RESUMO
El desarrollo de la medicina del sueño ha experimentado notables avances por contribuciones provenientes tanto de las ciencias básicas como de los estudios clínicos, destacando una relación positiva entre la preservación de un sueño normal y un amplio espectro de beneficios en diferentes indicadores de salud individual y de la población. Un adecuado conocimiento de los postulados y mecanismos fisiológicos del sueño actualmente más aceptados a escala molecular, celular y sistémica, permiten desarrollar conceptos objetivos que otorgan mayor solidez a la evaluación del sueño. La etapificación del sueño, su arquitectura, variables de continuidad del mismo, asícomo el índice de microdespertares, entre otros, tienen una aplicación clínica directa: se pueden describir y utilizar rangos normales de parámetros polisomnográficos con sus características a lo largo de la edad, y variantes cronotípicas individuales. De este modo, se espera seguir avanzando tanto en el temprano y correcto diagnóstico como en una mejor toma de decisiones médicas.Muy probablemente, debido a la función integradora del sueño, es que este juega un rol tan crucial en la salud, avalado por un cuerpo de evidencia que muestra un importante impacto beneficioso de un sueño sano en la calidad de vida, morbilidad y la prevención primaria de enfermedades muy variadas
The development of sleep medicine has experienced notable advances due to contributions from both basic science and clinical studies, highlighting a positive relationship between the preservation of normal sleep and a wide spectrum of benefits in different indicators of individual and population health.An adequate knowledge of the currently more accepted physiological postulates and mechanisms of sleep, on a molecular, cellular and systemic scale, allows the development of objective concepts that give greater solidity to sleep assessment. Sleep staging, architecture, and continuity variables such as the microarousal index, among others, have direct clinical applications: normal ranges of polysomnographic parameters can be described and used with their characteristics throughout age and individual chronotype variants. In this way, it is further advances are expected both in early and correct diagnosis and in better medical treatments.Evidence supports the crucial role sleep plays in overall health. Most likely due to its integrative function, healthy sleep has an important beneficial impact on quality of life, morbidity and primary prevention of a wide variety of diseases
Assuntos
Humanos , Qualidade de Vida , Sono/fisiologia , Fases do Sono , Ritmo Circadiano , Qualidade do Sono , Duração do SonoRESUMO
ABSTRACT Purpose: To compare the severity and laterality of keratoconus according to allergic rhinitis, scratching and sleeping habits, and manual dexterity. Methods: Objective assessments regarding allergic rhinitis, eye itching, and sleeping position among patients with keratoconus (diagnosed based on corneal tomography) were conducted. Diagnostic criteria and classification were based on the Amsler-Krumeich classification. Results: Ocular pruritus was reported by 29 of 34 participants (85.29%). Eighteen participants (62.07%) reported equal scratching of both eyes, six (20.69%) more on the right eye, and five (17.24%) more on the left eye. Comparison of the main sleeping position and the eye with more severe presentation of the disease using Fisher's exact test revealed some correlations (0.567 and 0.568 in the right and left eye, respectively). However, these correlations were not statistically significant. Conclusions: The association between higher keratometry values and sleeping position appears to be more significant than that reported between keratometry and itching, or manual dexterity.
RESUMO Objetivo: Comparar a gravidade e a lateralidade do ceratocone de acordo com a rinite alérgica, os hábitos de coçar e dormir e a destreza manual. Métodos: Foram realizadas questões objetivas sobre rinite alérgica, prurido ocular e posição do sono em pacientes com ceratocone, diagnosticados com base na tomografia corneana. Esses exames foram analisados e classificados de acordo com a classificação de Amsler-Krumeich. Resultados: O prurido ocular foi referido por 29 (85,29%) dos 34 voluntários. Dezoito sujeitos (62,07%) relataram coçar ambos os olhos igualmente, 6 (20,69%) mais no olho direito e 5 (17,24%) mais no olho esquerdo. Comparando-se a posição de dormir principal e o olhos com apresentação mais grave da doença, foi encontrada alguma relação baseada no teste exato de Fisher (0,567 no olho direito e 0,568 no olho esquerdo), embora nenhuma comparação parecesse estatisticamente significante. Conclusões: A associação entre maiores valores de ceratometria e posição do sono parece ser mais importante do que entre ceratometria e prurido ou destreza manual.
