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- ItemSomente MetadadadosO impacto da qualidade do sono no equilibrio corporal dos indivíduos com vestibulopatias periféricas(Universidade Federal de São Paulo (UNIFESP), 2013-08-04) Andrade Junior, Mario Chueire de [UNIFESP]; Gananca, Fernando Freitas Gananca [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objetivo: avaliar o impacto da qualidade do sono no equilíbrio corporal e na qualidade de vida de indivíduos com vestibulopatias periférica. Métodos: 52 indivíduos com vestibulopatias periféricas foram submetidos à avaliação otoneurológica, incluindo o Dizziness Handicap Inventory, (DHI) e posturografia do Tetrax® (Sunlight Medical Ltd.) em oito condições sensoriais e avaliação sobre a qualidade do sono por meio do índice de qualidade do sono de Pittsburgh (PSQI). 32 indivíduos saudáveis (G3) participaram como controle. Resultados: 14 vestibulopatas (G1) apresentaram boa qualidade de sono e 38 (G2) apresentaram má qualidade do sono conforme o escore global do PQSI (p= 0.001). O DHI mostrou pior qualidade de vida de G2 em comparação ao G1 (p= 0,045). O G2 apresentou maior índice de risco de queda na posturografia comparado ao G3 (p= 0.012) e resultado significante com maior índice de estabilidade geral em cinco condições sensoriais em comparação ao G3. Nos grupos de vestibulopatas houve correlação linear significante, indicando que quanto pior a qualidade do sono, maior o risco de queda e pior a qualidade de vida. Conclusão: A má qualidade do sono encontrada na maioria dos vestibulopatas avaliados provoca impacto negativo no equilíbrio corporal demonstrado pelo maior índice de estabilidade geral (maior instabilidade corporal), maior índice de risco de queda e piora da qualidade de vida.
- ItemSomente MetadadadosParassonias do sono não-rem na doença de machado-joseph: avaliações clínica e polissonográfica(Universidade Federal de São Paulo (UNIFESP), 2014-08-31) Silva, Giselle Melo Fontes [UNIFESP]; Prado, Gilmar Fernandes Do Prado [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Indroduction: The majority of spinocerebellar ataxias (SCA) are autosomal dominant neurodegenerative disorders that affect the cerebellum and its connections, and have a marked clinical and genetic variability. The spinocerebellar ataxia type 3 (SCA3) or Machado-Joseph disease (MJD) is the most common worldwide. MJD is classically characterized by progressive ataxia and variable other motor and non-motor symptoms. Sleep disorders are common and include: REM sleep behavior disorder (RBD), restless legs syndrome (RLS), insomnia, excessive daytime sleepiness, excessive fragmentary myoclonus and sleep apnea. Objective: This study aims to characterize and to determinate the frequency of the NREM-related parasomnias and other sleep parameters and disorders in MJD patients compared to a control group. Materials and Methods: Forty-seven patients with clinical and genetic diagnosis of MJD and 47 control subjects were evaluated clinically and by polysomnography. Results: MJD patients had a higher frequency of arousals from slow wave sleep (p<0.001), parasomnias complaints (confusional arousal/sleep terrors p=0.001, RBD p<0.001 and nightmares p<0.001), REM sleep without atonia (p<0.001), periodic limb movements of sleep-PLMS index (p<0.001), duration and percentage of N3 sleep (p<0.001) and percentage of N1 sleep (p<0.001). However MJD patients had a lower duration of N2 sleep (p<0.001). Conclusion: These data expose that NREM-related parasomnias must be included in the spectrum of sleep disorders in MJD patients.
