INTRODUÇÃO: O envelhecimento é um processo contínuo e dinâmico que produz alterações biopsicossociais que culminam com a morte. Embora normais, tais alterações acabam por comprometer a Qualidade de Vida (QV) dos idosos. Dentre elas cabe citar: aposentadoria, viuvez, mudanças de papéis na família e na sociedade, falta de motivação e dificuldade de planejar o futuro, deficiências orgânicas, entre outras. Muitos idosos conseguem adaptar-se e conviver com essas alterações enquanto outros não as aceitam e se tornam vulneráveis ao surgimento de doenças tais como a insônia e a depressão. OBJETIVOS: identificar a presença de insônia em idosos institucionalizados; avaliar a presença de sinais e sintomas depressivos em idosos institucionalizados; verificar a percepção dos idosos institucionalizados em relação à sua QV; comparar a QV nos idosos institucionalizados insones e nãoinsones; comparar os idosos institucionalizados no que se refere à presença de sinais e sintomas depressivos entre insones e não- insones; correlacionar sinais e sintomas depressivos e QV no grupo de insones comparado ao de não-insones; comparar com grupo comparativo os itens citados acima. MÉTODOS: o estudo foi realizado no asilo \"São João Bosco\" e no centro de convivência dos idosos \"João Nogueira Vieira\", ambos situados em Campo Grande-MS; Utilizou-se o Mini-Exame do Estado Mental, o WHOQOL-breve, a Escala de Avaliação para Depressão de Hamilton e o Questionário de Sono do Adulto de Giglio. RESULTADOS: no que se refere aos idosos institucionalizados: 77,8% apresentou insônia inicial, 47,2% apresentou insônia intermediária e 16,7%, insônia final enquanto que no grupo comparativo 25,8% apresentou insônia inicial, 42,8% insônia intermediária e 18%, insônia final; em relação aos sinais e sintomas depressivos, 52,8% dos idosos institucionalizados e 18% do grupo comparativo apresentou-os; quanto à percepção da \"Qualidade de Vida\", 72,2% dos idosos institucionalizados referiu estar \"nem satisfeito/nem insatisfeito\" em relação ao \"domínio social\" assim como 91,6% em relação ao domínio \"psicológico\" e 50% quanto ao domínio \"físico\" enquanto 88,9% relatou estar \"insatisfeito\" quanto ao domínio \"ambiente\" enquanto 79,4% do grupo comparativo referiu estar \"satisfeito\" em relação ao domínio \"relações sociais\", 84,6% relatou estar \"insatisfeito\" em relação ao domínio \"ambiente\" e a maioria informou estar \"nem satisfeita/nem insatisfeita\" quanto ao domínio \"psicológico\" (61,5%) e \"físico\" (87,2%). CONCLUSÃO: houve maior ocorrência de insônia nos idosos institucionalizados; houve maior ocorrência de sinais e sintomas depressivos nos idosos institucionalizados; houve diferença na percepção da QV entre os idosos institucionalizados e o grupo comparativo; ocorreu diferença na percepção da QV entre os idosos institucionalizados insones e não-insones; os sinais e sintomas depressivos foram mais freqüentes nos idosos institucionalizados insones em relação aos não-insones; houve diferença na percepção negativa da QV entre os idosos institucionalizados insones e com sinais e sintomas depressivos em relação aos nãoinsones e com sinais e sintomas depressivos / INTRODUCTION: Growing old is a dynamic and continuous process, however biopsychosocial ordinary changes can compromise quality of life and also lead senior citizens to death. Several elderly citizens can adapt themselves to those changes and live longer, while others become vulnerable to the emergence of illnesses like insomnia and depression. OBJECTIVES: identify insomnia in institutionalized senior citizens; evaluate depressive signs and symptoms in institutionalized senior citizens; check institutionalized senior citizens\'s perceptions as to their quality of life; compare signs and citizens and quality of life in institutionalized senior citizens; compare depressive signs and symptoms and quality of life in senior citizens; correlate depressive signs and symptoms and quality of life between the insomniac and non-insomniac group of institutionalized senior citizens and compare the items above with comparative group; METHODOLOGY: the study was conducted at \"São João Bosco\" Asylum and with senior citizens who joined a contact center for the elderly called \"João Nogueira Vieira\" (composing the comparative group), both in the city of Campo Grande, MS. Data were obtained from Mini-Mental State, brief - WHOQOL test, Hamilton Depression Rating Scales and Giglio\'s Sleep Questionnaire. RESULTS: concerning occurrence of insomnia 77.8% of institutionalized senior citizens reported initial insomnia, 47.2% had intermediate insomnia and 16,7% had final insomnia while 25.8% presented initial insomnia, 42.8% intermediate insomnia and 18.0% final insomnia; as to depressive signs and symptoms 52.8% of institutionalized senior citizens showed those while the larger part of comparative group did not manifest either feature; the subjective perception of institutionalized senior citizens regarding \"quality of life\" pointed