Introduction: The Restless Legs Syndrome (RLS) is a frequent neurological disorder with a prevalence ranging from 5 - 10%. RLS is characterized by an urge to move the lower extremities during the night, thus RLS causes sleep disturbance. It presents as both idiopathic and secondary form. Idiopathic RLS is associated with common genetic variants in MEIS1, BTBD9, PTPRD and MAP2K5/SCOR1. Recently, multiple sclerosis (MS) was identified as a common cause for secondary RLS, the prevalence of RLS in patients with MS ranges from 13.3 to 37.5%. The aim of our study was to analyse the clinical and genetic aspects of this disorder, especially in patients with multiple sclerosis. In the clinical part, we evaluated the prevalence of RLS among Czech patients with MS and we compared the extent of brain damage between patients with and without RLS using magnetic resonance imaging (MRI). In the genetic part, we further analysed the impact of known genetic variants (MEIS1, BTBD9, MAP2K5/SCOR1, PTPRD) for RLS in other European populations and in patients with MS. Methods: Clinical part: Each patient with MS underwent a semi-structured interview. A patient was considered to be affected by RLS if he/she met all four standard criteria at life- long interval. Lesion load (LL - T2), brain atrophy - T1 and brain...

Dans cette thèse, nous étudions le contrôle dynamique des systèmes de partage de ressources qui se posent dans divers domaines : réseaux de gestion des stocks, services de santé, réseaux de communication, etc. Nous visons à allouer efficacement les ressources disponibles entre des projets concurrents, selon certains critères de performance. Ce type de problème est de nature stochastique et peut être très complexe à résoudre. Nous nous concentrons donc sur le développement de méthodes heuristiques performantes. Dans la partie I, nous nous plaçons dans le cadre des Restless Bandit Problems, qui est une classe générale de problèmes d’optimisation dynamique stochastique. Relaxer la contrainte de trajectoire dans le problème d’optimisation permet de définir une politique d’index comme heuristique pour le modèle contraint d’origine, aussi appelée politique d’index de Whittle. Nous dérivons une expression analytique pour l’index de Whittle en fonction des probabilités stationnaires de l’état dans le cas où les bandits (ou projets) suivent un processus de naissance et de mort. D’une part, cette expression nécessite la vérification de plusieurs conditions techniques, d’autre part elle ne peut être calculée explicitement que dans certains cas spécifiques. Nous prouvons ensuite, que dans le cas particulier d’une file d’attente multi-classe avec abandon, la politique d’index de Whittle est asymptotiquement optimale aussi bien pour les régimes à faible trafic comme pour ceux à fort trafic. Dans la partie II, nous dérivons des heuristiques issues de l’approximation des systèmes stochastiques de partage de ressources par des modèles fluides déterministes. Nous formulons dans un premier temps une version fluide du problème d’optimisation relaxé que nous avons introduit dans la partie I, et développons une politique d’index fluide. L’index fluide peut toujours être calculé explicitement et surmonte donc les questions techniques qui se posent lors du calcul de l’index de Whittle. Nous appliquons les politiques d’index de Whittle et de l’index fluide à plusieurs cas : les fermes de serveurs éco-conscients, l’ordonnancement opportuniste dans les systèmes sans fil, et la gestion de stockage de produits périssables. Nous montrons numériquement que ces politiques d’index sont presque optimales. Dans un second temps, nous étudions l’ordonnancement optimal de la version fluide d’une file d’attente multi-classe avec abandon. Nous obtenons le contrôle optimal du modèle fluide en présence de deux classes de clients en concurrence pour une même ressource. En nous appuyant sur ces derniers résultats, nous proposons une heuristique pour le cas général de plusieurs classes. Cette heuristique montre une performance quasi-optimale lorsqu’elle est appliquée au modèle stochastique original pour des charges de travail élevées. Enfin, dans la partie III, nous étudions les phénomènes d’abandon dans le contexte d’un problème de distribution de contenu. Nous caractérisons une politique optimale de regroupement afin que des demandes issues d’utilisateurs impatients puissent être servies efficacement en mode diffusion. / In this thesis we study the dynamic control of resource-sharing systems that arise in various domains: e.g. inventory management, healthcare and communication networks. We aim at efficiently allocating the available resources among competing projects according to a certain performance criteria. These type of problems have a stochastic nature and may be very complex to solve. We therefore focus on developing well-performing heuristics. In Part I, we consider the framework of Restless Bandit Problems, which is a general class of dynamic stochastic optimization problems. Relaxing the sample-path constraint in the optimization problem enables to define an index-based heuristic for the original constrained