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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Effets du vieillissement sur les déficits cognitifs associés au syndrome des apnées obstructives du sommeil

Mathieu, Annie January 2007 (has links)
Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal
22

Surveillance temps-réel des systèmes Homme-Machine. Application à l'assistance à la conduite automobile

Gonzalez-Mendoza, Miguel 16 July 2004 (has links) (PDF)
Ce travail se situe dans le cadre de la surveillance de systèmes homme-machine, où l'opérateur humain est un élément de décision dans la boucle. Ce type de systèmes nécessite une surveillance automatisée globale temps-réel, incluant la détection d'incidents techniques et de défaillances humaines. Partant de l'hypothèse que la partie technologique travaille " correctement " et/ou qu'elle est surveillée par un système de diagnostic, nous nous centrons sur la partie opérateur humain, la plus critique à surveiller. Nous présentons un système de diagnostic appliqué à la surveillance du conducteur automobile à partir d'informations fournies par des capteurs embarqués dans le véhicule. Les travaux ont été développés dans le cadre du projet Européen AWAKE et le projet national " facteurs de dégradation de la vigilance et de la sécurité dans les transports " de PREDIT.<br />Nous proposons une stratégie générale de système temps-réel pour la surveillance du niveau de vigilance du conducteur (dynamique lente) et la surveillance du niveau de risque lié à la situation actuelle de conduite (dynamique instantanée), à travers :<br />* L'analyse temporelle et fréquentielle des signaux mécaniques (mesures de performance) par ondelettes et filtres, pour en extraire des caractéristiques dynamiques, statistiques et fréquentielles sur la dégradation de la conduite,<br />* L'apprentissage par SVM, méthode pour laquelle nous avons développé des stratégies d'implémentation adaptées pour un apprentissage en ligne et pour des problèmes de grande taille,<br />* La fusion par FIS, afin de profiter de l'expertise humaine et produire un diagnostic sur le niveau de risque lié à la sortie de la voie de circulation.<br />* La validation d'une telle approche à travers des EEG et EOG (mesures physiologiques) et des autoévaluations (mesures subjectives).<br />Nous appliquons cette méthodologie à diverses expériences des programmes AWAKE et PREDIT réalisées sur des simulateurs ou des démonstrateurs.
23

Ciclo vigília/sono e a saúde dos adolescentes / Sleep-wake cycle and health of adolescents

