Thesis (Ph. D.)--Pennsylvania State University, 1996. / Includes bibliographical references.

Thesis (Ph. D.)--Drexel University, 2006. / Includes abstract and vita. Includes bibliographical references (leaves 121-134).

Thesis (M.S.)--Oregon State University, 2004. / Includes bibliographical references.

The population of the world is aging. In Sweden alone, almost 20% of the population is 65 years or older. As people get older, problems with sleep disturbances and sleep quality tends to increase, as do the risks of falling injuries. In this thesis, methods for calculating sleep quality and if a person is about to leave a bed were devised. A bed sensor, measuring ballistocardiographical signals, was used to measure activity in bed and vital signs of the occupant. The Cole-Kripke algorithm, used to calculate sleep quality based on activity from a wrist worn sensor, was adapted to the bed sensor system and compared to results from the ActiGraph wGT3X-BT activity monitor, which is frequently used in research. The bed sensor systems sleep quality estimations showed strong correlation with the ActiGraph, with a Pearson correlation coefficient of 0.946. Two approaches were made to estimate if a subject was about to leave the bed, one by training a neural network on labeled night data, and one using a linear equation with each term consisting of activity data, optimized by linear regression. The neural network approach suffered from limited data, but the linear method showed more promise, with accuracy, specificity and sensitivity all over 70%.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-08-04T14:25:51Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Mestrado REVISÃO PÓSBANCA_FINA_BIBIOCENTRAL_FINAL_25032016_NOVA_FINALLL.pdf: 2238183 bytes, checksum: 8badaa7ab119eec4d05d114cc326bddb (MD5) / Made available in DSpace on 2016-08-04T14:25:51Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Mestrado REVISÃO PÓSBANCA_FINA_BIBIOCENTRAL_FINAL_25032016_NOVA_FINALLL.pdf: 2238183 bytes, checksum: 8badaa7ab119eec4d05d114cc326bddb (MD5) Previous issue date: 2016-03-01 / O regime de plantão noturno, afeta o ciclo circadiano acarretando consequências negativas, causando alterações na vida e saúde dos profissionais de Enfermagem.O sono é uma etapa da fisiologia humana complexa relacionada ao comportamento humano e um dos grandes enigmas da neurociência.Objetivo: Verificar as repercussões da alteração do sono em profissionais de enfermagem com atividade laboral noturna Método: Aplicação de formulário à 179 profissionais (técnicos e enfermeiros), tendo como critério de inclusão possuir 03 anos ou mais de tempo na profissão em plantões noturnos. Foram excluídos desta pesquisa, os trabalhadores de enfermagem que não quiseram participar do estudo ou não responderam ao questionário, e aqueles que possuem menos de 03 anos de tempo na profissão em plantões noturnos. O instrumento de avaliação utilizado foi um formulário com 23 questões de múltiplas escolhas objetivas, no qual abordava perguntas referentes a: dados sócio demográficos (sexo, idade, nível de escolaridade e estado civil), hábitos do cotidiano (rotinas, lazer, alimentação) e morbidades apresentadas (doenças e sintomas). Realizou-se um projeto piloto, com 30 profissionais, os quais foram excluídos da amostra de 179 participantes, para avaliar possíveis dificuldades na compreensão das questões do formulário pelos profissionais e para realizar a calibração do pesquisador responsável pelas entrevistas. Os dados foram digitados em planilha EXCEL 7.0 e posteriormente foram transferidos para tabela de entrada do SPSS (Statistical Package for the Social Sciences) versão 21. Os dados foram apresentados considerando o grupo total de profissionais, por categorias, tempo de trabalho em plantões noturnos, doenças adquiridas e sintomas associados. A verificação da hipótese de normalidade dos dados foi realizada através dos testes estatísticos de Shapiro-Wilk e da igualdade de variâncias através do teste F de Levene. Os resultados foram expressos através de frequências absoluta e relativa nas variáveis categóricas e das medidas estatísticas: média, desvio padrão e mediana para a variável idade. Para verificar associação entre as repercussões da privação de