Sleep regularity in athletes: Comparing sex, competitive level and sport type.

This study aims to describe the athletes' sleep regularity using the Sleep Regularity Index (SRI) and determine whether factors, such as sex, competitive level and sport type, could affect the sleep/wake rhythm. It is a descriptive, cross-sectional study consisting of 172 athletes (25 ± 7 y old; 45 women). Seventy-three competed in team sports and 99 in individual sports. Furthermore, 56 competed in the international level, 95 in the national and 21 in the regional. We recorded the SRI values for at least 5 d via continuous actigraphy. We recorded a mean SRI value of 73 ± 12. We found no significant differences between athletes' sleep parameters in relation to sleep regularity. Furthermore, SRI data showed no correlations (Spearman's ρ) with sleep parameters, bed time and wake time. Female athletes (p = 0.001) and individual sport athletes (p = 0.001) reported better sleep regularity than their counterparts. International-level athletes reported better sleep regularity than those in other competitive levels (national: p = 0.001; regional: p = 0.024). Our study showed that international level athletes, female athletes and individual sport athletes reported better sleep regularity. Additionally, SRI data showed no correlation with athletes' sleep parameters, bed and wake time.

Are physical inactivity, sitting time and screen time associated with obstructive sleep apnea in adults? A cross-sectional study.

BACKGROUND: Sitting time, screen time and low physical activity (PA) levels have been associated with several diseases and all-cause mortality. PA is related to better sleep quality and absence of daytime sleepiness, along with lower risks of obstructive syndrome apnea (OSA). However, studies on the relationship between sitting time, screen time and OSA are scarce in the literature. OBJECTIVE: To analyze associations between PA levels, sitting time, screen time and OSA among adults with suspected sleep disorder. DESIGN AND SETTING: Cross-sectional study conducted at Hospital Israelita Albert Einstein. METHODS: Data were collected from 369 adults with suspected sleep disorders who visited the hospital's neurophysiology clinic between August 2015 and January 2017. RESULTS: Correlations between hypopnea and PA indicators were demonstrated for total sitting time (0.123; P = 0.019) and total screen time (0.108; P = 0.038). There was also a correlation between latency for rapid-eye-movement sleep (REM_LAT) and total sitting time (0.103; P = 0.047) and a negative correlation between mean oxyhemoglobin saturation (SaO_Avg) and total PA time (-0.103; P = 0.048). There were no associations between PA parameters and apnea-hypopnea index. After adjusting for confounding factors (body mass index, age and gender), sitting time and screen time were not associated with OSA. CONCLUSION: After adjusting for anthropometric and clinical factors, excessive sitting time or screen time was not associated with OSA in adults suspected of sleep disorders. Age, gender, hypertension, body mass index and waist circumference were associated with OSA.

Effects of resistance training on metabolic and cardiovascular responses to a maximal cardiopulmonary exercise test in Parkinson`s disease.

OBJECTIVE: To evaluate the effects of resistance training on metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson's disease. METHODS: Twenty-four patients with Parkinson's disease (modified Hoehn and Yahr stages 2 to 3) were randomly assigned to one of two groups: Control or Resistance Training. Patients in the Resistance Training Group completed an exercise program consisting of five resistance exercises (two to four sets of six to 12 repetitions maximum per set) twice a week. Patients in the Control Group maintained their usual lifestyle. Oxygen uptake, systolic blood pressure and heart rate were assessed at rest and during cycle ergometer-based maximal cardiopulmonary exercise testing at baseline and at 12 weeks. Assessments during exercise were conducted at absolute submaximal intensity (slope of the linear regression line between physiological variables and absolute workloads), at relative submaximal intensity (anaerobic threshold and respiratory compensation point) and at maximal intensity (maximal exercise). Muscle strength was also evaluated. RESULTS: Both groups had similar increase in peak oxygen uptake after 12 weeks of training. Heart rate and systolic blood pressure measured at absolute and relative submaximal intensities and at maximal exercise intensity did not change in any of the groups. Muscle strength increased in the Resistance Training but not in the Control Group after 12 weeks. CONCLUSION: Resistance training increases muscle strength but does not change metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson's disease without cardiovascular comorbidities.