Assuntos
Humanos , Córnea , Topografia da Córnea , Hipersensibilidade , Ceratocone , Visão Ocular , Ceratocone/diagnósticoRESUMO
Resumo Objetivo: Comparar a qualidade do sono, a depressão e a esperança em mulheres com câncer de mama ao longo de aproximadamente um ano. Métodos: Estudo longitudinal, com 107 mulheres, em hospital universitário. Foram utilizados os instrumentos: questionário de caracterização sociodemográfica e clínica; Índice de Qualidade do Sono de Pittsburgh; Inventário de Depressão de Beck e Escala de Esperança de Herth. Os dados foram coletados em T0, antes da cirurgia de retirada do tumor, e após a mesma em: T1, em média 3,2 meses; T2, em média 6,1 meses; em T3, em média 12,4 meses. Resultados: A má qualidade do sono persistiu ao longo do seguimento; a esperança aumentou em T1; a proporção de mulheres com depressão moderada e grave elevou-se em T3. Houve correlação significativa entre os escores indicativos de qualidade do sono, de depressão e de esperança nos quatro tempos. Conclusão: Os achados deste estudo indicam a importância do seguimento por tempo prolongado.
Abstract Objectives: To compare sleep quality, depression, and hope in women with breast cancer over an approximate period of 1 year. Methods: This longitudinal study included 107 women assisted at a teaching hospital. The following instruments were used: Questionnaire on Socio-demographic and Clinical Characteristics; Pittsburgh Sleep Quality Index; Beck Depression Inventory; and Herth Hope Scale. Data were collected at T0, before tumor removal surgery, and after surgery at T1 (average of 3.2 months), T2 (average of 6.1 months), and T3 (average of 12.4 months). Results: Poor sleep quality persisted over the follow-up; hope increased at T1; the proportion of women with moderate and severe depression increased at T3. There was a significant correlation among scores indicating sleep quality, depression, and hope in all four time points. Conclusion: Our study findings suggest the significance of long-term follow-up.
RESUMO
STUDY OBJECTIVES: Delayed hypercapnic arousals may occur in obstructive sleep apnea. The impaired arousal response is expected to promote more pronounced oxyhemoglobin desaturations. We hypothesized that long-term sleep fragmentation (SF) results in injury to or dysfunction of wake-active neurons that manifests, in part, as a delayed hypercapnic arousal response. DESIGN: Adult male mice were implanted for behavioral state recordings and randomly assigned to 4 weeks of either orbital platform SF (SF4wk, 30 events/h) or control conditions (Ct4wk) prior to behavioral, histological, and locus coeruleus (LC) whole cell electrophysiological evaluations. MEASUREMENTS AND RESULTS: SF was successfully achieved across the 4 week study, as evidenced by a persistently increased arousal index, P < 0.01 and shortened sleep bouts, P < 0.05, while total sleep/wake times and plasma corticosterone levels were unaffected. A multiple sleep latency test performed at the onset of the dark period showed a reduced latency to sleep in SF4wk mice (P < 0.05). The hypercapnic arousal latency was increased, Ct4wk 64 ± 5 sec vs. SF4wk 154 ± 6 sec, P < 0.001, and remained elevated after a 2 week recovery (101 ± 4 sec, P < 0.001). C-fos activation in noradrenergic, orexinergic, histaminergic, and cholinergic wake-active neurons was reduced in response to hypercapnia (P < 0.05-0.001). Catecholaminergic and orexinergic projections into the cingulate cortex were also reduced in SF4wk (P < 0.01). In addition, SF4wk resulted in impaired LC neuron excitability (P < 0.01). CONCLUSIONS: Four weeks of sleep fragmentation (SF4wk) impairs arousal responses to hypercapnia, reduces wake neuron projections and locus coeruleus neuronal excitability, supporting the concepts that some effects of sleep fragmentation may contribute to impaired arousal responses in sleep apnea, which may not reverse immediately with therapy.