O trabalho é um recurso de integração social que favorece o desenvolvimento pessoal e traz benefícios importantes, mas diante de fortes tensões pode gerar transtornos mentais, somáticos, sociais e estresse. O estresse interfere no desempenho, nas relações sociais e no sono. O equilíbrio entre as atividades diárias de trabalho e o sono é essencial para a saúde mental, merecendo cuidados especiais quando o trabalhador exerce influência na educação de pessoas, como ocorre com o professor. O objetivo desta pesquisa é investigar a presença de sintomas de estresse e a qualidade do sono de professores da rede pública de Poços de Caldas, buscando correlação com o padrão ocupacional. A pesquisa estudou uma população de 165 professores de Poços de Caldas, através do ISS-LIPP, do PSQI-BR e do QFEP, para avaliar o impacto do estresse na saúde do professor e na qualidade do sono. Os dados revelaram que 59% dos professores apresentaram estresse, a maioria na fase de resistência (39%) e com prevalência do estresse psicológico. Além disso, indicaram que 46,7% dos professores são maus dormidores, evidenciando associação entre os sintomas físicos e psicológicos de estresse e o sono. As mulheres, parcela predominante da população estudada (88,5%), apresentaram mais estresse físico que os homens (p=0,015). Este estudo revelou a importância da investigação do estresse e do sono na prevenção de transtornos na saúde mental do professor, e nas do estudo do estresse e do sono para prevenir transtornos na saúde mental do professor e consequências sociais no trabalho e na qualidade de vida / Work is a resource of social integration for it favors both personal development in society and brings about other important benefits, but under intense tensions it may produce mental, somatic and social disruptions as well as stress. Stress interferes in performance, in social relationships and sleep. The balance between work daily activities and sleep is an essential condition for mental health, and as such deserves proper care chiefly when the worker is in charge of children education as it occurs with teachers. The objective of this research is to investigate the relationship between the development of symptoms of stress and the quality of teachers sleep. The population here under scrutiny was the public schools teachers of Poços de Caldas. It was aimed at searching the rates of stress and the latter´s correlation with Brazilian occupational standards. That aim was accomplished in a population of 165 teachers, through the means of ISS-LIPP, PSQI-BR and QFEP, in order to identify and understand the impact of stress in teachers health and the quality of their sleep. The findings revealed that 59% of the teachers are stressed, being the majority at the resistance phase (39%) and a large amount of them under the prevalence of psychological stress. Moreover, they disclosed that 46.7% of the teachers sleep badly, pointing out undeniable association between sleep and both physical and psychological stress. Women, as the prevailing subgroup of the studied population (88.5%), presented more physical stress than men (p=0,015). The conclusion of this study also disclosed the call for further developments in the investigation of teachers stress as a means for the prevention of social disruptions, disturbances in teachers mental health as well as in quality of their lives

Direct current (DC) potential is an objective measure of the functional state of the human organism. It is a sensitive and accurate indicator of short- and long-term adaptations to stress, adaptive capacities, and it is an important marker of athlete readiness. Sleep is posited to be the most efficacious strategy for improving recovery to enhance sport performance, and adequate sleep is considered vital to normal psycho-physiological function. Thus, optimal sleep may enhance the functional state, in turn enhancing an athlete’s adaptability to training stress. However, little is known about the relationship between sleep and DC potential. Therefore, the purpose of this study was to examine the effect of acute (one-night) and extended (two-night) sleep quantity and quality on DC potentials in collegiate American football players. Twenty-four Division 1 American football players (Age: 20.6 ± 1.30 yr; Height: 183.4 ± 6.40 cm; Body mass: 114.40 ± 24.60 kg) wore a wrist-worn actigraphy band seven days per week over the course of 136 days, which spanned the pre-season training camp and competitive season, to measure sleep quantity and quality. DC potential was assessed six days per week using the Omegawave Ltd (Espoo, Finland) athlete monitoring system either 30 minutes upon waking or 75-120 minutes prior to the onset of the football training session. Sleep quantity was stratified into duration categories and sleep quality was stratified within sleep latency, number of awakenings, and sleep efficiency variables. Sleep quantity and quality were evaluated using acute (one night) and extended (rolling average of two consecutive nights) sleep outcomes. Within subject comparisons of DC potential were made across sleep quantity and quality categories using repeated-measures analysis of variance to examine the influence of acute and extended sleep quantity and quality on DC potential outcomes. The level of significance was set at p ≤ 0.025. Statistically significant main effects were identified for acute sleep (F3,16 = 4.68, p < .02, η2p = 0.47) and extended sleep durations (F2,17 = 7.71, p < 0.005, η2p = 0.48). Specifically, for acute sleep durations, there was a 17.1% increase in DC potentials (3.59, p < 0.01, Cohen’s d = 0.52, SE 1.18) for sleep durations ≥ 7 hours to < 9 hours, compared to sleeping < 6. For extended sleep, there was a 20% increase in DC potentials (4.53, p < 0.002, Cohen’s d = 0.68, SE = 1.13) when recording a two-day sleep average of ≥ 7.5 hours and < 9 hours, compared to an extended sleep duration of < 6 hours. A statistically significant main effect was also identified for extended wake episodes (F2,19 = 4.5, p = 0.025, η2p = 0.32). For extended sleep periods with > 4 wake episodes there was a 12% increase in DC potentials (2.57 ± 2.24mV, p < 0.25, Cohen’s d = 0.34) compared to extended sleep periods with 2-3 wake episodes. There was not a significant effect of acute (p ≥ 0.20) sleep quality or extended latency (p > 0.18) and efficiency (p > 0.08) on DC potentials. These findings suggest that sleep quantity affects DC bio-potentials and thus the functional state of the athlete. Specifically, sleep durations between 7.00/7.50 to 9 hours correspond with higher measures of DC potentials compared to lesser durations. Given the effect of sleep quantity on biological markers for training adaptability, practitioners should prioritize sleep in the training process and educate athletes on proper sleep hygiene and sleep quantity to enhance their readiness to train.

