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ABSTRACT Objective: To investigate the association between sleep duration, nocturnal awakenings, and sleep latency with body mass index (BMI) at six and 12 months of age. Methods: 179 children from a birth cohort were enrolled. At six and 12 months of age, anthropometric data were obtained using standardized techniques and infants' mothers answered the Brief Infant Sleep Questionnaire for sleep data. The association of BMI with the independent variables (sleep duration, latency, and nocturnal awakenings) was assessed by linear regression models. Analyses were adjusted for potential confounders and a p-value<0.05 was adopted to define statistical significance. Results: For each additional hour of sleep duration, BMI was reduced by 0.15 kg/m² (95% confidence interval [CI] -0.28; -0.01; p=0.03) and each additional minute of sleep latency increased BMI by 0.01 kg/m² (95%CI -0.00; 0.03; p=0.02). These associations were independent of gestational age, child sex, birth weight, duration of exclusive breastfeeding, smoking during pregnancy, and mother's BMI, education, and marital status. Nocturnal awakenings showed no association with the outcome. Conclusions: Our findings suggest that sleep duration and sleep latency time are associated with BMI in the first year of life. Insights into the influence of sleep early in life on weight status may be helpful to complement future nutritional recommendations and prevent and treat obesity.

RESUMO Objetivo: Investigar a associação entre duração do sono, despertares noturnos e latência do sono com o índice de massa corporal (IMC) aos seis e 12 meses de idade. Métodos: foram incluídas 179 crianças de uma coorte de nascimentos. Aos seis e 12 meses de idade, dados antropométricos foram obtidos por meio de técnicas padronizadas e as mães dos lactentes responderam ao Brief Infant Sleep Questionnaire para dados do sono. A associação do IMC com as variáveis independentes (duração do sono, latência e despertares noturnos) foi avaliada por modelos de regressão linear. As análises foram ajustadas para potenciais fatores de confusão e o p-valor<0,05 foi adotado para definir a significância estatística. Resultados: Para cada hora adicional de duração do sono, o IMC foi reduzido em 0,15 kg/m² (intervalo de confiança [IC]95% -0,28; -0,01; p=0,03) e cada minuto adicional no tempo de latência resultou em aumento de 0,01 kg/m² (IC95% -0,00; 0,03; p=0,02) no IMC. Essas associações foram independentes da idade gestacional, sexo da criança, peso ao nascer, duração do aleitamento materno exclusivo, tabagismo durante a gravidez e IMC, escolaridade e estado civil da mãe. Os despertares noturnos não apresentaram associação com o desfecho. Conclusões: Nossos achados sugerem que a duração e a latência do sono estão associadas ao IMC no primeiro ano de vida. Informações sobre a influência do sono no início da vida sobre o status do peso podem ser úteis para complementar futuras recomendações nutricionais e prevenir e tratar a obesidade.

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Introducción: La calidad del sueño tiene efectos en la salud física y mental, su alteración en estudiantes universitarios dificulta los procesos de memoria, concentración y capacidad de aprendizaje. En Colombia los estudios de sueño se centran principalmente en estudiantes de medicina y enfermería, y muy pocos identifican su relación con la carga académica. Objetivo: Describir los cambios en la calidad del sueño durante un semestre académico y acorde al ciclo de formación en universitarios de una facultad de salud y rehabilitación de Cali, Colombia. Materiales y métodos: Estudio descriptivo, prospectivo mediante la aplicación del Índice de calidad del sueño de Pittsburgh al inicio y cierre del semestre a 241 estudiantes de Fisioterapia, Nutrición y Terapia ocupacional. Resultados: La mayoría de participantes eran mujeres, de 20 años o menos y de estratos socioeconómicos medio y bajo. Al inicio del semestre el 76,35% de estudiantes dormían 7 horas o más y al final se redujo al 49,79%. Al inicio del estudio el 24,90% presentaban mala calidad del sueño y al final la cifra ascendió a 54,36%. Conclusiones: Se presentó un incremento significativo de mala calidad del sueño al final del semestre académico, siendo mayor el cambio en los estudiantes del ciclo profesional.

