Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2018-12-04T18:22:09Z No. of bitstreams: 1 CAMILA_DOS_SANTOS_EL_HALAL.pdf: 6036562 bytes, checksum: 43db97c52dcd3d105fd3916ba1d0f0cd (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-12-06T10:22:40Z (GMT) No. of bitstreams: 1 CAMILA_DOS_SANTOS_EL_HALAL.pdf: 6036562 bytes, checksum: 43db97c52dcd3d105fd3916ba1d0f0cd (MD5) / Made available in DSpace on 2018-12-06T10:35:35Z (GMT). No. of bitstreams: 1 CAMILA_DOS_SANTOS_EL_HALAL.pdf: 6036562 bytes, checksum: 43db97c52dcd3d105fd3916ba1d0f0cd (MD5) Previous issue date: 2018-08-17 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The period extending from pregnancy to the months following delivery, although usually associated to positive feelings, represents a moment of great vulnerability to the development of major depressive disorders. Perinatal depression is a frequent pathology, and its consequences extend beyond the mother, potentially affecting the relationship with her partner and family functioning. Early exposure to maternal depression is associated to lower breastfeeding rates, impairment of mother-infant bonding, and consequences over child growth and development. Perinatal depression has been linked to infant sleep disturbances as early as in the neonatal period, with description of more night wakings, shorter sleep duration and more fragmented sleep. Sleep plays a fundamental role in child cognitive, social, and emotional development, and its disturbances, in a crucial moment of brain development, may facilitate significant and persistent dysfunctions. Studies associating maternal depression to child sleep disturbances show important heterogeneity in terms of design as in moment of sleep assessment. Sleep patterns go through important changes throughout the first twelve months of life, rendering impaired the association?s precise evaluation, as well as that of its potential long-term consequences. This study aimed to investigate the association between perinatal depression and altered infant sleep macrostructure at one year of life among participants in a birth cohort. In this population-based study, recruitment was carried out from pregnancy to soon after delivery, aiming to include all livebirths in the municipality of Pelotas throughout the year of 2015. Participants to one or both cohort-nested trials and those lacking information on maternal depression were excluded from these analyses. For the diagnosis of perinatal depression, the Edinburgh Postnatal Depression Scale (EPDS) was completed during pregnancy and 3 months after delivery, having been considered perinatally depressed mothers who scored ?13 points in one or both follow-ups. Infant sleep was assessed at 3 months through the Brief Infant Sleep Questionnaire (BISQ) and, at 12 months, through the same subjective questionnaire added to objective data derived from continuous 24-hour actigraphy. Main sleep outcomes were number of night time wakings, night vigil time and total sleep duration in 24 hours. The sample consisted of 2222 mothers/infants, in which prevalence of perinatal depression was of 22.3% (CI 95% 20.5-24). Adjusted analyses using Poisson?s regression from BISQ-derived data showed greater risk of >3 night time wakings at 12 months among infants of depressed mothers (RR 1.52; CI 95% 1.06-2.18; p=0.02). Actigraphic data did not, however, confirm those findings (adjusted RR=1.24; CI 95% 0.85-1.81; p=0.26). No association was found between perinatal depression and the other investigated sleep variables. This study suggests a potential defining role of dysfunctional cognition among mothers with a history of perinatal depression on infant sleep characteristics at the end of the first year of life. / O per?odo que se estende da gesta??o at? os meses seguintes ao parto, apesar de normalmente