model, the so-called Whittle index policy. We derive a closed-form expression for the Whittle index as a function of the steady-state probabilities for the case in which bandits (projects) evolve in a birth-and-death fashion. This expression requires several technical conditions to be verified, and in addition, it can only be computed explicitly in specific cases. In the particular case of a multi-class abandonment queue, we further prove that the Whittle index policy is asymptotically optimal in the light-traffic and heavy-traffic regimes. In Part II, we derive heuristics by approximating the stochastic resource-sharing systems with deterministic fluid models. We first formulate a fluid version of the relaxed optimization problem introduced in Part I, and we develop a fluid index policy. The fluid index can always be computed explicitly and hence overcomes the technical issues that arise when calculating the Whittle index. We apply the Whittle index and the fluid index policies to several systems: e.g. power-aware server-farms, opportunistic scheduling in wireless systems, and make-to-stock problems with perishable items. We show numerically that both index policies are nearly optimal. Secondly, we study the optimal scheduling control for the fluid version of a multi-class abandonment queue. We derive the fluid optimal control when there are two classes of customers competing for a single resource. Based on the insights provided by this result we build a heuristic for the general multi-class setting. This heuristic shows near-optimal performance when applied to the original stochastic model for high workloads. In Part III, we further investigate the abandonment phenomena in the context of a content delivery problem. We characterize an optimal grouping policy so that requests, which are impatient, are efficiently transmitted in a multi-cast mode.

Bakgrund: Restless legs syndrome (RLS) är en vanligt förekommande, underdiagnostiserad neurologisk sjukdom som orsakar lidande hos individen. Distriktssköterskor i telefonrådgivning utgör ofta första patiententkontakten med primärvården. Studier gällande distriktssköterskors erfarenhet av individer med RLS-associerade symtom och behandlingsbehov saknas varvid stort behov sågs av studien för ökad identifiering av dessa individer.  Syfte: Syftet var att beskriva hur distriktssköterskor erfar symtombild och behandlingsbehov hos individer med RLS-associerade besvär vid telefonrådgivning inom primärvården med fokus på möjligheter och hinder utifrån 4-habits kommunikationsmodell.  Metod: En kvalitativ intervjustudie med innehållsanalys genomfördes med 16 sjuksköterskor och distriktssköterskor yrkesverksamma i sex svenska regioner inom primärvården. En deduktiv ansats utifrån 4-habits kommunikationsmodell genomfördes.  Resultat: Resultatet presenteras utifrån kommunikationsmodellens delar; Investera i början innefattar; Patientmötets påverkansfaktorer, Försöka förstå patientens RLS-associerade symtom och Erfarenhet av RLS-associerade symtom. Ta reda på patientens perspektiv; Patientens symtombeskrivning som utgångspunkt och Symtomens inverkan på patientens livssituation. Visa empati; Förhålla sig till patientens situation och Tillitens betydelse i patientmötet. Investera i slutet; Triagering av patienter med RLS-associerade symtom, Egenvårdsrådgivning vid RLS-associerade symtom och Samsyn i slutet av samtalet. Slutsats: 4-habits kommunikationsmodell utgjorde struktur i distriktssköterskornas telefonrådgivningsarbete. Distriktssköterskorna lyssnade och ville förstå patienter med RLS-associerade symtom men begränsad kunskap avseende symtom och behandlingsbehov samt tidspress var hindrande faktorer. / Background: Restless legs syndrome (RLS) is a common, underdiagnosed neurological disease that causes great suffering. Primary healthcare nurses in telephone counseling are often patient's first contact with primary care. Studies regarding primary healthcare nurses experiences of individuals with RLS-associated symptoms and treatment needs are lacking. This study could contribute to increased awareness.  Purpose: The purpose was to describe how primary healthcare nurses experience symptoms and treatment needs of individuals with RLS-associated symptoms during telephone counseling in primary care with focus on opportunities and obstacles based on the 4-habits model. Method: A qualitative interview study with content analysis was conducted with 16 nurses working in six Swedish regions within primary healthcare. A deductive approach based on the 4-habits communication model was carried out. Results: Opportunities and obstacles in the primary healthcare nurses telephone counseling work, were identified based on the different parts of the 4-habits model; Invest in the beginning, elicit the patient's perspective, demonstrate empathy and invest in the end.  Conclusion: The 4-habits model contribute to primary healthcare nurses telephone counseling. The nurses listened and wanted to understand patients with RLS-associated symptoms, but limited knowledge regarding symptoms and treatment needs as well as time pressure were hindering factors.

