Sleep habits, fatigue, and sleepiness in Chiclayo-Peru's bus drivers.

OBJECTIVE: The objectives of the study are to describe sleep habits, fatigue, and sleepiness in Chiclayo's (Peru) bus drivers and explore their relation with traffic accidents. MATERIAL AND METHODS: This is a descriptive cross-sectional study with a non-probability consecutive sampling. The sample size was 126 drivers. Sleepiness was evaluated using the Epworth Sleepiness Scale and sleep hygiene with validated questionnaires. We used a history of traffic accident or a near-traffic accident as an independent variable and applied chi-squared, t, and Mann-Whitney U tests to evaluate initial associations, which were later tested with a multivariate analysis. RESULTS: The mean age was 47.8 ± 9, 7 years, all were male. Twenty-seven (21%) bus drivers drove 10 or more hours per day; twenty-seven (21%) drove 5 or more hours without stopping; and eleven (9%) slept less than 6 h per day. Ninety-three (74%) drivers had fatigue while driving; thirty-one (25%) sleepiness; thirty-six (29%) had an accident or near accident; and (35%) had nodding while driving. Nodding while driving (PR 2.13, IC 1.26-3.59, p < 0.01) and the number of years as a driver (PR 1.03, IC 1.00-1.05, p = 0.02) were associated with an accident or near accident. CONCLUSION: Fatigue, sleepiness, and a history of accident or near accident were frequent. Having had an accident or near accident was significantly associated with nodding while driving and the number of years as a driver in Chiclayo's bus drivers.

Scientific research in obstructive sleep apnea syndrome: bibliometric analysis in SCOPUS, 1991-2012.

PURPOSE: The research in obstructive sleep apnea (OSA) may be beneficial from the collaboration between countries and researchers. In this study, we aimed to analyze the scientific research on OSA from 1991 to 2012 and to evaluate the collaboration networks between countries. METHODS: We conducted a bibliometric study in the SCOPUS database. The systematic search was limited to "articles" published from 1991 to 2012. Articles are results of original research; we evaluated the following criteria: number of countries represented, number of authors, number of citations, and journal names. We determined which countries were the most productive (more articles published) and the number of collaborations between these countries. The probability of citation was evaluated using adjusted odds ratios in a logistic regression analysis. RESULTS: We found a total of 6,896 OSA-related articles that had been published in 1,422 journals, 50 % of these articles were concentrated in 41 journals. Of the 74 different countries associated with these articles, the USA had the highest involvement with 23.8 % of all articles published. The probability of citation increased by 1.23 times for each additional author, and by 2.23 times for each additional country represented; these findings were independent of time since publication, journal, or the country of the author. CONCLUSIONS: Scientific production on OSA is increasing with limited international collaboration. The country with the greatest production in this period (1991-2012) was the USA, which concentrated the international collaboration network on OSA. We recommended that articles should be produced with international collaboration to improve the quantity of scientific publications and their chances of publication in high impact journals.

Sleepiness and nocturnal hypoxemia in Peruvian men with obstructive sleep apnea.

PURPOSE: To evaluate the intensity of nocturnal hypoxemia associated with sleepiness in Peruvian men with a diagnosis of obstructive sleep apnea (OSA). METHODS: We carried out a secondary data analysis based on a study which includes patients with OSA who were seen in a private hospital in Lima, Peru from 2006 to 2012. We included male adults who had polysomnographic recordings and who answered the Epworth sleepiness scale (ESE). The intensity of nocturnal hypoxemia (oxygen saturation ≤90%) was classified in four new categories: 0, <1, 1 to 10 and >10% total sleep time with nocturnal hypoxemia (NH). When the ESE score was higher than 10, we used the definitions presence or absence of sleepiness. We used Poisson regression models with robust variance to estimate crude and adjusted prevalence ratios (PR) for association between sleepiness and NH. RESULTS: 518 male patients with OSA were evaluated. Four hundred and fifty-two (87%) patients had NH and 262 (51%) had sleepiness. Of the 142 (27.4%) patients who had >10% total sleep time with NH, 98 (69.0%) showed sleepiness and had a greater probability of sleepiness prevalence, with a crude PR of 1.82 (95% CI 1.31-2.53). This association persisted in the multivariate models. CONCLUSIONS: We found an association between NH and sleepiness. Only patients with the major intensity of NH (over 10% of the total sleep time) had a greater probability of sleepiness. This suggests that sleepiness probably occurs after a chronic process and after overwhelming compensatory mechanisms.