that 72.2% of them felt neither \"satisfied nor unsatisfied\" as to \"social relationship\", \"psychological\" (91.6%) and \"physical\" (50.0%) and 88.9% referred \"unsatisfied\" about \"environmental\" domain of WHOQOL-bref while comparative group members showed 79.5% being \"satisfied\" with \"social relationship\" domain, the large majority neither \"satisfied nor unsatisfied\" with \"physical\" (87.2%) and \"psychological\" domains and 84.6% were \"unsatisfied\" about \"environmental\" domain of WHOQOL-bref. CONCLUSIONS: greater occurrence of insomnia was found in institutionalized senior citizens than in comparative group; greater occurrence of depressive signs and symptoms in institutionalized senior citizens than in comparative group; significant difference was detected in perception of quality life among institutionalized senior citizens and comparative group; institutionalized senior citizens displayed worse quality of life in physical environmental and social relationship domains of WHOQOL, and global and subjective perception of quality of life, results showed and in health, more incidence of depressive signs and symptoms in insomniac institutionalized senior citizens; insomniac institutionalized senior citizens with depressive signs and symptoms referred being more affected in environmental and social relationship

Orientador: Daniela Aparecida Godoi Gonçalves / Resumo: Introdução: Estudos recentes demonstram a existência de sensibilização central (SC) associada com a disfunção temporomandibular (DTM) dolorosa. A presença de SC inclui hipofunção do sistema inibitório descendente da dor, afetando a modulação dos fenômenos nociceptivos. Há indícios de associação entre insônia e SC em pacientes com dores crônicas. Entretanto, a literatura não dispõe de estudos investigando esta associação em pacientes com DTM dolorosa. Objetivos: Estimar a associação entre SC, DTM dolorosa e insônia, e avaliar a qualidade, duração total, latência e eficiência de sono em indivíduos com e sem SC. Metodologia: O presente estudo clínico transversal, foi conduzido em uma amostra composta por 104 indivíduos adultos (20 a 65 anos de idade), distribuídos em dois grupos: 1) DTM; 2) DTM e insônia. A DTM foi classificada pelo Research Diagnostic Criteria for Temporomandibular Disorders. O diagnóstico da insônia foi realizado de acordo com os critérios da 3ª Classificação Internacional de Distúrbios de Sono e quantificado por meio do questionário do Índice de Gravidade de Insônia. A presença de SC foi avaliada por meio dos testes quantitativos sensoriais (limiar de dor à pressão e somação temporal) e o teste de Modulação Condicionada da Dor (CPM). Os parâmetros dos testes quantitativos sensoriais foram transformados em valores de z-score. O teste ANCOVA a 2 fatores foi utilizado para testar a diferença entre os grupos. Para testar o efeito do CPM, utilizamos o teste ANCOVA... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Previous studies have shown an association between temporomandibular disorders (TMD) and central sensitization(CS). The presence of CS includes hypofunction of the pain inhibitory system, affecting the modulation of the nociceptive function. There is evidence of the association between insomnia and CS in individuals with chronic pain. However, there are no studies about this association in patients with TMD. Aim: To estimate the association between CS, TMD pain and insomnia and to assess sleep quality, duration, latency and efficiency in individuals with and without CS. Methods: This cross-sectional study was conducted in a sample of 104 individuals, aged between 20-65 years, stratified into two groups: 1) TMD; and 2) TMD and insomnia. TMD were classified according to Research Diagnosis Criteria for Temporomandibular Disorders (RDC/TMD). Insomnia was assessed according to the criteria of the 3rd International Classification of Sleep Disorders, and quantified by the Insomnia Severity Index questionnaire. The presence of SC was evaluated through quantitative sensorial testing (QST), which were pressure pain threshold (PPT) and temporal summation (TS) and the conditioned pain modulation test (CPM). The QST parameters (LDP and ST) were transformed into z-score profiles. The 2-factor ANCOVA was used to test the difference between groups. To test the CPM effect, we used a 2-factor ANCOVA for repeated measures. The level of significance adopted was 5%. Results: There were no associa... (Complete abstract click electronic access below) / Mestre

