Made available in DSpace on 2015-07-22T20:50:31Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-05-27 / A restrição de sono de maneira crônica é uma condição observada por parte da população em geral e esta condição é regida por mecanismos reguladores fisiológicos do sono. Dados do nosso laboratório revelam que animais submetidos ao protocolo de restrição de sono crônica ao longo de 21 dias, com oportunidade de sono de 6h diárias não apresentaram prejuízo de memória. Entretanto, neste estudo a avaliação do desempenho dos animais na tarefa de esquiva inibitória ocorreu apenas na fase clara. Além disso, recentemente, foi demonstrado, que o desempenho dos animais privados de sono (96h) varia de acordo com a fase circadiana em que ocorreu a oportunidade de sono. O objetivo do presente estudo foi investigar a possibilidade da restrição crônica de sono prejudicar o desempenho de ratos na tarefa de esquiva inibitória quando os animais tivessem oportunidade de dormir em diferentes fases circadianas, ou seja, nas fases, clara e escura. Além disso, foi realizado o registro de sono para análise dos padrões de sono durante a fase clara e na fase escura. A restrição de sono crônica foi realizada pelo método das plataformas múltiplas e os animais foram treinados na tarefa de esquiva inibitória. Uma hora após o treino, os animais foram submetidos ao teste. Demonstramos que seis horas de oportunidade de sono (fase clara e escura) não produziu prejuízo no desempenho da tarefa de memória. Entretanto, nós observamos um déficit no desempenho na tarefa de esquiva inibitória após 4h de oportunidade de sono somente na fase escura, ou seja, quando a oportunidade de dormir ocorreu no período de maior atividade dos animais. As análises do padrão de sono revelam que apesar dos animais terem apresentado rebote de sono nos dois momentos circadiano, observamos maior aumento na porcentagem, no número de episódios e na duração média do sono paradoxal durante a fase escura. Quando reduzimos a oportunidade de sono para 3h o prejuízo no desempenho na tarefa de memória já é observado na fase clara. Estes resultados sugerem que a restrição de sono crônica produz prejuízo de memória dependendo da duração da oportunidade de sono, mudanças na duração e no número de episódios de sono paradoxal e da coincidência entre os fatores homeostático e circadiano. / There are numerous studies suggesting that sleep deprivation induce deleterious effects in the rat performance on memory tasks. However, there are but a few studies on the effects of experimental chronic sleep restriction on those tasks. Recently, we observed that rats submitted to a protocol of chronic sleep restriction in which the animals were sleep-deprived for 18h/day and allowed to sleep for 6h in the light phase, during 21 consecutive days, showed no deficits on memory. Here, we investigated the possibility that chronic sleep restriction would impair the performance on the inhibitory avoidance task when rats are allowed to sleep in different circadian phases. Rats were deprived of sleep using the platform method and then trained in a step-through inhibitory avoidance task. One hour after training, the animals were given a retention test. Neither 6h of sleep opportunity (light and dark phase) nor 4h sleep opportunity (light phase) induced impairment on inhibitory avoidance. However, we observed a deficit on performance on inhibitory avoidance task after 4h of sleep opportunity in the dark phase, when there is no coincidence between circadian and homeostatic pressure. Also, 3h of sleep, even in the light phase were not enough to prevent the memory impairment. These results suggest that the memory impairment of sleep deprived rats could be a result of disrupted coincidence between circadian and homeostatic drivers to sleep. / TEDE / BV UNIFESP: Teses e dissertações

Kognitiv beteendeterapi för primär insomni är inte lika effektivt som KBT för annan problematik. Behandlingen har mest fokuserat på förändring av sömn och bortsett från andra faktorer som kan bidraga till problematiken. Denna studie syftade till att utvärdera effekten av att addera en intervention mot en ytterligare faktor, nämligen oro, till behandling. Studien hade en single subject-design med två betingelser, med och utan oroshantering, för- och eftermätning och sju deltagare. Resultaten tyder på att metoden konstruktiv oro tillförde bättre utfall på sömn, oro och daglig funktion. Slutsatsen är att fokus på fler faktorer än sömn, som oro och dagtidsfunktion, kan effektivisera KBT för primär insomni. / Cognitive behavioral therapy for primary insomnia is not as effective as CBT for other problems. The treatment has primary focused on change of sleep and neglected other factors which can contribute to the problem. The purpose of this study was to investigate the effect of adding an intervention aimed at an additional factor, namely worry, to treatment. The study had a single subject design with two conditions, with and without constructive worry, pre- and posttest and seven participants. The results indicated that the intervention constructive worry added better outcomes on sleep, worry and daytime function.  The conclusion that can be drawn is that a focus on more factors than sleep, such as worry and daytime function, can render CBT for primary insomnia more effective.