sono noturno e as categorias profissionais, foi utilizado o teste t –Student com variâncias iguais para a variável idade e nas variáveis categóricas foi utilizado o teste Qui-quadrado de Pearson ou o teste Exato de Fisher quando a condição para utilização do teste Qui-quadrado não foi verificada para avaliar a força da diferença foi obtido o Odds Ratio (OR)Resultados:Observou-se que53,1% dos entrevistados observaram o aparecimento de doenças após plantões noturnos. Destes, as mais citadas foram: distúrbios do sono (26,8%), hipertensão (17,3%) coluna (16,2%), gastrite (11,7%) e vasculares (10,1%). O estudo em questão observou que as doenças com diferenças significativas entre as categorias profissionais foram: Problemas de coluna 6,5% vs 19,5%, Afecções vasculares 2,2% vs 12,8% e Hipertensão 6,5% vs 21,1%, para enfermeiros e técnicos em enfermagem, respectivamente, e a categoria de técnicos em enfermagem é a mais acometida, devido as suas atribuições exigirem mais tempo de vigília, pela sua assistência direta ao paciente, o profissional está sujeito a maior ocorrência de morbidades.Conclusão: entende-se que o plantão noturno tem impacto negativo na saúde desses trabalhadores. / Sleep is a stage of complex human physiology related to human behavior and one of the great puzzles of neuroscience. The night shifts, affects the circadian cycle leading to negative consequences, causing changes in the life and health of nursing professionals. Objective: To investigate the effects of sleep change in nurses with night work activity Method: Form Application to 179 professionals (technicians and nurses), with the inclusion criteria have 03 years or longer in the profession in night shifts. They were excluded from this research, nursing workers who refused to participate in the study or did not respond to the questionnaire, and those with less than 03 years of time in the profession in night shifts. The evaluation instrument used was a form with 23 questions of multiple choice objective, which addressed questions relating to: socio-demographic data (gender, age, education level and marital status), daily habits (routines, leisure, food) and presented morbidities (diseases and symptoms). We carried out a pilot project with 30 professionals, who were excluded from the sample of 179 participants to assess possible difficulties in understanding the professional form of questions and to calibrate the researcher responsible for the interviews. Data were entered into EXCEL 7.0 spreadsheet and were subsequently transferred to SPSS input table (Statistical Package for Social Sciences) version 21. The data were presented considering the total group of professionals, by category, time working in night shifts, acquired diseases and associated symptoms. Verification of the data normality hypothesis by means of statistical tests of Shapiro-Wilk and equal variances by F Levene test. The results were expressed by absolute and relative frequencies for the categorical variables and statistical measurements: mean, standard deviation and median for age variable. To assess the association between the impact of deprivation of nighttime sleep and professional categories, we used the t-Student test with equal variances for the variable age and the categorical variables we used chi-square test or Fisher's exact test when the condition for using the chi-square test was not checked to assess the strength of the difference was obtained Odds Ratio (OR) results: it was observed that 53.1% of respondents noted the emergence of diseases after night shifts. Of these, the most mentioned are: sleep disorders (26.8%), hypertension (17.3%) column (16.2%), gastritis (11.7%) and vascular (10.1%). The study in question noted that diseases with significant differences between occupational categories were: column Problems 6.5% vs 19.5%, vascular disorders 2.2% vs 12.8% and hypertension 6.5% vs 21 1% for nurses and nursing technicians, respectively, and the category of nursing technicians is the most affected, because their duties require more waking time by its direct patient care, the professional is subject to higher occurrence of morbidities . Conclusion: it is understood that the night shift has negative impact on the health of these workers.