Introduction: Sleep quality affects physical and mental health and its alteration in university students hinders memory processes, concentration, and learning capacity. In Colombia, studies on sleep patterns focus mainly on medical and nursing students and few of them identify its relationship with academic load. Objective: To describe sleep quality changes during an academic semester and according to education cycles in university students from a health and rehabilitation program in Cali, Colombia. Materials and methods: Descriptive prospective study, which applied the Pittsburg Sleep Quality Index at the beginning and end of the semester to 241 Physiotherapy, Nutrition, and Occupational Therapy students. Results: Most participants were women, aged 20 years old or younger, and belonged to medium to low socioeconomic strata. At the beginning of the semester, 76.35% of students were able to sleep 7 hours or more and at the end this population decreased to 49.79%. At the beginning of the study, 24.9% displayed poor sleep quality, whereas this group increased to 54.36% at the end. Conclusions: There was a significant increase in poor sleep quality at the end of the academic semester, the change being greater in students from the professional cycle.

Introdução: A qualidade do sono tem efeitos na saúde física e mental, sua alteração em estudantes universitários dificulta os processos de memória, concentração e capacidade do aprendizagem. Na Colômbia, os estudos do sono se concentram basicamente em estudantes de medicina e enfermería, e poucos identificam sua relação com a carga acadêmica. Objetivo: Descrever as alterações na qualidade do sono durante um semestre letivo de acordo com o ciclo de formação em estudantes universitários de uma escola de saúde e reabilitação em Cali, Colômbia. Materiais e métodos: Estudo descritivo, prospectivo por meio da aplicação do Índice de Qualidade do Sono de Pittsburgh no início e final do semestre em 241 alunos de Fisioterapia, Nutrição e Terapia Ocupacional. Resultados: A maioria dos participantes foram mulheres, com idade igual ou inferior a 20 anos e de estratos socioeconômicos médio e baixo. No início do semestre, 76,35% dos alunos dormiam 7 horas ou mais, e no final diminuiu para 49,79%. No início do estudo, 24,90% tinham má qualidade do sono e no final o número subiu para 54,36%. Conclusões: Houve um aumento significativo da má qualidade do sono no final do semestre letivo, sendo a alteração maior nos estudantes do ciclo profissional.

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La prueba de latencia múltiple del sueño nos permite evaluar objetivamente las variaciones normales y patológicas en la somnolencia y el estado de alerta. Es una prueba que evalúa qué tan rápido una persona se duerme en condiciones estandarizadas que facilitan el sueño, y se repite a intervalos de 2 horas durante todo el día. Es el estándar para documentar el inicio del sueño REM (SOREMP), que es un síntoma de narcolepsia y en la somnolencia idiopática podría ser útil. Su uso está ampliamente descrito en adultos, pero la prueba no es tan común en niños. En esta revisión, se analizan los valores en adultos y niños, y su utilidad, a partir de la historia de la prueba.

The multiple sleep latency test allows us to objectively assess normal and pathological variations in sleepiness and alertness. It is a test that assesses how quickly a person falls asleep under standardized conditions that facilitate sleep and is repeated at 2-h intervals throughout the day. is the standard for documenting sleep onset REM (SOREMP), which is a symptom of Narcolepsy and idiopathic sleepiness could be useful. Its use is widely described in adults, but the test is not so common in children. In this review, we analyze the values in adults and children, and their usefulness, based on from the history of the test.

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Ashwagandha (Withania somnifera) is considered a potent adaptogen and anti-stress agent that could have some potential to improve physical performance. This preferred reporting items for systematic reviews and meta-analyses (PRISMA)-based comprehensive systematic review and Bayesian meta-analysis aimed to evaluate clinical trials up to 2020 from PubMed, ScienceDirect, and Google Scholar databases regarding the effect of Ashwagandha supplementation on physical performance in healthy individuals. Besides implementing estimation statistics analysis, we developed Bayesian hierarchical models for a pre-specified subgroup meta-analysis on strength/power, cardiorespiratory fitness and fatigue/recovery variables. A total of 13 studies met the requirements of this systematic review, although only 12 were included in the quantitative analysis. A low-to-moderate overall risk of bias of the trials included in this study was detected. All Bayesian hierarchical models converged to a target distribution (Ȓ = 1) for both meta-analytic effect size (µ) and between-study standard deviation (τ). The meta-analytic approaches of the included studies revealed that Ashwagandha supplementation was more efficacious than placebo for improving variables related to physical performance in healthy men and female. In fact, the Bayesian models showed that future interventions might be at least in some way beneficial on the analyzed outcomes considering the 95% credible intervals for the meta-analytic effect size. Several practical applications and future directions are discussed, although more comparable studies are needed in exercise training, and athletic populations are needed to derive a more stable estimate of the true underlying effect.

