono/fisiologia , Eletroencefalografia/métodos , Eletromiografia/métodos , Humanos , Transtornos do Sono-Vigília/diagnóstico
19.
BMC Neurol ; 19(1): 166, 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31315588

RESUMO

BACKGROUND: Acquired epileptiform opercular syndrome (AEOS) with electrical status epilepticus during sleep (ESES) may be recurrent and intractable. The real-time transcranial Doppler ultrasound-sleep-deprived video electroencephalogram (TCD-SDvEEG) can be used to observe the relationships among hemodynamic, electrophysiological, and clinical factors in a patient during therapy. This study reported the case of a healthy 5-year-old boy with AEOS. CASE PRESENTATION: The patient had initial seizures during sleep at the age of 1 year, with the left mouth pouting, left eye blinking and drooling for several seconds, and, sometimes, the left upper-limb flexion and head version to the left, lasting for 1-2 min. The combined antiepileptic drug regimens, including valproate, lamotrigine, and clonazepam, failed in the present case. Therefore, the add-on high-dose methylprednisolone therapy was provided. Also, the serial TCD-SDvEEG was used to monitor the dynamic changes before and after add-on steroid treatment. The results showed less than 15% variation in the range of blood flow fluctuation with spikes during non-rapid eye movement sleep after treatment. This was similar to the outcomes in healthy children and also accorded with the clinical improvements such as seizure control, drooling control, and language ability melioration. However, 95% of spike-wave index (SWI) was still maintained. The improvements in cerebral hemodynamics and clinical manifestations were faster and earlier than the SWI progression. CONCLUSIONS: The real-time TCD-SDvEEG was highly sensitive in detecting therapeutic changes. The findings might facilitate the understanding of the mechanisms underlying neurovascular coupling in patients with AEOS accompanied by ESES.


Assuntos
Eletroencefalografia/métodos , Transtornos do Sono-Vigília/diagnóstico , Estado Epiléptico/diagnóstico , Anticonvulsivantes/uso terapêutico , Pré-Escolar , Humanos , Masculino , Metilprednisolona/uso terapêutico , Convulsões/tratamento farmacológico , Sono/fisiologia , Transtornos do Sono-Vigília/fisiopatologia , Estado Epiléptico/tratamento farmacológico , Estado Epiléptico/fisiopatologia , Síndrome , Falha de Tratamento , Ultrassonografia Doppler Transcraniana , Ácido Valproico/uso terapêutico
20.
Eur Arch Otorhinolaryngol ; 276(10): 2803-2809, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31309274

RESUMO

PURPOSE: There are many year-round modifiers of chronic rhinosinusitis (CRS). However, it is unknown whether there are seasonal variations in the sinonasal symptom burden of CRS. METHODS: This was a retrospective cross-sectional study of sinonasal symptom burden measured using the 22-item Sinonasal Outcome Test (SNOT-22) and its four associated nasal, sleep, ear/facial discomfort and emotional subdomains in 1028 individuals with CRS. The season (winter, spring, summer or fall) when the SNOT-22 was completed was recorded. Regressions, controlling for clinical and demographic characteristics, were performed to seek association between season of the year and SNOT-22 total and subdomain scores. RESULTS: The mean SNOT-22 scores were 37.4 for those individuals completing their SNOT-22 in the fall, 40.5 in the winter, 37.4 in the spring and 36.0 in the summer. There was a statistically significant association between higher SNOT-22 scores and completing the SNOT-22 in the wintertime (adjusted ß = 4.08, 95% CI 0.74-7.42, p = 0.017). When seeking association between season and SNOT-22 subdomain scores, wintertime was associated only with higher emotional (adjusted ß = 0.48, 95% CI 0.14-0.81, p = 0.006) and sleep (adjusted ß = 2.23, 95% CI 0.54-3.91, p = 0.010) subdomain scores. Examining individual SNOT-22 items, these associations were due to more symptoms related to depressed mood ("sad") and psychomotor retardation. CONCLUSION: There are seasonal variations in symptom burden of CRS patients, independent of aeroallergen hypersensitivity, with the greatest increase in baseline CRS symptomatology during the winter. This finding was most strongly associated with increased emotional symptomatology and depressed mood.


Assuntos
Depressão , Rinite , Sinusite , Transtornos do Sono-Vigília , Adulto , Doença Crônica , Estudos Transversais , Depressão/etiologia , Depressão/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Rinite/diagnóstico , Rinite/fisiopatologia , Rinite/psicologia , Estações do Ano , Sinusite/diagnóstico , Sinusite/fisiopatologia , Sinusite/psicologia , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/fisiopatologia
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