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Association between Sleep Quality and Cardiac Autonomic Modulation in Adolescents: A Cross Sectional Study. 青少年睡眠质量与心脏自主神经调节之间的关系:一项横断面研究
IF 1.6 Q4 CLINICAL NEUROLOGY Pub Date : 2023-11-22 eCollection Date: 2023-12-01 DOI: 10.1055/s-0043-1776750
Ozeas de Lima Lins-Filho, Aluisio Andrade-Lima, Auguste Daniel Torres, Luciano Machado Oliveira, Wagner Luiz do-Prado, Raphael Ritti-Dias, Diego Giulliano Destro Christofaro, Breno Quintella Farah

Objective  To analyze the impact of sleep quality/duration on cardiac autonomic modulation on physically active adolescents with obesity. Materials and Methods  The present cross-sectional study included 1,150 boys with a mean age of 16.6 ± 1.2 years. The assessment of cardiac functions included the frequency domain of heart rate variability (HRV; low frequency - LF; high frequency - HF; and the ratio between these bands -LF/HF -, defined as the sympathovagal balance), and each parameter was categorized as low / high . Physical activity levels and sleep quality/duration were obtained by questionnaires. Abdominal obesity was assessed and defined as waist circumference > 80 th percentile. Results  Poor sleep quality resulted in lower HF (odds ratio [OR]: 1.8; 95% confidence interval [95%CI]: 1.01-3.21]) regardless of physical activity and abdominal obesity. Moreover, the study found no association between sleep duration and HRV parameters in adolescents. Conclusion  Sleep quality, not sleep duration, reduces parasympathetic cardiac modulation apart from other factors such as physical activity and abdominal obesity in adolescents.

目的 分析睡眠质量/持续时间对体力活动量大的肥胖青少年心脏自主神经调节的影响。材料与方法 本次横断面研究共纳入 1150 名男孩,平均年龄为 16.6 ± 1.2 岁。对心脏功能的评估包括心率变异的频域(HRV;低频-LF;高频-HF;以及这些频段之间的比值-LF/HF-,定义为交感摇摆平衡),每个参数被分为低/高两类。体力活动水平和睡眠质量/持续时间通过问卷调查获得。腹部肥胖是指腰围大于 80th 百分位数。结果 无论体力活动和腹部肥胖与否,睡眠质量差都会降低高频率(几率比 [OR]:1.8;95% 置信区间 [95%CI]:1.01-3.21])。此外,研究还发现青少年的睡眠时间与心率变异参数之间没有关联。结论 除体力活动和腹部肥胖等其他因素外,睡眠质量(而非睡眠时间)会降低青少年副交感神经对心脏的调节作用。
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引用次数: 0
2023 Guidelines on the Diagnosis and Treatment of Insomnia in Adults – Brazilian Sleep Association 2023 年成人失眠症诊断和治疗指南 - 巴西睡眠协会
IF 1.6 Q4 CLINICAL NEUROLOGY Pub Date : 2023-10-01 DOI: 10.1055/s-0043-1776281
L. F. Drager, Maria Assis, Andrea Frota Rego Bacelar, D. Poyares, Silvia Gonçalves Conway, G. Pires, Alexandre Pinto de Azevedo, Alicia Carissimi, A. Eckeli, Álvaro Pentagna, Carlos Maurício Oliveira Almeida, C. Franco, E. Sobreira, F. Stelzer, Giuliana Macedo Mendes, G. Minhoto, Ila Marques Porto Linares, Ksdy Maiara Moura Sousa, L. Gitaí, Lucia Sukys-Claudino, M. Sobreira-Neto, Marcio Andrei Zanini, Regina Margis, Sandra Cristina Gonçalves Martinez
Abstract Chronic insomnia disorder (simplified in this document as insomnia) is an increasingly common clinical condition in society and a frequent complaint at the offices of different areas of health practice (particularly Medicine and Psychology). This scenario has been accompanied by a significant evolution in treatment, as well as challenges in approaching patients in an appropriately way. This clinical guideline, coordinated by the Brazilian Sleep Association and the Brazilian Association of Sleep Medicine and counting on the active participation of various specialists in the area, encompasses an update on the diagnosis and treatment of insomnia in adults. To this end, it followed a structured methodology. Topics of interest related to diagnosis were written based on theoretical framework, evidence in the literature, and professional experience. As for the topics related to the treatment of insomnia, a series of questions were developed based on the PICO acronym (P – Patient, problem, or population; I – Intervention; C – Comparison, control, or comparator; O – Outcome). The work groups defined the eligible options within each of these parameters. Regarding pharmacological interventions, only the ones currently available in Brazil or possibly becoming available in the upcoming years were considered eligible. Systematic reviews were conducted to help prepare the texts and define the level of evidence for each intervention. The final result is an objective and practical document providing recommendations with the best scientific support available to professionals involved in the management of insomnia.