The thesis deals with the relationship of the child suffering from the ADHD and the child's family to the school. The objective was to find out what is the most important to the parents and the children and what influences the relationship and attitude of the child and the child's family to school. The theoretical part describes in which way the ADHD symptoms in the child influence relationship situations of all parties involved. It points out to potential problematic situations, lack of understanding in communication and potential risks for occurrence of conflicts. The crucial part of the thesis is a qualitative research survey carried out in the form of interviews with children and their parents. Its results show that mutual communication of the family and the school is very important as prevention from a lot of negative experience on both sides. The most frequent problems the child and the family cope with include non-functional communication with the teacher, bad relationship of the child with the teacher, insufficient cooperation and lack of understanding on both sides, which often escalates to changing schools. KEYWORDS ADHD in kids, family, school, teachers, mutual communication, changing schools, use of psychopharmaca

Fidgeting and otherwise constant movements in individuals can be beneficial in those who suffer from Attention Deficit/Hyperactivity Disorder or Generalized Anxiety Disorder as well as others. However this constant movement can also be a distraction to others as well as protrude an air of no self confidence. It is the drawbacks from these actions that we wish to address. By developing an intelligent system that can detect these motions and alert the user, it will allow the wearer of the device to self correct. It is in this self control that one may exhibit more confidence or simply reduce the level of irritation experienced by those in the immediate vicinity. We have designed and built a low cost, mobile, lightweight, untethered, wearable prototype device. It will detect these actions and deliver user selectable biofeedback through a light emitting diode, buzzer, vibromotor or an electric shock to allow for self control. / by Scott A. Barnard. / Thesis (M.S.C.S.)--Florida Atlantic University, 2009. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2009. Mode of access: World Wide Web.

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Added 1 bitstream(s) on 2015-08-11T03:26:20Z : No. of bitstreams: 5 Publico-165a.pdf: 463473 bytes, checksum: cae240c8ee591f50351d96ca3258bfba (MD5) Publico-165b.pdf: 155628 bytes, checksum: 1115706461101400dcec7e30309c015b (MD5) Publico-165c.pdf: 1838976 bytes, checksum: 98bc6262f927468869ae5e34cde1918a (MD5) Publico-165d.pdf: 1269518 bytes, checksum: f1bbb32c8edea554dfa6517033d47653 (MD5) Publico-165e.pdf: 1520227 bytes, checksum: 275186328f675001df3bba84180ce117 (MD5) / Contexto: A síndrome das pernas inquietas (SPI) é uma desordem caracterizada por uma angustiante necessidade de movê-las e, às vezes, mover também outras partes do corpo, geralmente acompanhada de desconforto ou dor. O tratamento desta síndrome com agonistas dopaminérgicos tem sido reconhecido como terapêutica de primeira linha, porque parece eficaz com base em princípios fisiopatológicos; vários grupos farmacológicos compreendem seu tratamento. Objetivos: Avaliar se intervenções farmacológicas são eficazes e seguras para o tratamento da SPI. Método: Revisão Sistemática Cochrane de estudos randomizados ou quasirandomizados sobre agentes farmacológicos utilizados no tratamento da SPI. Foram avaliados os seguintes desfechos para cada fármaco: alívio dos sintomas medido pela escala de gravidade para a síndrome das pernas inquietas (IRLSSG Rating Scale), eventos adversos, parâmetros polissonográficos, melhora subjetiva, qualidade de vida, impressão clínica global, impressão global do paciente, escala de sonolência de Epworth MSLT: Múltiplos Testes de Latência do Sono; PLMI: índice dos Movimentos Periódicos