Carniel, Joana Desirée 25 June 2014 (has links)
Made available in DSpace on 2016-12-06T17:07:01Z (GMT). No. of bitstreams: 1 Joana Carniel - Dissertacao.pdf: 1480883 bytes, checksum: 0e7aa3c6da93e8b4a83835b3d8e72d16 (MD5) Previous issue date: 2014-06-25 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / During the teenage years, there are significant alterations in the expression of the Sleep-Wake Cycle with great consequences for health. The two main objectives of this study were to validate the Pediatric Daytime Sleepiness Scale (PDSS) for the Brazilian Portuguese and analyze the associations between the matters of health with the variables related to the Sleep-Wake Cycle of teenagers. In order to answer the first objective the sample was formed by 90 teenagers of both sexes, age ranging form 11 to 18 years old, enrolled in two private schools, one in Florianopolis-SC and the other in Curitiba-PR. To answer the second objective, a sample was formed considering a population of teenagers in a private school in Florianopolis-SC (N=198). To validate, the typical process of analysis like translation, back translation and the analysis of internal consistency were used. To evaluate the issues related to the Sleep-Wake Cycle, it was analyzed: time to go to sleep and wake up (day with no classes), the duration of the sleep, the excessive daily somnolence, the chronotype and the quality of the sleep. In the health variables, issues like the perception of health and stress, the consumption of nutrients during school snack, physical activities, time used in media for recreation, BMI and weight status were investigated. Analysis of association, differences between averages and internal consistency were made considering a significance level of 5%. It was checked that the PDSS presented suitable indicators of contents validity and clarity of language in Brazilian Portuguese. The analysis of the internal consistency identified Cronbach`s alpha of 0,784. The PDSS showed suitable reproducibility in test-retest (p=0,725). The scores of the PDSS presented negative and significant interconnection with the duration of the sleep (r= -0,214; p=0,011). In the second objective, it was observed that teenagers who sleep less, show more somnolence (p=0,028), spend more time in front of the screen of electronic devices exercising sedentary behavior (p=0,011) and spend more time commuting to school (p=0,023). Other than that, the results show that the tendency to eveningness is associated to a bigger consumption of carbohydrates in the school snack (p=0,032), with more leisure time in front of the screen of electronic devices (p=0,005) and a bigger BMI (p=0.017). It can be pointed out that health and sleep issues in teenagers have important relations and that the accompaniment of these matters in the school environment is necessary. / Na adolescência, ocorrem significativas alterações na expressão do ciclo vigília/sono com importantes consequências para a saúde. Os dois objetivos principais deste estudo foram, validar a Pediatric Daytime Sleepiness Scale (PDSS) para o português brasileiro e analisar as associações entre as questões de saúde com as variáveis relacionadas ao ciclo vigília/sono de adolescentes. Para responder ao primeiro objetivo a amostra foi formada por 90 adolescentes, de ambos os sexos, com idades de 11 a 18 anos matriculadas em duas escolas particulares, sendo uma em Florianópolis SC e outra em Curitiba PR. Para responder ao segundo objetivo formou-se uma amostra considerando a população de adolescentes de uma escola particular de Florianópolis SC. Para validação utilizou-se o processo típico de análise como, tradução, retrotradução e análise da consistência interna. Para avaliar as questões relacionadas ao ciclo vigília/sono foram analisados: os horários de dormir e acordar (nos dias com e sem aulas), a duração do sono, a sonolência diurna excessiva, o cronotipo e a qualidade do sono. Nas variáveis de saúde foram investigadas questões como a percepção de saúde e estresse, consumo de nutrientes no lanche escolar, atividade física, tempo de utilização de mídias no lazer, IMC e status de peso. Realizaram-se análises de associação, diferenças entre médias e de consistência interna considerando um nível de significância de 5%. Verificou-se que a PDSS apresentou adequados indicadores de validade de conteúdo e clareza de linguagem em português do Brasil. A análise da consistência interna identificou alfa de Cronbach de 0,784. A PDSS apresentou adequada reprodutibilidade em teste-reteste (p=0,725). Os escores da PDSS apresentaram correlação negativa e significativa com a duração do sono (r= -0,214; p=0,023). No segundo objetivou observou-se que os adolescentes que dormem menos tempo apresentam maior sonolência (p=0,028), passam mais tempo em frente às telas de mídias eletrônicas exercendo comportamento sedentário (p=0,011) e possuem maior tempo de deslocamento para a escola (p=0,023). Além disso, os resultados mostram que a tendência a vespertinidade se associou com maior consumo de carboidrato no lanche escolar (p=0,032), com mais tempo do lazer em frente às telas de mídias eletrônicas (p=0,005) e com maior IMC (p=0,017). Destaca-se que as questões de saúde e sono dos adolescentes possuem importantes relações e que o acompanhamento destas questões no ambiente escolar faz-se necessário.
24

Dist?rbios do sono em pacientes com transtorno depressivo / Evaluation of sleep disorders complaints in outpatients with depressive disorder

