RESUMO
BACKGROUND: Physiological changes during pregnancy are often accompanied by reduced sleep quality, sleep disruptions, and insomnia. Studies conducted among men and non-pregnant women have documented psychiatric disorders as common comorbidities of insomnia and other sleep disorders. However, no previous study has examined the association between stress-related sleep disturbances and psychiatric disorders among pregnant women. METHODS: This cross-sectional study included a total of 2051 pregnant women in Peru. The Spanish-language version of the Ford Insomnia Response to Stress Test (FIRST-S) was used to assess sleep disruptions due to stressful situations. Symptoms of antepartum depression, generalized anxiety disorder, and posttraumatic stress disorder (PTSD) were examined using the Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7 and PTSD Checklist - Civilian Version, respectively. High risk for psychosis was assessed using the Prodromal Questionnaire. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CI). RESULTS: Stress-related sleep disturbance was reported by 33.2% of women. Of all women, 24.9% had antepartum depression, 32.2% had generalized anxiety disorder, 30.9% had PTSD, and 27.6% were assessed as having a high risk of psychosis. After adjusting for confounders, women with stress-related sleep disturbances were more likely to experience antepartum depression (OR = 2.74; 95%CI: 2.22-3.38), generalized anxiety disorder (OR = 2.48; 95%CI: 2.04-3.02), PTSD (OR = 2.36; 95%CI: 1.93-2.88), and high risk for psychosis (OR = 2.07; 95%CI: 1.69-2.54) as compared to women without stress-related sleep disturbances. CONCLUSIONS: Stress-related sleep disturbances during pregnancy are associated with increased odds of psychiatric disorders. Inquiring about stress related sleep disturbances during antenatal care may be beneficial for identifying and caring for women at high risk of psychiatric disorders.
Assuntos
Depressão , Complicações na Gravidez , Gestantes , Transtornos do Sono-Vigília , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Peru , Gravidez , Complicações na Gravidez/epidemiologia , Gestantes/psicologia , Sono , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/epidemiologiaRESUMO
STUDY OBJECTIVES: Estimate the genetic and environmental influences on the relationship between onset of regular cannabis use and young adult insomnia. METHODS: In a population-based twin cohort of 1882 twins (56% female, mean age = 22.99, SD = 2.97) we explored the genetic/environmental etiology of the relationship between onset of regular cannabis use and insomnia-related outcomes via multivariate twin models. RESULTS: Controlling for sex, current depression symptoms, and prior diagnosis of an anxiety or depression disorder, adult twins who reported early onset for regular cannabis use (age 17 or younger) were more likely to have insomnia (ß = 0.07, p = 0.024) and insomnia with short sleep on weekdays (ß = 0.08, p = 0.003) as young adults. We found significant genetic contributions for the onset of regular cannabis use (a2 = 76%, p < 0.001), insomnia (a2 = 44%, p < 0.001), and insomnia with short sleep on weekdays (a2 = 37%, p < 0.001). We found significant genetic correlations between onset of regular use and both insomnia (rA = 0.20, p = 0.047) and insomnia with short sleep on weekdays (rA = 0.25, p = 0.008) but no significant environmental associations between these traits. CONCLUSIONS: We found common genetic liabilities for early onset of regular cannabis use and insomnia, implying pleiotropic influences of genes on both traits.
Assuntos
Cannabis , Distúrbios do Início e da Manutenção do Sono , Adolescente , Adulto , Doenças em Gêmeos/epidemiologia , Doenças em Gêmeos/genética , Feminino , Humanos , Masculino , Sono/genética , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/genética , Gêmeos/genética , Adulto JovemRESUMO
The present study aimed to analyze the construct validity of the Pediatric Daytime Sleepiness Scale (PDSS) for the evaluation of the daytime sleepiness construct in adolescents through confirmatory factorial analysis. The cross-sectional study was carried out with a sample of 773 adolescents aged 14 to 19 years, enrolled in the state schools of Paranaguá, Paraná, Brazil. We investigated the sex, age, school year, study shift, occupational status, socioeconomic level and daytime sleepiness. The PDSS questions were not normal (p <0.001) and the mean total score was 14.87 (5.62). With Schwarz's BIC adjustment indicators = 142,389 and Akaike's AIC = 105,389, the model reached the criteria of the global adjustment indicators of the model in the confirmatory analysis, in which RMSEA = 0.020; CFI = 0.986; TLI = 0.977; SRMR = 0.021, with 17 degrees of freedom, KMO = 0.8504 and Cronbach's Alpha = 0.737, with three correlations. We conclude that the construct validity of the PDSS remains valid and confirms its factor structure with only one factor. Thereby, it was verified that the operationalization of the construct sleepiness of adolescents through this scale is adequately conceptualized to the behavior of the age group.