dos Membros. A autora desta tese avaliou os estudos recuperados nas buscas, utilizando critérios que envolviam os métodos randômicos, de cegamento e sigilo de alocação. As divergências foram resolvidas em reunião de consenso. Resultados: As buscas manual e eletrônica encontraram 1.026 estudos. Foram incluídos 94 ensaios clínicos que atendiam aos critérios de inclusão (estudos randomizados ou quasi-randomizados). A análise dos dados considerados em conjunto permitiu concluir que as intervenções farmacológicas foram efetivas para os agonistas dopaminérgicos. Dentre as drogas de segunda linha, apenas a clonidina mostrou-se efetiva. A qualidade dos estudos foi adequada para os ensaios clínicos envolvendo os agonistas dopaminérgicos, parcialmente adequada para levodopa e anticonvulsivantes e pouco adequada para os demais fármacos estudados. Conclusões: Há evidências de que os agonistas dopaminérgicos são eficazes e seguros para o tratamento da SPI a curto prazo, mas não há evidência científica de que os demais fármacos são efetivos nesta doença. / Background: The restless legs syndrome (RLS) is a disorder characterized by a distressing need to move the legs and sometimes other parts of the body. Usually accompanied by a marked sense of discomfort or pain in the leg or other body part affected. The treatment of restless legs syndrome with dopamine agonists has been recognized as the main first-line treatment because it seems to be effective based on pathophysiologic principles. Although, several pharmacological drugs are envolved in the treatment of RLS. Objectives: To assess whether pharmacological interventions are effective and safe for the treatment of RLS. Methods: Systematic Cochrane Review of randomized studies or quasi-randomized on pharmacological agents used to treat RLS. The following outcomes were assessed for each drug: relief of symptoms measured by the restless legs syndrome ranting scale (IRLSSG Rating Scale), adverse events, polysomnographic parameters, subjective improvement, quality of life and clinical global impression, overall impression of the patient , the scale of Epiworth MSLT: Multiple Sleep Latency Test; PLM periodic limb movments and others. The authors evaluated the studies retrieved in searches using criteria involving the method of randomization, blinding and the method of allocation concelment. Disagreements were resolved by consensus. Results: The electronic and manual search found 1,026 studies. Were included 94 studies that met the clinical criteria for inclusion (randomized studies or quasi-randomized). The analysis of data, taken together, indicated that the pharmacological interventions were effective for dopamine agonists. Among the second-line drugs, only clonidine was shown to be effective. The quality of studies was suitable for clinical trials involving the dopamine agonists, partially adequated to levodopa and anticonvulsants, and unsuited for the other drugs studied. Conclusions: There is evidence that dopamine agonists are effective and safe for the treatment of RLS in the short term, there is no scientific evidence that all drugs are effective in this disease. / TEDE / BV UNIFESP: Teses e dissertações

nÃo hà / Este trabalho consiste de dois estudos: o primeiro estudo avalia o papel da morfometria por ressonÃncia magnÃtica (RM) no diagnÃstico diferencial das sÃndromes parkinsonianas; o segundo avalia as alteraÃÃes do sono nessas sÃndromes e suas relaÃÃes com alteraÃÃes estruturais na RM. Nas fases iniciais da doenÃa o diagnÃstico diferencial entre as sÃndromes parkinsonianas pode ser de difÃcil realizaÃÃo. As medidas por RM podem contribuir para o diagnÃstico diferencial entre a doenÃa Parkinson (DP), paralisia supranuclear progressiva (PSP) e atrofia de mÃltiplos sistemas (AMS). O objetivo do primeiro estudo foi avaliar o valor diagnÃstico das alteraÃÃes anatÃmicas estruturais identificadas pela RM no diagnÃstico diferencial dessas sÃndromes. Foram estudados 21 casos com DP, 11 casos com