Depressive symptoms in patients with obstructive sleep apnea/hypopnea syndrome.

OBJECTIVE: The objective of this study was to determine the frequency of depressive symptoms in Peruvian patients with obstructive sleep apnea/hypopnea (OSAH) and the association between the presence of depressive symptoms and OSAH severity. METHODS: Physical examination, Beck Depression Inventory (BDI), and Epworth Sleepiness Scale (ESS) were applied, and a polysomnography test was performed. RESULTS: Data on 312 patients, 12 % females, 46.1 ± 11.7 years of age, were analyzed. BDI and ESS scores were 8.3 ± 5.7 and 9.8 ± 5.5, respectively. A total of 244 (78 %) patients had OSAH: 27 % of the cases were mild, 23 % were moderate, and 50 % were severe. Eighteen percent of the population had depression. A univariate analysis found a relationship between depressive symptoms and OSAH, as well as with some polysomnographic variables related to OSAH severity. The association between depression and OSAH was not significant in the multivariate analysis. CONCLUSIONS: No association was found between depressive symptoms and OSAH.

Clinical and polysomnographic differences between OSAH patients with/without excessive daytime sleepiness.

PURPOSE: The purpose of this study is to describe the clinical and polysomnographic differences found in patients diagnosed with obstructive sleep apnea-hypopnea (OSAH), with or without excessive daytime sleepiness (EDS) measured by the Epworth Sleepiness Scale (ESS). METHODS: A physical examination, ESS, and polysomnography were applied to all the participants, considering an ESS score of >10 to indicate EDS and an ESS score of ≥ 16 to indicate severe EDS. Univariate (chi-squared or Student's t test) and multivariate (multiple logistic regression) analysis approaches were used. A value of p < .05 was considered statistically significant. RESULTS: The study covered 151 OSAH patients, including 129 (85 %) male patients, 66 (44 %) with EDS and 23 (21 %) with severe EDS. In the univariate analysis of demographic and polysomnographic variables, a comparison between patients without and with EDS showed that the latter had a larger neck circumference, maximum O2 desaturation, and increased sleep time at <90 % O2 saturation, with significant statistical differences. In the multivariate analysis, this statistical significance disappears. A comparison between patients without EDS and with severe EDS did not reveal differences in demographic or polysomnographic variables. CONCLUSIONS: Patients with OSAH and ESD showed more hypoxemia, but we did not find significant differences between OSAH patients with or without EDS.

Validation and modification of the Epworth Sleepiness Scale in Peruvian population.

PURPOSE: The main purpose of this study was to develop a cross-cultural adaptation of the Epworth Sleepiness Scale for Peruvian population (ESS-VP) and to provide evidence of reliability and validity to this scale. We also modified the ESS-VP for non-driving Peruvian population (ESS-MPV). METHODS: Participants were Peruvians between 18 and 65 years. Five-phase design: Translation and retranslation of the original scale; comprehension evaluation (n = 60); reliability or test-retest (n = 75); internal consistency and construct validity (n = 219); and change of sensibility (n = 36). Just as in the ESS-PV, the same procedure was applied to ESS-MPV except the first phase. RESULTS: The ESS-PV and ESS-MPV had an adequate comprehension. They were reliable over time (test-retest), being better within a period of 2 weeks. They also had adequate internal consistency (Cronbach's alpha: 0.790 and 0.789). Two factors were extracted in both scales, being only the first factor in which all items showed statistically significant loads. Both scales are sensitive to sleepiness change in patients with obstructive sleep apnea during treatment. CONCLUSIONS: The ESS-VP and ESS-MPV, adapted to adult Peruvian population, are comparable to the original scale, reliable, valid, and change-sensitive. It is proposed that the ESS-MPV should be applied in Peruvian population who do not drive motorized vehicles.