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RESUMEN Esta es una revisión de algunos ensayos clínicos realizados acerca de las repercusiones en la estructura, arquitectura y percepción del sueño en los consumidores de cannabis. Para la búsqueda bibliográfica se consultó bases de datos, con especial énfasis en revisiones sistemáticas, metaanálisis, estudios de cohortes, ensayos controlados aleatorios y estudios de casos y controles. Las palabras claves incluyeron términos que describen el uso del cannabis combinado con otros que se refieren al sueño o anormalidades del sueño (por ejemplo: sueño, insomnio, polisomnografía, tiempo total de sueño, latencia del sueño, sueño de onda lenta, sueño de movimiento ocular rápido y su latencia). Se extrajeron datos relevantes de cada uno de los artículos consultados. Se resumió la literatura disponible sobre mediciones subjetivas y objetivas, correlaciones clínicas y paraclínicas, diferencias entre el consumo agudo, crónico y la abstinencia, y otros puntos de discusión. Se realizaron varias correlaciones moleculares y anatómicas que explican los cambios en el sueño desde el punto de vista del sistema nervioso central. Finalmente, los resultados demuestran una disminución de la latencia del sueño con el uso agudo a dosis bajas, además menor tiempo de vigilia luego del inicio del sueño, aumento del sueño de ondas lentas y disminución del sueño de movimientos oculares rápidos; estos efectos no permanecen con el uso crónico, ya que posteriormente se presenta una peor calidad del sueño; el escenario también varía con la abstinencia, puede presentarse insomnio, disminución del tiempo total del sueño de onda lenta y del sueño total.

ABSTRACT This is a review of some clinical trials conducted on the impact on sleep structure, architecture and perception in cannabis users. For the literature search, consult database queries with special emphasis on systematic reviews, meta-analyzes, cohort studies, randomized controlled trials, and case-control studies. Keywords include terms that describe cannabis use combined with others that specify sleep or sleep abnormalities (for example: sleep, insomnia, polysomnography, total sleep time, sleep latency, slow wave sleep, motion sleep fast eyepiece and its latency). Relevant data was extracted in each of the articles consulted. The available literature is summarized on: subjective and objective measurements, clinical and paraclinical correlations, differences between acute and chronic consumption and abstinence, and other points of discussion. Tese are various molecular and anatomical correlations that explain changes in sleep from the point of view of the central nervous system. Finally, results frequently decrease sleep latency with acute use at low doses, plus shorter waking time after sleep onset, increased slow wave sleep and decreased rapid eye movement sleep, these effects do not persist with chronic use since later there is a worse quality of sleep; The setting also changes with abstinence where insomnia may occur, decreased total time for slow wave sleep and total sleep.

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STUDY OBJECTIVES: To evaluate whether dietary patterns are associated with sleep quality in Mexican midlife women. METHODS: The study population included 4,467 Mexican women from a longitudinal study of teachers. In 2008, a semiquantitative food frequency questionnaire was administered. Principal components analysis identified 3 dietary patterns: Fruits and Vegetables, Western (meat and processed), and Modern Mexican (tortillas and soda, low in fiber and dairy). Starting in 2012, follow-up questionnaires included the Pittsburgh Sleep Quality Index, which yields a score ranging from 0 to 21 (higher scores = worse quality). Modified Poisson regression analyses examining the association between dietary patterns (categorized into quartiles) and poor sleep quality (score > 5) were conducted, adjusting for socio-demographic and lifestyle confounders and baseline comorbid conditions. RESULTS: Women were 41.0 ± 7.1 years at baseline, with an average follow-up of 5.5 ± 0.7 years. In fully adjusted models, women in the least-healthy quartile of the Fruits and Vegetables pattern compared with the most were 21% more likely to have poor quality sleep at follow-up (95% confidence interval 1.06, 1.42), while those in the highest quartiles of the Modern Mexican pattern were 23% more likely to have poor quality sleep compared with the lowest quartiles (95% confidence interval 1.06 to 1.43, respectively). CONCLUSIONS: A fruit and vegetable-based dietary pattern was associated with higher sleep quality, while an unhealthier diet pattern was associated with worse sleep quality in midlife women.