摘要 慢性失眠症(本文中简化为失眠症)是社会上越来越常见的一种临床病症,也是不同医疗领域(尤其是医学和心理学)的常见病。在这种情况下,治疗方法也随之发生了重大变化,同时,以适当的方式对待患者也面临着挑战。本临床指南由巴西睡眠协会和巴西睡眠医学协会协调制定,得到了该领域多位专家的积极参与,其中包括成人失眠症诊断和治疗的最新进展。为此,该指南采用了结构化方法。与诊断有关的主题是根据理论框架、文献证据和专业经验编写的。至于与失眠症治疗相关的主题,则根据 PICO 首字母缩写词(P - 患者、问题或人群;I - 干预;C - 对比、对照或比较者;O - 结果)制定了一系列问题。工作组在每个参数中定义了符合条件的选项。关于药物干预,只有目前在巴西上市或未来几年可能上市的药物才被认为符合条件。为帮助编写文本和确定每种干预措施的证据水平,还进行了系统性回顾。最终形成了一份客观实用的文件,为参与失眠症治疗的专业人员提供了具有最佳科学依据的建议。
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引用次数: 0
Brazilian Consensus on Sleep-Focused Speech-Language-Hearing Sciences - 2023 Brazilian Sleep Association 巴西睡眠集中语言听力科学共识- 2023巴西睡眠协会
Q4 CLINICAL NEUROLOGY Pub Date : 2023-10-01 DOI: 10.1055/s-0043-1776109
Luciana Moraes Studart-Pereira, Esther Mandelbaum Gonçalves Bianchini, Márcia Assis, Marieli Timpani Bussi, Camila de Castro Corrêa, Thays Crosara Abrahão Cunha, Luciano Ferreira Drager, Vanessa Ieto, Geraldo Lorenzi-Filho, Gabriele Ramos de Luccas, Evelyn Lucien Brasil, Silmara Regina Pavani Sovinski, Edilson Zancanella, Gabriel Natan Pires
Abstract Introduction This consensus aimed to develop a structured document presenting the role of sleep-focused Speech-Language-Hearing (SPH) Sciences (SPHS). The recommendations were based on the expertise of specialists and on evidence in the literature, aiming to guide the coverage of this area and the consequent improvement in the quality of the professionals' approach. Methods A Delphi method was conducted with 49 SLH pathologists (SLHP), four sleep physicians, one dentist, one physical therapist, and one methodologist. Four Delphi panel rounds were conducted in Google Forms. The items were analyzed based on the panelists' percentage of agreement; consensuses were reached when ⅔ (66.6%) of valid responses were on a same on a same answer (either “agree” or “disagree”). Results Participants voted on 102 items. The mean consensus rate was 89.9% ± 10.9%. The essential topics were the importance of professional training, the SLH diagnosis, and the SLH treatment of sleep disorders. It was verified that all fields of the SLHS are related to the area of sleep; that sleep-focused SLH pathologists (SLHP) are the responsible for assessing, indicating, and conducting specific orofacial myofunctional therapy for sleep-disordered breathing alone or in combination with other treatments; that SLHP are included in interdisciplinary teams in the area of sleep in public and private services. Discussion The Brazilian consensus on sleep-focused SLHS is a landmark in this area. This consensus described the scope of action of sleep-focused SLHP and systematized recommendations being useful as a reference for the professional practice in the area of sleep.