[Effects of exposure to altitude on neuropsychology aspects: a literature review]. / Efeitos da exposição à altitude sobre os aspectos neuropsicológicos: uma revisão da literatura.

OBJECTIVE: Discuss the effects of altitude exposure on neuropsychological functions. METHOD: We have conducted a literature review using as source indexed articles at Pubmed in the period from 1921 to 2008, using the following key words: 'cognition and hypoxia', 'hypoxia and neuropsychology', 'acute hypoxia', 'chronic hypoxia', and 'acclimatization and hypoxia', as well as specific books on the subject. DISCUSSION: Acute and chronic effects of Hypoxia can alter many of the neuropsychological functions in different altitudes due to physiological changes resulted by the oxygen (O2) partial decrease that can lead to neuropsychological alterations in individuals exposed to high altitudes. CONCLUSION: Individuals exposed to high altitudes must use an O2 supplementation and the practice of acclimatization, among other strategy ways that can be used in order to minimize the negative effects of hypoxia on neuropsychological aspects.

Correlation of sleep quality with fatigue and disease activity among patients with primary Sjögren's syndrome: a cross-sectional study.

BACKGROUND: Fatigue is a frequent symptom in patients with primary Sjögren's syndrome (pSS) and can be a cause of or be associated with sleep disorders. OBJECTIVE: To assess the sleep quality of pSS patients and its relationship with fatigue and disease activity. DESIGN AND SETTING: Analytical observational study conducted at an exercise psychobiology laboratory. METHODS: Sleep quality was evaluated using the Pittsburg sleep quality index (PSQI) and actigraphy. Fatigue was evaluated through the Profile of Fatigue and Discomfort - Sicca Symptoms Inventory (PROFAD-SSI-SF) and a visual analogue scale for fatigue (VAS-fatigue). Disease activity was evaluated using a visual analogue scale for pain (VAS-pain), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) and Disease Activity Index (ESSDAI). We summarized the data through descriptive statistics. RESULTS: A total of 50 female patients with pSS, of average age 56.4 years, were included in the study; 80% presented low disease activity. The total PSQI score showed that 74% had poor sleep. The actigraphy showed mean sleep latency of 26.2 minutes and mean nightly awakening of 48.2 minutes (duration of wakings after sleep onset, WASO). There were correlations between PSQI and VAS-pain, VAS-fatigue, PROFAD-SSI and ESSPRI. Actigraphy showed a correlation between the duration of WASO and ESSDAI. CONCLUSION: The present study provides important information regarding correlations between sleep disorders and disease activity. There is a need for proper control over disease activity and for development of strategies to help patients to sleep better in order to diminish their fatigue.

Sleep and COVID-19: considerations about immunity, pathophysiology, and treatment.

The fear and uncertainty caused by the coronavirus disease 2019 (COVID-19) pandemic, threats to survival are one of the main problems of everyday life; however, mental health care must also be considered a priority. During social isolation also called self-quarantine, the restricted mobility and social contact, concern about financial resources and availability of supplies, fear of infection, questions about the duration of self-quarantine, cause anxiety, depression, stress, insomnia and reduced the quality and quantity of sleep, that may present a greater risk to the health of the general population. Sleep disorders are increasingly becoming a major health issue in modern society, and are influenced by retinal stimulation by electronic devices, as well extended and/or night shift-work, which may aggravate the systemic and lung inflammation during viral infections. Sleep disorders can induce pro-inflammatory states and be harmful during the COVID-19 pandemic. The possible interactions between many drugs used to treat COVID-19, and those used to treat sleep disorders are unknown, mostly due to the lack of a standard protocol to treat these patients. Insufficient sleep or irregular sleep-wake cycles may impair health, immune system, induce pro-inflammation state, and may lead to increased vulnerability to viral infections, involving inflammatory and oxidative/antioxidant imbalance. In this sense, obstructive sleep apnea has been associated with recognized COVID-19 risk comorbidities and considered a risk factor for COVID-19. During the COVID-19 pandemic, health care cannot stop, and telemedicine has presented itself as an alternative method of delivering services. When a face-to-face visit is mandatory, or in locations with minimal community transmission where sleep centers have resumed activities, it is important that the sleep center facilities are properly prepared to receive the patients during the COVID-19 pandemic, and follow all relevant safety rules. In this work we gathered a group of researchers, specialists in aspects related to chronobiology, sleep, sleep disorders, and the immune system. Thus, we conducted a narrative review in order to address the relationship between COVID-19 and sleep, as well as its immunological aspects and strategies that may be applied in order to mitigate the harmful effects on health that affects everyone during the pandemic.