Orientador: Rubens Nelson Amaral de Assis Reimão / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-15T18:35:50Z (GMT). No. of bitstreams: 1 Rocha_CeliaReginadaSilva_D.pdf: 6590104 bytes, checksum: 914a9ba91c4cc093a989c25c30387121 (MD5) Previous issue date: 2010 / Resumo: A adolescência é tida como um período de transição, marcado por significativas transformações nos aspectos bioquímicos, fisiológico e psicossocial, acarretando ansiedade e muita angústia, configurando-se como fatores de risco para o surgimento de algum tipo de distúrbio. Neste estudo, verificamos a ocorrência de sintomas de depressão, compulsão alimentar e distúrbios do sono em estudantes do terceiro ano do ensino médio e de curso pré-vestibular. Foi realizado um estudo transversal, descritivo. A amostra de 529 estudantes (M=241; F=288) de sete escolas públicas e privadas e dois cursos pré-vestibulares, de um bairro de classe média, da cidade de São Paulo, na faixa etária entre 16 e 19 anos. Os instrumentos utilizados foram: Inventário Beck de Depressão (BDI), Questionário sobre Padrões Alimentares e Peso - Revisado (QEWP-R) e o Índice de Qualidade do Sono de Pittsburgh (IQSP). A análise dos dados indica maior percentual de sintomatologia depressiva no grupo feminino e entre estudantes dos cursinhos. Verificou-se a presença de indícios de compulsão alimentar com maior percentual nos estudantes das escolas particulares. Em relação aos distúrbios do sono mostram diferenças significativas no período de estudo, problemas para ficar acordado, qualidade subjetiva do sono, latência, duração do sono, uso de medicação, eficiência habitual do sono, sonolência diurna e distúrbios do sono e número de pessoas na casa. Houve Associação entre distúrbios do sono e indícios de compulsão alimentar, distúrbios do sono e sintomatologia depressiva. Concluímos que na população estudada existe a ocorrência de sintomatologia depressiva, indícios de episódios de compulsão alimentar e distúrbios do sono / Abstract: Adolescence is a period of transition marked by significant transformations in biochemical, physiological and psychosocial aspects, leading to anxiety and anguish, which consist in risk factors for the appearance of some type of disturbance. In this study, we verified the occurrence of symptoms of depression, eating compulsion and sleep disturbances in third-year intermediate students and students enrolled in courses for university entrance examination. This was a transversal and descriptive study comprising 529 students (241 males; 288 females) from seven public and private schools and two courses for university entrance examination located in a middle-class district in the city of São Paulo, in the age group of 16-19 years. The instruments used were: Beck Depression Inventory (BDI), Questionnaire on Eating and Weight Patterns - Revised (QEWP-R) and the Pittsburgh Sleep Quality Index (PSQI). The data analysis indicated a major percentage of depressive symptomatology in the group of females and among students of the courses. It was verified a major percentage of eating compulsion signs in students of private schools. Concerning sleep disturbances, they showed significant differences regarding the period of study, difficulty staying awake, subjective quality of sleep, latency, sleep duration, medication use, habitual sleep efficiency, daytime sleepiness, and number of people at home. There was an association between sleep disturbances and eating compulsion signs, as well as sleep disturbances and depressive symptomatology. We could conclude that there was an occurrence of depressive symptomatology, signs of eating compulsion and sleep disturbances / Doutorado / Saude da Criança e do Adolescente / Doutor em Saude da Criança e do Adolescente

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A qualidade do sono à um poderoso preditor de saÃde, pois està relacionado com o risco para problemas de saÃde crÃnicos, como diabetes mellitus, hipertensÃo, obesidade e a SM. Esta à uma agregaÃÃo de problemas cardiometabÃlicos que eleva substancialmente a morbi-mortalidade humana independente da causa. O grau da relaÃÃo entre SM e a quantidade/qualidade do sono jà està estabelecido em idosos, pessoas de meia idade, operÃrios e atà crianÃas, mas, em adultos jovens, aparentemente saudÃveis, ainda à desconhecido. Dessa forma, o objetivo geral desta pesquisa foi analisar a relaÃÃo entre SM e indicadores de saÃde com a qualidade do sono de universitÃrios de Fortaleza-CearÃ. Pesquisa observacional, quantitativa, com desenho transversal. Foram avaliados 701 universitÃrios de 24 cursos das seis Ãreas de conhecimento da UFC entre marÃo e junho de 2011 em duas etapas. Na primeira, os alunos preencheram um instrumento sobre indicadores sociodemogrÃficos, de saÃde e uma versÃo validada e adaptada, aos padrÃes brasileiros, do Pittsburgh Sleep Quality Index. Numa