Diego Grasel Barbosa

Factors associated with short sleep duration in adolescents

Abstract Objective: This study aimed to investigate the prevalence and factors associated with short sleep duration in adolescents from Maravilha – Santa Catarina (SC), southern Brazil. Methods: The sample consisted of 516 adolescents aged 10–19 years of both genders. Issues associated with short sleep duration and difficulty falling asleep, chronotype, daytime sleepiness, physical activity, sedentary behavior and weight status were investigated. Results: The prevalence of short sleep duration (<8h on school days) was 53.6%. Adolescents aged 17–19 years showed a 2.05-fold (95%CI: 1.20–3.50) greater prevalence of short sleep duration than those aged 10–12 years. The ones studying in morning and evening shifts had a higher prevalence of short sleep duration compared to those in the afternoon shift. Older age and school shift were the main factors associated with short sleep duration. Conclusions: Adolescents from Maravilha showed high prevalence of short sleep duration, and older adolescents that studied in the morning and evening shifts showed reduced sleep.

Sono e adolescência: quantas horas os adolescentes precisam dormir?

Objetivo Determinar a especificidade e a sensibilidade de uma medida para apontar o melhor ponto de corte para a duracao de sono como preditor da sonolencia diurna excessiva em adolescentes. Metodos Participaram do estudo 1.359 adolescentes, com idades de 14 a 21 anos, de duas cidades do sul do Brasil, que responderam a questionario de habitos de sono e sonolencia diurna. Utilizou-se a Receiver Operating Characteristic para estimar a capacidade preditiva da duracao de sono para a sonolencia diurna excessiva. Resultados A media de duracao do sono para os adolescentes com sonolencia diurna excessiva foi de 7,9 horas e para aqueles sem sonolencia diurna excessiva foi de 8,33 horas (p < 0,001). A prevalencia de sonolencia diurna excessiva foi de 35,7%. Foi observada correlacao significativa e negativa entre a duracao do sono e as idades analisadas (p < 0,001). A analise de Receiver Operating Characteristic indicou duracao minima de 8,33 horas como protecao para a sonolencia diurna excessiva. Conclusao Foi observada alta prevalencia de sonolencia diurna excessiva e propoe-se como possivel duracao de sono um minimo de 8,33 horas nos dias com aula para que os adolescentes evitem esse desfecho.

Factors associated with sleep duration in Brazilian high school students

ABSTRACT The aim of this study was to investigate the factors associated with short sleep duration on southern Brazilian high school students. Our study was comprised of 1,132 adolescents aged 14 to 19 years, enrolled in public high schools in São José, Brazil. The students answered a questionnaire about working (work and workload), health perception, smoking, school schedule, sleep (duration and daytime sleepiness), and socio-demographics data. The results showed that more than two thirds of adolescent workers had short sleep duration (76.7%), and those with a higher workload (more than 20 hours) had a shorter sleep duration (7.07 hours) compared to non-workers (7.83 hours). In the analysis of factors associated with short sleep duration, adolescents who worked (OR = 2.12, 95% CI 1.53 to 2.95) were more likely to have short sleep duration compared to those who did not work. In addition, older adolescents (17–19 years) and students with poor sleep quality were 40% and 55% more likely to have short sleep duration compared to younger adolescents (14–16 years) and students with good sleep quality, respectively. Adolescents with daytime sleepiness were more likely to have short sleep duration (OR = 1.49, 95% CI 1.06 to 2.07) compared to those without excessive daytime sleepiness. In addition students of the morning shift (OR = 6.02, 95% CI 4.23 to 8.57) and evening shift (OR = 2.16, 95% CI 1.45 to 3.22) were more likely to have short sleep duration compared to adolescents of the afternoon shift. Thereby adolescents who are workers, older, attended morning and evening classes and have excessive daytime sleepiness showed risk factors for short sleep duration. In this sense, it is pointed out the importance of raising awareness of these risk factors for short sleep duration of students from public schools from São José, located in southern Brazil.