Backgrounds and aims. Insomnia is a common sleep problem with significant health burden to individuals, families and society. Several risk factors contributed to the development of insomnia with significant familial aggregation phenomenon. According to this prospective study, we aimed to (1) explore the longitudinal course and outcomes of insomnia in both children and their parents; (2) confirm the familial aggregation and heritability of insomnia by detailed clinical interviews; (3) explore the potential biological markers of insomnia in terms of heart rate variability, 24-hour urinary cortisol and serial salivary cortisol. / Conclusions. Insomnia is commonly found in both adolescents and adults with moderate persistence rate after 5 years in Hong Kong Chinese. Our findings of increased risk of chronic medical burdens and various upper airway inflammatory diseases in both adolescent and adult subjects with insomnia suggested that insomnia requires comprehensive medical attention. Insomnia is a highly heritable disorder with robust familial aggregations, with a heritability of 0.67 for lifetime insomnia. We found gene-environment interaction on the pathogenesis of insomnia. Our findings strongly suggested the necessity of further molecular genetic analysis on insomnia. Daytime HRV, 24-hour urinary cortisol and serial salivary cortisol might not be the reliable biological markers for insomnia. (Abstract shortened by UMI.) / Results. Phase 1. The prevalences of insomnia were 4.5%, 10.8% and 13.9% at baseline and 6.6%, 8.1% and 11.6% at follow-up for children, fathers and mothers respectively. Similar incidence rate of insomnia was found across adolescents, fathers and mothers (6.2%, 5.4% and 6.8% respectively, p>0.05), while highest persistence rate of insomnia was found in mothers (43.8%), followed by fathers (26.9%) and adolescents (14.9%) (mothers vs adolescents OR(95%CI)=4.43(2.22--8.86); mothers vs fathers OR(95%CI) = 2.11(1.31--3.42); fathers vs adolescents OR(95%CI) = 2.17(0.98--4.52)). Insomnia at baseline was significantly associated with frequent episodes of allergic rhinitis, asthma, and laryngopharyngitis and chronic use of medicine at follow-up in adolescents (p<0.05). Insomnia at baseline was also significantly associated with poor medical outcomes in adults, including frequent allergic rhinitis, otitis media, hypertension, arthritis, psychiatric disorders, chronic pain and gastroesophageal reflux disease at follow-up in middle-aged adults (p<0.05). Phase 2 study . The first degree relatives' recurrent rate was higher in those adolescents with insomnia than those adolescents without insomnia (43.9% vs 22.9% for current insomnia and 51.1% vs 28.0% for lifetime insomnia, respectively p<0.001). Genetic analysis showed that the heritabilities were 0.57 +/- 0.19 for current insomnia and 0.67 +/- 0.13 for lifetime insomnia after adjusted for age and gender. There was significant synergistic interaction between parental history of insomnia and life stress on the development of insomnia of offsprings (p=0.002). Insomnia disorder and its severity were also found to correlate with neuroticism personality, psychological distress and poor quality of life. The phenotypic correlations of insomnia with these factors could be mainly explained by genetic component in bivariate genetic analysis. Phase 3 study. (1) Subjective sleep quantity and quality was consistently and negatively correlated with 24-hour urinary cortisol and salivary cortisol levels in adolescents. However, there was no such association in adults. (2) Adolescents with insomnia diagnosis had lower salivary cortisol at 0 minute after waking up (T1) but less decrease in AUCi3 than non-insomniac adolescents. Although there was no difference in serial salivary cortisol between insomniacs and non-insomniacs in adult, insomnia diagnosis interacted with gender on the effects of AC1Ji and salivary cortisol level at 10:00 pm. (3) There was no difference in 24-hour urinary cortisol between insomniacs and non-insomniacs. (4) There were some inconsistent associations of salivary cortisol with objective and subjective sleep parameters between continuous and dichotomized approaches. Fox example, there was no correlation between salivary cortisol and objective sleep measures in adults when using continuous variables, but, short sleepers as defined by objective TIB≤400 minutes had higher cortisol levels at T1 (13.5+/-7.9 nmol/L vs 11.2+/-5.0 nmol/L) and T2 (14.0+/-6.0 vs 11.5+/-6.2 nmol/L) than their counterparts (TIB>400 minutes). In brief, cortisol (both salivary and urinary samples) level was more likely to be correlated with subjective measures of sleep than objective measures or insomnia diagnosis. In particular, the association predominantly occurred in adolescent group. / Zhang, Jihui. / Adviser: Yun-bwote Wing. / Source: Dissertation Abstracts International, Volume: 73-01, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 245-249). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