Gender differences in sleep patterns and sleep complaints of elite athletes.

OBJECTIVE: The present study aimed to investigate the gender differences for sleep complaints, patterns and disorders of elite athletes during preparation for the Rio 2016 Olympic Games. METHODS: The study included 146 athletes from the Brazilian Olympic Team (male: n=86; 59%; female: n=60; 41%). The assessment of the Olympic athletes' sleep took place in 2015, during the preparation period for the Rio Olympic Games. The athletes underwent a single polysomnography (PSG) evaluation. Sleep specialists evaluated the athletes and asked about their sleep complaints during a clinical consultation. In this evaluation week, the athletes did not take part in any training or competitions. RESULTS: The prevalence of sleep complaints was 53% of the athletes during the medical consultation, the most prevalent being insufficient sleep/waking up tired (32%), followed by snoring (21%) and insomnia (19.2%). In relation to the sleep pattern findings, the men had significantly higher sleep latency and wake after sleep onset than the women (p=0.004 and p=0.002, respectively). The sleep efficiency and sleep stages revealed that men had a lower percentage of sleep efficiency and slow wave sleep than the women (p=0.001 and p=0.05, respectively). CONCLUSION: Most athletes reported some sleep complaints, with men reporting more sleep complaints than women in the clinical evaluation. The PSG showed that 36% of all athletes had a sleep disorder with a greater reduction in sleep quality in men than in women.

Relationship between functional classification, upper extremity muscle strength, and agility in wheelchair rugby athletes / La relación entre la clasificación funcional, la fuerza muscular de las extremidades superiores y la agilidad de los deportistas de rugby en silla de ruedas / A relação entre classificação funcional, força muscular de membros superiores e agilidade de atletas do rúgbi em cadeira de rodas

ABSTRACT This study aimed to compare the strength and agility of wheelchair rugby (WR) athletes with different functional classifications (FC) and describe the relationship between agility and upper extremity isometric muscle strength (IMS). A total of 10 WR athletes were analyzed, divided into two groups: Group 1 (G1): FC 0.5 and 1.0; and Group 2(G2): FC 1.5 to 2.5. IMS was evaluated by a dynamometer, and agility by a zig-zag test. Spearman's correlation was used to describe the relationship between IMS and performance on the agility test. In contrast, the t-test was used to compare strength and agility between different FCs (p≤0.05). Shoulder extensor IMS was higher in G2 athletes (p=0.001; d=3.10), which were also more agile than G1 athletes (G1=23.66s>G2=17.55s; p=0.015; d=2.00). Both groups showed a correlation between bilateral shoulder extensor strength and agility (r=−0.721; p=0.019). Athletes with high FC scores are more agile than athletes with low scores and, therefore, have greater movement speed when performing WR tasks. Greater shoulder extensor muscle strength is associated with greater agility in WR athletes.

RESUMEN El objetivo de este estudio fue comparar la fuerza y la agilidad de los deportistas de rugby en silla de ruedas (RSR) desde diferentes clasificaciones funcionales (CF), así como describir la relación entre la agilidad y la fuerza muscular isométrica (FMI) de las extremidades superiores. Se evaluaron a diez deportistas RSR en dos grupos: Grupo 1 (G1): CF 0,5 y 1,0; y Grupo 2 (G2): CF 1,5 a 2,5. En la evaluación de la FMI se utilizó la dinamometría; y en la evaluación de la agilidad, la prueba de zigzag. La correlación de Spearman se utilizó para describir la relación entre la FMI y el rendimiento en la prueba de agilidad, mientras que la prueba t se utilizó para comparar la fuerza y la agilidad entre las diferentes CF (p≤0,05). La FMI de los extensores del hombro fue mayor en el G2 (p=0,001; d=3,10), y este también fue más ágil que el G1 (G1=23,66s>G2=17,55s; p=0,015; d=2,00). Hubo una correlación entre la fuerza muscular bilateral de los extensores del hombro y la agilidad en ambos grupos (r=−0,721; p=0,019). Los deportistas con altas puntuaciones de CF fueron los más ágiles en comparación con aquellos con bajas puntuaciones, por lo tanto, se constata que tienen una mayor velocidad de desplazamiento en la realización de tareas de RSR. Una mayor fuerza muscular de los extensores de hombro se asocia con una mayor agilidad en los deportistas RSR.