data posterior, com os alunos em jejum por doze horas, coletaram-se os seguintes dados bioquÃmicos: glicemia venosa de jejum, triglicerÃdeos, LDL-C, HDL-C e o cortisol. Nessa mesma ocasiÃo, foram mensurados pressÃo arterial, circunferÃncia abdominal, peso corporal e altura. Analisaram-se os componentes da SM consoante o critÃrio da NCEP-ATP III. Os dados sofreram tripla digitaÃÃo e foram analisados no software STATA versÃo 8.0. Parcela substancial dos universitÃrios eram maus dormidores (95,2%) enquanto uma minoria tinha SM (1,6%). Os alunos com menor duraÃÃo do sono foram os da Ãrea de agrÃrias (6,24h DP 1,23h) e tecnologia (6,29h DP 1,24) (p=0,04). Grande maioria dos alunos maus dormidores (39%) tinha uma renda supeior a seis salÃrios mÃnimos (p=0,03). Os universitÃrios que moravam sozinhos (IC-95%- 1,03-1,08) (p<0,001) ou com os pais, (p<0,020), com idade &#8805; 30 anos (IC95%-1,02-1,07) (p<0,001), com mÃdio risco para etilismo (IC95%-1,03-1,07) (p<0,001) e os fumantes diÃrios (IC95%-1,02-1,06) (p<0,001) apresentavam uma chance superior a 1,05, 1,05,1,05, 104 e 1,05, respectivamente, de possuir mà qualidade do sono. Praticamente todos os alunos com cortisol elevado (96,1%) tinham sono com eficiÃncia de 65-74% (p=0,02). Hà um aumento de 5% na probabilidade de universitÃrios maus dormidores apresentarem SM (RP=1,05; IC 95%:1,03-1,07) (p=0,013). Estes alunos tambÃm possuem uma chance superior a 1,05 de apresentar glicemia elevada (RP=1,05; IC95%-1,03-1,07) (p<0,001). NÃo houve correlaÃÃo estatisticamente significante entre os componentes da SM isolados e o PSQI. Portanto, os universitÃrios maus dormidores possuem uma probabilidade maior de apresentar SM comparativamente aos bons dormidores. à importante que os profissionais de saÃde considerem a avaliaÃÃo da qualidade do sono desses jovens na prevenÃÃo e combate à SM, assim como na elaboraÃÃo de estratÃgias individualizadas para a promoÃÃo da saÃde deles. / The quality of sleep is a powerful predictor of health, because it is related with the risk for chronic health problems, such as diabetes, hypertension, obesity and metabolic syndrome. This is an aggregation of cardio-metabolic problems that substantially increases human morbidity and mortality from any cause. The level of relationship between MS and the quantity/quality of sleep is already established in the elderly, middle-aged people, workers and even children, but in young adults, apparently healthy, is still unknown. Thus, the objective of this research was to analyze the relationship between MS and health indicators with the quality of sleep university in Fortaleza-CearÃ. Observational quantitative research using cross-sectional design. We evaluated 701 college students from 24 courses in the six areas of knowledge of the UFC between March and June 2011 in two stages. In the first, students filled an instrument on socio-demographic and health indicators and a validated version adapted to Brazilian standards from the Pittsburgh Sleep Quality Index. In a posterior date with students fasted for twelve hours, we collected the following biochemical data: fasting venous plasma glucose, plasma triglycerides, LDL-C, HDL-C and cortisol. On the same occasion, we measured blood pressure, waist circumference, height and weight. We analyzed the components of MS based on the NCEP-ATP III. Data were triple typed and analyzed in STATA software version 8.0. A substantial amount of the college students were poor sleepers (95.2%) while a minority had MS (1.6%). Students with shorter sleep duration were in the area of land sciences (6.24h SD  1.23 h) and technology (6.29 h SD  1.24) (p=0.04). Most of the poor sleepers students (39%) had an income above six minimum wages (p=0.03). The students who lived alone (95% CI - 1.03-1.08) (p<0.001) or with parents (p<0.020), age &#8805; 30 years (95% CI - 1.02-1.07) (p<0.001), with average risk for alcoholism (95% CI - 1.03-1.07) (p<0.001) and daily smokers (95% CI - 1.02-1.06) (p<0.001) presented a chance of having poor sleep quality more than 1.05, 1.05, 1.05, 1.04 and 1.05, respectively. Virtually all students with elevated cortisol levels (96.1%) had sleep efficiency with 65-74% (p=0.02). There is a 5% increase in the probability of poor sleepers college students develop MS (PR = 1.05, 95% :1,03-1, 07) (p = 0.013). These students also have a chance greater than 1.05 to present high glucose (PR=1.05; 95% CI â 1.03-1.07) (p<0.001). There was no statistically significant correlation between the individual components of MS and the PSQI. Therefore, the college students poor sleepers have a higher relative risk of presenting SM compared to good sleepers. It is important that health professionals consider the assessment of sleep quality of these young people to prevent and combat MS, as well as in developing individualized strategies to promote their health.