Sleep is not a solitary activity for the majority of adults, this impacts sleep quality, health, and well-being. Couples experience sleep concordance, or a synchronization of sleep-wake times, which can improve and diminish sleep quality (Gunn et al., 2015). This study explores the association between sleep concordance and sleep quality by examining attachment style as a moderator. Daily sleep diaries were completed by 179 heterosexual couples. Sleep concordance was calculated by dividing total time partners were in bed together by total time at least one partner was in bed each day. Data were analyzed using a multilevel model described by Bolger and Laurenceau (2013). There was a positive association between daily sleep concordance and sleep quality for men. Women with higher secure attachment style scores reported greater sleep quality, and women with higher insecure attachment style scores reported lower sleep quality. Among women with higher secure attachment style scores and lower avoidant attachment style scores there was a negative association between mean sleep concordance and sleep quality. There was no association between sleep concordance and sleep quality for higher anxious attachment scores. Future research is needed to address causal relationships. Findings indicate men and women may experience sleep concordance differently.

Objetivo: Evaluar si existe asociación entre el Síndrome de Desgaste Profesional (SDP) y la mala calidad de sueño (MCS) en médicos que laboran en Instituciones Prestadoras de Servicios de Salud en el Sistema de Salud Peruano (SSP), controlada por variables demográficas, sociales y laborales. Métodos: Realizamos un análisis secundario de datos del Cuestionario 2 de la Encuesta Nacional de Satisfacción de Usuarios en Salud (ENSUSALUD-2016), la cual contó con un muestreo probabilístico, estratificado, bietápico con representatividad nacional. El SDP lo medimos con la versión validada al español del Maslach Burnout Inventory - Human Services Survey, el cual se compone de tres dominios del SDP: Agotamiento Emocional, despersonalización y la falta de realización personal; categorizados en tres niveles de deterioro: alto, moderado y bajo. La MCS fue medida con la versión validad al español del cuestionario de Jenkins. Estimamos Odds Ratio (OR) con IC 95% mediante modelos lineales generalizados, familia binomial link (logit) para muestras complejas. Resultados: Incluimos 2216 médicos, 69,2% fueron varones y la edad promedio fue 45,5 años y de todos ellos, 14,4%, tuvieron agotamiento emocional alto y 16,9% agotamiento emocional moderado. En el caso de la despersonalización, 416 (16,8%) presentaron niveles altos y 337 (16,2%) tuvieron niveles moderados. Mientras que 243 (12,9%) tuvieron falta de realización personal alta y 571(27,1%) moderada. Por otro lado, 269 (10,9%) tuvieron MCS. Encontramos que un agotamiento emocional moderado (ORa1: 5,6; IC95%: 2,1-15,1) y alto (ORa1: 6,6; IC95%: 4,2-10,3) incrementaron la odds de MCS. Asimismo, un alto deterioro en la despersonalización (ORa1: 3,5; IC 95%: 2,0-6,0) se asoció con MCS. En el caso de falta de realización personal, no encontramos evidencia estadística de asociación. Conclusión: Los niveles moderados y altos de agotamiento emocional, así como los niveles altos de despersonalización se asociaron con MCS en médicos que laboran en el SSP. Nuestros hallazgos pueden orientar la toma de decisiones a nivel de recursos humanos en salud. / Objective: To evaluate the association between Burnout Syndrome (BS) and poor sleep quality (PSQ) in physicians working in the Peruvian Health System (PHS) controlled by demographic, social and working variables. Methods: We carried out a secondary analysis of data from questionnaire 2 of the National Survey of Health User Satisfaction (ENSUSALUD-2016), which has a probabilistic, stratified, two-stage sampling with national representativeness. We measured the BS with the validated version in Spanish of Maslach Burnout Inventory - Human Services Survey, which measured three domains of BS: Emotional Exhaustion, depersonalization and the lack of personal achievement; categorized into three deterioration levels: low, moderate and high. The PSQ was measured with the Spanish version of the Jenkins questionnaire. We performed generalized lineal models binomial family link (logit) for complex sampling to estimate Odds Ratio (OR) with 95% CI. Results: We included 2216 doctors, 69.2% were males, and the average age was 45.5 years. Of all of them, 14.4% had high levels of emotional exhaustion. In depersonalization domain, 16.8% had high levels. While 12.9% had high levels of lack of personal achievement. Proportion of doctors with was PSQ was 10.9%. We observed that moderate (ORa1: 5.6, 95% CI: 2.1-15.1) and high (ORa1: 6.6, 95% CI: 4.2-10.3) levels of emotional exhaustion increased the odds of PSQ. Likewise, a high level of depersonalization (ORa1: 3.5, 95% CI: 2.0-6.0) was associated with PSQ. In the case of lack of personal achievement, we did not found statistical evidence of association. Conclusion: Moderate and high levels of emotional exhaustion and high levels of depersonalization were associated with PSQ in doctors working in the PHS. This primary evidence can guide decision-making at the level of human resources in health. / Tesis