RESUMO O objetivo do estudo foi comparar a força e a agilidade de atletas do rúgbi em cadeira de rodas (RCR) por meio de diferentes classificações funcionais (CFs), bem como descrever a relação da agilidade com a força muscular isométrica (FMI) de membros superiores. Foram analisados 10 atletas de RCR, divididos em dois grupos: Grupo 1 (G1): CF 0,5 e 1,0; e Grupo 2 (G2): CF 1,5 a 2,5. A FMI foi avaliada pela dinamometria, e a agilidade pelo teste em ziguezague. A correlação de Spearman foi utilizada para descrever a relação entre a FMI e o desempenho no teste de agilidade, enquanto o teste t foi usado para comparar a força e a agilidade entre as diferentes CFs (p≤0,05). A FMI dos extensores do ombro foi maior no G2 (p=0,001; d=3,10), que também se mostrou mais ágil que o G1 (G1=23,66s>G2=17,55s; p=0,015; d=2,00). Verificou-se a correlação entre força muscular bilateral de extensores de ombro e agilidade em ambos os grupos (r=−0,721; p=0,019). Atletas com pontuação alta na CF são mais ágeis comparados a atletas com pontuações baixas e, portanto, apresentam maior velocidade de deslocamento ao executar as tarefas do RCR. Maior força muscular dos extensores de ombro é associada à maior agilidade em atletas do RCR.

Relationship between adiponectin and leptin on osteocalcin in obese adolescents during weight loss therapy.

OBJECTIVES: Obesity is a multifactorial disease characterized by the presence of the pro-inflammatory state associated with the development of many comorbidities, including bone turnover marker alterations. This study aimed to investigate the role of the inflammatory state on bone turnover markers in obese adolescents undergoing interdisciplinary weight loss treatment for one year. SUBJECTS AND METHODS: Thirty four post-pubescent obese adolescents with primary obesity, a body mass index (BMI) greater than > 95th percentile of the CDC reference growth charts, participated in the present investigation. Measurements of body composition, bone turnover markers, inflammatory biomarkers and visceral and subcutaneous fat were taken. Adolescents were submitted to one year of interdisciplinary treatment (clinical approach, physical exercise, physiotherapy intervention, nutritional and psychological counseling). RESULTS: Reduction in body mass, body fat mass, visceral and subcutaneous fat, as well as, an increase in the body lean mass and bone mineral content was observed. An improvement in inflammatory markers was seen with an increase in adiponectin, adiponectin/leptin ratio and inteleukin-15. Moreover, a positive correlation between the adiponectin/leptin ratio and osteocalcin was demonstrated. Further, both lean and body fat mass were predictors of osteocalcin. Negative associations between leptin with osteocalcin, adiponectin with Beta CTX-collagen, and visceral fat with adiponectin were observed. CONCLUSIONS: It is possible to conclude that the inflammatory state can negatively influence the bone turnover markers in obese adolescents. In addition, the interdisciplinary weight loss treatment improved the inflammatory state and body composition in obese adolescents. Therefore, the present findings should be considered in clinical practice.

[Nonpharmacologic treatment of chronic insomnia]. / Tratamento não farmacológico para a insônia crônica.

The purpose of this manuscript is to briefly describe the main modalities of non-pharmacological therapy and its utilization on the chronic insomnia treatment. Insomnia is the most frequent sleep disorder and that is more associated with psychiatry disorders. The pharmacotherapy is the most frequent treatment, but the nonpharmacologic therapy has been studied. The most common therapy modalities include behavioral approaches, stimulus control, sleep restriction, paradoxical intention, sleep hygiene, progressive muscle relaxation and biofeedback and, more recently, physical exercise practices. At first behavioral therapy aimed to improve sleep quality, however, recent studies have been emphasizing the effect of behavioral and cognitive approaches on quality of life, on decrease of dosage and frequency of drugs intake. Since insomnia is a chronic condition, long-term and safe treatments are warranted.