associado a sentimentos positivos, representa um momento de grande vulnerabilidade ao desenvolvimento de quadros depressivos maiores. A depress?o perinatal ? um dist?rbio frequente, cujas consequ?ncias se estendem para al?m da mulher acometida, potencialmente exercendo efeito sobre a rela??o com o parceiro e o funcionamento familiar. Exposi??o precoce a depress?o materna associa-se a menores taxas de amamenta??o, preju?zo do v?nculo com o beb?, e consequentes efeitos sobre o crescimento e desenvolvimento infantis. Evid?ncias associam a depress?o perinatal a dist?rbios do sono da crian?a desde o per?odo neonatal, sob a forma de maior n?mero de despertares noturnos, menor dura??o de sono e maior fragmenta??o. O sono, por sua vez, exerce papel primordial no desenvolvimento cognitivo, social e emocional da crian?a, e seus dist?rbios, em um per?odo crucial do desenvolvimento cerebral, podem favorecer disfun??es significativas e permanentes. Existe uma importante heterogeneidade em rela??o tanto ao delineamento dos estudos que associam depress?o materna a dist?rbios do sono na crian?a, quanto ao momento de avalia??o do sono, que sofre mudan?as significativas no decorrer dos primeiros doze meses de vida. Com isso, a avalia??o dessa poss?vel associa??o fica prejudicada, assim como a mensura??o de suas consequ?ncias a longo prazo. Este estudo objetivou investigar a presen?a de associa??o entre depress?o perinatal e altera??es da macroarquitetura do sono de lactentes com um ano de vida, participantes de uma coorte de nascimentos. Neste estudo de base populacional, o recrutamento ocorreu desde a gesta??o at? logo ap?s o parto, visando incluir todos os nascidos vivos na cidade de Pelotas no transcorrer de 2015. Participantes de uma das interven??es aninhadas ? coorte e aqueles sem informa??es referentes ? depress?o materna foram exclu?dos desta an?lise. Para diagn?stico de depress?o perinatal, foi aplicada a Escala de Depress?o P?s-natal de Edimburgo (EPDS) na gesta??o e 3 meses ap?s o parto, tendo sido consideradas deprimidas as m?es com pontua??o ?13 em um ou ambos os acompanhamentos. O sono dos lactentes foi avaliado aos 3 meses atrav?s do Brief Infant Sleep Questionnaire (BISQ) e, aos 12 meses, a partir dos mesmos dados subjetivos somados a informa??es objetivas obtidas a partir de 24 horas cont?nuas de actigrafia. Os principais desfechos de sono analisados foram o n?mero de despertares noturnos, dura??o da vig?lia noturna, e tempo total de sono em 24 horas. A amostra constituiu-se de 2.222 m?es e lactentes, na qual a preval?ncia de depress?o perinatal foi de 22,3% (IC95% 20,5-24). Pelo BISQ, as an?lises ajustadas atrav?s de regress?o de Poisson mostraram maior risco para >3 despertares noturnos aos 12 meses entre filhos de m?es deprimidas (RR 1,52; IC95% 1,06-2,18; p=0,02). No entanto, a avalia??o dos dados actigr?ficos n?o confirmou este achado (RR ajustado=1,24; IC95% 0,85-1,81; p=0,26). N?o houve associa??o entre depress?o perinatal e as demais vari?veis do sono. Este estudo sugere um potencial papel definidor da impress?o disfuncional entre m?es com hist?ria de depress?o perinatal sobre as caracter?sticas do sono dos lactentes ao final do primeiro ano de vida.

Made available in DSpace on 2016-04-04T18:28:16Z (GMT). No. of bitstreams: 1 Micheli Aparecida Gomes dos Santos.pdf: 4751573 bytes, checksum: 7ca8f16261c512805eef4512cc814ae4 (MD5) Previous issue date: 2014-02-18 / Pontif?cia Universidade Cat?lica de Campinas / The aim of this study was to evaluate and compare the level of stress and anxiety in a sample of patients with obstructive sleep apnea syndrome (OSAS) before and after a month of medical or surgical treatment. To collect the data were used the ISSL - Inventory of Stress Symptoms for Adults Lipp, the Beck Anxiety Scale (BAI), answered twice, once before the