Spanish version of Jenkins Sleep Scale in physicians and nurses: psychometric properties from a Peruvian nationally representative sample.

OBJECTIVE: To evaluate the psychometric properties of the Spanish version of Jenkins Sleep Scale with 4 items (JSS-4) of the Peruvian health system's (PHS) nurses and physicians. METHODS: We carried out a psychometric study based on secondary analysis in a sample from a nationally representative survey that used acomplex sampling design. The participants were physicians and nurses aged 18-65 years, working in PHS private and public facilities, who have fulfilled all JSS-4 items. We performed a confirmatory factor analysis. Reliability was evaluated via two estimates - classic alpha (α) and categorical omega (ω) coefficients. Also, we tested the invariance across groups of variables. The convergent validity was evaluated based on the relation between JSS-4 and PHQ-2 using Pearson's correlation coefficient and effect size (Cohen's d). Also, we designed normative values based on percentiles. RESULTS: We included 2100 physicians and 2826 nurses in the analysis. We observed that the unidimensional model has adequate goodness-of-fit indices and values of α and ω coefficients. No measurement invariance was found between the groups of professionals and age groups; however, invariance was achieved between sex, monthly income, work-related illness, and chronic illness groups. Regarding the relation with other variables, the JSS-4 has a small correlation with PHQ-2. Also, profession and age-specific normative values were proposed. CONCLUSION: JSS-4 Spanish version has adequate psychometric properties in PHS nurses and physicians.

Frequency of use and preferences for information and communication technologies in patients with sleep apnea: A multicenter, multinational, observational cross-sectional survey study.

BACKGROUND: Obstructive sleep apnea (OSA) is a condition characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep. An accessible method to facilitate self-management education is through information and communication technologies (ICTs). PURPOSE: To assess the frequency of and preferences for ICT use in patients with sleep apnea. METHODS: A multicenter, multinational, observational cross-sectional survey study was conducted between 2018 and 2019 in sleep units in different countries of Latin America, including patients of both genders older than 18 years with a diagnosis of sleep apnea. Participants were asked to complete 20 questions in a self-administered survey about the frequency of use of ICTs and their preferences for receiving disease-related information. RESULTS: A total of 435 patients participated in the study, with a mean age of 59.1 ± 14.0; 62.5% (n = 272) were males. Most patients had access to cellphones (92.4%, n = 402), smartphone (83.0%, n = 361) and an internet connection (82.3%, n = 358). One-to-one ICTs were regarded as the most frequently used ICT type, as 75.4% (n = 328) of participants reported using them daily (χ2(4) = 848.207, p =.000). With respect to categories of interest, one-to-one ICTs were also the best rated ICT type to receive (59.1%, n = 257; χ2(2) = 137.710, p =.000) and ask physicians (57.0%, n = 248; χ2(2) = 129.145, p =.000) information about OSA. Finally, older adults and those with lower educational levels were found to be less likely to use and be interested in ICTs. CONCLUSION: Most patients have access to different ICTs and often use them to seek and receive medical information. The preferred ICTs include those in the one-to-one category (WhatsApp, email) and the one-to-many category (web browsers) for general health and OSA-related information.

Using a generic measure of quality of life in patients with obstructive sleep apnea.