INTRODUÇÃO: O abuso de drogas, tais como a cocaína, pode alterar o sono e comprometer diversos aspectos da vida. Neste trabalho avaliamos as características do sono e a Qualidade de Vida (QV) em pacientes dependentes de cocaína, na fase de intoxicação (uso da droga). MÉTODO: Realizado no Instituto Bairral de Psiquiatria, o grupo de estudo foi composto de 40 pacientes, idade média de 28,92, sendo 37 homens e 3 mulheres, com diagnóstico de dependência de cocaína, avaliados por ocasião da internação e, 40 indivíduos controles, composto por familiares e profissionais que trabalham no hospital, pareados por idade e gênero. Os instrumentos utilizados compreenderam: Entrevista Clínica Semi-dirigida, Classificação Econômica Brasil, Índice de Qualidade do Sono de Pittsburgh, Inventário de Depressão de Beck, Inventário de Ansiedade de Beck, Escala de Qualidade de Vida WHOQOL-Breve. RESULTADOS: Houve significativa diferença entre os dois grupos quanto à pontuação global com maior comprometimento do sono no grupo de estudo (p<0,001) e, estatisticamente, o grupo de estudo possui escores menores de QV que o grupo controle, com exceção do domínio meio ambiente (p=0,137). Com relação a sintomas depressivos e de ansiedade, os resultados apontaram que o grupo de estudo apresenta índices mais elevados destes sintomas. CONCLUSÃO: Há prejuízo na qualidade do sono e QV dos dependentes de cocaína, com presença de sintomas depressivos e de ansiedade. / INTRODUCTION: Drug abuse, such as cocaine, can alter sleep and endanger several aspects of life. In this study, we evaluate sleep characteristics and Quality of Life (QL) in cocaine users\' patients, at intoxication phase (drug use). METHOD: It was accomplished at Institute Bairral of Psychiatry, the study group was composed of 40 patients, average age of 28.92, that is 37 men and 3 women, that keep with cocaine relation diagnostically clinically as dependent, evaluated as soon as admitted in the hospital, 40 controls subjects, composed by relatives and professionals that work at the hospital, paired per age and gender. The used instruments comprised: Clinic Interview Semi-directed, Brazil Economical Classification, Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Quality of Life Scale WHOQOL-BREF. RESULTS: There was significant difference between both groups regarding global punctuation with great sleep damage in study group (p<0,001) and, statistically, the study group has smaller scores of QL than control group, except for environment domain (p=0.137). Regarding depressive\'s symptoms and anxiety, results showed that the study group has more elevated indexes of these symptoms. CONCLUSION: There is a damage of sleep quality and QL of cocaine users, with depressive symptoms and anxiety.

INTRODUÇÃO: O abuso de drogas, tais como a cocaína, pode alterar o sono e comprometer diversos aspectos da vida. Neste trabalho avaliamos as características do sono e a Qualidade de Vida (QV) em pacientes dependentes de cocaína, na fase de intoxicação (uso da droga). MÉTODO: Realizado no Instituto Bairral de Psiquiatria, o grupo de estudo foi composto de 40 pacientes, idade média de 28,92, sendo 37 homens e 3 mulheres, com diagnóstico de dependência de cocaína, avaliados por ocasião da internação e, 40 indivíduos controles, composto por familiares e profissionais que trabalham no hospital, pareados por idade e gênero. Os instrumentos utilizados compreenderam: Entrevista Clínica Semi-dirigida, Classificação Econômica Brasil, Índice de Qualidade do Sono de Pittsburgh, Inventário de Depressão de Beck, Inventário de Ansiedade de Beck, Escala de Qualidade de Vida WHOQOL-Breve. RESULTADOS: Houve significativa diferença entre os dois grupos quanto à pontuação global com maior comprometimento do sono no grupo de estudo (p<0,001) e, estatisticamente, o grupo de estudo possui escores menores de QV que o grupo controle, com exceção do domínio meio ambiente (p=0,137). Com relação a sintomas depressivos e de ansiedade, os resultados apontaram que o grupo de estudo apresenta índices mais elevados destes sintomas. CONCLUSÃO: Há prejuízo na qualidade do sono e QV dos dependentes de cocaína, com presença de sintomas depressivos e de ansiedade. / INTRODUCTION: Drug abuse, such as cocaine, can alter sleep and endanger several aspects of life. In this study, we evaluate sleep characteristics and Quality of Life (QL) in cocaine users\' patients, at intoxication phase (drug use). METHOD: It was accomplished at Institute Bairral of Psychiatry, the study group was composed of 40 patients, average age of 28.92, that is 37 men and 3 women, that keep with cocaine relation diagnostically clinically as dependent, evaluated as soon as admitted in the hospital, 40 controls subjects, composed by relatives and professionals that work at the hospital, paired per age and gender. The used instruments comprised: Clinic Interview Semi-directed, Brazil Economical Classification, Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Quality of Life Scale WHOQOL-BREF. RESULTS: There was significant difference between both groups regarding global punctuation with great sleep damage in study group (p<0,001) and, statistically, the study group has smaller scores of QL than control group, except for environment domain (p=0.137). Regarding depressive\'s symptoms and anxiety, results showed that the study group has more elevated indexes of these symptoms. CONCLUSION: There is a damage of sleep quality and QL of cocaine users, with depressive symptoms and anxiety.