start of treatment and another, one month after the start of the treatment, and a sociodemographic questionnaire. The sample consisted of 18 patients, 13 men and 5 women, aged between 26 and 74 years (Mean=51,83, SD=13,46). The assessment showed that 77,8% (n=14) of patients had stress on the first evaluation, and such amount was reduced to 16,7% (n=3) in the second evaluation after treatment. Thus, patients showed a significant decrease in mean stress symptoms after treatment (z=-3,53, p<0,000). In relation to anxiety , 44,4% of participants had a minimum degree of anxiety symptoms at the first assessment, although were present mild, moderate and severe degrees. In the second assessment serious cases disappear and there was a significant decrease in moderate cases. Patients showed a significant decrease in mean anxiety symptoms of post-treatment (z=-3,51, p<0,000). Patients with moderate apnea showed a significant decrease in mean stress (z=-2,971, p<0,003) and anxiety symptoms (z=-2,032, p<0,042) of post-treatment. The same occurred in relation to stress (z=-2,023, p<0,043) and anxiety (z=-2,944, p<0,003) in patients with severe apnea. Furthermore, women showed no significant improvement in the symptoms of post-treatment in stress (z=-1,633; p=0,102) and anxiety (z=-1,625; p=0,104) symptoms, while men had reduced the symptoms of stress (z=-3,184; p=0,001) and anxiety (z=-3,062; p=0,001). The research of the type of treatment showed significant improvement in stress (z=- 3,21, p=0,001) and anxiety symptoms (z= -3,17, p=0,001) in patients who were treated with CPAP . Already in the surgical group, no significant differences in any of the constructs assessed were noted. Thus it was possible to see that the patients showed significant improvement in symptoms of stress and anxiety in the second evaluation, in order to be able to say to this group of individuals, that treatment had the desired effect, being effective in improving symptoms of stress and anxiety for the general sample for the two levels (moderate and severe) illness, for males and for patients who were treated with CPAP. / O objetivo deste estudo foi avaliar e comparar o n?vel de stress e de ansiedade em uma amostra de portadores da S?ndrome da Apneia Obstrutiva do Sono (SAOS), antes e ap?s um m?s de tratamento cl?nico ou cir?rgico. Para a coleta dos dados foram utilizados o ISSL -Invent?rio de Sintomas de Stress para Adultos de Lipp, a Escala de Ansiedade de Beck (BAI), respondidos duas vezes, uma antes do in?cio do tratamento e outra, um m?s ap?s o in?cio do mesmo, al?m de um question?rio sociodemogr?fico. A amostra foi composta por 18 pacientes, sendo 13 homens e 5 mulheres, com idade entre 26 e 74 anos (M?dia=51,83; DP=13,46). A avalia??o demonstrou que 77,8% (n=14) dos pacientes apresentavam stress na primeira avalia??o, sendo que tal valor foi reduzido para 16,7% (n=3) na segunda avalia??o, ap?s tratamento. Assim, pacientes apresentaram uma diminui??o significativa na m?dia de sintomas de stress p?s-tratamento (z=-3,53, p<0,000). Em rela??o ? ansiedade, 44,4% dos participantes apresentavam grau m?nimo de sintomas de ansiedade na primeira avalia??o, embora se fizessem presentes graus leve, moderado e grave. Na segunda avalia??o os casos graves desaparecem e houve uma importante diminui??o nos casos moderados. Os pacientes apresentaram uma diminui??o significativa na m?dia de sintomas de ansiedade p?s-tratamento (z=-3,51, p<0,000). Pacientes com SAOS moderada apresentaram uma diminui??o significativa na m?dia de sintomas de stress (z=-2,971, p<0,003) e sintomas de ansiedade (z=-2,032, p<0,042) p?s-tratamento. O mesmo ocorreu em rela??o em rela??o ao stress (z=-2,023, p<0,043) e ansiedade (z=-2,944, p<0,003) dos pacientes com SAOS grave. Por outro lado, mulheres n?o apresentaram melhora significativa nos