PURPOSE: To evaluate the utility of a Multicultural Quality of Life Index (MQLI) in patients with Obstructive Sleep Apnea-Hypopnea (OSAH). METHODS: Physical examination, MQLI and the Epworth Sleepiness Scale (ESS) were applied to participants. In addition, a polysomnography or a respiratory polygraphy was carried out. RESULTS: A total of 221 patients participated, 186 (84%) males, mean age 48.8 ± 11.8 years. The MQLI scores 7were .73 ± 1.45 and the ESS 9.9 ± 5.2. A total of 188 (85%) patients had OSAH: 40 (21%) mild, 43 (23%) moderate, and 105 (56%) severe. The average time to answer the MQLI was 3.5 min. Cronbach's alpha index was 0.930. MQLI score in patients with and without OSAH was 7.73 versus 7.75 (p = 0.949); and by severity: non-OSAH 7.75, mild 8.04, moderate 8.14, and severe 7.44 (p = 0.023). There was a slight correlation between MQLI score and Apnea-Hypopnea Index in total population, but it disappeared when we analyzed by severity. MQLI and ESS correlation was R = -0.3256 (p < 0.0001). CONCLUSIONS: The MQLI has limitations in identifying quality of life (QOL) alterations and a poor correlation with severity in OSAH patients. The MQLI quantifies QOL in a general way. We recommend supplementing the QOL evaluation with disease-specific instruments.

Infected Cavitations, Bullae and Interstitial Lung Disease in a COVID-19 Patient in Lima, Peru.

A 48-year-old Peruvian man was diagnosed with COVID-19 in December 2020. His infection resolved and he was discharged from hospital after 14 days. However, 1 week later he presented with haemoptysis, malaise, pleuritic pain, infected cavitations, bullae, extensive interstitial lung disease and pneumomediastinum. He recovered after antibiotic treatment and was discharged after 8 days. His symptoms may have been due alveolar rupture due to persistent cough during and after diffuse inflammation of the lung parenchyma caused by COVID-19 infection. LEARNING POINTS: SARS-CoV-2 infection may be associated with lung bullae and cavitations as COVID-19 sequelae.Patients with respiratory problems after COVID-19 should be monitored closely and undergo pulmonary tests.COVID-19 patients may experience complications for several months due to bacterial infections.

[Factors associated with daytime sleepiness in public transportation drivers in Lima Metropolitan area]. / Factores asociados a somnolencia diurna en conductores de transporte público de Lima Metropolitana.

OBJECTIVE: . To determine the frequency of sleepiness and its associated factors in public transportation drivers in Lima metropolitan area. MATERIALS AND METHODS: . Transversal analytical study carried out on drivers between 18 and 65 years old who work in a public transportation company registered in the Municipality of Lima. Sleepiness was assessed using a version of the Epworth Sleepiness Scale validated in Peru. The variables that could behave as associated factors were obtained by a data collection sheet. Logistic regression was used to estimate the magnitude of the association between sleepiness and variables considered as associated factors. RESULTS: . Four hundred forty (440) drivers were included, median age was 38.0 years and the majority (99.3%) were males. From the total number of drivers, 17.7% (78) experienced daytime sleepiness. A significant association was found between sleepiness and the 2 x 1 rotation system (p=0.038), and between sleepiness and hours of sleep under seven (p=0.011). Logistic regression analysis showed that drivers with six or fewer hours of sleep were more likely to have daytime sleepiness (OR 1.83, 95% CI: 1.03-3.25). CONCLUSIONS: . Approximately one out of five drivers experienced daytime sleepiness, which was associated with having six or fewer hours of sleep per day.