[Relation between sleep and obesity: a literature review]. / Relação entre sono e obesidade: uma revisão da literatura.

Reduction in sleep time has become an endemic condition in modern society and current literature has found important epidemiological associations between damage in the habitual standard of sleep and obesity. On this basis, the present revision analyzed the role of sleep and its alteration in the promotion of obesity. Diverse studies indicate that subjects that sleep less have greater possibility of becoming obese, and the shortening of sleep increases the leptin/ghrelin reason, generating increase of the appetite and hunger. This can be associated to the biggest caloric intake and promotion of obesity. An adequate standard of sleep becomes basic for the regulation of body mass and must be stimulated by health professionals.

Safety and health of professional drivers who drive on Brazilian highways.

Traffic accidents and resulting injuries and deaths have become a global epidemic. In Brazil, most professional drivers, especially truck drivers, face irregular working hours and can be awake for more than 18 hours/day, which reduces their performance and alertness. In this article, we discuss the laws related to Brazilian professional drivers and their current amendments (No. 12,619/2012 and No. 13,103/2015) in relation to working hours at the wheel and rest breaks, which are vital for the quality of life of drivers and society in general. We note that the new law appears to be less efficient than the previous one as it causes insecurity and concern to the users of the transportation system, drivers, and employers. To restrict and reduce accidents, deaths, and injuries in traffic, appropriate legislation is essential, aiming at the safety of workers and users of highways. The law must also benefit the commercial aspect, strengthening the reduction in production and logistics losses. Additionally, traffic education programs are needed, as well as better supervision in relation to total working hours. RESUMO Acidentes de trânsito com consequentes lesões e mortes têm se tornado uma epidemia em nível mundial. No Brasil, a maioria dos motoristas profissionais, sobretudo motoristas de transporte de cargas, enfrenta jornada de trabalho irregular e permanece acordado por mais de 18 horas/dia, o que reduz seu desempenho e estado de alerta. Neste artigo, discutimos as leis dos motoristas profissionais brasileiros e suas alterações vigentes (nº 12.619/2012 e nº 13.103/2015) em relação às horas de trabalho ao volante e a pausas para descanso, imprescindíveis para a qualidade de vida dos motoristas e para a sociedade em geral. Observamos que a nova legislação se mostra menos eficiente que a anterior por causar insegurança e preocupação aos usuários do sistema de transporte, aos próprios motoristas e aos empregadores. Para restringir e reduzir acidentes, mortes e lesões no trânsito, é fundamental uma legislação adequada, que vise à segurança do trabalhador e dos usuários das rodovias. A legislação deve, também, beneficiar o aspecto comercial, que se fortalece pela redução das perdas de produção e logística. Adicionalmente, são necessários programas de educação no trânsito e melhor fiscalização em relação ao tempo total de jornada de trabalho.

Applicability of predictive equations for resting energy expenditure in obese patients with obstructive sleep apnea.

OBJECTIVE: To investigate the applicability of predictive equations for resting energy expenditure (REE) in obese individuals with obstructive sleep apnea (OSA) and the effects of OSA severity on REE. MATERIALS AND METHODS: Twenty-nine obese men, 41.5 ± 7 years old, with moderate and severe OSA were recruited. All subjects were submitted to a clinical polysomnography, body composition, and indirect calorimetry measurements. REE was also predicted by three different equations: Harris and Benedict (1919), Cunningham (1990), and DRI (2002). RESULTS: No effects of OSA severity on REE were found. The measured REE (2416.0 ± 447.1 kcal/day) and the REE predicted by equations were different from each other (F = 2713.88; p < 0.05): Harris and Benedict (2128.0 ± 245.8 kcal/day), Cunningham (1789.1 ± 167.8 kcal/day) and DRI (2011.1 ± 181.4 kcal/day). Pearson correlations showed a moderate positive correlation between the REE measured and predicted by all equations. CONCLUSION: Our findings suggest that predictive equations for REE underestimate the energy expenditure in obese patients with sleep apnea. Also, no effects of OSA severity on REE were found.