sintomas de stress p?s-tratamento (z=-1,633; p=0,102) e nem na ansiedade (z=-1,625; p=0,104), ao passo que os homens obtiveram diminui??o dos sintomas de stress (z=-3,184; p=0,001) e ansiedade (z=-3,062; p=0,001). A investiga??o do tipo de tratamento indicou melhora significativa nos sintomas de stress (z=-3,21, p=0,001) e ansiedade (z= -3,17, p=0,001) nos pacientes que fizeram tratamento com CPAP. J? no grupo cir?rgico n?o foram notadas diferen?as significativas em nenhum dos construtos avaliados. Desse modo foi poss?vel visualizar que os pacientes demonstraram melhora significativa nos sintomas de stress e ansiedade na segunda avalia??o, de modo a se poder afirmar, para esse grupo de indiv?duos, que o tratamento teve o efeito desejado, sendo eficaz na melhora dos sintomas de stress e ansiedade para a amostra geral, para os dois n?veis da doen?a (moderada e grave), para o sexo masculino e para os pacientes que fizeram tratamento com CPAP.

Made available in DSpace on 2014-12-17T15:16:04Z (GMT). No. of bitstreams: 1 RafaelaP.pdf: 554087 bytes, checksum: 7d7c8a0a2087e44b60ffd98a4157a3cb (MD5) Previous issue date: 2009-03-31 / The restriction of physical fitness is directly related with hypertension and sleep disorders, while the respiratory muscle strength is associated with hypertension, but the literature is scarce regarding its relationship with sleep disorders and particularly with excessive daytime sleepiness. Objectives: To compare physical fitness and strength of respiratory muscles between people with hypertension with excessive daytime sleepiness (EDS) and non EDS people, those who do not feel excessive daytime sleepiness, in addition to relate aerobics resistance and functional mobility of patients. Methods: An observational, analytical and transversal study, evaluated 32 elderly with hypertension, divided into two groups (EDS and non EDS), in which the following topics were measured; respiratory muscular strength, functional fitness, level of physical activity, level of excessive daytime sleepiness, quality of sleep and intensity of the patients snoring. Results: There was a significant difference in the level of EDS (P=0,00) and quality of sleep (p=0,03), however, the data related to snoring intensity (p=0,18), maximum inspiratory pressure PImax (p=0,39) and maximum expiratory pressure PEmax (p=0,98) did not show any difference. Also, no significant difference was observed concerning physical fitness, presenting p=0,08 for the sitting and getting up test on the chair in 30 ; p=0,54 for the extension and flexing of the elbow test in 30 ; p=0,38 for the walking test 6 ; p=0,38 for the parking gear test 2 , p=0,08 for the sitting and reaching test; p=0,42 for the scratching the back test; p=0,49 for the getting up and walking test; and p=0,62 for the global rate of activity limitation. There was moderate positive correlation between 6MWT and 2MST, r=0,54 (p=0,01) and negative moderate correlation between 6MWT and TUG, r=-0,61 (p=0,000) and between 2MST and TUG, r=-0,60 (p=0,000). Conclusion: The presence of EDS in the hypertension people studied, showed a bad quality of sleep, however this sleepiness did not influence the strength of the respiratory muscles. The physical fitness came out diminished in all hypertension people, regardless of the presence or non presence of sleep disturbance; and there is a close relationship between cardiovascular resistance and physical mobility, since when there is less cardiovascular resistance, there is precarious physical mobility and vice-versa / A limita??o na capacidade funcional relaciona-se diretamente com a hipertens?o e com os dist?rbios do sono, j? a for?a dos m?sculos respirat?rios est? associada com a hipertens?o, mas a literatura ? escassa quanto sua rela??o com os dist?rbios do sono e, principalmente, com a sonol?ncia