OBJETIVOS: . Determinar la frecuencia de somnolencia y sus factores asociados en conductores de transporte público de Lima Metropolitana. MATERIALES Y MÉTODOS: . Estudio analítico transversal realizado en conductores de entre 18 y 65 años, que laboren en alguna empresa de transporte público registrada en la Municipalidad de Lima. La somnolencia se evaluó mediante una versión de la Escala de Somnolencia de Epworth validada en Perú. Las variables que se pudieron comportar como factores asociados se obtuvieron mediante una ficha de recolección de datos. Se utilizó la regresión logística para estimar la magnitud de la asociación entre la somnolencia y las variables consideradas como factores asociados. RESULTADOS: . Se incluyeron a 440 conductores, cuya mediana de edad fue 38,0 años y la mayoría (99,3%) fueron varones. Del total de conductores el 17,7% (78) presentaron somnolencia diurna. Se encontró una asociación significativa entre la somnolencia y el sistema de rotación 2 x 1 (p=0,038) y entre la somnolencia y las horas de sueño menores a siete (p=0,011). El análisis de regresión logística demostró que aquellos conductores con seis o menos horas de sueño tienen mayor probabilidad de somnolencia diurna (OR 1,83; IC95%: 1,03-3,25). CONCLUSIONES: . Aproximadamente, uno de cada cinco conductores presentó somnolencia diurna, la cual estuvo asociada con tener seis o menos horas de sueño al día.

Two Cases of Sleep-Related Eating Disorder Responding Promptly to Low-Dose Sertraline Therapy.

ABSTRACT: We report two cases of adult males with sleep-related eating disorder (SRED), with durations of 3 and 7 years, and without associated psychiatric history. In both cases, the use of low-dose (25 mg) sertraline taken at bedtime resulted in immediate, full and sustained resolution of symptoms at the latest follow-ups. The sertraline efficacy was of particular benefit for the patient reported on in case 2 who was a commercial airline pilot subjected to a highly restricted list of Federal Aviation Administration-approved medications. Risk factors for SRED included smoking cessation and work-related stress in case 1, and a history of sleepwalking and work-related circadian disruptions and partial sleep deprivations in case 2. Sertraline therapy of SRED is considered within a review of all current pharmacologic therapies of SRED.

Reliability and Validity of the Functional Outcomes of Sleep Questionnaire - Spanish Short Version (FOSQ-10SV) in Peruvian Patients With Obstructive Sleep Apnea.

STUDY OBJECTIVES: The aim of this study was to verify the reliability and validity of the Spanish short version of the Functional Outcomes of Sleep Questionnaire (FOSQ-10SV) in Peruvian patients with obstructive sleep apnea (OSA). METHODS: Participants underwent physical examinations, completed the FOSQ-10SV, and polysomnography tests were carried out. RESULTS: A total of 672 patients were analyzed, 75 females (11%), mean age 50.5 ± 13.8 years. A total of 563 patients (84%) had OSA. The mean FOSQ-10SV score was 15.96 ± 3.23. The FOSQ-10SV Cronbach alpha was 0.84 and two significant factors were extracted in the factor analysis-both factors explained a variance of 43% and 14%. A significant correlation was found between the FOSQ-10SV score and the apnea-hypopnea index. Patients with more severe disease have a lower FOSQ-10SV score (P = .003). Ninety-nine patients with OSA who started continuous positive airway pressure treatment were followed, and we observed an improvement in the FOSQ-10SV score from pretreatment to posttreatment (P < .001). CONCLUSIONS: The FOSQ-10SV has internal consistency, construct validity, and the sensitivity to change in Peruvian patients with OSA who undergo treatment.

Ventilatory Cycle Measurements and Loop Gain in Central Apnea in Mining Drivers Exposed to Intermittent Altitude.