Chellappa, Sarah Laxhmi 19 July 2006 (has links)
Made available in DSpace on 2014-12-17T14:13:51Z (GMT). No. of bitstreams: 1 SarahLC.pdf: 479103 bytes, checksum: 18505e514106184b131f32d9fea8ec78 (MD5) Previous issue date: 2006-07-19 / To evaluate sleep disorder complaints in outpatients with depressive disorder from a general hospital. Methods: An observational, cross-sectional study was carried out with a study sample composed of 70 patients (44 women and 26 men) with diagnosis of depressive disorder, according to the DSM-IV criteria. The patients were interviewed and evaluated by the Identification Questionnaire, the Sleep Habits Questionnaire and the Beck Depression Inventory (BDI). Results: In this study, 50 (71.3%) patients had recurrence of sleep disorder complaints. Mean BDI score was 35.83+8.85, with significant differences between patients with (38.50+8.70) and without (29.60+7.80) recurrence (p<0.05) and among patients with 1, 2, 3 and >3 episodes (p<0.05). In this study, 49 (70%) patients had insomnia and 21 (30%) had subjective excessive sleepiness. Significant differences were observed between the mean duration in months of the sleep disorders (7.16+2.10) and the depressive disorder (6.12+1.90) (p<0.05). Discussion: In the study sample, recurrence of sleep disorder complaints was high and significantly associated with severe depression. Insomnia was prevalent and the mean duration of sleep disorders was higher in relation to depressive disorder / Identificar e avaliar os transtornos do sono presentes em pacientes ambulatoriais com transtorno depressivo do Hospital Universit?rio Onofre Lopes, Natal, RN. M?todos: Foi realizado um estudo transversal com uma amostra n?o-probabil?stica de 70 pacientes, sendo 26 homens e 44 mulheres, com m?dia de idade de 40,48 + 12,54. A sele??o dos pacientes foi realizada segundo os seguintes crit?rios de inclus?o: idade entre 18 e 65 anos e diagn?stico de transtorno depressivo dado atrav?s de entrevista cl?nica segundo os crit?rios da DSM-IV. Os pacientes foram entrevistados e avaliados atrav?s dos seguintes instrumentos: Ficha de identifica??o e de avalia??o m?dica; Prontu?rios m?dicos; Question?rio de H?bitos do Sono; ?ndice de Qualidade do Sono de Pittsburgh; Escala de Sonol?ncia de Epworth; Invent?rio de Depress?o de Beck; Escala de Idea??o Suicida de Beck. Resultados: Neste estudo, 50 (71,3%) pacientes apresentaram recorr?ncia das queixas de transtornos do sono, que foi associada significativamente ? gravidade do epis?dio depressivo. Um total de 49 (70%) pacientes apresentou ins?nia e 21 (30%) sonol?ncia excessiva. A dura??o m?dia dos transtornos do sono foi maior em rela??o ? do transtorno depressivo. Na amostra, os pacientes apresentaram qualidade subjetiva do sono ruim, principalmente em pacientes com ins?nia. Houve uma associa??o entre a ins?nia e a sonol?ncia excessiva com a idea??o suicida. A sonol?ncia diurna excessiva foi freq?ente nos pacientes com transtorno depressivo e associado significativamente ? gravidade do quadro depressivo e ? idea??o suicida. A preval?ncia de pesadelos nos pacientes foi elevada e relacionada ? gravidade do quadro depressivo. Paralelamente, o Question?rio de H?bitos do Sono, utilizado neste estudo para acessar as queixas de transtornos do sono, foi confi?vel e v?lido para o uso na avalia??o da ins?nia e da sonol?ncia excessiva em pacientes depressivos ambulat?rias. Conclus?es: Houve uma marcante associa??o entre os transtornos do sono, como ins?nia, sonol?ncia excessiva e pesadelos, com o transtorno depressivo, sugerindo que a investiga??o criteriosa dos transtornos do sono ? necess?ria na avalia??o da gravidade do quadro depressivo
25

Efeitos da expansão rápida da maxila cirurgicamente assistida na síndrome da apneia obstrutiva do sono, na sonolência diurna e na morfologia da via aérea / Effects of surgically assisted rapid maxillary expansion on obstructive sleep apnea syndrome, on daytime sleepiness and on airway morphology