atrofia de mÃltiplos sistemas forma cerebelar (AMS-c), 8 casos de atrofia de mÃltiplos sistemas forma parkinsoniana (AMS-p) e 20 com PSP. A Ãrea sagital mediana do mesencÃfalo (Ams), Ãrea sagital mediana da ponte (Apn), largura mÃdia do pedÃnculo cerebelar mÃdio (PCM) e pedÃnculo cerebelar superior (PCS) foram medidas pela RM. ComparaÃÃes mÃltiplas foram realizadas entre a PD, AMS-c, AMS-p e PSP. A morfometria da Apn, PCM e PCS apresentaram diferenÃas entre os casos com diferentes diagnÃsticos. A Ams e a morfometria do PCS foram as medidas mais preditivas para o diagnÃstico de PSP, de tal forma que uma Ãrea do mesencÃfalo < 105 mm2 e a medida do PCS < 3 mm mostraram uma grande probabilidade para este diagnÃstico (sensibilidade de 95,0 e 80,0%, respectivamente). Nos casos de AMS-c, a morfometria da Apn < 315mm2 apresentou boa especificidade e valor preditivo positivo para o diagnÃstico (93,8% e 72,7%, respectivamente). Em conclusÃo, demonstramos que dimensÃes e valores de cortes obtidos a partir de exames de RM podem diferenciar entre PD, PSP e AMS-c, com boa sensibilidade, especificidade e precisÃo. Na segunda etapa desse trabalho, foram avaliados e comparados os distÃrbios do sono em pacientes com DP, AMS e PSP e as possÃveis associaÃÃes com a morfometria por RM do encÃfalo em 16 casos de DP, 13 AMS, 14 PSP e 12 controles. Os distÃrbios do sono foram avaliados pela escala de SonolÃncia de Epworth, Ãndice de Qualidade do sono de Pittsburgh (IQSP), escala de pernas inquietas e questionÃrio de Berlim. A Apn e Ams e largura do PCS e do PCM foram medidas pela RM. A mà qualidade do sono, o risco da sÃndrome da apnÃia obstrutiva do sono (SAOS) e sÃndrome das pernas inquietas (SPI) foi detectado em todos os grupos. Pacientes com AMS apresentaram maior risco de SAOS e menor nÃmero de casos com SPI. Nos casos de AMS, uma correlaÃÃo entre os escores do IQSP e o estÃgio do Hoehn & Yahr foi observada (p<0,05). Na PSP, a SPI foi freqÃente (57%) e relacionou-se com a menor duraÃÃo e pior eficiÃncia do sono. Na DP, sonolÃncia diurna excessiva relacionou-se com a atrofia do PCM (p=0,01). Em conclusÃo, o alto risco de SAOS foi comum e proeminente nos casos de AMS. SPI foi mais freqÃente na DP e na PSP. Nos casos com PSP, a SPI associou-se com uma reduÃÃo da eficiÃncia e duraÃÃo do sono; e nos pacientes com DP e sonolÃncia excessiva diurna apresentaram maior atrofia do PCM (DP com sonolÃncia excessiva diurna PCM= 16,08Â0,93; DP sem sonolÃncia excessiva diurna PCM =17,82 0,80 p=0,01), sugerindo degeneraÃÃo de estruturas do tronco cerebral nesses pacientes. / We describe two studies, as follows: one concerns the role of cerebral morphometry as evaluated by magnetic resonance imaging (MRI) in the differential diagnosis of the parkinsonian syndromes; the other is about sleep alterations and the relationship with MRI changes in these syndromes. MRI measures can be useful for differential diagnosis between Parkinson disease (PD), progressive supranuclear palsy (PSP) and multiple system atrophy (MSA). The aim of this study was to evaluate the diagnostic value of structural anatomic changes identified by MRI in the differential diagnosis of these syndromes. We studied 21 cases with PD, 11 with MSA-c, 8 with MSA-p, 20 with PSP and 12 controls. Midbrain area (Ams), Pons area (Apn), middle cerebellar peduncle (MCP) and superior cerebellar peduncle (SCP) width were measured using MRI. Multiple comparisons were made between PD, MSA-p, MSA-c and PSP and we show that Apn, MCP and SCP width morphometry dimensions have clear cut differences in these syndromes. The Ams and SCP were the most predictive measures of PSP. A Midbrain area below 105 mm2 and SCP less than 3 mm showed a major probability for this diagnosis (sensitivity of 95.0 and 80.0%, respectively). For the group of MSA-c patients, an Apn area below 315mm2 showed good specificity and positive predictive value (93.8% and 72.7%, respectively). In conclusion, we demonstrate that dimensions and cut off values