Capacity of Objective Measures of Physical Activity to Predict Brazilian Children’s Low Motor Proficiency

This study analyzed the associations between physical activity (PA) and motor proficiency (MP) to determine what level of moderate PA might help avoid low MP in 8-10-year-old Brazilian children. We assessed MP of 98 children using the Bruininks-Oseretsky Motor Proficiency, Second Edition Short Form (BOT-2 SF), and we assessed PA using the GT3X + accelerometer. We analyzed data using means, standard deviations, frequency distribution, spearman correlation coefficients, Mann–Whitney U test, and the Receiver Operating Characteristics curve. There was a difference between groups of children with adequate or better versus low MP in minutes/day of moderate PA (defined as 2,296–4,011 accelerometer counts/minute; U = 666.0, p = .045) such that those with less time engaged in moderate PA had lower MP scores than peers with adequate MP. There was also a positive correlation between moderate PA and the strength and agility MP domain (rs = .226; p = .025). In addition, minutes/day of moderate PA less than or equal to 142.56 minutes showed predictive capacity for low MP (area under the curve = 0.635; p = .027). Thus, objective measures of PA were able to predict low MP in 8-10-year-old Brazilian children, with an approximate guideline of about 2.5 hours per day of moderate PA needed to protect against low MP.

Factor structure of the Brazilian version of Pediatric Daytime Sleepiness Scale

ABSTRACT 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.

Proposal of cutoff points for pediatric daytime sleepiness scale to identify excessive daytime sleepiness

ABSTRACT The objective of the present study was to propose cutoff points for the Pediatric Daytime Sleepiness Scale (PDSS) through sensitivity and specificity analyses in order to identify excessive daytime sleepiness, considering parameters such as duration and quality of sleep, health perception, stress control and depressive moods (feelings of sadness) in adolescents. A total of 1,132 adolescents, aged 14–19 years old, of both sexes, from the public high school of São José – SC, answered the questionnaire with information on age, daytime sleepiness, sleep duration, health perception, stress management, depressive moods (feelings of sadness) and quality of sleep. The Receiver Operating Characteristic (ROC) curve was used to estimate cutoff points considering the sensitivity and specificity values that best identify adolescents with excessive daytime sleepiness, using independent variables as a reference. The majority of the sample was female (54.2%), aged 14–16 years. The girls presented worse quality of sleep (66.4%), and the boys had a more positive perception of health (74.8%), better stress control (64.8%) and lower depressive moods (feelings of sadness) (63.3%). The largest area in the ROC curve was the one that considered sleep quality as a parameter in both sexes (area of the curve = 0.709 and 0.659, respectively, for boys and girls, p < 0.001). Considering sleep quality as a reference, the cutoff point for excessive daytime sleepiness was 15 points. The other parameters used were also significant (p < 0.005). Poor sleep quality was the parameter most strongly related to daytime sleepiness, and a cutoff of 15 points for the PDSS for both sexes should be used in the definition of excessive daytime sleepiness. For the other parameters, stress management, depressive mood (feelings of sadness) and health perception, different cutoff points are suggested for boys and girls.

Padrões de sono e sonolência diurna: comparação entre adolescentes do interior e da região metropolitana

Introduction: Sleep is a physiological process whose expression in humans is influenced by social and environmental factors. Objective: Compare the variables sleep and daytime sleepiness in adolescents from a municipality in the countryside and from a metropolitan city. Method: Study participants were 1645 adolescents from representative samples of two cities of the state of Santa Catarina, Brazil: one from the interior of the state and another from a metropolitan area. Adolescents responded to a self-administered questionnaire on sociodemographic issues, sleeping and waking times on weekdays and weekends, daytime sleepiness, and health perception. Results: Adolescents living in the metropolitan region presented delayed sleeping (p < 0.001), waking (p < 0.001), and mid-sleep (p < 0.001) times compared with those of adolescents from the countryside. No statistically significant differences were observed between the means of sleep duration identified (p = 0.645). Adolescents also presented similar sleepiness indexes (p = 0.082). Association of negative health perception with high scores on the Pediatric Daytime Sleepiness

