Rubens Reimão

Sleep habits, sleepiness and accidents among truck drivers

OBJECTIVE To evaluate the quality of sleep, shift work, alcohol and psychostimulant drug use, and the prevalence of accidents among truck drivers. METHOD Data were collected using a demographic questionnaire, the Epworth Sleepiness Scale (ESS) and the Pittsburgh sleep quality index (PSQI). Statistical analysis was conducted using the Student t, chi-square, Pearson and Fisher tests. RESULTS 43.2% of the drivers drove over 16 h a day, and 2.9% worked shifts. Mean number of sleep hours/day was 5.97+/-1.47; 23.8% slept <5 hours; 50.9% made use of alcohol, 95.6% of caffeine, and 11.1% of amphetamines. Mean PSQI was 4.95+/-2.56; 35.4% had a PSQI >5; 23 subjects snored more than three times a week (11.1%). Mean ESS was 6.56+/-4.2; 21.7% had a score >10. In the preceding five years, 27 drivers (13.1%) were involved in accidents, 5 of which resulted in injuries and 3 in deaths. CONCLUSION Results showed a high prevalence of sleep disorders, use of alcohol and psychostimulant drugs, and accidents.

Pitolisant, an Inverse Agonist of the Histamine H3 Receptor: An Alternative Stimulant for Narcolepsy-Cataplexy in Teenagers With Refractory Sleepiness

ObjectiveNarcolepsy is a rare disabling sleep disorder characterized by excessive daytime sleepiness and cataplexy (sudden loss of muscle tone). Drugs such as pitolisant, which block histamine H3 autoreceptors, constitute a newly identified class of stimulants because they increase brain histamine and enhance wakefulness in animal and human adult narcolepsy. MethodsWe report our experience with the off-label use of pitolisant in 4 teenagers with narcolepsy/cataplexy with severe daytime sleepiness, refractory to available treatments (modafinil, methylphenidate, mazindol, sodium oxybate, and D-amphetamine). ResultsAll teenagers developed their disease during childhood (11.3 ± 2.4 years; 50% boys) and were 17.3 ± 0.8 years old at the time of pitolisant therapy. Pitolisant treatment was increased from 10 to 30 mg (n = 1) and 40 mg (n = 3). The adapted Epworth Sleepiness Score decreased from 14.3 ± 1.1 to 9.5 ± 2.9 (P = 0.03) with pitolisant alone to 7 ± 3.4 when combined with mazindol (n = 1), methylphenidate (n = 1), or sodium oxybate plus modafinil (n = 1). Mean sleep onset latency increased from 31 ± 14 minutes to 36 ± 8 minutes (P = 0.21) on the maintenance of wakefulness test. The severity and frequency of cataplexy were slightly improved. Adverse effects were minor (insomnia, headache, hot flushes, leg pain, and hallucinations) and transitory, except for insomnia, which persisted in 2 teenagers. The benefit was maintained after a mean of 13 months. ConclusionsPitolisant could constitute an acceptable alternative for the treatment of refractory sleepiness in teenagers with narcolepsy.

Excessive daytime sleepiness in Campo Grande general population, Brazil

The prevalence of excessive daytime sleepiness (EDS) in general population was determined by means of 408 home interviews of adults, in a representative sample of Campo Grande city, Brazil. The random sample was stratified by sex, age and economic social status. EDS was considered in those with indexes 11 or more in the Epworth Sleepiness Scale. Statistics used chi-square, Fisher and Pearson tests; and inferences based on binomial distribution parameters; the significance level was 5% and confidence interval (CI) was 95%. The prevalence of EDS was 18.9% of the general population ( SD=1.9%; CI 15.1% to 22.7%). No significant association was found between EDS and the use of hypnotics, nor with insomnia, body mass index, sex, age, years of schooling, economic social status, marital status, occupation and the use of alternative means to improve sleep. When the sample was separated according to sex, only the male group showed significant association between EDS and actual insomnia (p=0.005).

Nightly use of computer by adolescents: its effect on quality of sleep

OBJECTIVE To analyze the influence of nocturnal use of computer and their effect on sleep quality, in a group of adolescents. METHOD Two middle schools were chosen for the research. The sample consisted of adolescents n=160 (55M; 105F), with ages ranging from 15 to 18 years. Questionnaire about computer use with the objective of obtaining information regarding the time and number of hours of nocturnal computer use, were applied for collection of data. They included the Pittsburgh Sleep Quality Index (PSQI), utilized to quantfy sleep quality; student report cards were used to note students absences and grades were used. RESULTS The Multiple Logistic Regression test indicated that nocturnal computer use impairs good sleep (p=0.0062). CONCLUSION Irregular sleep patterns associated with nightly computer use deteriorate sleep quality.

Quality of sleep among university students: effects of nighttime computer and television use.