STUDY OBJECTIVES: By measuring the apnea length, ventilatory phase, respiratory cycle length, and loop gain, we can further characterize the central apneas of high altitude (CAHA). METHODS: Sixty-three drivers of all-terrain vehicles, working in a Peruvian mine located at 2,020 meters above sea level (MASL), were evaluated. A respiratory polygraph was performed in the first night they slept at high altitude. None of the subjects were exposed to oxygen during the test or acetazolamide in the preceding days of the test. RESULTS: Sixty-three respiratory polygraphs were performed, and 59 were considered for analysis. Forty-six (78%) were normal, 6 (10%) had OSA, and 7 (12%) had CAHA. Key data from subjects include: residing altitude: 341 ± 828 MASL, Lake Louise scoring: 0.4 ± 0.8, Epworth score: 3.4 ± 2.7, apneahypopnea index: 35.7 ± 19.3, CA index: 13.4 ± 14.2, CA length: 14.4 ± 3.6 sec, ventilatory length: 13.5 ± 2.9 sec, cycle length: 26.5 ± 4.0 sec, ventilatory length/CA length ratio 0.9 ± 0.3 and circulatory delay 13.3 ± 2.9 sec. Duty ratio media [ventilatory duration/cycle duration] was 0.522 ± 0 0.128 [0.308-0.700] and loop gain was calculated from the duty ratio utilizing this formula: LG = 2π / [(2πDR-sin(2πDR)]. All subjects have a high loop gain media 2.415 ± 1.761 [1.175-6.260]. Multiple correlations were established with loop gain values, but the only significant correlation detected was between central apnea index and loop gain. CONCLUSIONS: Twelve percent of the studied population had CAHA. Measurements of respiratory cycle in workers with CAHA are more similar to idiopathic central apneas rather than Hunter-Cheyne-Stokes respiration. Also, there was a high degree of correlation between severity of central apnea and the degree of loop gain. The abnormal breathing patterns in those subjects could affect the sleep quality and potentially increase the risk for work accidents.

Clinical factors associated with extreme sleep apnoea [AHI>100 events per hour] in Peruvian patients: A case-control study-A preliminary report.

PURPOSE: The severity of obstructive sleep apnoea (OSA) ranges from mild or moderate to severe sleep apnoea. However, there is no information available on the clinical characteristics associated with cases involving more than 100 events per hour. This is a preliminary report and our goal was to characterise the demographics and sleep characteristics of patients with Extreme OSA and compare with patients with sleep apnoea of lesser severity. We hypothesised that patients with Extreme OSA (AHI>100) is associated with an increased comorbidities and/or risk factors. METHODS: We carried out a case-control study on male patients with OSA who were seen in a private hospital in Lima, Peru between 2006 and 2012. Cases were identified if their apnoea/hypopnea index (AHI) was higher than 100 (Extreme OSA), and four controls were selected per case: two with 15-29 AHI and two with 30-50 AHI, matched according to case diagnosis dates. We evaluated demographic, past medical history, and oxygen saturation variables. RESULTS: We identified 19 cases that were matched with 54 controls. In the multivariate model, only arterial hypertension, neck circumference, age, and over 10% in SatO2Hb≤90% in total sleep time (T90) were associated with Extreme OSA. Arterial hypertension had an OR=6.31 (CI95%: 1.71-23.23) of Extreme OSA. Each 5-cm increment in neck circumference was associated with an increase of OR=4.34 (CI95%: 1.32-14.33), while T90>10% had an OR=19.68 (CI95%: 4.33-89.49). Age had a marginal relevance (OR=0.95; CI95%: 0.92-0.99). CONCLUSION: Our results suggest that arterial hypertension, neck circumference, and over 10% SatO2Hb≤90% in total sleep time were associated with a higher probability of Extreme OSA. We recommend investigators to study this population of Extreme OSA looking for an early diagnosis and the identification of prognostic factors in comparison with moderate to severe levels.

Sleepiness and sleep characteristics in students from an urban district of Lima, Peru.