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STUDY OBJECTIVES: This study describes high-throughput phenotyping strategies for sleep and circadian behavior in mice, including examinations of robustness, reliability, and heritability among Diversity Outbred (DO) mice and their eight founder strains. METHODS: We performed high-throughput sleep and circadian phenotyping in male mice from the DO population (n = 338) and their eight founder strains: A/J (n = 6), C57BL/6J (n = 14), 129S1/SvlmJ (n = 6), NOD/LtJ (n = 6), NZO/H1LtJ (n = 6), CAST/EiJ (n = 8), PWK/PhJ (n = 8), and WSB/EiJ (n = 6). Using infrared beam break systems, we defined sleep as at least 40 s of continuous inactivity and quantified sleep-wake amounts and bout characteristics. We developed assays to measure sleep latency in a new environment and during a modified Murine Multiple Sleep Latency Test, and estimated circadian period from wheel-running experiments. For each trait, broad-sense heritability (proportion of variability explained by all genetic factors) was derived in founder strains, while narrow-sense heritability (proportion of variability explained by additive genetic effects) was calculated in DO mice. RESULTS: Phenotypes were robust to different inactivity durations to define sleep. Differences across founder strains and moderate/high broad-sense heritability were observed for most traits. There was large phenotypic variability among DO mice, and phenotypes were reliable, although estimates of heritability were lower than in founder mice. This likely reflects important nonadditive genetic effects. CONCLUSIONS: A high-throughput phenotyping strategy in mice, based primarily on monitoring of activity patterns, provides reliable and heritable estimates of sleep and circadian traits. This approach is suitable for discovery analyses in DO mice, where genetic factors explain some proportion of phenotypic variation.

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Previous studies have suggested that insomnia with objective short sleep duration is associated with a higher risk of hypertension, and it has been speculated that the underlying mechanism is physiological hyperarousal. In this study, we tested whether insomnia with physiological hyperarousal measured by Multiple Sleep Latency Test (MSLT), a standard test of sleepiness/alertness, is associated with increased risk of hypertension. Two hundred nineteen chronic insomniacs and 96 normal sleepers were included in this study. Chronic insomnia was defined based on standard diagnostic criteria with symptoms lasting ≥6 months. All subjects underwent 1 night in laboratory polysomnography followed by a standard MSLT. We used the median mean MSLT value (ie, >14 minutes) and the 75th percentile of mean MSLT value (ie, >17 minutes) to define hyperarousal. Hypertension was defined based either on blood pressure measures or on diagnosis treatment by a physician. After controlling for age, sex, body mass index, apnea-hypopnea index, diabetes mellitus, smoking, alcohol, and caffeine use, insomnia combined with MSLT >14 minutes increased the odds of hypertension by 300% (odds ratio=3.27; 95% confidence interval=1.20-8.96), whereas insomnia combined with MSLT >17 minutes increased even further the odds of hypertension by 400% (odds ratio=4.33; 95% confidence interval=1.48-12.68) compared with normal sleepers with MSLT ≤14 minutes. Insomnia associated with physiological hyperarousal is associated with a significant risk of hypertension. Long MSLT values may be a reliable index of the physiological hyperarousal and biological severity of chronic insomnia.