ANÁLISE DA SONOLÊNCIA DIURNA EM ADOLESCENTES POR MEIO DA PEDIATRIC DAYTIME SLEEPINESS SCALE: REVISÃO SISTEMÁTICA

ABSTRACT Objective: To systematically review the use of the Pediatric Daytime Sleepiness Scale (PDSS) in the analysis of daytime sleepiness in children and adolescents. Data source: The electronic databases PubMed and SciELO were consulted between 2003 and 2015. As inclusion criterion, studies were considered in English, Spanish and Portuguese, original articles of any type of design, articles with a sample of children and/or adolescents, articles that used the PDSS. Duplicate articles, articles with no relation to the theme, articles with another investigated population, and articles that the parents answered the instrument for their children were excluded. To find the material with these features, the terms “Daytime sleepiness” AND “adolescents” and “Daytime sleepiness” AND “children” were used in the searches. In addition, the descriptor “Pediatric Daytime Sleepiness Scale” was used to filter more specifically. Data synthesis: Initially, 986 studies related to daytime sleepiness were identified. Considering the inclusion criteria, we analyzed 26 studies composed of 18,458 subjects aged 0 to 37 years. The diurnal sleepiness score ranged from 6.7±0.6 to 25.7±0.6 points. In general, all included studies investigated other sleep variables in addition to daytime sleepiness, such as: sleep duration, sleep quality, sleep hygiene or sleep disorders (narcolepsy and cataplexy), respiratory disorders, neurological and developmental disorders. Conclusions: There was a moderate use of PDSS to evaluate daytime sleepiness. This instrument allows the monitoring of factors that influence excessive daytime sleepiness in children and adolescents.

Assessment of sleep in subjects with visual impairment: Comparison using subjective and objective methods

ABSTRACT The objective of the present study was to verify the agreement between objective and subjective measures of sleep in people with and without visual impairment. Thirty-seven subjects with visual impairment participated in the study (19 blind without light perception and 18 low-vision), as well as 34 subjects with normal vision, with paired age and gender characteristics. For the subjective sleep evaluation, we used the Sleep Quality Index—PSQI and for the objective evaluation we used the ActiGraph GT3X+. Among the three analyzed groups, the blind was the only ones who presented differences between subjective and objective sleep duration (p = 0.021). Furthermore, the concordance between subjective and objective sleep duration (ICC = 0.388; p = 0.108) was not observed in blind subjects, and a greater variability of differences in sleep duration between the two methods was observed by the Bland Altman scatter plot. We concluded that the sleep duration obtained by PSQI did not show agreement for the objective sleep duration in blind subjects without light perception.

ADOLESCENTES COM SONOLÊNCIA DIURNA EXCESSIVA PASSAM MAIS TEMPO EM COMPORTAMENTO SEDENTÁRIO

Introducao: A diminuicao da atividade fisica, a baixa duracao do sono e o aumento do tempo sentado tem sido cada vez mais percebidos na adolescencia. Objetivos: Investigar a associacao entre comportamento sedentario e variaveis de sono (sonolencia diurna e duracao de sono) de adolescentes de um municipio de pequeno porte do sul do Brasil. Metodos: Trata-se de uma amostra representativa, de base escolar, do municipio de Maravilha, SC, Brasil, formada por 516 adolescentes de ambos os sexos, com 10 a 19 anos de idade. Foram investigadas as associacoes entre comportamentos sedentarios, sono, percepcao de estresse e atividade fisica. O comportamento sedentario foi investigado por meio do tempo sentado durante o dia. Alem disso, outras questoes foram investigadas, como: sexo, faixa etaria, turno escolar, local de domicilio, renda e grau de instrucao do chefe de familia, duracao do sono e sonolencia diurna, percepcao de estresse e nivel de atividade fisica. Resultados: A prevalencia de baixa duracao do sono foi de 53,6%. A media de tempo sentado durante um dia de semana foi de 382,2 min., sendo superior no sexo feminino (p = 0,001). Os adolescentes com baixa duracao do sono apresentaram valores medios mais altos de tempo sentado (p < 0,001), sonolencia diurna (p < 0,001) e sonolencia em sala de aula (p < 0,001). Os adolescentes com maior sonolencia tinham 4,97 (IC: 2,50-9,87) vezes mais chance de ter comportamento sedentario elevado. Conclusao: Adolescentes com maior sonolencia diurna apresentaram maior tempo dedicado aos comportamentos sedentarios. Assim, as medidas de educacao para um estilo de vida mais ativo na adolescencia devem observar tambem questoes gerais sobre sono e sonolencia diurna.