摘要:本共识旨在发展一份结构化的文件,展示睡眠聚焦语音语言听力科学(SPH)的作用。这些建议以专家的专门知识和文献中的证据为基础,旨在指导这一领域的覆盖范围,并由此提高专业人员方法的质量。方法采用德尔菲法对49名睡眠障碍病理学家、4名睡眠内科医生、1名牙科医生、1名物理治疗师和1名方法学家进行调查。在谷歌表格中进行了四轮德尔菲小组讨论。这些项目是根据小组成员的同意百分比进行分析的;当三分之二(66.6%)的有效回复在同一答案上相同(“同意”或“不同意”)时,达成共识。参与者对102个项目进行了投票。平均共识率为89.9%±10.9%。主要的主题是专业培训的重要性,SLH的诊断,以及SLH治疗睡眠障碍。结果表明,SLHS的所有脑区都与睡眠区有关;以睡眠为重点的SLH病理学家(SLHP)负责评估、指示和实施针对睡眠呼吸障碍的特定口面肌功能治疗,单独或与其他治疗相结合;在公共和私营服务机构的睡眠领域,将特殊睡眠人员纳入跨学科小组。巴西人对以睡眠为重点的SLHS的共识是这一领域的一个里程碑。这一共识描述了以睡眠为中心的SLHP的作用范围和系统化的建议,可作为睡眠领域专业实践的参考。
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引用次数: 0
Positive Pressure Ventilation Treatment Based on Daytime and Night-time Titration in Patients with Obesity Hypoventilation Syndrome: A Randomized Controlled Trial 基于昼夜滴定的正压通气治疗肥胖低通气综合征患者:一项随机对照试验
Q4 CLINICAL NEUROLOGY Pub Date : 2023-09-01 DOI: 10.1055/s-0043-1773790
Babak Amra, Marzieh Ghasemi, Forogh Soltaninejad, Mehrzad Salmasi
Abstract Objectives The aim of the present study was to investigate the improvements of gas exchange and excessive daytime sleepiness in patients with obesity hypoventilation syndrome (OHS) in daytime and night-time split polysomnography (DSPSG and NSPSG). Materials and Methods In the present randomized controlled trial, patients with OHS were enrolled in two DSPSG (51 patients) and NSPSG (50 patients) groups in the Bamdad respiratory and sleep research center in Isfahan, Iran. In both groups, the diagnostic polysomnography (PSG) and titration were conducted in one session according to the guidelines of NSPSG. SpO2, PaCO2, and the Epworth Sleepiness Scale (ESS), were measured initially and 12 weeks after treatment. Furthermore, the PSG parameters and the type of treatments for the two groups were recorded and analyzed. Results A total of 101 OHS patients (age: 62.02 ± 12.4 year old; 61 females [60.4%]) were evaluated. There were no significant differences regarding BMI, gender, and AHI between groups (p > 0.05). Primary SpO2, PaCO2, and ESS were not significantly different between the two groups. After 12 weeks of treatment by continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP), there were significant improvement of SpO2, PaCO2, and ESS score (p < 0.001). The amount of change of these variables was not different between groups. Among all variables, only the lower SpO2 and higher PaCO2 were associated with response to BiPAP. Discussion There were no significant differences in the number of changes of SpO2, PaCO2, and ESS by treatment in the DSPSG and NSPSG groups. Therefore, DSPSG may be considered as a valuable alternative method for the diagnosis and titration in OHS patients. Clinical Trials IRCT20170512033930N2
摘要目的探讨肥胖低通气综合征(OHS)患者在白天和夜间分割多导睡眠图(DSPSG和NSPSG)下气体交换和日间过度嗜睡的改善情况。材料与方法在本随机对照试验中,OHS患者被纳入伊朗伊斯法罕Bamdad呼吸与睡眠研究中心的DSPSG组(51例)和NSPSG组(50例)。两组均按照NSPSG指南进行诊断性多导睡眠图(PSG)和滴定术。治疗前和治疗后12周分别测量SpO2、PaCO2和Epworth嗜睡量表(ESS)。记录并分析两组患者PSG参数及治疗方式。结果101例OHS患者(年龄:62.02±12.4岁;61名女性(60.4%)被评估。两组间BMI、性别和AHI无显著差异(p >0.05)。两组间原发性SpO2、PaCO2、ESS差异无统计学意义。持续气道正压(CPAP)或双水平气道正压(BiPAP)治疗12周后,SpO2、PaCO2、ESS评分均有显著改善(p <0.001)。这些变量的变化量在组间没有差异。在所有变量中,只有较低的SpO2和较高的PaCO2与BiPAP的反应相关。DSPSG组与NSPSG组治疗前后SpO2、PaCO2、ESS变化数无显著差异。因此,DSPSG可能被认为是OHS患者诊断和滴定的有价值的替代方法。临床试验IRCT20170512033930N2