diurna excessiva. Objetivos: Comparar capacidade funcional e for?a dos m?sculos respirat?rios entre hipertensas com sonol?ncia diurna excessiva (SDE) e hipertensas sem SDE, al?m de relacionar resist?ncia aer?bica e mobilidade funcional das pacientes. M?todos: Estudo observacional, anal?tico e transversal, avaliou 32 idosas hipertensas, divididas em dois grupos (com SDE e sem SDE), nos quais foram mensurados for?a muscular respirat?ria, capacidade funcional, n?vel de atividade f?sica, grau de sonol?ncia diurna excessiva, qualidade do sono e intensidade do ronco. Resultados: Houve diferen?a significativa no grau de SDE (p=0,00) e qualidade do sono (p=0,03), por?m os dados relativos ? intensidade do ronco (p=0,18), press?o inspirat?ria m?xima - PIm?x (p=0,39), e press?o expirat?ria m?xima - PEm?x (p=0,98) n?o apresentaram diferen?as significativas. Tamb?m n?o foi observada diferen?a significativa quanto ? capacidade funcional, apresentando p=0,08 para o teste sentar e levantar da cadeira em 30 ; p=0,54 para o teste extens?o e flex?o do cotovelo em 30 ; p=0,38 para o teste da caminhada de 6 (TC6 ); p=0,38 para o teste da marcha estacion?ria dos 2 (TME2 ); p=0,08 para o teste sentar e alcan?ar; p=0,42 para o teste co?ar as costas; p=0,49 para o teste levantar e caminhar (TUG); e p=0,62 para o ?ndice global de limita??o das atividades. Houve correla??o positiva moderada entre TC6 e TME2 , r=0,36 (p=0,04) e correla??o negativa moderada entre TC6 e TUG, r=-0,59 (p=0,000) e entre TME2 e TUG, r=-0,66 (p=0,000). Conclus?o: A presen?a de SDE, nas hipertensas estudadas, demonstrou uma qualidade de sono ruim, entretanto essa sonol?ncia n?o influenciou a for?a dos m?sculos respirat?rios. A capacidade funcional apresentou-se diminu?da em todas as hipertensas, independentemente da presen?a ou n?o de dist?rbios do sono; e, foi ainda demonstrada a rela??o entre resist?ncia cardiovascular e mobilidade funcional, de modo que havendo menor resist?ncia cardiovascular, h? mobilidade funcional prec?ria e vice-versa

Made available in DSpace on 2014-12-17T15:36:54Z (GMT). No. of bitstreams: 1 PatriciaCR.pdf: 428870 bytes, checksum: 48df95894e05ff05b5a20f8974a6b856 (MD5) Previous issue date: 2008-12-12 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Brain injury can be associated with changes in the sleep-wake cycle. However, studies about sleep disturbances and their relationship with quality of sleep are scarce. Besides, it remains to be known how stroke affects the mechanisms of sleep. The aim of this study was to investigate quality of sleep, complaints of sleep disturbances and associated factors in stroke patients from the Physical Therapy services in Natal -RN. This was a cross-sectional descriptive study involving 70 individuals (aged 45-65 years), 40 patients (57 ? 7 years), 11 ? 9 months after injury, and 30 healthy individua ls (52 ? 6 years), evaluated with the Pittsburgh Sleep Quality Index (PSQI) and Sleep Habits Questionnaire. The data were analyzed by Chi-square test, t Student test and logistic regression. Poor quality sleep was found in 57,5% of the patients (6,3 ? 3,5) and was significantly higher than in the control population (3,9 ? 2,2) (t Student test, p=0,002). The patients showed significantly higher value of PSQI than controls: sleep latency (p=0,019), length of sleep (p=0,039) and dysfunction during the day (p=0,001). Regarding complaints of sleep disturbances (dyssomnias and parasomnias) analyzed by Chi-square test, the complaint of insomnia was the most prevalent (patients: 37,5%; healthy subjects: 6,7%; p=0,007). Regression analysis showed that sl eep latency (p=0,036) and complaint of insomnia (p=0,036) were associated with quality sleep. In addition, female gender (p=0,036) and complaint of broken sleep (p=0,003) were considered risk factors for the presence