Pedro Pileggi Vinha 22 May 2015 (has links)
A apneia obstrutiva do sono é uma síndrome que produz múltiplas comorbidades, aumentando significativamente a taxa de mortalidade dos seus portadores. A atresia maxilar vem sendo descrita como um dos fatores etiológicos da SAOS, entretanto não existem estudos que demonstrem a eficácia no tratamento em adultos com consequente redução dos eventos obstrutivos durante o sono. Este trabalho tem como objetivo principal a verificação da expansão rápida da maxila cirurgicamente assistida (ERMCA), nos eventos obstrutivos do sono e demais parâmetros polissonográficos, na sonolência diurna e no comportamento morfométrico da via aérea. A amostra foi realizada em indivíduos adultos com apneia obstrutiva do sono (SAOS), atresia maxilar e mordida cruzada. O método adotado foi um ensaio clínico prospectivo com 16 participantes (7 mulheres / 9 homens) com idade de 40,23 ± 10,23, todos portadores de SAOS comprovada por polissonografia (PSG) de noite toda (IDR superior a 5), atresia maxilar e mordida cruzada posterior. Previamente todos participantes foram submetidos a uma tomografia computadorizada (TC) da via aérea superior e foi aplicado o teste da Escala de Sonolência de Epworth (ESE). Todos os pacientes foram então submetidos à ERMCA, e posteriormente, todos os exames foram refeitos para comparação. Foi constatada uma redução no IDR de 35,46 ± 38,54 para 16,07 ± 19,73, uma redução média de 54,68% (p=0,0013) e no IAH em 56,24% (33,23 ± 39,54 para 14,54 ± 19,48: p=0,001), uma redução dos índices de microdespertares e dessaturação, além da melhora de diversos parâmetros polissonográficos. O ESE apresentou uma melhora de 12,50 ± 5,32 para 7,25 ± 3,53 (p<0,001). A via aérea total ampliou em média 23,99% (p=0,016), mas de uma maneira mais expressiva na sua metade inferior (28,63% p=0,008). Em relação aos resultados obtidos por meio da ERMCA observou-se uma melhora da SAOS, redução dos índices relacionados aos distúrbios respiratórios durante o sono, de microdespertar e de dessaturação, ampliação da via aérea, principalmente na metade inferior, além de melhorar a sonolência diurna, devolvendo- a para a normalidade. / Obstructive sleep apnea syndrome (OSAS) is a condition that produces multiple comorbidities, significantly increasing the mortality rate of affected individuals. Maxillary atresia is being described as one of the etiological factors of OSAS, although there are no studies demonstrating the efficacy of treatment in adults with a consequent reduction of obstructive events during sleep. The main objective of the present study was to determine the effects of surgically assisted rapid maxillary expansion (SARME) on obstructive sleep events and all other polysomnography (PSG) parameters, on daytime sleepiness and on the morphometric behavior of the airways. The study was conducted on adult individuals with OSAS, maxillary atresia and crossbite. The method involved a prospective clinical assay with 16 participants (7 women/9 men) aged 40.23 ± 10.23 years, with OSAS confirmed by all-night PSG (respiratory disorder index (RDI) higher than 5), maxillary atresia and posterior crossbite. All participants were first submitted to computed tomography of the upper airways and to the Epworth Sleepines Scale (ESS) test. All patients were then submitted to SARME and all exams were later repeated for comparison. RDI was reduced from 35.46 ± 38.54 to 16.07 ± 19.73, (a mean reduction of 54.68%, p=0.0013), the apnea-hypopnea index (AHI) was reduced from 33.23 ± 39.54 to14.54 ± 19.48 (a mean reduction of 56.24%, p=0.001), and micro-awakenings and desaturation were also reduced. The ESS score improved from 12.50 ± 5.32 to 7.25 ± 3.53 (p<0.001). Mean total airway area was increased by 23.99% (p=0.016), although in a more expressive manner in the lower half (28.63%, p=0.008). The results obtained by SARME revealed an improvement of OSAS, a reduction of the indices related to respiratory disorders during sleep, of micro-awakennings and of desaturation, as well as airway expansion, especially in the lower half, and improvement of daytime sleepiness with a return to normality.
26

Troubles du sommeil et de l’éveil dans la phase chronique d’un traumatisme craniocérébral modéré-sévère