obtained from routine MRI can differentiate between PD, PSP and MSA-c with good sensitivity, specificity and accuracy. Despite common reports in PD, in other parkinsonian syndromes, sleep disturbances have been less frequently described. We compare sleep disturbances in patients with PD, MSA and PSP and analyze associations with brain MRI morphometry. This was a cross-sectional study of 16 PD cases, 13 MSA and 14 PSP. Sleep disturbances were evaluated by Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI), Restless Legs Scale and Berlin questionnaire. Apn, Ams, MCP width, and SCP width were measured using MRI. Poor quality sleep, risk of obstructive sleep apnea (OSA) and restless legs syndrome (RLS) were detected in all groups. Patients with MSA showed higher risk of OSA and less frequent RLS. In MSA, a correlation between PSQI scores and Hoehn and Yahr stage was observed (p<0.05). In PSP, RLS was frequent (57%) and related with reduced sleep duration and efficiency. In PD, excessive daytime sleepiness was related to atrophy of the MCP (p= 0.01). High risk of OSA was common and prominent in MSA cases. RLS was more frequent in PD and PSP, and in PSP, was associated with reduced sleep efficiency and sleep duration. In conclusion, the morphometric analysis of PD patients with excessive daytime sleepiness showed more atrophy of MCP (PD with excessive daytime sleepiness MCP= 16.08Â0.93; PD without excessive daytime sleepiness MCP=17.82Â0.80 p= 0.01) suggesting widespread degeneration of brainstem sleep structures on the basis of sleep abnormalities in these patients.

Orientador: Andrea Maculano Esteves / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Aplicadas / Made available in DSpace on 2018-08-27T14:39:48Z (GMT). No. of bitstreams: 1 Frank_MiriamKannebley_M.pdf: 2017505 bytes, checksum: 90d5e835563ce643e9eae9def3b7e5ed (MD5) Previous issue date: 2015 / Resumo: A relação entre hipertensão e os distúrbios do movimento relacionados ao sono, como a síndrome das pernas inquietas (SPI) vem sendo observada em seres humano, porém as causas e mecanismos que circundam esta comorbidade ainda não estão elucidados. O presente estudo investigou se a diminuição da pressão arterial (PA) induzida pelo exercício físico e/ou um inibidor-enzima conversora de angiotensina pode afetar a atividade locomotora de ratos espontaneamente hipertensos (SHR), com ênfase no sistema dopaminérgico. Na metodologia foi utilizado ratos da linhagem SHR e Wistar normotensos distribuídos em 4 grupos: controle, exercício físico, enalapril e exercício físico+ enalapril. O exercício físico foi realizado em esteira rolante e o enalapril administrado por gavagem, ambos durante 8 semanas. Durante este período a atividade locomotora e a PA de todos os grupos de ambas as linhagens foram avaliadas através do teste no Campo Aberto e por pletismografia de cauda, respectivamente. Após eutanásia dos animais os receptores dopaminérgicos, o transportador de dopamina, e a tirosina hidroxilase da região do corpo estriado foram avaliados através do Western Blot. O grupo SHR controle apresentou maiores valores na PA, maior atividade locomotora e níveis mais baixos dos receptores D2 e tirosina hidroxilase em comparação com todos os outros grupos ao longo do período experimental. Em geral, o exercício físico e o enalapril atenuaram estas alterações. Este estudo sugere a existência de comorbidade entre hipertensão e os sintomas sugestivos da SPI no modelo animal SHR, que são mediadas por mudanças dopaminérgicas. O exercício físico e o enalapril conferiram proteção tanto para a hipertensão quanto para mudanças comportamentais observadas / Abstract: The relationship between hypertension and sleep-related movement disorders, like restless legs syndrome (RLS) has been hypothesized for humans, but the causes and mechanisms are not elucidated. We investigated whether the alteration of blood pressure (BP) induced by physical exercise and/or an angiotensin-converting enzyme inhibitor (enalapril) can