INTRODUCTION: Sleepiness in students has an impact on their learning, focus and memory. Sleepiness is caused by multiple factors. Therefore, our objective was to estimate the frequency of sleepiness in Peruvian students and assess its relation to lifestyle and sleep habits. METHODS: Cross-sectional study conducted on first through fifth year secondary students. The Spanish version of the pediatric daytime sleepiness scale (0 to 32 points) was administered and sleep and demographic characteristics and harmful habits, among others were investigated. Excessive sleepiness was considered as a score higher than 20 points, and its association was assessed using raw and adjusted odds ratios. RESULTS: The study included 586 students; the average score in the pediatric daytime sleepiness scale was 13.0 ± 5.5; 11.9% of students had excessive sleepiness. Smoking was associated with excessive sleepiness, with an adjusted OR of 6.9 (95% CI: 2.9-17.0); alcohol consumption showed an OR of 4 (95% CI: 1.5-10.5), and practicing sports showed an OR of 0.5 (95% CI: 0.3-0.9). Likewise, having a bad sleep quality (OR: 5.4; 95% CI: 3.1-9.5) and taking more than 60 minutes to fall asleep (OR: 2.5; 95% CI: 1.16.0) were associated with a higher probability of having sleepiness. CONCLUSION: Sleepiness was observed in 12% of the studied population, and was found to be lower than the rates described in studies with different populations. Excessive sleepiness is associated with smoking and frequent alcohol consumption, a lower level of sports practice, and bad sleep habits.

[Restless Legs Syndrome : A Threat to the quality of life]. / Síndrome de piernas inquietas: una amenaza a la calidad de vida.

Restless legs syndrome is a disorder associated with the imperative need to move the legs, starting at different times of day and it gets worse at night, relieved by activity, affecting the quality of life and sleep who sufferers it. Despite being a common disorder at any age, in adults with a prevalence of up to 10%, is not diagnosed by doctors and first level specialists that is why diagnostic and therapeutic interventions get delayed contributing to the perpetuation of symptoms and worsening quality of life. Since its diagnosis is purely clinical, getting familiar with this disorder is essential to ensure proper focus and thus rule out other diseases commonly confused with this one. Restless legs syndrome has a multi-factorial etiology that ranges from a genetic and hereditary, which are called primary restless legs syndrome, to its association with multiple pathologies, known as secondary restless legs syndrome. As for its management, drug therapy and non-drug therapy is aimed at symptom control, as its cure is not possible, although occasionally the condition can refer to later repeat in months or years.

[Sleep habits and traffic accidents in inter-provincial bus drivers of Arequipa, Peru]. / Hábitos del sueño y accidentes de tránsito en conductores de ómnibus interprovincial de Arequipa, Perú

In order to determine sleep habits in bus drivers and their relationship to accidents in the city of Arequipa, Peru, a cross-sectional descriptive study was conducted in a non-probabilistic sample of 166 drivers. Driving hours per day were 9.4 ± 3.7. 54% (89) drive over 4 hours without stopping; 74% (123) drive at night; and 87% (145) sleep on the bus. 75% reported fatigue while driving (124). 27% (45) had drowsiness; 24% (40) reported having been in or on the verge of an accident while driving. Sleepiness or fatigue while driving was common in this population and their driving and rest habits could contribute to this.

Factores asociados a somnolencia diurna en conductores de transporte público de Lima Metropolitana / Factors associated with daytime sleepiness in public transportation drivers in Lima Metropolitan area

RESUMEN Objetivos . Determinar la frecuencia de somnolencia y sus factores asociados en conductores de transporte público de Lima Metropolitana. Materiales y métodos . Estudio analítico transversal realizado en conductores de entre 18 y 65 años, que laboren en alguna empresa de transporte público registrada en la Municipalidad de Lima. La somnolencia se evaluó mediante una versión de la Escala de Somnolencia de Epworth validada en Perú. Las variables que se pudieron comportar como factores asociados se obtuvieron mediante una ficha de recolección de datos. Se utilizó la regresión logística para estimar la magnitud de la asociación entre la somnolencia y las variables consideradas como factores asociados. Resultados . Se incluyeron a 440 conductores, cuya mediana de edad fue 38,0 años y la mayoría (99,3%) fueron varones. Del total de conductores el 17,7% (78) presentaron somnolencia diurna. Se encontró una asociación significativa entre la somnolencia y el sistema de rotación 2 x 1 (p=0,038) y entre la somnolencia y las horas de sueño menores a siete (p=0,011). El análisis de regresión logística demostró que aquellos conductores con seis o menos horas de sueño tienen mayor probabilidad de somnolencia diurna (OR 1,83; IC95%: 1,03-3,25). Conclusiones . Aproximadamente, uno de cada cinco conductores presentó somnolencia diurna, la cual estuvo asociada con tener seis o menos horas de sueño al día.