of insomnia. Our results show that stroke affects the homeostatic process of sleep. Shorter sleep latency and the absence of insomnia are considered protective factors for good sleep quality and this should be taken into consideration in the diagnostic and therapeutic strategies / A les?o cerebral pode estar associada a altera??es do ciclo sono-vig?lia. No entanto, estudos sobre dist?rbios do sono e suas rela??es com a qualidade de sono s?o raros. Al?m disso, ainda precisa ser conhecido como o Acidente Vascular Cerebral (AVC) afeta os mecanismos do sono. O objetivo deste estudo foi investigar a qualidade de sono, as queixas de dist?rbios do sono e os fatores associados nos pacientes com AVC de servi?os de Fisioterapia em Natal-RN. Este foi um estudo transversal e volvendo 70 indiv?duos (idade 45-65 anos) , 40 pacientes (57 ? 7 anos), 11 ? 9 meses ap?s a les?o, e 30 saud?veis (52 ? 6 anos), avaliados com o ?ndice de Qualidade de sono de Pittsburgh (IQSP) e o Question?rio de H?bitos do Sono. Os dados foram analisados atrav?s dos testes Qui-quadrado, t Student e da Regress?o Log?stica. Qualidade de sono ruim foi encontrada em 57,5% dos pacientes (6,3 ? 3,5) e foi significativamente maior do que na popula??o controle (3,9 ? 2,2) (teste t Student, p=0,002). Os pacientes apresentaram valor significativamente maior de IQSP do que os controles: lat?ncia para o sono ( p=0,019), dura??o do sono (p=0,039) e disfun??o durante o dia (p=0,001). Com rela??o ?s queixas de dist?rbios de sono (dissonias e parassonias) analisadas pelo Qui-quadrado, a queixa de ins?nia foi a mais prevalente (pacientes: 37,5%; saud?veis: 6,7%; p=0,007). A an?lise de regress?o mostrou que a lat?ncia para o sono (p=0,036) e a queixa de ins?nia (p=0,036) estiveram associadas com qualidade de sono. Al?m disso, o sexo feminino (p=0,036) e a queixa de sono fragmentado (p=0,003) foram considerados fatores de risco para a presen?a de ins?nia. Nossos resultados mostram que o AVC afeta o processo homeost?tico do sono. A menor lat?ncia para o sono e a aus?ncia de ins?nia s?o consideradas fatores de prote??o para a boa qualidade de sono e isso deve ser levado em considera??o nas estrat?gias diagn?stica e terap?utica.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-02-21T21:56:14Z No. of bitstreams: 1 JohnnatasMikaelLopes_TESE.pdf: 2253087 bytes, checksum: 8ea5a4600233d33c90a661541ca7dba5 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-02-23T21:44:08Z (GMT) No. of bitstreams: 1 JohnnatasMikaelLopes_TESE.pdf: 2253087 bytes, checksum: 8ea5a4600233d33c90a661541ca7dba5 (MD5) / Made available in DSpace on 2018-02-23T21:44:08Z (GMT). No. of bitstreams: 1 JohnnatasMikaelLopes_TESE.pdf: 2253087 bytes, checksum: 8ea5a4600233d33c90a661541ca7dba5 (MD5) Previous issue date: 2017-07-27 / Os dist?rbios do sono s?o caracterizados por altera??es no ciclo sono-vig?lia. Os estudos relativos ?s condi??es do sono e suas repercuss?es na popula??o brasileira s?o em sua grande maioria de contexto cl?nico, reduzindo a representatividade dos achados. O objetivo do estudo foi identificar fatores biol?gicos/sa?de, comportamentais e sociais associados com as queixas de redu??o da fun??o reparadora do sono (FRS), ins?nia e sonol?ncia excessiva diurna (SED) na popula??o brasileira assim como os efeitos destas queixas na ocorr?ncia de morte e eventos cardio-cerebrovasculares em idosos. O estudo foi desenvolvido em dois delineamentos. O primeiro foi uma an?lise de dados transversais oriundos da Pesquisa Nacional de Sa?de de 2013. Neste delineamento visava-se estimar a ocorr?ncia da redu??o da FRS, queixas de ins?nia e sonol?ncia excessiva e suas associa??es. O segundo desenho trata-se de uma coorte prospectiva de idosos comunit?rios com linha base em 2009, dividida em grupo de expostos ?s queixas de ins?nia e sonol?ncia e n?o expostos, para