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Abstract ­ Excessive sleepiness (ES) is an increased tendency to initiate involuntary sleep for naps at inappropriate times. Objective: The objective of this study was to assess ES in air traffic controllers (ATCo). Methods: 45 flight protection professionals were evaluated, comprising 30 ATCo, subdivided into ATCo with ten or more years in the profession (ATCo≥10, n=15) and ATCo with less than ten years in the profession (ATCo<10, n=15) and 15 aeronautical information services operators (AIS), subdivided into AIS with ten years or more in the profession (AIS≥10, n=8) and AIS with less than ten years in the profession (AIS<10, n=7), who were included as the control group. The Epworth Sleepiness Scale and Maintenance of Wakefulness Test were used for evaluating subjective and objective excessive sleepiness. Kruskal-Wallis was used for ES and Mann-Whitney for sleep latency (SL), collection time in minutes (mins), and expressed as Median (Minimum-Maximum), p<0.05. Results: ATCo≥10 12 (6-14) mins and ATCo<10 10 (1-15) mins showed greater sleepiness compared to CONTROL1 7 (3-8) mins and CONTROL2 6 (4-6) mins, p=0.001*. A total of 77.27% of the ATCo and 16.67% of the AIS had an SL of less than 20 minutes. The ATCo presented an SL of 16.59 (3.25-40), lower than that of the AIS of 31.71 (10.63-40) mins, p<0.05*. Conclusion: Brazilian air traffic controllers exhibit excessive sleepiness.

Resumo ­ A sonolência excessiva (SE) é a uma tendência aumentada de se iniciar o sono por cochilos involuntários em momentos inapropriados. Objetivo: O objetivo deste trabalho foi avaliar SE em controladores de trafego aéreo (CTA). Métodos: Foram avaliados 45 profissionais de proteção ao voo, sendo 30 CTA, subdivididos em CTA com dez ou mais anos na profissão (CTA≥10, n=15) e CTA com menos de dez anos na profissão (CTA<10, n=15) e 15 operadores de serviços de informações aeronáuticas (AIS), subdivididos em AIS com dez anos ou mais na profissão (AIS≥10, n=8) e AIS com menos de dez anos na profissão (AIS<10, n=7). A Escala de Sonolência de Epworth e o Teste de Manutenção da Vigília foram empregados para avaliação subjetiva e objetiva de sonolência excessiva. Utilizou-se: Kruskal-Wallis para os dados de SE e Mann-Whitney para a latência de sono. Tempo coletado em minutos (mins). Todos os dados foram expressos em mediana (mínimo-máximo), p<0,05). Resultados: CTA≥10 12 (6-14) mins e CTA<10 10 (1-15) mins apresentaram um aumento de sonolência, quando comparados ao CONTROLE1 7 (3-8) mins e ao CONTROLE2 6 (4-6) mins, p=0,001*. 77,27% dos CTA e 16,67% dos AIS apresentaram latência de sono abaixo de 20 minutos. Os CTA apresentaram uma latência de sono de 16,59 (3,25-40) mins abaixo dos AIS 31,71(10,63-40), p<0,05*. Conclusão: Controladores de tráfego aéreo apresentam sonolência excessiva

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Excessive sleepiness (ES) is an increased tendency to initiate involuntary sleep for naps at inappropriate times. OBJECTIVE: The objective of this study was to assess ES in air traffic controllers (ATCo). METHODS: 45 flight protection professionals were evaluated, comprising 30 ATCo, subdivided into ATCo with ten or more years in the profession (ATCo≥10, n=15) and ATCo with less than ten years in the profession (ATCo<10, n=15) and 15 aeronautical information services operators (AIS), subdivided into AIS with ten years or more in the profession (AIS≥10, n=8) and AIS with less than ten years in the profession (AIS<10, n=7), who were included as the control group. The Epworth Sleepiness Scale and Maintenance of Wakefulness Test were used for evaluating subjective and objective excessive sleepiness. Kruskal-Wallis was used for ES and Mann-Whitney for sleep latency (SL), collection time in minutes (mins), and expressed as Median (Minimum-Maximum), p<0.05. RESULTS: ATCo≥10 12 (6-14) mins and ATCo<10 10 (1-15) mins showed greater sleepiness compared to CONTROL1 7 (3-8) mins and CONTROL2 6 (4-6) mins, p=0.001*. A total of 77.27% of the ATCo and 16.67% of the AIS had an SL of less than 20 minutes. The ATCo presented an SL of 16.59 (3.25-40), lower than that of the AIS of 31.71 (10.63-40) mins, p<0.05*. CONCLUSION: Brazilian air traffic controllers exhibit excessive sleepiness.

