In a population-based study conducted in rural Ecuador, 635 stroke-free persons aged > 40 years were interviewed with the Epworth sleepiness scale and screened to assess their cardiovascular health (CVH) status. Excessive daytime somnolence was present in 22% persons and a poor CVH status in 69%. In a generalized linear model after adjusting for age and sex, excessive daytime somnolence was not associated with a poor CVH status or with any of the individual metrics in the poor range. Excessive daytime somnolence may not be linked to cardiovascular risk factors at the rural level.
Keywords: Sleep disorders, Excessive daytime somnolence Epworth sleepiness scale Cardiovascular health Population-based study Atahualpa
Inadequate sleep undermines many cognitive functions, including memory, concentration, and attention, which are vital in everyday activities. We hypothesized that poor quality or shorter sleep length may impair reading-related skills, resources, and outcomes, specifically verbal working memory span, verbal efficiency, and reading comprehension. Contrary to the hypotheses, neither short sleep length nor self-reported sleep quality were related to reading skills performance. However, longer sleep times were significantly related to lower verbal efficiency, and participants with the poorest sleep quality fared significantly better on the reading comprehension task than participants with moderate sleep quality. Given the paucity of research examining sleep and reading specifically, as well as these surprising data, more research in this area is warranted.
Keywords: Sleep, Memory, Verbal efficiency, Reading comprehension
OBJECTIVES: The present study aims to test the factor structure of two sleep questionnaires and their internal consistency in a sample of adolescents and their respective parents and to evaluate the validity and robustness of a three-dimensional model about sleep, addressing nine subcategories related to sleep habits, personal and environmental factors.
METHODS: Participants were 654 adolescents from Portuguese schools, who completed "My Sleep and I" questionnaire, and 664 parents who completed "My child's sleep" questionnaire; to them confirmatory factor analysis was applied.
RESULTS: Confirmatory factor analysis indicate that a nine-factor model has better fit indices compared with the others tested models for both samples (adolescents: χ2/df (Chi-square/degrees of freedom)=2.59, Comparative Fit Index (CFI)=.82, Goodness-of-Fit Index (GFI)= .92, Root Mean Square Error of Approximation (RMSEA)=.049, Expected Cross-Validation Index (ECVI)=1.416; Parents: χ2/df= 2.89, CFI=.85, GFI=.91, RMSEA=.053, ECVI=1.528). Moreover, the comparison of the models through Δχ2 index (chi-square difference between rival models) indicates a better fit for this model, Δχ2 (24)=186.5, p<.001 for adolescents and Δχ2 (24)=209, p<.001 for parents. Also, the three second-order factors have good internal consistency, convergent and discriminant validity for all factors in both samples.
CONCLUSIONS: Results postulate that the three factors and their nine subcategories account for correlations between sleep habits, self-perceptions and knowledge about sleep.
Keywords: Sleep, Adolescent, Parent, Confirmatory factor analysis
Long-term treatments with dopaminergic agents are associated with adverse effects, including augmentation. Augmentation consists of an exacerbation of restless legs syndrome (a sleep-related movement disorder) symptoms during treatment compared to those experienced during the period before therapy was initiated. The objective of this study was to examine locomotor activity in rats after long-term dopaminergic treatment and its relationship with expression of the D2 receptor, in addition to demonstrating possible evidence of augmentation. The rats were divided into control (CTRL) and drug (Pramipexole—PPX) groups that received daily saline vehicle and PPX treatments, respectively, for 71 days. The locomotor behavior of the animals was evaluated weekly in the Open Field test for 71 days. The expression of the dopamine D2 receptor was evaluated by Western Blot analysis. The animals that received the PPX demonstrated a significant reduction in locomotor activity from day 1 to day 57 and a significant increase in immobility time from day 1 to day 64 relative to baseline values, but these values had returned to baseline levels at 71 days. No changes in the expression of the D2 receptor were demonstrated after treatment with a dopaminergic agonist. This study suggests changes in locomotor activity in rats after long-term PPX treatment that include an immediate reduction of locomotion and an increase in immobilization, and after 64 days, these values returned to baseline levels without evidence of augmentation. In addition, it was not possible to demonstrate a relationship between locomotor activity and the expression of D2 receptors under these conditions.