The quantification of athlete pre-competitive sleep behaviour is of interest owing to the possibility that sleep loss may have a negative effect on health and performance. The purpose of this study was to monitor and quantify the sleep/wake patterns of South African cyclists prior to competitive races. A total of 336 cyclists, male and female and of differing competition levels, cycling in either the 2015 Tsogo Sun Amashova or the 2016 Telkom 94.7 Cycle Challenge completed an altered version of the Competitive Sports and Sleep Questionnaire. The questionnaire asked cyclists to report on precompetitive sleep over the past year. A subset of 92 cyclists also recorded a Core Consensus Sleep Diary for the three nights leading up to the races. The questionnaire showed that 67% of the cyclists reported worsened sleep at least once prior to competition within the past 12 months. The sleep diary found that the cyclists’ average sleep duration the night before the races was 6h19min (±1h38min), which was significantly less than two and three nights prior to the races. Sleep quality was also shown to deteriorate significantly the night before the races. The contributing factors leading to worsened pre-competitive sleep were the time the cyclists had to wake-up as well as perceived increases in sleep latency and awakenings after sleep onset. Anxiety was found to be the major cause of sleep disturbances. While females were found to be significantly more likely to report having experienced poorer sleep before competition in the past year, the sleep diary showed no difference in sleep the night before the races between the sexes. Females were significantly more likely to report instances of unpleasant dreams and waking up during the night. Again, the sleep diary data did not corroborate these findings. Females were also found to report significantly more accounts of nervousness or thoughts about competition as being the cause of sleep problems. There was no difference in sleep loss the night before competition when comparing competition-level groups. The only significant difference was that recreational cyclists were more likely to report sleeping in foreign environments as a cause of sleep disturbances. Despite a large percentage of cyclists experiencing pre-competitive sleep loss, over half (55%) perceived sleep loss to have no impact on their performance. Analysis of pre-sleep behaviour also revealed that the cyclists engaged in several practices that may have a negative effect on subsequent sleep. The vast majority of the cyclists (61%) indicated having no specific strategy to help them sleep the night before competition. Fifteen percent of cyclists reporting using media devices to help them fall asleep, a practice that has been shown to disrupt sleep. In conclusion, most cyclists, regardless of sex and level of competition experience precompetitive sleep loss attributed largely to anxiety but with the perception that this loss in sleep does not negatively impact their performance.

Background-Previous studies have documented a high prevalence of atrial fibrillation (AF) in individuals with obstructive sleep apnea (OSA). Central sleep apnea (CSA) has been associated with AF in patients with heart failure. However, data from prospective cohorts are sparse and few studies have distinguished the associations of obstructive sleep apnea from CSA with AF in population studies. Methods and Results-We assessed the association of obstructive sleep apnea and CSA with incident AF among 2912 individuals without a history of AF in the SHHS (Sleep Heart Health Study), a prospective, community-based study of existing ("parent") cohort studies designed to evaluate the cardiovascular consequences of sleep disordered breathing. Incident AF was documented by 12-lead ECG or assessed by the parent cohort. obstructive sleep apnea was defined by the obstructive apnea-hypopnea index (OAHI). CSA was defined by a central apnea index >= 5 or the presence of Cheyne Stokes Respiration. Logistic regression was used to assess the association between sleep disordered breathing and incident AF. Over a mean of 5.3 years of follow-up, 338 cases of incident AF were observed. CSA was a predictor of incident AF in all adjusted models and was associated with 2-to 3-fold increased odds of developing AF (central apnea index >= 5 odds ratio [OR], 3.00, 1.40-6.44; Cheyne-Stokes respiration OR, 1.83, 0.95-3.54; CSA or Cheyne-Stokes respiration OR, 2.00, 1.16-3.44). In contrast, OAHI was not associated with incident AF (OAHI per 5 unit increase OR, 0.97, 0.91-1.03; OAHI 5 to <15 OR, 0.84, 0.59-1.17; OAHI 15 to <30 OR, 0.93, 0.60-1.45; OAHI >= 30 OR, 0.76, 0.42-1.36). Conclusions-In a prospective, community-based cohort, CSA was associated with incident AF, even after adjustment for cardiovascular risk factors.