Assuntos
Comportamento do Adolescente , Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Sono , Inquéritos e Questionários , Adolescente , Fatores Etários , Brasil , Estudos Transversais , Distúrbios do Sono por Sonolência Excessiva/fisiopatologia , Distúrbios do Sono por Sonolência Excessiva/psicologia , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Psicometria , Reprodutibilidade dos Testes , Fatores de Risco , Fatores de Tempo , Adulto JovemRESUMO
STUDY OBJECTIVES: To evaluate the construct validity and factor structure of the Spanish-language version of the Ford Insomnia Response to Stress Test questionnaire (FIRST-S) when used in early pregnancy. METHODS: A cohort of 647 women were interviewed at ≤ 16 weeks of gestation to collect information regarding lifestyle, demographic, and sleep characteristics. The factorial structure of the FIRST-S was tested through exploratory and confirmatory factor analyses (EFA and CFA). Internal consistency and construct validity were also assessed by evaluating the association between the FIRST-S with symptoms of depression, anxiety, and sleep quality. Item response theory (IRT) analyses were conducted to complement classical test theory (CTT) analytic approaches. RESULTS: The mean score of the FIRST-S was 13.8 (range: 9-33). The results of the EFA showed that the FIRST-S contained a one-factor solution that accounted for 69.8% of the variance. The FIRST-S items showed good internal consistency (Cronbach α = 0.81). CFA results corroborated the one-factor structure finding from the EFA; and yielded measures indicating goodness of fit (comparative fit index of 0.902) and accuracy (root mean square error of approximation of 0.057). The FIRST-S had good construct validity as demonstrated by statistically significant associations of FIRST-S scores with sleep quality, antepartum depression and anxiety symptoms. Finally, results from IRT analyses suggested excellent item infit and outfit measures. CONCLUSIONS: The FIRST-S was found to have good construct validity and internal consistency for assessing vulnerability to insomnia during early pregnancy.
Assuntos
Complicações na Gravidez/psicologia , Distúrbios do Início e da Manutenção do Sono/complicações , Distúrbios do Início e da Manutenção do Sono/psicologia , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adolescente , Adulto , Análise Fatorial , Feminino , Humanos , Peru , Gravidez , Primeiro Trimestre da Gravidez , Psicometria , Reprodutibilidade dos Testes , Tradução , Adulto JovemRESUMO
Obesity causes or exacerbates a host of medical conditions, including cardiovascular, pulmonary, and endocrine diseases. In addition, there is growing evidence that obesity and sleep problems are linked in adolescents and that they are significant obstacles for learning, having a negative impact on behavior, and attainment of social competence and quality of life. The theoretical basis of this relationship is discussed. Several studies investigating the relationships between obesity, sleep disturbance, and a number of important negative outcomes are reviewed.
Assuntos
Ritmo Circadiano/fisiologia , Escolaridade , Obesidade/epidemiologia , Obesidade/psicologia , Adolescente , Criança , Cultura , Ingestão de Alimentos/fisiologia , Humanos , Sono/fisiologia , Privação do Sono/psicologia , Sono REM/fisiologia , América do Sul/epidemiologiaRESUMO
STUDY OBJECTIVES: Inadequate sleep and sleep disordered breathing (SDB) can impair learning skills. Questionnaires used to evaluate sleepiness in adults are usually inadequate for adolescents. We conducted a study to evaluate the performance of a Spanish version of the Pediatric Daytime Sleepiness Scale (PDSS) and to assess the impact of sleepiness and SDB on academic performance. DESIGN: A cross-sectional survey of students from 7 schools in 4 cities of Argentina. MEASUREMENTS: A questionnaire with a Spanish version of the PDSS was used. Questions on the occurrence of snoring and witnessed apneas were answered by the parents. Mathematics and language grades were used as indicators of academic performance. PARTICIPANTS: The sample included 2,884 students (50% males; age: 13.3 +/- 1.5 years) RESULTS: Response rate was 85%; 678 cases were excluded due to missing data. Half the students slept <9 h per night on weekdays. The mean PDSS value was 15.74 +/- 5.93. Parental reporting of snoring occurred in 511 subjects (23%); snoring was occasional in 14% and frequent in 9%. Apneas were witnessed in 237 cases (11%), being frequent in 4% and occasional in 7%. Frequent snorers had higher mean PDSS scores than occasional or nonsnorers (18 +/- 5, 15.7 +/- 6 and 15.5 +/- 6, respectively; P < 0.001). Reported snoring or apneas and the PDSS were significant univariate predictors of failure and remained significant in multivariate logistic regression analysis after adjusting for age, sex, body mass index, specific school attended, and sleep habits. CONCLUSIONS: Insufficient hours of sleep were prevalent in this population. The Spanish version of the PDSS was a reliable tool in middle-school-aged children. Reports of snoring or witnessed apneas and daytime sleepiness as measured by PDSS were independent predictors of poor academic performance.