estimar seus efeitos sobre a mortalidade e eventos cardiovasculares, em oito anos de seguimento. As an?lises dos dados transversais ocorreram atrav?s de modelagem de Cox com a inclus?o dos pesos amostrais no c?lculo das estimativas e para os dados prospectivos aplicou-se modelagem de Poisson. Adotou-se um ??0,05. O estudo foi submetido ao Comit? de ?tica em Pesquisa do Hospital Onofre Lopes, recebendo o parecer 2.048.708. Os resultados do primeiro estudo indicam que aproximadamente 28,2% (IC95%:27,4%-29,0%) dos adultos e 34,1% (IC95%:32,6%-35,7%) em idosos relatam queixas de ins?nia e sonol?ncia. A FRS estava reduzida em 34,1% (IC95%:32,6%-35,7%) em adultos e 29,2% (IC95%:27,2%-30,6%) nos idosos. As queixas de ins?nia/SED foram relatadas em 28,2% (IC95%: 27,4%-29,0%) nos adultos e 34,1% (32,6%-35,7%) no idosos. Nos adultos, a redu??o da FRS associa-se com as mulheres (RPaj1=1,12; IC95%: 1,05-1,20/ RPajus2=1,22; IC95%:1,09-1,37), baixos estratos sociais DE (RPaj1=1,21;1,07-1,35, RPaj2=1,42;1,18-1,71) e C (RPaj1=1,30;1,12-1,50), sintomas depressivos (RPaj1=3,22;2,94-3,52/RPaj=3,29;2,83-3,83), oscila??o comportamental (RPaj1=1,51;1,41-1,63/ RPaj2=1,66;1,46-1,89), m? percep??o de sa?de geral (RPaj=1,32;1,20-1,38/ RPaj2=2,30;1,92-2,75), m? percep??o de sa?de bucal (RPaj=1,11;1,04-1,19), ter condi??o cr?nica de sa?de (RPaj1=1,23;1,15-1,31/ RPaj2=1,42;1,26-1,61), ter queixas de ins?nia/SED (RPaj1=2,47;2,28-2,67/ RPaj2=3,03;2,66-3,47), possuir atividade laboral (RPaj1=1,32;1,23-1,42/ RPaj2=1,27;1,13-1,44)e morar em zona urbana (RPaj2=1,31;1,10-1,55). Baixo peso (RPaj1=0,82;0,69-0,98), estilo de vida saud?vel (RPaj1=0,91;0,83-0,99/ RPaj2=0,74;0,64-0,87) e reduzido apoio social (RPaj1=0,88;0,80-0,96) s?o inversamente associados a redu??o da FRS em adultos. Em idosos, a redu??o da FRS associa-se com a ra?a/cor branca (RPaj2=1,18;1,01-1,39), dificuldade em atividades di?rias (RPaj1=1,13;1,01-1,27/ RPaj2=1,36;1,12-1,65), usar computador/internet (RPaj1=1,14;1,01-1,30) e, assim como nos adultos, sintomas depressivos (RPaj1=3,37;2,87-3,97/ RPaj2=3,77;2,88-4,96), oscila??o comportamental (RPaj1=1,75;1,53-1,99/ RPaj2=1,81;1,46-2,24), m? percep??o de sa?de geral (RPaj1=1,50;1,23-1,82/ RPaj2=3,12;2,31-4,21), regular percep??o de sa?de bucal (RPaj=1,21;1,08-1,37), ter condi??o cr?nica de sa?de (RPaj2=1,58;1,11-2,40), ter queixas de ins?nia/SED (RPaj1=2,45;2,14-2,79/ RPaj2=3,46;2,77-4,33), ter apoio social (RPaj1=1,14;1,01-1,30) e morar em zona urbana (RPaj2=1,32;1,02-1,72). O delineamento prospectivo revelou 40 (25,97%:19,04-32,89) mortes no per?odo e 48 (30,76%:23,52-38,01) eventos cardio-cerebrovasculares. Os homens apresentaram maior risco (RR=1,88; 1,01-3,50) de morte. A depress?o (RR=2,04;1,06-3,89), gravidade da ins?nia (RR=2,39;1,52-4,56) e lat?ncia do sono entre 16-30 minutos (RR=3,54;1,26-9,94) e 31-60 minutos (RR=2,23;1,12-4,47) aumentam o risco de morte independentemente em idosos comunit?rios. Os eventos cardio-cerebrovasculares foram preditos apenas por idosos hipertensos e/ou diab?ticos (RR=8,30;1,98-34,82). As queixas de redu??o da FRS, ins?nia e sonol?ncia atingem quase um ter?o da popula??o brasileira e est? intimamente relacionada ?s condi??es emocionais, cronicidade e urbaniza??o. As queixas de gravidade da ins?nia e a dificuldade de iniciar o sono parecem aumentar a mortalidade em idosos, juntamente com sintomas depressivos. / Sleep disturbances are characterized by changes in the sleep-wake cycle. Studies on sleep conditions and their repercussions on the Brazilian population are mostly in the clinical context, reducing the impact of the findings. The aim was to identify biological/health, behavioral and social factors associated with complaints of reduction of sleep repair function (SRF), insomnia and excessive daytime sleepiness (EDS) in the Brazilian population, as