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引用次数: 0
The Effects of Shift Work on the Immune System: A Narrative Review 轮班工作对免疫系统的影响:一个叙述性的回顾
Q4 CLINICAL NEUROLOGY Pub Date : 2023-09-01 DOI: 10.1055/s-0043-1772810
Marianne Stenbekk Thorkildsen, Lise Tuset Gustad, Jan Kristian Damås
Abstract Working a shift work schedule has been hypothesized to have negative effects on health. One such described consequence is altered immune response and increased risk of infections. Former reviews have concluded that more knowledge is needed to determine how shift work affects the immune system. Since the last review focusing on this subject was published in 2016, new insight has emerged. We performed a search of the topic in PubMed, Scopus and Embase, identifying papers published after 2016, finding a total of 13 new studies. The articles identified showed inconsistent effect on immune cells, cytokines, circadian rhythms, self-reported infections, and vaccine response as a result of working a shift schedule. Current evidence suggests working shifts influence the immune system, however the clinical relevance and the mechanism behind this potential association remains elusive. Further studies need to include longitudinal design and objective measures of shift work and immune response.
轮班工作已经被假设对健康有负面影响。其中一个描述的后果是免疫反应改变和感染风险增加。以前的评论得出结论,需要更多的知识来确定轮班工作如何影响免疫系统。自2016年发表关于这一主题的上一篇综述以来,出现了新的见解。我们在PubMed、Scopus和Embase中搜索了该主题,确定了2016年之后发表的论文,共发现了13项新研究。研究发现,轮班制对免疫细胞、细胞因子、昼夜节律、自我报告感染和疫苗反应的影响不一致。目前的证据表明,工作班次影响免疫系统,然而临床相关性和这种潜在关联背后的机制仍然难以捉摸。进一步的研究需要包括纵向设计和轮班工作和免疫反应的客观测量。
{"title":"The Effects of Shift Work on the Immune System: A Narrative Review","authors":"Marianne Stenbekk Thorkildsen, Lise Tuset Gustad, Jan Kristian Damås","doi":"10.1055/s-0043-1772810","DOIUrl":"https://doi.org/10.1055/s-0043-1772810","url":null,"abstract":"Abstract Working a shift work schedule has been hypothesized to have negative effects on health. One such described consequence is altered immune response and increased risk of infections. Former reviews have concluded that more knowledge is needed to determine how shift work affects the immune system. Since the last review focusing on this subject was published in 2016, new insight has emerged. We performed a search of the topic in PubMed, Scopus and Embase, identifying papers published after 2016, finding a total of 13 new studies. The articles identified showed inconsistent effect on immune cells, cytokines, circadian rhythms, self-reported infections, and vaccine response as a result of working a shift schedule. Current evidence suggests working shifts influence the immune system, however the clinical relevance and the mechanism behind this potential association remains elusive. Further studies need to include longitudinal design and objective measures of shift work and immune response.","PeriodicalId":21848,"journal":{"name":"Sleep Science","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Cervical Fat Tissue Volume is a Predictor for Moderate to Severe OSA 宫颈脂肪组织体积是中度至重度OSA的预测指标