Keywords: Augmentation, Dopaminergic agonist, Animal model, Locomotor behavior, Dopaminergic receptor
Environmental noise, especially that caused by transportation means, is viewed as a significant cause of sleep disturbances. Poor sleep causes endocrine and metabolic measurable perturbations and is associated with a number of cardiometabolic, psychiatric and social negative outcomes both in adults and children. Nocturnal environmental noise also provokes measurable biological changes in the form of a stress response, and clearly affects sleep architecture, as well as subjective sleep quality. These sleep perturbations are similar in their nature to those observed in endogenous sleep disorders. Apart from these measurable effects and the subjective feeling of disturbed sleep, people who struggle with nocturnal environmental noise often also suffer the next day from daytime sleepiness and tiredness, annoyance, mood changes as well as decreased well-being and cognitive performance. But there is also emerging evidence that these short-term effects of environmental noise, particularly when the exposure is nocturnal, may be followed by long-term adverse cardiometabolic outcomes. Nocturnal environmental noise may be the most worrying form of noise pollution in terms of its health consequences because of its synergistic direct and indirect (through sleep disturbances acting as a mediator) influence on biological systems. Duration and quality of sleep should thus be regarded as risk factors or markers significantly influenced by the environment and possibly amenable to modification through both education and counseling as well as through measures of public health. One of the means that should be proposed is avoidance at all costs of sleep disruptions caused by environmental noise.
Keywords: Environmental noise, Sleep disturbances, Health outcomes
Sleep loss appears to affect the capacity for performance and access to energetic resources. This paper reviews research examining the physical substrates referred to as resource capacity, the role of sleep in protecting that capacity and the reaction of the system as it attempts to respond with effort to overcome the limitations on capacity caused by sleep loss. Effort is the extent to which an organism will exert itself beyond basic levels of functioning or attempt alternative strategies to maintain performance. The purpose of this review is to bring together research across sleep disciplines to clarify the substrates that constitute and influence capacity for performance, consider how the loss of sleep influences access to those resources, examine cortical, physiological, perceptual, behavioral and subjective effort responses and consider how these responses reflect a system reacting to changes in the resource environment. When sleep deprived, the ability to perform tasks that require additional energy is impaired and the ability of the system to overcome the deficiencies caused by sleep loss is limited. Taking on tasks that require effort including school work, meal preparation, pulling off the road to nap when driving drowsy appear to be more challenging during sleep loss. Sleep loss impacts the effort-related choices we make and those choices may influence our health and safety.
Keywords: Sleep loss, Sleep deprivation, Effort, Performance, Subjective effort
Rapid maxillary expansion (RME) is a widely used practice in orthodontics. Scientific evidence shows that RME can be helpful in modifying the breathing pattern in mouth-breathing patients. In order to promote the restoration of physiological breathing we have developed a rehabilitation program associated with RME in children. The aim of the study was a literature review and a model of orofacial rehabilitation in children with obstructive sleep apnea undergoing treatment with rapid maxillary expansion. Muscular training (local exercises and general ones) is the key factor of the program. It also includes hygienic and behavior instructions as well as other therapeutic procedures such as rhinosinusal washes, a postural re-education (Alexander technique) and, if necessary, a pharmacological treatment aimed to improve nasal obstruction. The program should be customized for each patient. If RME is supported by an adequate functional rehabilitation, the possibility to change the breathing pattern is considerably amplified. Awareness, motivation and collaboration of the child and their parents, as well as the cooperation among specialists, such as orthodontist, speech therapist, pediatrician and otolaryngologist, are necessary conditions to achieve the goal.
Keywords: Palatal expansion technique, Mouth breathing, Myofunctional therapy, Speech therapy, Obstructive sleep apnea
Restless legs syndrome (RLS) is characterized by unpleasant sensations mainly in the legs. 43% of RLS-associated conditions have also been associated with systemic iron deficiency. The objective of this study was to review in the literature the relationship between iron metabolism and RLS. With an initial search using the keywords combination "Iron Metabolism OR Iron Deficiency AND Restless Legs Syndrome," 145 articles were screened, and 20 articles were selected. Few studies were found for this review in the period of 2001-2014, however, the correlation between RLS and iron was evident.
Keywords: Restless Legs Syndrome, Iron Deficiency Anemia, Attention Deficit Hyperactivity, Disorder, Pregnancy, Supplementation, Iron Genes