The Swedish work force underwent dramatic changes during an economic crisis in the 1990s. In the aftermath, sick leave increased at an unprecedented rate and stress-related disorders, such as burnout, depression, and sleep disturbances replaced earlier work-related diagnoses. Sleep disturbances have been demonstrated to both precede and succeed mental and physical illnesses, including burnout, depression, anxiety, and cardiovascular disease. Disturbed sleep is also a common complaint in Sweden as well as in the rest of the Western world. Sleep has been shown to easily be disturbed by cognitive, emotional, and physiological arousal (stress). However, several studies have demonstrated that social support has a protective effect against the adverse effects of stress as well as a generally beneficial effect on health. Other studies, though, suggest that lack of social support may increase the risk for mental and physical ill-health. The purpose of this thesis was therefore to investigate the association between social support and disturbed sleep; foremost in working populations. Epidemiological methods were applied to investigate the association between social support and disturbed sleep. Three studies were used; a cross-sectional (MONICA, n = 1,179), a longitudinal (WOLF, n = 2,479), and a case-referent (SHEEP and VHEEP in conjunction, n = 6,231) study. The data was obtained by questionnaires, and social support was operationalized as network and emotional support. Disturbed sleep was defined as difficulties falling asleep, difficulties maintaining sleep, repeated awakenings, and disturbed sleep. Gender was taken into consideration throughout the studies. Foremost, low network support was found to increase the risk for contracting disturbed sleep. Which source the network support was derived from did not alter the association between low network support and disturbed sleep—low network support at work increased the risk for disturbed sleep as did low network outside work. Prolonged low network support and impaired emotional support did also increase the risk for sleep disturbances in men who were under strain at work. Furthermore, open coping buffered against low network support in the association with disturbed sleep five years later in women, whereas low network support increased the risk for developing disturbed sleep at a later date when interacting with covert coping both in women and in men. Moreover, disturbed sleep was shown to mediate low network support in myocardial infarction in women. In conclusion, the association between social support and disturbed sleep is complex and includes both interactions with other personality variables and mediating associations. Previous research on negative effects of low social support was confirmed as was previously observed gender differences in social support.

Orientador: Wilza Carla Spiri / Resumo: Introdução: A prevalência da obesidade vem aumentando entre adultos em todo o mundo e está associada com aumento do risco de morbimortalidade, bem como redução da expectativa de vida com resultados negativos de saúde. Também associa-se a outras patologias como transtorno de ansiedade, comportamento compulsivo e desequilíbrio no comportamento do sono. Apesar da obesidade ser considerada uma patologia previnível, ainda existem grandes dificuldades associadas com a perda de peso e a sua manutenção através da modificação do estilo de vida no cenário atual, mostrando a necessidade de investigação de fatores que abordem não só o peso, mas também patologias e/ou sintomas associados. A terapia floral faz parte de um campo emergente de terapias vibracionais, e suas essências, feitas a partir de plantas silvestres, flores e árvores do campo, atuam harmonizando as emoções, e não tratando de condições físicas. Neste contexto, aparece como uma alternativa para o alivio do comportamento ansioso dos indivíduos, pois não há incompatibilidade com outros métodos de tratamento, e pode ser indicada a um grande número de pessoas em qualquer etapa da vida. Objetivo: Identificar se o tratamento com terapia floral altera o grau de ansiedade de indivíduos com sobrepeso ou obesidade, com consequente melhora no padrão de sono, redução nos sintomas de compulsão alimentar, redução na frequência cardíaca de repouso e melhora nos níveis de pressão arterial. Métodos: Ensaio Clínico Randomizado, paralelo, co... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: The prevalence of obesity is increasing among adults worldwide and is associated with an increased risk of morbidity and mortality, as well as a reduction in life expectancy with negative health outcomes. It is also associated with other pathologies such as anxiety disorder, compulsive behavior and imbalance in sleep behavior. Although obesity is considered a predictable pathology, there are still great difficulties associated with weight loss and its maintenance by modifying lifestyle in the current scenario, showing the need to investigate factors that address not only weight but also pathologies and / or associated symptoms. Floral therapy is part of an emerging field of vibrational therapies, and its essences, made from wild plants, flowers and field trees, work by harmonizing emotions, not by treating physical conditions. In this context, it appears as an alternative for the relief of the anxious behavior of individuals, as there is no incompatibility with other treatment methods, and can be indicated to a large number of people at any stage of life. Objective: To identify whether treatment with floral therapy changes the degree of anxiety of overweight or obese individuals, with consequent improvement in sleep pattern, reduction in binge eating symptoms, reduction in resting heart rate and improvement in blood pressure levels. Methods: Randomized, parallel, two-arm, double-blind, placebo-controlled, four-week clinical trial conducted at a public stitution ... (Complete abstract click electronic access below) / Doutor

Made available in DSpace on 2015-07-22T20:50:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-10-27 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Associação Fundo de Incentivo à Psicofarmacologia (AFIP) / O objetivo do presente estudo foi avaliar os efeitos do exercício aeróbio moderado no padrão do sono, na qualidade de vida e no perfil de humor de pacientes com insônia crônica primária, bem como verificar se esses efeitos são dependentes do horário da prática do exercício. Dezenove pacientes com insônia crônica primária (45 anos [EP &#61617; 1,9]) foram distribuídos aleatoriamente entre os grupos MANHÃ (10:00 &#61617; 1 h) e TARDE (18:00 &#61617; 1 h). Todos os voluntários participaram de um protocolo de exercícios aeróbios, realizados em intensidade moderada (caminhada), durante 50 minutos, 3 vezes/semana, durante 6 meses. Para avaliar o sono foram utilizados a polissonografia e o diário do sono, a qualidade de vida foi medida pelo questionário Medical Outcome Study Short Form - 36 (MOS SF-36) e o humor pelo questionário Profile of Mood States (POMS). Na polissonografia, os resultados demonstraram, nos dois grupos (MANHÃ e TARDE), reduções na latência do sono, no tempo acordado após o início do sono, além de aumento na eficiência do sono, após a intervenção. No diário do sono, significantes melhoras foram observadas na latência do sono, na qualidade do sono e na sensação de descanso ao acordar, nos dois grupos. Além disto, a qualidade de vida (atividades sociais e limitação por aspectos emocionais) e o perfil de humor (tensão-ansiedade, depressão e distúrbio total de humor) melhoraram após a intervenção. Estes efeitos não diferiram quanto ao horário do dia. Podemos concluir que o exercício aeróbio crônico, realizado em intensidade moderada, produz significantes melhoras no padrão do sono, na qualidade de vida e no perfil de humor de pacientes com insônia crônica primária. De forma geral, estes efeitos parecem não diferir quando o exercício físico é realizado pela manhã ou ao final da tarde. / To evaluate the effect of chronic moderate aerobic exercise on sleep, quality of life and mood of individuals with chronic primary insomnia, and to examine whether these effects differed for morning vs. late-afternoon exercise. Nineteen sedentary individuals with chronic primary insomnia (mean age 45.0 [SE &#61617; 1.9] years) completed 6-month moderate aerobic exercise training (3 days/week), randomized to the morning (10:00 &#61617; 1 h) or late-afternoon (18:00 &#61617; 1 h). Across both time points, polysomnographic data demonstrated significant reductions in sleep onset latency and wake time after sleep onset, and a significant increase in sleep efficiency following exercise. Sleep diary data revealed significant improvements in sleep onset latency, sleep quality and feeling rested in the morning. There was generally no significant difference in response to morning vs. late-afternoon exercise. Following exercise, significant increases in some quality of life measures, and significant reductions in Profile of Mood State measures of tension-anxiety, depression and total mood disturbance were found. These effects did not vary by time of day. In conclusion, chronic moderate aerobic exercise elicited significant improvements in sleep, quality of life and mood in individuals with chronic primary insomnia; these effects generally did not differ for morning vs. late-afternoon exercise. / FAPESP: 2008/02862 - 1 / FAPESP: 98/14303 - 3 / TEDE / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2015-07-22T20:50:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-06-29 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Associação Fundo de Incentivo à Psicofarmacologia (AFIP) / No período do climatério, cerca de 80% das mulheres são acometidas pelas consequências do hipoestrogenismo: alterações fisiológicas, psicológicas, ondas de calor, nictúria, alterações de humor. Essas modificações contribuem para o aumento da prevalência de insônia nessa fase, que atinge cerca de 28% a 63% das mulheres pós-menopausadas. A presença de tais sintomas associados a condições sócio-culturais, como a aposentadoria, a valorização