- ItemAcesso aberto (Open Access)Qualidade de vida em crianças com distúrbios obstrutivos do sono: avaliação pelo OSA-18(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2006-12-01) Silva, Viviane Carvalho da [UNIFESP]; Leite, Álvaro Jorge Madeiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Ceará Faculdade de Medicina Hospital Universitário Walter Cantídeo; Universidade Federal do Ceará Faculdade de Medicina Departamento de Saúde Materno-InfantilSleep-disordered breathing (SDB) is prevalent. There is evidence of their effect on quality of life. AIM: To assess the quality of life in children with SDB before and after adenoidectomy or adenotonsillectomy. METHODS: A prospective before and after interventional study, with a component for assessment. A consecutive sample of children referred to adenoidectomy or adenotonsillectomy was recruited from the otolaryngology clinic; guardians answered a specific survey for the evaluation of quality of life in children with SDB, the OSA-18, before and at least 30 days after surgery. Nasofibroscopic and otolaryngological exams and a semi-structured survey on the child s social and clinical profile were done on both appointments. RESULTS: 48 children with a mean age of 5.93 years (SD=2.43) were evaluated. The mean number of schooling years for guardians was 8.29 years (SD=3.14). The most frequent symptoms were: agitated sleep, apnea and snoring. The total mean score of the initial OSA-18 was 82.83 (major impact); following surgery, the total mean score was 34.15. The differences in the total scores and in the domains between the initial OSA-18 and post-surgery scores were all significant (p<0.00). CONCLUSION:SDB has a relevant impact on quality of life, and patients show dramatic improvements after surgical treatment.
- ItemAcesso aberto (Open Access)Qualidade de vida em crianças com distúrbios respiratórios do sono(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2012-10-01) Gomes, Amaury de Machado; Santos, Otávio Marambaia dos; Pimentel, Kleber; Marambaia, Pablo Pinillos; Gomes, Leonardo Marques; Pradella-Hallinan, Márcia Lurdes de Cássia [UNIFESP]; Lima, Manuela Garcia; Escola Bahiana de Medicina e Saúde Pública; ABORL-CCF Inooa; Faculdade de Medicina do Porto; UFBA; Universidade Federal de São Paulo (UNIFESP)Children may present sleep-disordered breathing (SDB) and suffer with adverse effects upon their quality of life. OBJECTIVE: This study assessed the quality of life of children with SDB, compared subjects with obstructive sleep apnea syndrome (OSAS) and primary snoring (PS), and identified which areas in the OSA-18 questionnaire are more affected. METHODS: This is a historical cohort cross-sectional study carried out on a consecutive sample of children with history of snoring and adenotonsillar hyperplasia. The subject's quality of life was assessed based on the answers their caregivers gave in the OSA-18 questionnaire and on diagnostic polysomnography tests. RESULTS: A number of 59 children participated in this study with mean age of 6.7 ± 2.26 years. The mean score of the OSA-18 was 77.9 ± 13.22 and the area most affected were caregiver concerns (21.8 ± 4.25), sleep disturbance (18.8 ± 5.19), physical suffering (17.3 ± 5.0). The impact was low in 6 children (10.2%), moderate in 33 (55.9%) and high in 20 (33.9%). PS was found in 44 children (74.6%), OSAS in 15 (25.6%). OSAS had higher score on physical suffering area than PS (p = 0.04). The AI (r = 0.22; p = 0.08) and AHI (r = 0.14; p = 0.26) were not correlated with OSA-18. CONCLUSION: Sleep disordered breathing in childhood cause impairment in quality of life and areas most affected the OSA-18 were: caregiver concerns, sleep disturbance and physical suffering. OSAS has the domain physical suffering more affected than primary snorers.
- ItemSomente MetadadadosQualidade do sono em longevos com dor crônica(Universidade Federal de São Paulo (UNIFESP), 2016-09-13) Felix, Ricardo Humberto de Miranda [UNIFESP]; Santos, Fania Cristina dos Santos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: Chronic pain and sleep disorder prevalence increases each decade of life, impacting the social and functional aging. Although just few studies have evaluated this binomial in elderly people. Following this, we aimed to evaluate sleep quality of oldest-old with chronic pain and associated factors. Methods: Descriptive, analytical and cross-sectional study from ?Longevos Project?, with community-dwelling elderly people aged 80 years old or older which included those with chronic pain. Social demographic, functionality, physical activity, use of medicines and comorbidities, references of self-perception of health, tracking of depressive disorder and sleep were evaluated. Chronic pain was evaluated uni-and multidimensional and sleep according to Pittsburg Sleep Quality Index (PSQI). Results: the sample was composed for 51 elderly people, mean age 87.5 years old, having 80.4% women and 76.5% Caucasians; majority functional independent, sedentary, with polipharmacy and a mean of 5 comorbities. The self-perception of health and sleep were regular for 52.9% and good for 68.6%, respectively. The tracking of depression was positive for 41.2% of the sample. It was observed high prevalence of bad sleep quality, having 49% of ?poor sleepers?. The factors that were significantly associated with poor sleep quality were: self-perception of sleep (p 0.010), number of comorbidities (p 0.008), use of analgesics (p 0.048) and antidepressive medicines (p 0.017), multidimensional measurement of pain (p 0.013) and pain-induced depression (p<0.001). In a linear regression analysis only pain-induced depression and self-perception of sleep were independently correlated to bad sleep quality. Conclusion: high prevalence of poor sleep quality in oldest-old with chronic pain was found, and also the significant and independent association of this with the self-perception of sleep and pain-induced depression.