Short-term l-arginine supplementation attenuates elevation of interleukin 6 level after resistance exercise in overweight men.

BACKGROUND AND AIM: l-Arginine (l-arg) supplementation and resistance exercise can induce changes in inflammatory and anti-inflammatory cytokines; however, it has not been investigated in obese hypertensive men. This study examines the effects of short-term l-arg supplementation and acute resistance exercise (AREX) on cytokine levels in obese hypertensive men. METHODS: Eight obese hypertensive men aged 46 ± 6 yrs. with an average body weight of 92.56 ± 9.9 kg and a BMI of 31.68 ± 2.18 kg/m2 participated in a randomized, double-blinded, crossover study. The patients were distributed into exercise groups based on the type of supplementation (6 g/day of placebo or l-arg for 7 days). Supplementation periods were separated by a seven-day washout period. The AREX regimen consisted of eight exercises with an exercise intensity of 60% of 1 repetition maximum. The interleukins IL-1ra, IL-6, and IL-10 and the IL-6/IL10 ratio were determined at rest, immediately after exercise and 1 h after exercise sessions. RESULTS: IL-1ra levels exhibited a significant difference both immediately and 1 h after exercise when the l-arg and placebo groups were compared (P < 0.05). IL-6 levels increased significantly after exercise in the placebo group compared with the l-arg group (P < 0.05). The placebo group showed a decrease in the IL-10 levels 1 h after exercise compared with resting levels (P < 0.05). The IL-6/IL-10 ratio showed a statistically significant increase in the placebo group after exercise compared to the l-arg group (P < 0.05). CONCLUSIONS: LARG supplementation attenuates the cytokine increase after AREX, in particular peak IL-6 levels decrease and exercise induced decreases in IL-10 levels are attenuated.

Training load, stress, recovery, mood, and motivation of athletes with spinal cord injury in wheelchair rugby during a competitive preseason

Abstract Aim: This study aims to characterize the stress, recovery, mood, and motivation together with the training load of athletes with cervical spinal cord injury (CSCI) during a period of resumption of wheelchair rugby (WCR) training. Additionally, it aims to compare the psychological and load training aspects during a competitive preseason and determine the correlations between training load, mood, stress, and recovery. Methods: We evaluated variables such as mood (Brazilian Mood Scale, BRAMS), stress and recovery (Recovery-Stress Questionnaire for Athletes, RESTQ-Sport 76) and training load (Subjective Perception of Effort - SPE) of eight high-performance athletes of wheelchair rugby with CSCIs at three different times (E1 = returning from vacation, E2 = half of the preseason, and E3 = after 2 months of training) for 2 months at a monthly interval. We also evaluated motivation (Sport Motivation Scale) at E1 and E3. Results: Results indicated few changes during the competitive preseason in terms of stress, recovery, and mood. However, the training load decreased toward the end of this period. Furthermore, we found that physical complaints positively correlated with depression when resuming training. In the middle of the competitive preseason period, we also noted positive correlations between conflict/pressure and fatigue and between fatigue and energy loss. At the end of this period, the SPE and arbitrary units correlated positively with conflict/pressure. Conclusion: We found few changes during the competitive preseason in terms of stress, recovery, and mood but not motivation, which did not change during this period. On the other hand, the training load decreased at the end of the competitive preseason. Furthermore, we observed correlations between training load and psychological aspects at different times.

Are physical inactivity, sitting time and screen time associated with obstructive sleep apnea in adults? A cross-sectional study