A sonolência excessiva (SE) é a uma tendência aumentada de se iniciar o sono por cochilos involuntários em momentos inapropriados. OBJETIVO: O objetivo deste trabalho foi avaliar SE em controladores de trafego aéreo (CTA). MÉTODOS: Foram avaliados 45 profissionais de proteção ao voo, sendo 30 CTA, subdivididos em CTA com dez ou mais anos na profissão (CTA≥10, n=15) e CTA com menos de dez anos na profissão (CTA<10, n=15) e 15 operadores de serviços de informações aeronáuticas (AIS), subdivididos em AIS com dez anos ou mais na profissão (AIS≥10, n=8) e AIS com menos de dez anos na profissão (AIS<10, n=7). A Escala de Sonolência de Epworth e o Teste de Manutenção da Vigília foram empregados para avaliação subjetiva e objetiva de sonolência excessiva. Utilizou-se: Kruskal-Wallis para os dados de SE e Mann-Whitney para a latência de sono. Tempo coletado em minutos (mins). Todos os dados foram expressos em mediana (mínimo-máximo), p<0,05). RESULTADOS: CTA≥10 12 (6-14) mins e CTA<10 10 (1-15) mins apresentaram um aumento de sonolência, quando comparados ao CONTROLE1 7 (3-8) mins e ao CONTROLE2 6 (4-6) mins, p=0,001*. 77,27% dos CTA e 16,67% dos AIS apresentaram latência de sono abaixo de 20 minutos. Os CTA apresentaram uma latência de sono de 16,59 (3,25-40) mins abaixo dos AIS 31,71(10,63-40), p<0,05*. CONCLUSÃO: Controladores de tráfego aéreo apresentam sonolência excessiva.

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OBJECTIVE: To determine the correlations between excessive daytime sleepiness (EDS), assessed by the Epworth sleepiness scale (ESS), and the multiple sleep latency test (MSLT) and nocturnal sleep architecture features, clinical symptoms of narcolepsy (CSN) and subjective sleep quality (SSQ) in patients with narcolepsy. METHOD: Twenty three untreated patients were studied and compared with a matched control group. Diagnosis of narcolepsy was carried out employing a clinical interview, a polysomnographic (PSG) record, and an MSLT. RESULTS: Subjective number of awakenings was the SSQ indicator that best correlated with EDS (ESS and MSLT). Regarding clinical features, diurnal tiredness and sleep paralysis correlated with ESS values. Increase in ESS was related with decrease in total sleep time, SWS, and sleep onset latency. On the other hand, increase in MSLT was related with decrease in SWS. CONCLUSION: These data suggest that EDS in patients with narcolepsy could be impaired by disturbed nocturnal sleep.

OBJETIVO: Determinar as correlações entre hipersonolência, avaliada pela escala de sonolência Epworth (ESE) e o teste múltiplo de latência do sono (TMLS) com a arquitetura do sono (AS), sintomas e qualidade subjetiva do sono em pacientes narcolepticos. MÉTODO: Comparou-se um grupo de vinte e tres pacientes narcolepticos sem tratamento com grupo controle. O diagnóstico de narcolepsia foi realizado por uma entrevista clinica, polissonografia e o TMLS. RESULTADOS: O número subjetivo de despertares foi o indicador com maior relação com a hipersonolência, o cansaço diurno e a paralisia do sono também foi correlacionados com a ESE.O aumento do índice na ESE foi correlacionado com uma diminuição do tempo total do sono, no sono de ondas lentas (SOL) e com a latência para o início do sono. O incremento na TMLS foi relacionado com diminuição do SOL. CONCLUSÃO: Os dados sugerem que a hipersonolência diurna em pacientes portadores de narcolepsia pode se correlacionar com as alterações da arquitetura do sono noturno.

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