Insufficient sleep duration and poor sleep quality can potentiate weight gain and obesity in adolescents. Furthermore, overweight and obese females are at unique risk for insufficient sleep and associated health complications. We examined self-reported sleep duration and self-reported adequacy of sleep duration as potential moderators of the relationship between eating behavior and several cognitive processes including hedonic hunger, executive dysfunction, and self-control. We used a multisystemic conceptual framework to highlight the pathways that may explain the relationship between sleep behaviors and the Healthy Eating Index (HEI). The study employed a cross-sectional design. Participants completed baseline measures of height and weight, self-control, executive functioning, hedonic hunger, and sleep functioning. Self-report of poor sleep adequacy directly influenced executive dysfunction which consequently explained a decrease in self-control functioning. Moreover, we evaluated whether sleep deprivation and extension influences caloric intake. We offer novel yet promising evidence that 9 hrs of sleep fostered greater self-control functioning which promoted intake of 484.69 fewer calories per day compared to sleep deprivation. Our study is well-positioned to improve understanding of individual cognitive subsystems and the mechanism that underlies the influence of sleep behavior on weight-related behaviors among overweight and obese females. Findings from this study have the potential to inform health interventions that promote healthy eating and sleep behaviors.

Sömnsvårigheter inklusive insomni är ett utbrett problem för stora delar av befolkningen. Personer med insomni tenderar att oroa sig över sin sömn och har dysfunktionella antaganden kring sömnbristens konsekvenser. Studiens huvudsakliga syfte var att undersöka om skillnader i utfall mellan två behandlingsmetoder för insomni kunde tillräknas en exponeringseffekt. Studiens hypoteser var: 1a) Patienter som deltar i sömnrestriktion kommer få en större reducering av oro över sin sömn. 1b) Det finns ett samband mellan hög följsamhet till behandlingsmetoden och minskad oro över sömnen. 2) En kraftigare exponering medför lägre följsamhet till behandlingsmetoden. 3) Det finns ett samband mellan minskad oro över sömnen och minskade insomnisymptom. Data användes där 185 deltagare randomiserats till någon av KBT-behandlingarna för insomni sömnkomprimering (n=93) och sömnrestriktion (n=92). Oron hade minskat för studiedeltagarna fem veckor efter behandlingsstart men inga signifikanta skillnader påträffades mellan grupperna. Ett signifikant samband observerades mellan minskning av insomnisymptom och oro över sömnbrist. Slutsatser från uppsatsen är det redan etablerade sambandet mellan oro och insomni bekräftas. Studien kunde inte bekräfta hypotesen att exponering leder till minskad oro. Vidare forskning rekommenderas för att avgöra hur exponering kan användas för patienter med insomni för att möjliggöra effektivare behandlingsmetoder. / Sleep impairments including insomnia is a widespread problem affecting a large quantity of the population. Insomnia patients tend to worry about their sleep and having dysfunctional beliefs about sleep deficit consequences. The main purpose of this study was to examine if differences in results between two treatment methods could be attributed to effects of exposure. The hypotheses in the study were: 1a) Patients who participate in sleep restriction will have a greater reduction of sleep-related worry. 1b) There is a correlation between high compliance to the treatment methods and reduced sleep-related worry. 2) A greater exposure induces lower compliance to the treatment methods. 