Abstract BACKGROUND: Sitting time, screen time and low physical activity (PA) levels have been associated with several diseases and all-cause mortality. PA is related to better sleep quality and absence of daytime sleepiness, along with lower risks of obstructive syndrome apnea (OSA). However, studies on the relationship between sitting time, screen time and OSA are scarce in the literature. OBJECTIVE: To analyze associations between PA levels, sitting time, screen time and OSA among adults with suspected sleep disorder. DESIGN AND SETTING: Cross-sectional study conducted at Hospital Israelita Albert Einstein. METHODS: Data were collected from 369 adults with suspected sleep disorders who visited the hospital's neurophysiology clinic between August 2015 and January 2017. RESULTS: Correlations between hypopnea and PA indicators were demonstrated for total sitting time (0.123; P = 0.019) and total screen time (0.108; P = 0.038). There was also a correlation between latency for rapid-eye-movement sleep (REM_LAT) and total sitting time (0.103; P = 0.047) and a negative correlation between mean oxyhemoglobin saturation (SaO_Avg) and total PA time (-0.103; P = 0.048). There were no associations between PA parameters and apnea-hypopnea index. After adjusting for confounding factors (body mass index, age and gender), sitting time and screen time were not associated with OSA. CONCLUSION: After adjusting for anthropometric and clinical factors, excessive sitting time or screen time was not associated with OSA in adults suspected of sleep disorders. Age, gender, hypertension, body mass index and waist circumference were associated with OSA.

Influência da privação de sono no desempenho de atletas: uma revisão sistemática / The influence of sleep deprivation on athletes' performance: a systematic review

RESUMO O sono é uma estratégia importante para a recuperação de atletas e o estado de privação de sono pode influenciar a performance esportiva. O objetivo do estudo foi realizar uma revisão sistemática de literatura para analisar a influência da privação de sono no desempenho físico e esportivo de atletas. A pesquisa foi realizada a partir das bases de dados eletrônicas PubMed, Scopus, SportDiscus e Scielo. Foram selecionados artigos originais publicados escritos no idioma inglês ou português. Após a busca nas bases de dados foram encontrados 143 artigos sendo 45 no PubMed, 72 no Scopus, 1 no Scielo e 25 no SportDiscus. Posteriormente a análise dos artigos, 8 artigos foram incluídos no presente estudo de acordo com os critérios de inclusão. Após análise dos 8 artigos incluídos na revisão, concluiu-se que a privação de sono influenciou negativamente no desempenho físico e esportivo em 5 dos artigos analisados. Além disso, constatou-se que o período de privação de sono é determinante para o desempenho dos atletas nas tarefas esportivas.

ABSTRACT Sleeping is an important strategy for athletes' recovery and the state of sleep deprivation can influence the sports performance.The objective of the study was to carry out a systematic literature review in order to analyze the influence of sleep deprivation on the physical and athletic performance of athletes. The study was carried out from the electronic databases PubMed, Scopus, SportDiscus and Scielo. We selected original articles published and written in English or Portuguese were selected. After the search in the databases we found 143 articles were found being 45 from PubMed, 72 from Scopus, 1 from Scielo and 25 from SportDiscus. After the full analysis of the articles, only 8 of them articles were included in the present study according to the inclusion criteria. After analyzing the 8 articles included in the present review it was concluded that sleep deprivation negatively influenced physical and sports performance in 5 of the analyzed articles. In addition, it was found that the sleep deprivation period is determinant for athletes' performance in sports tasks.

Effects of resistance training on metabolic and cardiovascular responses to a maximal cardiopulmonary exercise test in Parkinson`s disease / Efeitos do treinamento resistido sobre as respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo na doença de Parkinson

ABSTRACT: Objective: To evaluate the effects of resistance training on metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson's disease. Methods: Twenty-four patients with Parkinson's disease (modified Hoehn and Yahr stages 2 to 3) were randomly assigned to one of two groups: Control or Resistance Training. Patients in the Resistance Training Group completed an exercise program consisting of five resistance exercises (two to four sets of six to 12 repetitions maximum per set) twice a week. Patients in the Control Group maintained their usual lifestyle. Oxygen uptake, systolic blood pressure and heart rate were assessed at rest and during cycle ergometer-based maximal cardiopulmonary exercise testing at baseline and at 12 weeks. Assessments during exercise were conducted at absolute submaximal intensity (slope of the linear regression line between physiological variables and absolute workloads), at relative submaximal intensity (anaerobic threshold and respiratory compensation point) and at maximal intensity (maximal exercise). Muscle strength was also evaluated. Results: Both groups had similar increase in peak oxygen uptake after 12 weeks of training. Heart rate and systolic blood pressure measured at absolute and relative submaximal intensities and at maximal exercise intensity did not change in any of the groups. Muscle strength increased in the Resistance Training but not in the Control Group after 12 weeks. Conclusion: Resistance training increases muscle strength but does not change metabolic and cardiovascular responses during maximal cardiopulmonary exercise testing in patients with Parkinson's disease without cardiovascular comorbidities.