Age-related macular degeneration (AMD) is a chronic, irreversible disease that robs individuals of vision, quality of life, and independence. It is the leading cause of blindness in industrialized countries. Sleep-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and/or hypopnea, insomnia, short sleep duration, and/or sleep disturbances (snoring, gasping, etc.). Because SDB has been shown to cause chronic hypoxia resulting in oxidative stress on the retina, it has been proposed that SDB may be associated with AMD. Based on the life course theory of chronic disease, this quantitative, cross-sectional study used data from the 2005-2008 National Health and Nutrition Examination Survey to study whether there was an association between SDB and AMD, including neovascular AMD and geographic atrophy in adults 40 years and older. Descriptive statistics and logistic regression analyses were used. The results suggest that AMD is associated with diagnosed sleep disorders, including sleep apnea and insomnia, as well as sleep apnea symptoms of gasping snoring, snorting, and stopping breathing. The findings of this study highlight the importance of diagnostic screening and therapeutic intervention to treat SDB. Early diagnosis and therapy for SDB could address not only the comorbidities associated with SDB, but could also prevent or slow the progression of AMD. In turn, this would yield lower rates of vision loss, reduced comorbidities associated with vision loss, and reduced impact of AMD on the health care system and social and financial costs to society.

Background. Obstructive Sleep Apnoea (OSA) is associated with an increase in nocturnal gastro-oesophageal reflux (nocturnalGOR) events and symptoms, however the mechanism for this remains undefined. Treatment of OSA with continuous positive airway pressure (CPAP) has been shown to reduce nocturnalGOR in individuals with OSA however the reasons for this reduction are not clear. The combination of OSA and nocturnalGOR could be particularly problematic for individuals who have had a lung transplant in whom Bronchiolitis Obliterans Syndrome (BOS) limits survival. It is thought that GOR plays a role in the development of BOS in these individuals. Methods and Results. Five interrelated studies were undertaken. The first two studies sought to determine and compare the prevalence and risk factors of nocturnalGOR in OSA patients with the general population. To do this, a GOR questionnaire was completed by 2,042 members of the general community as part of the Busselton Health Survey and by 1,116 patients with polysomnography-diagnosed OSA. Risk of OSA in the general population was determined using a standardised sleep questionnaire. 137 of the OSA patients completed the questionnaire before and after treatment with CPAP. The prevalence of nocturnalGOR symptoms reported more than once a week (frequent symptoms) was greater in OSA patients (10.1%) than the general population (5.8%) (p<0.001), in individuals from the general population at high (11.2%) than low risk of OSA (4.5%) (p<0.001) and in patients with severe (14.7%) than mild OSA (5.2%) (p<0.001). Treatment of OSA with CPAP decreased the prevalence of frequent nocturnalGOR from 9.0% to 3.8% (p=0.04). In the general population, high risk of OSA was independently associated with a 2.4-fold increased risk of frequent ABSTRACT vi nocturnalGOR symptoms than low risk. In the OSA group, disease severity was independently associated with nocturnalGOR symptoms, with an adjusted odds ratio of 1.7 for frequent nocturnalGOR symptoms.