affects the locomotor activity on the spontaneously hypertensive rats (SHR), with emphasis on dopaminergic system. We use SHR and normotensive wistar rats distributed into 4 groups for each strain: Control, Physical Exercise, Enalapril and Enalapril+Physical-Exercise. Physical exercise was performed on a treadmill and enalapril was administered by gavage, both for 8 weeks. During this period the locomotor activity were evaluated in an open field test and BP was evaluated by tail plethysmography. Dopaminergic receptors, dopamine transporter and tyrosine hydroxylase at the striatum were evaluated at by western blot. The control SHR group showed higher BP, more activity in the open field test and lower levels of D2 receptor and tyrosine hydroxylase compared with all other groups throughout the experimental period. In general, physical exercise and enalapril attenuated these alterations. This study suggests the existence of comorbidity between hypertension and sleep-related movement disorders in SHR, which are mediated by dopaminergic changes. Physical exercise and enalapril conferred protection for both hypertension and the observed behavioral changes / Mestrado / Metabolismo e Biologia Molecular / Mestra em Ciências da Nutrição e do Esporte e Metabolismo

Disruption of sleep causes adverse health outcomes and poor quality of life. People with sleep disruption have higher levels than people without disrupted sleep of depression and anxiety and increased rates of cardiovascular diseases. Women have a higher incidence than men of insomnia and depression related to poor sleep. The types of complaints differ significantly between the sexes. Women are more likely than men to complain of insomnia, headache, irritability, and fatigue than the "typical" symptoms of loud snoring and breathing cessation during sleep. Hormones play an important role in sleep in women. Reproductive hormones were found to have a protective effect on sleep apnea in women of premenopausal age. Pregnancy is another period when the prevalence of sleep apnea and restless leg syndrome increases from hormonal effect. Cardiovascular mortality is high in women with obstructive sleep apnea. Continuous positive airway pressure therapy improves outcomes in most cases of obstructive sleep apnea. The epidemiology, risk factors, diagnostic criteria, and therapies for the three most common sleep disorders (insomnia, obstructive sleep apnea, and restless leg syndrome), along with effects of menopause, pregnancy, and social factors on sleep in women, are key considerations for clinicians caring for female patients across the adult life span.

Disruption of sleep causes adverse health outcomes and poor quality of life. People with sleep disruption have higher levels than people without disrupted sleep of depression and anxiety and increased rates of cardiovascular diseases. Women have a higher incidence than men of insomnia and depression related to poor sleep. The types of complaints differ significantly between the sexes. Women are more likely than men to complain of insomnia, headache, irritability, and fatigue than the "typical" symptoms of loud snoring and breathing cessation during sleep. Hormones play an important role in sleep in women. Reproductive hormones were found to have a protective effect on sleep apnea in women of premenopausal age. Pregnancy is another period when the prevalence of sleep apnea and restless leg syndrome increases from hormonal effect. Cardiovascular mortality is high in women with obstructive sleep apnea. Continuous positive airway pressure therapy improves outcomes in most cases of obstructive sleep apnea. The epidemiology, risk factors, diagnostic criteria, and therapies for the three most common sleep disorders (insomnia, obstructive sleep apnea, and restless leg syndrome), along with effects of menopause, pregnancy, and social factors on sleep in women, are key considerations for clinicians caring for female patients across the adult life span.