This descriptive, cross-sectional study was based on subjective questionnaires that assessed nighttime habits of television viewing and Internet use during weekdays and perceived sleep quality among university students. Sleep perception was measured using the Pittsburgh Sleep Quality Index (PSQI). The study group comprised 710 university students aged 17-25 years. Analysis of sleep perception in relation to internet use revealed that 58.06% of subjects who accessed the internet between 19:00 and 21:00 slept poorly; 71.43% between 19:00 and 22:00; 73.33% between 19:00 and 24:00; and 52.38% between 19:00 and 03:00 (p = 0.0251). Concerning the relationship between television exposure and perceived sleep, the groups did not differ from each other (p = 0.9303). This study showed that internet use between 19:00 and 24:00 increases the risk of poor sleep among young adults, in comparison with television viewing times.Este estudo transversal descritivo com base em questionarios subjetivos avalia o habito de assistir TV e acessar a internet durante as noites nos dias de semana e a percepcao da qualidade do sono entre universitarios. Para avaliar a percepcao do sono foi aplicado o Indice de Qualidade do Sono de Pittsburgh. O grupo estudado incluiu 710 universitarios entre 17-25 anos. Para as analises da percepcao do sono relacionado ao habito de acessar o computador observou-se que acessam a internet e dormem mal: 58,06% entre as 19 e as 21h; 71,43% entre as 19 e as 22h; 73,33% entre as 19 e as 24h; 52,38% entre as 19 e as 3h (p=0,0251). Em relacao aos horarios de assistir TV e a percepcao do sono os grupos nao se diferenciaram entre si (p=0,9303). O estudo demonstra que acessar a internet durante os horarios das 19 as 24h aumenta as chances dos jovens dormirem mal quando comparado aos horarios de assistir TV.

Impact of Obesity in Children with Narcolepsy

To evaluate the impact of obesity on clinical and sleep characteristics in a population of narcoleptic children.

Depressive feelings in children with narcolepsy.

OBJECTIVES We aimed to evaluate depressive feelings and their correlations in children and adolescents with narcolepsy collected in national reference centers for narcolepsy. METHODS We compared clinical and sleep characteristics of patients with and without depressive symptoms evaluated on the Childrens Depression Inventory (CDI). RESULTS Our study sample included 88 children (44 boys; 44 de novo patients) with a mean age of 11.9 ± 3.1 years at diagnosis (37.5% were aged ⩽ 10 years). Obesity was found in 59% of the sample and cataplexy was present in 80.7%. The DQB1*0602 allele was positive in 93.5% of our sample. There were 25% of children who had clinically depressive feelings (CDI>16), especially girls older than the age of 10 years. Bivariate associations indicated that depressive feelings were associated with fatigue (48%), hyperactivity (31%), insomnia (16%), and excessive daytime sleepiness (EDS) (14-24%). In the multivariate model adjusted for gender and age, only fatigue explained the variability of the depression score. CONCLUSION In our large cohort, high levels of depressive symptoms essentially expressed by fatigue affected 25% of children with narcolepsy. The girls older than 10 years of age were especially vulnerable. The similar prevalence of depressive feelings in treated vs never-treated patients suggests a specific need for diagnosing and managing this symptom in young patients with narcolepsy.

Quality of sleep among university students: effects of nighttime computer and television use

This descriptive, cross-sectional study was based on subjective questionnaires that assessed nighttime habits of television viewing and Internet use during weekdays and perceived sleep quality among university students. Sleep perception was measured using the Pittsburgh Sleep Quality Index (PSQI). The study group comprised 710 university students aged 17-25 years. Analysis of sleep perception in relation to internet use revealed that 58.06% of subjects who accessed the internet between 19:00 and 21:00 slept poorly; 71.43% between 19:00 and 22:00; 73.33% between 19:00 and 24:00; and 52.38% between 19:00 and 03:00 (p = 0.0251). Concerning the relationship between television exposure and perceived sleep, the groups did not differ from each other (p = 0.9303). This study showed that internet use between 19:00 and 24:00 increases the risk of poor sleep among young adults, in comparison with television viewing times.Este estudo transversal descritivo com base em questionarios subjetivos avalia o habito de assistir TV e acessar a internet durante as noites nos dias de semana e a percepcao da qualidade do sono entre universitarios. Para avaliar a percepcao do sono foi aplicado o Indice de Qualidade do Sono de Pittsburgh. O grupo estudado incluiu 710 universitarios entre 17-25 anos. Para as analises da percepcao do sono relacionado ao habito de acessar o computador observou-se que acessam a internet e dormem mal: 58,06% entre as 19 e as 21h; 71,43% entre as 19 e as 22h; 73,33% entre as 19 e as 24h; 52,38% entre as 19 e as 3h (p=0,0251). Em relacao aos horarios de assistir TV e a percepcao do sono os grupos nao se diferenciaram entre si (p=0,9303). O estudo demonstra que acessar a internet durante os horarios das 19 as 24h aumenta as chances dos jovens dormirem mal quando comparado aos horarios de assistir TV.

Quality of Life in Children with Narcolepsy

To evaluate the health‐related quality of life (HRQL) and its correlates in children and adolescents with narcolepsy.

Sleep habits in native Brazilian Terena children in the state of Mato Grosso do Sul, Brazil

Sleep habits in childhood vary in function of physiological factors. Cultural traits also influence sleep habits. This research evaluates sleep habits of Native Brazilian Terena children. The Terena group here studied live in the central region of Mato Grosso do Sul, Brazil, on the plains; they are peaceful and dedicated mainly to agriculture. Two villages were studied, Tereré and Córrego do Meio, both in Reservations. Sleep characteristics of 67 children (40M;27F), 2 to 10 year olds, were evaluated in interviews with their mothers. The results evidenced that cosleeping, in the same bed with family members is the standard Terena pattern present in every evaluated child. The presence of two or more beds and a mean of five or more people in each bedroom was the typical finding. The authors propose that cosleeping and the presence of numerous family members reflect the high values attributed to family links in the Terena culture.