3a) There is a correlation between reduction of sleep-related worry and reduction of insomnia symptoms. Data consisted of 185 participants who was randomised into the CBT-treatments for insomnia sleep compression (n=93) or sleep restriction (n=92). A hypothesis was that sleep restriction implicate more exposure than sleep compression. Worry had decreased among participants after five weeks of treatment but no significant differences occurred between the groups. A significant correlation occurred between reduction of insomnia symptoms and reduction of worries regarding sleep deficit. Conclusions is that the already established correlation between worry and insomnia is confirmed. This study failed to confirm that exposure leads to reduced worry. Further research is advised to determine how exposure can be used for insomnia patients to enable more efficient treatment methods. / ClinicalTrials.gov Identifier: NCT02743338, CompRest - a Comparison Between Sleep Compression and Sleep Restriction for Treating Insomnia

Insomni är ett vanligt problem och det finns behov av ökad tillgänglighet till kostnadseffektiva behandlingar. Syftet var att undersöka om en enkomponentsbehandling (EK), bestående av sömnrestriktion/sömnkomprimering, var non-inferior till en multikomponent (MK) KBT- behandling vid insomni och om det fanns en skillnad i symtomreduktion. Gränsvärden för non- inferiority var d = 0.8, utifrån tidigare forskning, respektive en strängare gräns d = 0.4. Data från en forskningsstudie där deltagarna erhöll EK (n = 193) jämfördes mot en riktlinje i form av en KBT-behandling i reguljärvården, MK (n = 289). Båda grupper erhöll behandling via samma internetplattform, och Insomnia Severity Index (ISI) användes som utfallsmått. Resultaten visade att EK inte kunde bekräftas som non-inferior till MK direkt efter behandling eller vid 1-årsuppföljning när en sträng gräns användes. När en liberal gräns användes kunde EK bekräftas som non-inferior direkt efter behandling men inte ett år senare. Direkt efter behandling och vid 1-årsuppföljningen visade båda grupperna en signifikant minskning av insomnisymtom, men vid 1-årsuppföljningen visade MK en större minskning. Ett stort bortfall vid 1-årsuppföljning och mer terapeutstöd för MK kan ha påverkat resultaten. Fler RCT-studier med långtidsuppföljningar behövs inom området, och även studier på andra populationer. MK är att föredra, men vid begränsade resurser kan EK erbjudas med god effekt på både kort och lång sikt. / Insomnia is a common problem and there is a need for increased accessibility to cost-effective treatments. The purpose was to examine if an one-component treatment (EK), consisting of sleep-restriction/sleep-compression, were non-inferior to a multi-component (MK) CBT treatment for insomnia and if there was a difference in symptom reduction. The prestated margins for non-inferiority were d = 0.8, based on previous research, and a stricter margin of d = 0.4. Data from a research study where participants received EK (n = 193) was compared to a benchmark consisting of a CBT treatment in regular health care (MK) (n = 289). Both groups received treatment at the same Internet platform, and Insomnia Severity Index (ISI) was used as outcome measurement. The results showed that EK could not be confirmed as non-inferior to MK directly after treatment or at the one-year follow up when using a strict limit. When a liberal limit was used, EK could be confirmed as non-inferior directly after treatment but not one year later. Directly after treatment and at the one-year follow up both groups showed a significant symptom reduction, but at the one-year follow up MK showed a greater reduction. A large number of missing data at the one-year follow up and more therapeutic support in MK may have affected the results. More RCT-studies with longterm follow ups are needed in the area, and also studies of other populations. MK is preferable, but with limited resources EK can be offered with good effect both short term and long term.