Q4 CLINICAL NEUROLOGY Pub Date : 2023-09-01 DOI: 10.1055/s-0043-1772827
Glenda Ernst, Pablo Dalzotto, Melina Saban, Fernando M. Ferraro, Alejandro Salvado, Eduardo Enrique Borsini
Abstract Objective Obstructive sleep apnea (OSA) is a disorder characterized by recurrent pharyngeal obstruction during sleep, in which upper airway anatomy plays a key role in its pathogenesis. The aim of this study was to describe whether the quantification of cervical fat tissue volume (CFTV) obtained by Computed Tomography (CT)cephalometry is related to the severity of OSA. Methods Retrospective study between 2018 and 2020 in those patients > 18 years old, with diagnosis of OSA who performed a volumetric cephalometric imaging. Three-dimensional reconstruction of the images was performed and CFTV was measured. Results 91 patients were included in this study of which: without OSA (n: 7), mild (n: 19), moderate (n: 39) and severe OSA (n: 26). We observed a progressive increase of CFTV related to OSA severity has been observed (without OSA: 58.9 ml (47.9-87.5), mild: 59.1ml (48.4-78.3), moderate: 71 ml (42.6-127.1) and severe OSA 103.6 ml (81-153); p < 0.01); nevertheless, no differences were found in the airway volume and neck area. It was showed a significant correlation between CFTV and OSA indicators: AHI, ODI and T90 (Sp r: 0.48; 0.38 and 0.36; p < 0.01 respectively). CFTV cut-off value to discriminate AHI >15 ev/h with best sensitivity-specificity relationship was 64.1 ml with an area under the curve of 0.6 ± 0.06. Multivariate analysis showed that CFTV is a predictor for moderate to severe OSA (OR:3.05, IC95%: 1.14-8.17). Conclusion Cervical fat quantification by CT cephalometry correlates with OSA severity in adults. Fat volume > 64.1 ml increased more than three times the risk of OSA moderate to severe.
【摘要】目的阻塞性睡眠呼吸暂停(OSA)是一种以睡眠时反复咽部梗阻为特征的疾病,其发病机制与上呼吸道解剖结构密切相关。本研究的目的是描述通过计算机断层扫描(CT)头测术获得的颈椎脂肪组织体积(CFTV)的量化是否与OSA的严重程度有关。方法回顾性研究2018 ~ 2020年住院患者;18岁,诊断为阻塞性睡眠呼吸暂停,并进行了脑容量成像。对图像进行三维重建,并测量CFTV。结果本研究共纳入91例患者,其中:无OSA(7例)、轻度OSA(19例)、中度OSA(39例)、重度OSA(26例)。我们观察到与OSA严重程度相关的CFTV进行性增加(无OSA: 58.9 ml(47.9-87.5),轻度:59.1ml(48.4-78.3),中度:71 ml(42.6-127.1),重度OSA 103.6 ml (81-153);p & lt;0.01);然而,在气道体积和颈部面积上没有发现差异。CFTV与OSA指标AHI、ODI、T90有显著相关性(Sp r: 0.48;0.38和0.36;p & lt;0.01分别)。CFTV鉴别AHI >15 ev/h的敏感性-特异性关系最佳的临界值为64.1 ml,曲线下面积为0.6±0.06。多因素分析显示,CFTV是中重度OSA的预测因子(OR:3.05, IC95%: 1.14-8.17)。结论CT头位测量法定量宫颈脂肪与成人OSA严重程度相关。脂肪量>64.1毫升使患中度至重度OSA的风险增加三倍以上。
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引用次数: 0
The Importance of Sleep for Successful Neurorehabilitation after Stroke 睡眠对中风后神经康复的重要性
Q4 CLINICAL NEUROLOGY Pub Date : 2023-09-01 DOI: 10.1055/s-0043-1772805
Cristina Frange, Brian James Murray, Fernando Morgadinho Santos Coelho