well as the effects of these complaints on the occurrence of death and cardio-cerebrovascular events in the elderly. The study was developed in two designs. The first was an analysis of cross-sectional data from the National Health Survey of 2013. This study aimed to estimate the occurrence of reduced SRF, complaints of insomnia and excessive sleepiness and their associations. The second design is a prospective cohort of community-based older adults in 2009, divided into a group of exposed to insomnia and EDS and unexposed complaints, to estimate their effects on mortality and cardiovascular events at eight years follow-up. The cross-sectional data analyzes were performed using Cox modeling with inclusion of sample weights in the estimation of the estimates and for the prospective data, Poisson modeling was applied. It was adopted ??0.05. The study was submitted to the Research Ethics Committee of Hospital Onofre Lopes, receiving opinion 2,048,708. The results of the first study indicate that approximately 28.2% (95% CI: 27.4% -29.0%) of adults and 34.1% (95% CI: 32.6% -35.7%) in the elderly report complaints of insomnia and drowsiness. Sleep RF was reduced by 34.1% (95% CI: 32.6% -35.7%) in adults and 29.2% (95% CI: 27.2% -30.6%) in the elderly. Complaints of insomnia/EDS were reported in 28.2% (95% CI: 27.4% -29.0%) in adults and 34.1% (95% CI: 32.6% -35.7%) in the elderly. In adults, the reduction of RF stands out in relation to women (PRadj1=1.12; 95%CI:1.05-1.20/PRadj2=1.22; 95%CI:1.09-1,37), low social strata DE (PRadj1=1.21; 1.07-1.35/PRadj2=1.42;1.18-1.71) and C (PRadj1=1.30;1.12-1.50), depressive symptoms (PRadj1=3.22;2.94-3.52/PRadj2=3.29;2.83-383), emotional behavioral oscillation (PRadj1=1.51;1.41-1.63 /PRadj2=1.66;1.46-1.89), bad general health perception (PRadj1= 1.32;1.20-1.38 / PRadj2=2.30;2.05-2.90), bad perception of oral health (PRadj1=1.11;1.04-1.19), chronic health condition (PRadj1=1.23;1.15-1.31/PRadj2=1.42;1.26-1.61), insomnia/EDS complaints (PRadj1=2.47:2.28-2.67/PRadj2=3.03;1.23-1.42), livening urban areas (PRadj2=1.31;1.101.5). Low weight (PRadj1=0.82;0.690.98), healthy life style (PRadj1=0.91:0.830.99/PRadj2=0.74;0,64-0,87) and low social support (PRadj1=0.88;0.80-0.96) are inversely associated with reduction of RF in adults. In the elderly, the reduction in RF is associated with white (PRadj2=1.18;1.01-1.39), daily activities difficulty (PRadj1=1.13;1.01-1,27/PRadj2=1.36;1,12-1,65), use computer/internet (PRadj1=1.14;1.01-1.30) and, as well as in adults, depressive symptoms(PRadj1=3.37;2.87-3.97/PRadj2=3.77;2.88-4.96), behavioral oscillation (PRadj1=1.75;1.46-2.24), bad general health perception (PRadj1=1.50;1.23-1.82/PRadj2=3,12;2,31-4,21), regular oral health perception (PRadj=1.21;1.08-1.37), chronic health condition (PRadj1=1.58;1.11-2.40), insomnia/EDS complaints (PRadj1=2.45;2.14-2.79/PRadj2=3.46;2.77-4.33), social support (PRadj1=1.14;1.01-1.30) and living in urban areas (PRadj2=1.32;1.02- 1.72). The prospective design revealed 40 (25.97%;19.04-32.89) deaths in the period and 48 (30.76%;23.52-38.01) cardio-cerebrovascular events. Men presented higher risk (RR=1.88;1.01-3.50) of death. Depression (RR=2.04; 1.06-3.89), insomnia severity (RR=2.39;1.52-4.56) and sleep latency between 16-30 minutes (RR=3.54;1.26-9.94) and 31-60 minutes (RR=2.23;1.12-4.47) increase the risk of death independently in community-dwelling elderly. Cardiovascular events were predicted only by hypertensive and/or diabetic elderly (RR=8.30;1.98-34.82). The complaints of RFS reduction, insomnia/EDS affect almost a third of the Brazilian population and are closely related to emotional conditions, chronicity and urbanization. Complaints of insomnia severity and difficulty in initiating sleep seem to increase mortality in the elderly along with depressive symptoms.