- ItemAcesso aberto (Open Access)Síndrome das pernas inquietas em pacientes com síndrome pós-poliomielite(Universidade Federal de São Paulo (UNIFESP), 2014-04-30) Marin, Luis Fabiano [UNIFESP]; Prado, Gilmar Fernandes do [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objetivo: Investigar a prevalência da síndrome das pernas inquietas (SPI) em pacientes com a síndrome pós-poliomielite (SPP) e avaliar os aspectos clínicos e demográficos, assim como a gravidade da SPI na população estudada. Métodos: Cento e dezenove pacientes com diagnóstico de SPP do ambulatório de Pós-poliomielite do Setor de Investigação de doenças Neuromusculares da Universidade Federal de São Paulo foram investigados para SPI de acordo com os critérios diagnósticos estabelecidos pelo Grupo de Estudos Internacional da SPI (IRLSSG). A gravidade da SPI foi avaliada pela Escala de Gravidade da SPI do Grupo Internacional de Estudos da SPI (IRLS). Os pacientes foram avaliados quanto a dados demográficos, comorbidades clínicas, sonolência diurna, exames laboratoriais (hemograma, creatinina, glicose, dosagem de hormônio estimulante da tireoide, creatinofosforoquinase e ferritina) e quanto à localização dos sintomas da SPI. Resultados: A prevalência da SPI foi 36% (n=43; 32 mulheres e 11 homens). Houve concomitância entre as idades de início da SPI (mediana=41 anos) e da SPP (mediana=41 anos), não havendo diferença quanto à idade (p=0,999). A localização dos sintomas da SPI foi mais frequente nas pernas (84%), seguido de coxas (58%) e pés (26%). A gravidade da SPI apresentou mediana de 23 (20-28). Baixa escolaridade, sonolência diurna e depressão foram fatores preditivos para SPI. Conclusão: A prevalência de SPI neste grupo de pacientes foi maior que a esperada para a população geral. Um alto grau de concordância foi encontrado entre o início dos sintomas da SPI e da SPP. Este estudo sugere que a SPI deve ser investigada em indivíduos com SPP que apresentam queixas motoras e/ou sensitivas nos membros inferiores. Futuros estudos são necessários para investigar melhor a relação clínica e fisiopatológica entre a SPP e a SPI.
- ItemAcesso aberto (Open Access)Sleep terrors antecedent is common in adolescents with migraine(Academia Brasileira de Neurologia - ABNEURO, 2013-02-01) Fialho, Libânia Melo Nunes [UNIFESP]; Pinho, Ricardo Silva [UNIFESP]; Lin, Jaime [UNIFESP]; Minett, Thaís Soares Cianciarullo [UNIFESP]; Vitalle, Maria Sylvia de Souza [UNIFESP]; Fisberg, Mauro [UNIFESP]; Peres, Mario Fernando Prieto [UNIFESP]; Vilanova, Luiz Celso Pereira [UNIFESP]; Masruha, Marcelo Rodrigues [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Cambridge University Department of Public Health and Primary Care; Hospital Israelita Albert Einstein Instituto de Ensino e PesquisaMigraines and sleep terrors (STs) are highly prevalent disorders with striking similarities. The aim of this study was to evaluate the effect of the antecedent of STs by comparing adolescents suffering from migraines with healthy controls in a large consecutive series. METHODS: All patients were subjected to a detailed headache questionnaire and were instructed to keep a headache diary during a two-month period. The age range was 10 to 19 years. The diagnosis of STs was defined according to the International Classification of Sleep Disorders. RESULTS: A total of 158 participants were evaluated. Of these participants, 50 suffered from episodic migraines (EMs), 57 had chronic migraines (CMs) and 51 were control subjects (CG). Participants who had a history of STs had significantly more migraines than participants who did not. CONCLUSIONS: Migraine is strongly associated with a history of STs in the adolescent population independent of demographics and pain intensity.