RESUMO Objetivo: Avaliar os efeitos do treinamento resistido nas respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo em pacientes com doença de Parkinson. Métodos: Vinte e quarto pacientes com doença de Parkinson (estágios 2 a 3 de Hoehn e Yahr modificado) foram aleatoriamente randomizados em dois grupos: Controle e Treinamento Resistido. O Grupo Treinamento Resistido realizou, duas vezes por semana, cinco exercícios resistidos, duas a quatro séries, seis a 12 repetições máximas por série. O Grupo Controle manteve seu estilo de vida. No início e após 12 semanas, consumo de oxigênio, pressão arterial sistólica e frequência cardíaca foram avaliados em repouso e durante um teste de esforço cardiopulmonar máximo realizado em um cicloergômetro. As avaliações durante o exercício foram realizadas nas intensidades submáximas (a inclinação da regressão linear entre as variáveis fisiológicas e as cargas absolutas), nas intensidades submáximas relativas (limiar anaeróbico e ponto de compensação respiratória) e na intensidade máxima (pico do exercício). Adicionalmente, foi avaliada a força muscular. Resultados: Comparado com o início, o consumo de oxigênio pico aumentou, de forma semelhante, em ambos os grupos após 12 semanas. A frequência cardíaca e a pressão arterial sistólica avaliadas nas intensidades submáximas absolutas e relativas, assim como no pico do exercício, não se modificaram em nenhum dos grupos. Finalmente, diferente do Grupo Controle, a força muscular aumentou no Grupo Treinamento Resistido após 12 semanas. Conclusão: Em pacientes com doença de Parkinson sem comorbidades cardiovasculares, o treinamento resistido aumenta a força muscular, mas não modifica as respostas metabólicas e cardiovasculares ao teste de esforço cardiopulmonar máximo.

[Excessive daytime sleepiness]. / Sonolência excessiva.

Sleepiness is a physiological function, and can be defined as increased propension to fall asleep. However, excessive sleepiness (ES) or hypersomnia refer to an abnormal increase in the probability to fall asleep, to take involuntary naps, or to have sleep atacks, when sleep is not desired. The main causes of excessive sleepiness is chronic sleep deprivation, sleep apnea syndrome, narcolepsy, movement disorders during sleep, circadian sleep disorders, use of drugs and medications, or idiopathic hypersomnia. Social, familial, work, and cognitive impairment are among the consequences of hypersomnia. Moreover, it has also been reported increased risk of accidents. The treatment of excessive sleepiness includes treating the primary cause, whenever identified. Sleep hygiene for sleep deprivation, positive pressure (CPAP) for sleep apnea, dopaminergic agents and exercises for sleep-related movement disorders, phototherapy and/or melatonin for circadian disorders, and use of stimulants are the treatment modalities of first choice.

Objective short sleep duration is associated with the activity of the hypothalamic-pituitary-adrenal axis in insomnia.

OBJECTIVE: To evaluate the association between objective short sleep duration in patients with insomnia and changes in blood parameters related to hypothalamic-pituitary-adrenal (HPA) axis activity. METHOD: A cross-sectional pilot study was conducted in 30 middle-aged adults with chronic insomnia who were divided into 2 groups according to polysomnography (PSG) total sleep time (TST) (TST > 5h and < 5h). All patients underwent subjective analysis of sleep quality, anthropometric measurements, PSG, and determination off asting blood parameters. RESULTS: The results revealed lower sleep efficiency and higher sleep latency for those with a TST < 5h. The subjective sleep quality was worse in the TST < 5h. Significantly, higher glucose and cortisol levels were observed with a TST < 5h. Glucose, cortisol and ACTH levels were inversely correlated with the PSG total sleep time. CONCLUSION: Patients with insomnia with objective short sleep duration had HPA-associated endocrine and metabolic imbalances chronically linked to increases in cardiovascular risk observed with this more severe insomnia phenotype.