Abstract Sleep has important clinical implications for neurorehabilitation after stroke. We aimed to systematically explore sleep (including naps) as an essential factor in the neurorehabilitation of patients after stroke. After titles and abstracts were screened, 49 full texts were reviewed, and 7 were included in this review. Data were extracted and assessed for quality and risk of bias. We looked at any neurorehabilitation setting, and compared sleep with no sleep and explored these factors in stroke patients versus healthy individuals. Rehabilitation is critical for many activities that may need to be learned or re-learned following stroke and for returning to everyday life. In this context, sleep is essential in neurorehabilitation and physical therapy practice as it supports neuroplasticity, memory, and learning. The available data suggest that sleep should be considered in the treatment plan for successfully targeted physiotherapy to optimize cognitive and motor learning. Physical therapists should advise about sleep hygiene and therapies to improve sleep, both quality and quantity.
睡眠对脑卒中后神经康复具有重要的临床意义。我们旨在系统地探讨睡眠(包括小睡)在中风后患者神经康复中的重要作用。在对标题和摘要进行筛选后,对49篇全文进行综述,其中7篇纳入本综述。提取数据并评估其质量和偏倚风险。我们观察了所有的神经康复环境,比较了睡眠和不睡眠,并探讨了中风患者和健康人之间的这些因素。康复对于中风后可能需要学习或重新学习的许多活动以及恢复日常生活至关重要。在这种情况下,睡眠在神经康复和物理治疗实践中是必不可少的,因为它支持神经可塑性、记忆和学习。现有的数据表明,睡眠应该在治疗计划中考虑到成功的针对性物理治疗,以优化认知和运动学习。物理治疗师应该就睡眠卫生和改善睡眠质量和睡眠量的疗法提出建议。
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引用次数: 0
Sleep Medicine Knowledge Among Graduating Medical Students in Lebanon During an Economic and Political Crisis: A Preliminary Survey 经济和政治危机中黎巴嫩医科毕业生睡眠医学知识的初步调查
Q4 CLINICAL NEUROLOGY Pub Date : 2023-09-01 DOI: 10.1055/s-0043-1772828
Raissa Aoun, Victor Zibara, Christy Costanian, Hrayr P. Attarian, Sola Aoun Bahous
Abstract Objectives Sleep disorders are prevalent and underrecognized during both economic and political crises. They are a major reason for poor overall health and decreased quality of life. Sleep medicine education is limited at most medical schools, resulting in limited awareness of this important aspect of healthcare. The aim of the study is to assess sleep medicine knowledge of graduating medical students in Lebanon and to assess their readiness to tackle sleep health issues in a country during an unprecedented crisis. Methods Final-year medical students at 7 medical schools in Lebanon were invited to fill a survey between January 2020 and March 2021. The Assessment of Sleep Knowledge in Medical Education survey was used to assess their knowledge in sleep medicine. The curriculum organizers at the medical schools were also surveyed. Student's t-test was used for analysis. Results 158 and 58 students completed the survey during 2020 and 2021, with a mean overall score on sleep knowledge of was 17.5 and 15.9 /30, respectively. There was no difference in mean knowledge scores by gender, age, American versus European medical school systems, and between medical schools that included sleep medicine in their curriculum versus those that did not. Conclusions Presence of sleep medicine education in the curriculum was associated with higher scores on ASKME among graduating Lebanese medical students. Given the low response rate, however, this descriptive pilot data could be used as a launching pad for a larger study, with a more representative sample, for generalizable results.
