RESUMO
BACKGROUND: Sleep deprivation commonly increases seizure frequency in patients with genetic generalized epilepsy, though it is unknown whether there is an increased prevalence of sleepwalking or sleep paralysis in genetic generalized epilepsy patients. Establishing this could provide insights into the bio-mechanisms or genetic architecture of both disorders. The aim of this study was to determine the prevalence of sleepwalking and sleep paralysis in a cohort of patients with genetic generalized epilepsy and their relatives in extended families. METHODS: A structured interview based on International League Against Epilepsy (ILAE) and International Classification of Sleep Disorders (ICSD-3) criteria was applied to 67 index cases and their relatives to determine genetic generalized epilepsy subtypes and assess the occurrence of sleepwalking or sleep paralysis. Bivariate analysis was performed using chi-square and Fisher exact tests. RESULTS: The prevalence of sleepwalking and sleep paralysis was 15.3% (95% confidence interval 12.1-18.9) and 11.7% (95% confidence interval 8.7-15.3), respectively. Unusually, no sleepwalkers were found among individuals displaying epilepsy with generalized tonic-clonic seizures. Approximately a quarter of the patients had either parasomnia or genetic generalized epilepsy. Over half the genetic generalized epilepsy families had at least 1 individual with sleepwalking, and more than 40% of the families had one individual with sleep paralysis. CONCLUSION: The prevalence of sleepwalking or sleep paralysis is reported for individuals with genetic generalized epilepsy and their relatives. The co-existence of either parasomnia in the genetic generalized epilepsy patients and the co-aggregation within their families let suggest that shared heritability and pathophysiological mechanisms exist between these disorders. We hypothesize that sleepwalking/sleep paralysis and genetic generalized epilepsy could be variable expression of genes in shared pathways.
Assuntos
Epilepsia Generalizada/epidemiologia , Paralisia do Sono/epidemiologia , Sonambulismo/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos de Coortes , Colômbia , Epilepsia Generalizada/genética , Família , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto JovemRESUMO
OBJECTIVES: Narcolepsy is a disabling disease with a delayed diagnosis. At least 3 years before the disorder identification, several comorbidities can be observed in patients with narcolepsy. The early recognition of narcolepsy symptoms may improve long-term prognosis of the patients. Thus, we aimed to investigate the prevalence of the symptoms associated with narcolepsy and its social and psychological association in a sample of Sao Paulo city inhabitants. METHODS: We performed a cross-sectional evaluation with 1,008 individuals from the Sao Paulo Epidemiologic Sleep Study (EPISONO). Excessive daytime sleepiness (EDS) was assessed by the Epworth Sleepiness Scale. Volunteers were also asked about the occurrence of cataplectic-like, hypnagogic or hypnopompic hallucinations, and sleep paralysis symptoms. The participants underwent a full-night polysomnography and completed questionnaires about psychological, demographic, and quality of life parameters. RESULTS: We observed a prevalence of 39.2% of EDS, 15.0% of cataplectic-like symptom, 9.2% of hypnagogic or hypnopompic hallucinations, and 14.9% of sleep paralysis in Sao Paulo city inhabitants. A frequency of 6.9% was observed when EDS and cataplectic-like symptoms were grouped. The other associations were EDS + hallucinations (4.7%) and EDS + sleep paralysis (7.5%). Symptomatic participants were predominantly women and younger compared with patients without any narcolepsy symptom (n = 451). Narcolepsy symptomatology was also associated with a poor quality of life and symptoms of depression, anxiety, and fatigue. CONCLUSIONS: Narcolepsy-related symptoms are associated with poor quality of life and worse psychological parameters.
Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Fadiga/epidemiologia , Alucinações/epidemiologia , Narcolepsia/epidemiologia , Paralisia do Sono/epidemiologia , Adulto , Brasil/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Polissonografia , Prevalência , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: The aim of this study was to compare the prevalence of sleep habits and complaints and to estimate the secular trends through three population-based surveys carried out in 1987, 1995, and 2007 in the general adult population of the city of Sao Paulo, Brazil. METHODS: Surveys were performed using the same three-stage cluster-sampling technique in three consecutive decades to obtain representative samples of the inhabitants of Sao Paulo with respect to gender, age (20-80 years), and socio-economic status. Sample sizes were 1000 volunteers in 1987 and 1995 surveys and 1101 in a 2007 survey. In each survey, the UNIFESP Sleep Questionnaire was administered face-to-face in each household selected. RESULTS: For 1987, 1995, and 2007, respectively, difficulty initiating sleep (weighted frequency %; 95% CI) [(13.9; 11.9-16.2), (19.15; 16.8-21.6), and (25.0; 22.5-27.8)], difficulty maintaining sleep [(15.8; 13.7-18.2), (27.6; 24.9-30.4), and (36.5; 33.5-39.5)], and early morning awakening [(10.6; 8.8-12.7), (14.2; 12.2-16.5), and (26.7; 24-29.6)] increased in the general population over time, mostly in women. Habitual snoring was the most commonly reported complaint across decades and was more prevalent in men. There was no statistically significant difference in snoring complaints between 1987 (21.5; 19.1-24.2) and 1995 (19.0; 16.7-21.6), but a significant increase was noted in 2007 (41.7; 38.6-44.8). Nightmares, bruxism, leg cramps, and somnambulism complaints were significantly higher in 2007 compared to 1987 and 1995. All were more frequent in women. CONCLUSIONS: This is the first study comparing sleep complaints in probabilistic population-based samples from the same metropolitan area, using the same methodology across three consecutive decades. Clear trends of increasing sleep complaints were observed, which increased faster between 1995 and 2007 than from 1987 to 1995. These secular trends should be considered a relevant public health issue and support the need for development of health care and educational strategies to supply the population's increased need for information on sleep disorders and their consequences.