da juventude, o envelhecimento, refletem diretamente na qualidade de vida dessa população. Como a terapia hormonal tem sua indicação individualizada e não indicada em alguns casos, a procura por terapias coadjuvantes ou substitutivas é crescente, incluindo a massagem terapêutica, que pode aliviar os sintomas da insônia no período climatérico. O presente estudo é apresentado em dois trabalhos. O primeiro, um estudo piloto com sete voluntárias, que avaliou o efeito da massagem terapêutica em mulheres pós-menopausadas com insônia e apresentou melhora objetiva e subjetiva no sono. Os resultados deste estudo nos levaram à elaboração do segundo trabalho, randomizado e controlado. O trabalho 2 avaliou quarenta e quatro mulheres distribuídas em 3 grupos, controle, movimento passivo e massagem terapêutica. Os resultados dos questionários mostraram melhora no sono, nos sintomas climatéricos e na qualidade de vida. / In the climacteric period, approximately 80% of women are affected by consequences of hypoestrogenism: physiological and psychological alterations, hot flashes, nycturia, mood alterations. These changes contribute to the increase of insomnia prevalence in this phase, which affects approximately 28% to 63% of postmenopausal women. The presence of such symptoms associated with socio-cultural conditions, such as retirement, appreciation of youth, aging, reflect directly on quality of life of this population. As hormone therapy is indicated in certain cases and is not indicated for some patients, there has been an increase in the demand for complementary or alternative therapies, including therapeutic massage, which may relieve insomnia symptoms in the climacteric period. The present study is presented in two studies. The first one, a pilot study with seven individuals, evaluated the effects of therapeutic massage on post-menopausal insomniac women and demonstrated subjective and objective sleep improvement. The results of this study led us to conduct a second one, now a randomized and controlled trial, including 44 women, distributed into 3 groups (control, passive movement and therapeutic massage). The results of the questionnaires demonstrated improvement in sleep, climacteric symptoms and quality of life. / FAPESP: 98/143030-3 / TEDE / BV UNIFESP: Teses e dissertações

Submitted by Suzimar de Fatima Benato Fusco (sbenato@gmail.com) on 2018-04-25T18:24:53Z No. of bitstreams: 1 tese_suzimar_fusco_2018.pdf: 3080060 bytes, checksum: 4575e04721f212bd817687282caf1fc2 (MD5) / Approved for entry into archive by ROSANGELA APARECIDA LOBO null (rosangelalobo@btu.unesp.br) on 2018-04-26T18:56:10Z (GMT) No. of bitstreams: 1 fusco_sfb_dr_bot.pdf: 3080060 bytes, checksum: 4575e04721f212bd817687282caf1fc2 (MD5) / Made available in DSpace on 2018-04-26T18:56:10Z (GMT). No. of bitstreams: 1 fusco_sfb_dr_bot.pdf: 3080060 bytes, checksum: 4575e04721f212bd817687282caf1fc2 (MD5) Previous issue date: 2018-02-28 / Introdução: A prevalência da obesidade vem aumentando entre adultos em todo o mundo e está associada com aumento do risco de morbimortalidade, bem como redução da expectativa de vida com resultados negativos de saúde. Também associa-se a outras patologias como transtorno de ansiedade, comportamento compulsivo e desequilíbrio no comportamento do sono. Apesar da obesidade ser considerada uma patologia previnível, ainda existem grandes dificuldades associadas com a perda de peso e a sua manutenção através da modificação do estilo de vida no cenário atual, mostrando a necessidade de investigação de fatores que abordem não só o peso, mas também patologias e/ou sintomas associados. A terapia floral faz parte de um campo emergente de terapias vibracionais, e suas essências, feitas a partir de plantas silvestres, flores e árvores do campo, atuam harmonizando as emoções, e não tratando de condições físicas. Neste contexto, aparece como uma alternativa para o alivio do comportamento ansioso dos indivíduos, pois não há incompatibilidade com outros métodos de tratamento, e pode ser indicada a um grande número de pessoas em qualquer etapa da vida. Objetivo: Identificar se o tratamento com terapia floral altera o grau de ansiedade de indivíduos com sobrepeso ou obesidade, com consequente melhora no padrão de sono, redução nos sintomas de compulsão alimentar, redução na frequência cardíaca de repouso e melhora nos níveis de pressão arterial. Métodos: Ensaio Clínico Randomizado, paralelo, com dois braços, duplo cego, placebo-controlado, de quatro semanas, realizado em uma instituição pública do estado de São Paulo - Brasil. Os participantes foram indivíduos sadios de ambos os sexos, com idade de 20 a 59 anos, alfabetizados, com sobrepeso ou obesidade pelos critérios da Organização Mundial da Saúde (IMC ≥ 25 Kg/m2) e com ansiedade moderada ou elevada pelos critérios do Inventário de Ansiedade-Estado (IDATE com Escore ˃ 34). Para a coleta de dados utilizou-se questionário sócio-demográfico e clínico, escala de ansiedade IDATE-ESTADO, Escala de Compulsão Alimentar Periódica (ECAP) e Questionário de Padrão do Sono de Pittsburg (PSQI), aferição da pressão arterial e eletrocardiograma, no momento inicial e após 4 semanas de tratamento. A análise estatística foi realizada calculando o delta para expressar a diferença das médias das medidas de desfecho entre os momentos de avaliação dentro de cada grupo estudado. Em seguida, utilizou-se o Teste de Mann-Whittney para a comparação entre grupos. Análise multivariada foi realizada utilizando modelos de regressão linear robusta simples e múltipla. Resultados: A coleta de dados ocorreu entre setembro de 2015 e janeiro de 2017 e a amostra foi constituída por 40 participantes no grupo placebo e 41 no grupo floral, principalmente pelo sexo feminino (92,5% e 90,2%), com idade média de 42,9 e 38,5 anos e IMC médio de 34,31 e 33,5 kg/m2 nos grupos placebo e floral respectivamente. A análise multivariada mostrou redução estatisticamente significante no grupo floral quando comparado ao grupo Placebo nas seguintes variáveis: IDATE (β=-0,190; p<0,001), PSQI (β=-0,160; p=0,027), ECAP (β=-0,226; p=0,001) e frequência cardíaca de repouso (β=-0,07; p=0,003). Conclusão: indivíduos tratados com terapia floral apresentaram redução de sintomas ansiosos, melhora no padrão de sono, redução nos sintomas de compulsão alimentar e diminuição na frequência cardíaca de repouso maior do que aqueles tratados com placebo. Esse resultado evidencia a importância e a necessidade de ações de saúde em prol da redução da ansiedade e sintomas associados em indivíduos com sobrepeso ou obesidade e fortalece a terapia floral como prática integrativa e complementar na área da saúde. / Introduction: The prevalence of obesity is increasing among adults worldwide and is associated with an increased risk of morbidity and mortality, as well as a reduction in life expectancy with negative health outcomes. It is also associated with other pathologies such as anxiety disorder, compulsive behavior and imbalance in sleep behavior. Although obesity is considered a predictable pathology, there are still great difficulties associated with weight loss and its maintenance by modifying lifestyle in the current scenario, showing the need to investigate factors that address not only weight but also pathologies and / or associated symptoms. Floral therapy is part of an emerging field of vibrational therapies, and its essences, made from wild plants, flowers and field trees, work by harmonizing emotions, not by treating physical conditions. In this context, it appears as an alternative for the relief of the anxious behavior of individuals, as there is no incompatibility with other treatment methods, and can be indicated to a large number of people at any stage of life. Objective: To identify whether treatment with floral therapy changes the degree of anxiety of overweight or obese individuals, with consequent improvement in sleep pattern, reduction in binge eating symptoms, reduction in resting heart rate and improvement in blood pressure levels. Methods: Randomized, parallel, two-arm, double-blind, placebo-controlled, four-week clinical trial conducted at a public stitution in the state of São Paulo - Brazil. Participants were healthy individuals of both sexes, aged 20-59 years, literate, overweight or obese according to World Health Organization criteria (BMI ≥ 25 kg / m2) and with moderate or high anxiety according to the criteria of the State - Trait Anxiety Inventory (STAI) (STAI with Score ˃ 34). Data were collected using a sociodemographic and clinical questionnaire, State - Trait Anxiety Inventory (STAI), Binge-Eating Scale (BES) and Pittsburgh Sleep Quality Index (PSQI), blood pressure and electrocardiogram and after 4 weeks of treatment. Statistical analysis was performed by calculating the delta to express the difference of means of outcome measures between the moments of evaluation within each group studied. Then, the Mann-Whittney test was used for the comparison between groups. Multivariate analysis was performed using simple and multiple robust linear regression models. Results: Data collection occurred between September 2015 and January 2017, and the sample consisted of 40 participants in the placebo group and 41 in the floral group, mainly female (92.5% and 90.2%), with age mean of 42.9 and 38.5 years and mean BMI of 34.31 and 33.5 kg / m2 in the placebo and floral groups, respectively. The multivariate analysis showed a statistically significant reduction in the floral group when compared to the placebo group in the following variables: IDATE (β = -0.190, p <0.001), PSQI (β = -0.160, p = 0.004), ECAP (β = -0.226; p = 0.001) and resting heart rate (β = -0.07, p <0.001). Conclusion: Individuals treated with floral therapy had reduced anxiety symptoms, improved sleep patterns, reduced binge eating symptoms, and decreased resting heart rate greater than those treated with placebo. This result evidences the importance and necessity of health actions in favor of the reduction of anxiety and associated symptoms in overweight or obese individuals and strengthens floral therapy as an integrative and complementary practice in the health area.