ABSTRACT Objective . To determine the frequency of sleepiness and its associated factors in public transportation drivers in Lima metropolitan area. Materials and Methods . Transversal analytical study carried out on drivers between 18 and 65 years old who work in a public transportation company registered in the Municipality of Lima. Sleepiness was assessed using a version of the Epworth Sleepiness Scale validated in Peru. The variables that could behave as associated factors were obtained by a data collection sheet. Logistic regression was used to estimate the magnitude of the association between sleepiness and variables considered as associated factors. Results . Four hundred forty (440) drivers were included, median age was 38.0 years and the majority (99.3%) were males. From the total number of drivers, 17.7% (78) experienced daytime sleepiness. A significant association was found between sleepiness and the 2 x 1 rotation system (p=0.038), and between sleepiness and hours of sleep under seven (p=0.011). Logistic regression analysis showed that drivers with six or fewer hours of sleep were more likely to have daytime sleepiness (OR 1.83, 95% CI: 1.03-3.25). Conclusions . Approximately one out of five drivers experienced daytime sleepiness, which was associated with having six or fewer hours of sleep per day.

Peruvians' sleep duration: analysis of a population-based survey on adolescents and adults.

Background. Sleep duration, either short or long, has been associated with diseases such as obesity, type-2 diabetes and cardiovascular diseases. Characterizing the prevalence and patterns of sleep duration at the population-level, especially in resource-constrained settings, will provide informative evidence on a potentially modifiable risk factor. The aim of this study was to explore the patterns of sleep duration in the Peruvian adult and adolescent population, together with its socio-demographic profile. Material and Methods. A total of 12,424 subjects, mean age 35.8 years (SD ±17.7), 50.6% males, were included in the analysis. This is a cross-sectional study, secondary analysis of the Use of Time National Survey conducted in 2010. We used weighted means and proportions to describe sleep duration according to socio-demographic variables (area and region; sex; age; education attainment; asset index; martial and job status). We used Poisson regressions, taking into account the multistage sampling design of the survey, to calculate crude and adjusted prevalence ratios (PR) and 95% confidence intervals (95% CI). Main outcomes were short- (<6 h) and long-sleep duration (≥ 9 h). Results. On average, Peruvians slept 7.7 h (95% CI [7.4-8.0]) on weekdays and 8.0 h (95% CI [7.8-8.1]) during weekends. The proportions of short- and long-sleep, during weekdays, were 4.3% (95% CI [2.9%-6.3%]) and 22.4% (95% CI [14.9%-32.1%]), respectively. Regarding urban and rural areas, a much higher proportion of short-sleep was observed in the former (92.0% vs. 8.0%); both for weekdays and weekends. On the multivariable analysis, compared to regular-sleepers (≥ 6 to <9 h), short-sleepers were twice more likely to be older and to have higher educational status, and 50% more likely to be currently employed. Similarly, relative to regular-sleep, long-sleepers were more likely to have a lower socioeconomic status as per educational attainment. Conclusions. In this nationally representative sample, the sociodemographic profile of short-sleep contrasts the long-sleep. These scenarios in Peru, as depicted by sleeping duration, differ from patterns reported in other high-income settings and could serve as the basis to inform and to improve sleep habits in the population. Moreover, it seems important to address the higher frequency of short-sleep duration found in urban versus rural settings.