摘要目的在经济和政治危机期间,睡眠障碍普遍存在,但未得到充分认识。它们是整体健康状况不佳和生活质量下降的主要原因。大多数医学院的睡眠医学教育有限,导致人们对这一医疗保健重要方面的认识有限。这项研究的目的是评估黎巴嫩即将毕业的医科学生的睡眠医学知识,并评估他们在一个前所未有的危机中解决睡眠健康问题的准备情况。方法于2020年1月至2021年3月对黎巴嫩7所医学院的应届医学生进行问卷调查。采用《医学教育中睡眠知识的评估》调查对其睡眠医学知识进行评估。医学院的课程组织者也接受了调查。采用学生t检验进行分析。结果在2020年和2021年期间,有158名和58名学生完成了调查,睡眠知识的平均总分分别为17.5分和15.9分。在性别、年龄、美国和欧洲医学院系统、以及在课程中包含睡眠医学的医学院和未包含睡眠医学的医学院之间,平均知识得分没有差异。结论:课程中存在睡眠医学教育与黎巴嫩医科毕业生ASKME得分较高有关。然而,考虑到低回复率,这一描述性试点数据可以作为一个跳板,用于更大规模的研究,更具代表性的样本,以获得可推广的结果。
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引用次数: 1
Sleep Quality, Excessive Daytime Sleepiness, and Physical Activity Level in Health Professionals with and Without COVID-19: a Cross-Sectional Study 有和没有COVID-19的卫生专业人员的睡眠质量、白天过度嗜睡和身体活动水平:一项横断面研究
Q4 CLINICAL NEUROLOGY Pub Date : 2023-09-01 DOI: 10.1055/s-0043-1772807
Ana Carolynne Santos Neves, Sulyvan Italo Daher Chaves, Pedro Paulo Simões Siqueira, Karla Michelle Lima Alves, Luciana Moraes Studart-Pereira, Anna Myrna Jaguaribe-de-Lima
Abstract Objective To compare the sleep quality, excessive daytime sleepiness, and physical activity level in health professionals infected and not infected with COVID-19. Methods Cross-sectional study based on online forms (Google Forms) filled out by health professionals who cared for COVID- 19 patients in hospitals in the Recife metropolitan area, Brazil, between October 2020 and May 2021. Anthropometric, sociodemographic, and occupational data were collected, along with the assessment of excessive daytime sleepiness (with Epworth Sleepiness Scale [ESE]), sleep quality (with Pittsburgh Sleep Quality Index [PSQI]), and physical activity level (with International Physical Activity Questionnaire [IPAQ] – short version). Results A total of 96 participants were assessed (37 with COVID-19, 59 without COVID-19). There were no differences between the groups regarding physical activity levels classified as sedentary, moderately active, or highly active (p = 0.850), or the weekly energy expenditure (p = 0.522). Infected professionals had a greater workload than non-infected ones, besides poorer sleep quality (10.46 ± 3.75 vs. 7.88 ± 3.75; p = 0.001) and excessive daytime sleepiness (10.19 ± 3.05 vs. 8.44 ± 3.85; p = 0.016). Conclusion Based on the results, this study shows that professionals infected with COVID-19 have poorer sleep quality, associated with excessive daytime sleepiness, in contrast with non-infected professionals.