Background and Objective: Type 1 diabetes mellitus (T1DM) is one of the most common pediatric chronic illnesses. Youth with T1DM have been shown to be at risk for internalizing problems and obtaining insufficient sleep. An emerging body of literature has demonstrated the feasibility and potential benefit of increasing sleep duration as a strategy to improve psychological outcomes in nondiabetic school age populations. The current study seeks to investigate the relationship between sleep and internalizing symptoms and empirically examine the effect of a sleep extension intervention on internalizing symptoms in youth with T1DM. Methods: The sample consisted of 106 youth with T1DM (mean age = 13.5 ± 2.1 years) who were part of a larger study recruited over a three-year period. Participants were 52.8% male and 50.9% identified as non-white. The primary outcome measure was the Behavior Assessment System for Children, Second Edition (BASC-2), both parent and self-report. Other behavioral and sleep measures included actigraphy, sleep diary, the School Sleep Habits Survey (SSHS), Pediatric Symptoms Checklist (PSC), and the Child Sleep Habits Questionnaire (CSHQ). Participants were randomly assigned to either the Sleep Extension condition (n = 50), in which they were asked to extend their sleep duration, or the Fixed Sleep Duration condition (n = 56), in which they were asked to maintain the same amount of sleep as their baseline. Results: Average sleep durations varied across measures, with all values falling in the lower range or below national recommendations. More than a third (34.5%) of the sample had elevated scores for internalizing problems based on parent report, and 17.7% were elevated based on self-report. Pearson correlations indicated that parent reported sleep duration was negatively related to self-reported anxiety, r(106) = -0.237, p = 0.018, as well as parent-reported depression, r(106) = -0.218, p = 0.028, and emotional self-control, r(106) = -0.232, p = 0.018. No other measure of sleep duration was significantly correlated with internalizing symptoms. Secondary analyses of measures of sleep quality including sleep efficiency (SE), wake after sleep onset (WASO), and sleepiness, were significantly related to internalizing problems based on both parent and self-report (all p < 0.05), whereas more variability in sleep duration (CV) was related to higher self-reported depression, r(106) = 0.210, p = 0.033. Following the sleep intervention, participants in the Sleep Extension condition increased their average sleep duration by 26.71 minutes based on actigraphy, while participants in the Fixed Sleep duration decreased by 0.14 minutes from pre- to post-intervention. Participants in the Sleep Extension condition had significantly lower scores on the BASC-2 Internalizing Problems Composite than participants in the Fixed Sleep Duration condition following the intervention, after controlling for sex and baseline internalizing symptoms, F(1, 98) = 4.18, p = 0.044. On average, the Internalizing Problems Composite score of participants in the Sleep Extension condition decreased by almost half a standard deviation (4.65 ± 6.41 points), compared to a decrease of 2.31 ± 6.59 points for participants in the Fixed Sleep Duration condition. There were no significant effects for self-report. Conclusions: Youth with T1DM obtained insufficient sleep and experienced high rates of internalizing symptoms. The results also suggest that relations between sleep and internalizing symptoms exist; however, these associations may be more driven by other aspects of sleep rather than actual sleep loss, such as nighttime sleep disturbance, daytime sleepiness, and variability of the sleep schedule. The findings further indicated that a sleep extension intervention was effective in increasing sleep duration, as well as reducing parent-reported internalizing symptoms in a sample of children and adolescents with T1DM. This intervention has the potential to be utilized as a cost effective, and relatively easy to implement method for reducing internalizing symptoms in youth with T1DM.