Assuntos
Países em Desenvolvimento , Transtornos do Sono-Vigília/epidemiologia , População Urbana/estatística & dados numéricos , Adulto , Idoso , Brasil , Bruxismo/epidemiologia , Estudos Transversais , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Sonhos , Feminino , Inquéritos Epidemiológicos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Paralisia do Sono/epidemiologia , Transtornos da Transição Sono-Vigília/epidemiologia , Ronco/epidemiologia , Fatores Socioeconômicos , Sonambulismo/epidemiologia , Inquéritos e Questionários , Adulto JovemRESUMO
AIMS: The aim of the present study was to evaluate the prevalence and characteristics of sleep paralysis in adolescents using a folk expression. METHODS: Three hundred and twenty-two adolescents (mean age, 15.9 +/- 0.88 years; 66.8% female) from three high schools in Mexico City completed both a self-reported questionnaire, including a colloquial definition of sleep paralysis and the Epworth Sleepiness Scale. RESULTS: A high proportion of the adolescents (92.5%) had heard about the 'a dead body climbed on top of me' expression and 27.6% of them had experienced the phenomenon. Sleep paralysis was present in 25.5% while the prevalence rate for hypnagogic/hypnopompic hallucinations was 22%; 61% had experienced >or=2 episodes in their lifetime. The mean age of onset was 12.5 +/- 3 years. Sleepiness scores for the subjects who had experienced at least one event were not significantly different from subjects who had not experienced any. In 72% of cases, the episodes were composed of both sleep paralysis and hallucinations while 20.2% consisted of only sleep paralysis and 7.8% of only hallucinations. The number and characteristics of events were not significantly different between adolescents with only one episode and those with two or more episodes. CONCLUSIONS: The characteristics of the 'a dead body climbed on top of me' phenomenon suggest that is identical to sleep paralysis and a frequent experience among Mexican adolescents. During adolescence, sleep paralysis seems to be a recurrent phenomenon frequently accompanied by hallucinatory experiences.
Assuntos
Folclore , Paralisia do Sono/diagnóstico , Adolescente , Comportamento do Adolescente/psicologia , Idade de Início , Comorbidade , Feminino , Alucinações/diagnóstico , Alucinações/epidemiologia , Alucinações/psicologia , Humanos , Masculino , México/epidemiologia , Prevalência , Paralisia do Sono/epidemiologia , Paralisia do Sono/psicologia , Inquéritos e QuestionáriosRESUMO
Objetivo: Determinar la prevalencia de vida y las características de parálisis de sueño en estudiantes de 4º año de medicina humana de la UNMSM. Diseño: Estudio observacional, descriptivo, transversal. Lugar: Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Pacientes: Ciento treinta y nueve estudiantes de 4º año de medicina humana de la UNMSM. Intervenciones: Estudio de la prevalencia de vida y características, de tipo longitudinal no concurrente para la prevalencia de un mes, ejecutado en agosto de 2005, mediante una encuesta tipo cuestionario validada por juicio de expertos. Principales medidas de resultado: Prevalencia de vida, características y prevalencia de un mes de la parálisis del sueño en estudiantes de medicina. Resultados: La prevalencia de vida fue de 56 por ciento y la prevalencia en el último mes fue de 33 eventos por cada 100 estudiantes. El 83,2 por ciento tuvo alucinaciones durante los eventos de parálisis del sueño. El 58,8 por ciento tuvo ansiedad junto al evento. La forma de remisión más frecuente fue de manera espontánea (64,4 por ciento). Conclusiones: La prevalencia de parálisis del sueño es mayor en nuestro estudio que en las informadas en otras investigaciones, con un alto porcentaje de presentación de alucinaciones y ansiedad.
Objective: To determine life prevalence and characteristics of sleeping paralysis in San Marcos University human medicine fourth year students. Design: Observational, descriptive, cross-sectional study. Setting: Faculty of Medicine, San Marcos Major National University. Participants: One hundred thirty nine fourth year medicine students. Interventions: Life and characteristics sleeping paralysis non-concurrent longitudinal study for incidence density, done in August 2005, using a survey type questionnaire validated by experts. Main outcome measures: Sleeping paralysis life prevalence, characteristics, and one month prevalence in medical students. Results: Life prevalence was 56 per cent; prevalence in the last month was 33 events per 100 students; 83,2 per cent had hallucinations during the sleep paralysis events, 58,8 per cent experienced anxiety. Remission was usually spontaneous (64,4 per cent). Conclusions: The prevalence of sleeping paralysis in medical students is greater than that reported in previous investigations, with a high percentage of hallucinations and anxiety.