Obstructive Sleep Apnoea (OSA) is a disease characterised by repetitive upper airway obstructions which are manifest by desaturation and arousal from sleep. It has been known for many years that this interruption to the normal architecture of sleep may present to the clinician as excessive daytime somnolence often with a complaint of difficulties with concentration and short term memory. Previous work had demonstrated a relationship between variables of cognitive dysfunction in patients with obstructive sleep apnoea, however, little was known about which components of the syndrome contributed to this outcome and whether specific clinical thresholds of sleep disordered breathing could be defined for the development of cognitive dysfunction. In the context of this body of work cognitive dysfunction is defined as: a level of cognitive performance below normal derived values for a given cognitive test, when the subjects performance is controlled for age, sex and level of education.

"March 2004" / Bibliography: leaves 168-172. / 365 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D.)--University of Adelaide, Dept. of General Practice, 2004

Sleep disruption has been implicated in morbidity after major surgery since 1974. Sleep-related upper airway obstruction has been associated with death after upper airway surgery and profound episodic hypoxaemia in the early postoperative period. There is also evidence for a rebound in rapid eye movement (REM) sleep that might be contributing to an increase in episodic sleep-related hypoxaemic events later in the first postoperative week. Speculation regarding the role of REM sleep rebound in the generation of late postoperative morbidity and mortality has evolved into dogma without any direct evidence to support it. The research presented in this thesis involved two main areas: a search for evidence of a clinically important contribution of REM sleep rebound to postoperative morbidity, and a re-examination of the role of sleep in the causation of postoperative episodic hypoxaemic events. To assess the latter, a relationship between airway obstruction under anaesthesia and the severity of sleep-disordered breathing was sought. In 148 consecutive sleep clinic patients, 49% of those with sleep-disordered breathing (SDB) had a number of events in non-rapid eye movement sleep (NREM) that was greater than or equal to that in REM and 51% had saturation nadirs in NREM that were equal to or worse than their nadirs in REM. This suggests SDB is not a REM-predominant phenomenon for most patients. Of 1338 postoperative deaths occurring over 6.5 years in one hospital only 37 were unexpected, most of which were one or two days after surgery with no circadian variation in the time of death, casting further doubt on the potential role of REM rebound. Five of nine subjects studied preoperatively had moderately severe SDB. Unrecognised and significant SDB is common in middle-aged and elderly patients presenting for surgery suggesting overall perioperative risk of important adverse events from SDB is probably small. In 17 postoperative patients, sleep macro-architecture was variably altered with decreases in REM and slow wave sleep while stage 1 sleep and a state of pre-sleep onset drowsiness, both associated with marked ventilatory instability, were increased. Sleep micro-architecture was also changed with an increase in power in the alpha-beta electroencephalogram range. These micro-architectural changes result in ambiguity in the staging of postoperative sleep that may have affected the findings of this and other studies. Twenty-four subjects with airway management difficulty under anaesthesia were all found to have some degree of SDB. Those with the most obstruction-prone airways while anaesthetised had a very high incidence of severe SDB. Such patients warrant referral to a sleep clinic.

<p><em>Vårt syfte med denna studie var att göra en psykometrisk utvärdering av frågeformulären PSAS-C (Pre sleep arousal scale) och APSQ (Anxiety and preoccupation about sleep questionnaire). Teoretiska modeller har kommit fram till att kognitiv uppvarvning och förvrängd subjektiv perception av sömn skapar oro som kan bidra till utveckling av insomni. För att fånga upp oro vid insomni används idag två frågeformulär, PSAS-C och APSQ. Deltagare från en svensk longitudinell studie (n = 2333) ombads att svara på de två formulären. Båda skalorna visade på en god begreppsvaliditet och intern samstämmighet.</em><strong> </strong><em>Faktoranalyser, korrelationer och jämförelser av medelvärden visar att båda frågeformulären har goda psykometriska egenskaper och kan vara till stor nytta som mätinstrument för att fånga upp oro vid insomni.</em></p>