摘要目的比较新冠肺炎感染和未感染医务人员的睡眠质量、白天过度嗜睡和身体活动水平。方法基于2020年10月至2021年5月期间在巴西累西腓市区医院护理COVID- 19患者的卫生专业人员填写的在线表格(Google forms)进行横断面研究。收集了人体测量学、社会人口学和职业数据,同时评估了白天过度嗜睡(使用Epworth嗜睡量表[ESE])、睡眠质量(使用匹兹堡睡眠质量指数[PSQI])和身体活动水平(使用国际身体活动问卷[IPAQ] -简短版)。结果共纳入96例受试者,其中37例感染COVID-19, 59例未感染COVID-19。两组之间的体力活动水平分为久坐、中度活动或高度活动(p = 0.850),或每周能量消耗(p = 0.522)没有差异。感染专业人员的工作量大于未感染专业人员,睡眠质量较差(10.46±3.75∶7.88±3.75;P = 0.001)和白天嗜睡(10.19±3.05∶8.44±3.85;P = 0.016)。综上所述,本研究表明,与未感染COVID-19的专业人员相比,感染COVID-19的专业人员睡眠质量较差,白天嗜睡过多。
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引用次数: 0
Nocturnal Polysomnography without Technical Supervision in the Diagnosis of Respiratory Sleep Disorders, Diagnostic Performance of Home and Sleep Laboratory Studies 无技术监督的夜间多导睡眠图诊断呼吸性睡眠障碍,家庭和睡眠实验室研究的诊断表现
Q4 CLINICAL NEUROLOGY Pub Date : 2023-09-01 DOI: 10.1055/s-0043-1772809
María Florencia Angellotti, Sofía Grandval, Ileana Palma, Vanina Giovini, Verónica Jaritos, Gastón Diaz-Lapasini, Denise Carnevale, Juan Facundo Nogueira
Abstract Introduction Unattended Polysomnography (type 2 PSG) is a procedure for the diagnosis of sleep-disordered breathing (SDB). Published evidence on its performance and efficacy is limited. Available studies reveal a high rate of lost records that could limit its application. Objective To assess the efficacy of type 2 PSG and the rate of studies that must be repeated due to critical loss of signals. Methods prospective, descriptive study. Adult patients with suspected SDB were included. Unattended PSG was performed using portable equipment. 75 patients were connected at home and another 75 in the laboratory, without subsequent monitoring. Records were evaluated to determine the percentage of the night with adequate quality for each of the signals, considered as an evaluable signal for = 70% of the total recording time (TRT). The need to repeat the studies was also estimated. Results: 150 patients were recruited; 44% women; age 57.3 ± 15.4 years; BMI 29.4 ± 6.5. EEG and EOG signals were adequate in 149 records. Flow signal by pressure cannula was adequate in 146 and by thermistor in 67.8%. In only one study the signal of both effort bands were inadequate. Oximetry was lost in 4 cases. Ten tracings (6%) met the criteria for repetition; 8 hospital and 2 home. Conclusions Acceptable records were obtained in most unattended PSG studies, both at home and in the sleep laboratory. The rate of repetition of studies due to loss of signal was 6%, with failure in SaO2 or in flow signals being the main cause of the indication.
无人值守多导睡眠图(2型PSG)是一种诊断睡眠呼吸障碍(SDB)的方法。已发表的关于其性能和功效的证据有限。现有的研究表明,高丢失率的记录可能会限制其应用。目的评价2型PSG的疗效及因信号严重丢失而必须重复研究的比率。方法前瞻性、描述性研究。纳入疑似SDB的成年患者。使用便携式设备进行无人值守PSG。75名患者在家中连接,另外75名在实验室连接,没有后续监测。对记录进行评估,以确定每个信号质量足够的夜晚的百分比,将其视为可评估的信号,占总记录时间(TRT)的70%。还估计需要重复进行这些研究。结果:共纳入150例患者;44%的女性;年龄57.3±15.4岁;Bmi 29.4±6.5。149例脑电图、眼电信号正常。压力套管的流量信号在146例中是足够的,热敏电阻的流量信号在67.8%中是足够的。只有在一项研究中,两个努力波段的信号都不充分。4例血氧测定丢失。10例(6%)符合重复标准;8个医院,2个家庭结论:无论是在家里还是在睡眠实验室,大多数无人值守的PSG研究都获得了可接受的记录。由于信号丢失而重复研究的比率为6%,其中SaO2或流量信号失败是该适应症的主要原因。
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Sleep Science
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