El-Khatib, Héjar 07 1900 (has links)
Le traumatisme craniocérébral (TCC) modéré à sévère constitue une cause majeure d’invalidité chez les jeunes adultes. Il entraine des séquelles physiologiques, comportementales, cognitives et affectives qui entravent le devenir fonctionnel et psychosocial des survivants. Les perturbations de la qualité du sommeil et de l’éveil figurent parmi les plaintes les plus fréquentes et persistantes à la suite d’un TCC modéré à sévère, mais on ignore si celles-ci sont associées à une atteinte de l’intégrité du sommeil. Cette question est primordiale puisque le sommeil est central pour maintenir les capacités d’éveil et un fonctionnement cognitif optimal, ce qui est d’autant plus essentiel lorsque le cerveau est lésé. Cette thèse vise ainsi à caractériser la nature et les corrélats des perturbations du sommeil et de l’éveil durant la phase chronique d’un TCC modéré à sévère. L’association entre les capacités d’apprentissage post-TCC et l’activité à ondes lentes, une caractéristique du sommeil lent connue pour jouer un rôle dans la plasticité synaptique et la mémoire, est également explorée. Pour ce faire, des mesures objectives (actigraphie, polysomnographie) et subjectives (agenda de sommeil et questionnaires) de sommeil-éveil ont été conduites chez des survivants d’un TCC modéré à sévère et des sujets contrôles en bonne santé. La sévérité du trauma, la présence de comorbidités (anxiété, dépression, douleur) et la prise de médicaments psychotropes ont aussi été documentées. La première étude a montré que comparativement aux contrôles, les personnes ayant subi un TCC modéré à sévère rapportent un niveau significativement plus élevé de difficultés d’endormissement, de mauvaise qualité de sommeil, de somnolence diurne et de fatigue. L’actigraphie enregistrée sur une semaine à domicile n’a en revanche pas montrée de perturbations de la qualité du sommeil nocturne. Au contraire, la durée de sommeil sur une période de 24h était significativement supérieure chez les participants TCC par rapport aux contrôles, et cela particulièrement dans un sous-groupe de participants TCC sous médication psychotrope et qui ont subi un trauma global plus sévère. La présence de comorbidités était par ailleurs associée aux plaintes de sommeil-éveil dans le groupe TCC. Dans la deuxième étude, l’architecture du sommeil telle que mesurée par la polysomnographie a été évaluée. Là encore, les résultats indiquent que malgré des plaintes significatives de sommeil-éveil chez le groupe TCC, la macro- et microarchitecture du sommeil étaient similaires chez ces derniers comparativement au groupe contrôle. Toutefois, une association a été montrée entre la qualité du sommeil et la cognition post-TCC, de sorte que plus i l’activité à ondes lentes est élevée au cours du sommeil lent, meilleures sont les performances d’apprentissage et de mémoire épisodique du lendemain. Cette association était plus forte à la suite de la survenue d’un TCC plus sévère par rapport à un TCC moins sévère, suggérant une plus forte dépendance des survivants ayant subi un TCC sévère à l’activité à ondes lentes au cours du sommeil pour apprendre de nouvelles informations. Cette thèse apporte de nouvelles évidences que le cerveau lésé à la suite d’un TCC modéré à sévère semble capable de produire une architecture de sommeil comparable à celle de sujets contrôles en santé. Les plaintes de sommeil-éveil persistantes à la suite d’un TCC modéré à sévère apparaissent influencées par d’autres facteurs, notamment la survenue d’un trauma plus complexe nécessitant une prise en charge pharmacologique, ainsi que des facteurs environnementaux et comorbides. En outre, cette thèse supporte le besoin d’explorer davantage le rôle du sommeil dans les capacités cognitives post-TCC. / Moderate to severe traumatic brain injury (TBI) is a major cause of disability in young adults. It causes physiological, behavioral, cognitive and emotional sequelae that hinder functional and psychosocial outcomes. Disturbances in sleep quality and wakefulness are among the most common and persistent complaints in moderate to severe TBI survivors. However it is unclear if these complaints are associated with impaired sleep integrity. This question is crucial as sleep is central in wakefulness-promoting and optimal cognitive functioning, which is particularly essential when the brain is injured. This thesis aims to characterize the nature and correlates of sleep and wakefulness disturbances during the chronic phase of moderate to severe TBI. The association between post-TBI learning capacity and slow-wave activity, a sleep characteristic known to play a role in synaptic plasticity and memory, is also explored. To do this, objective (actigraphy, polysomnography) and subjective (sleep diary and questionnaires) sleep-wake measures were used in moderate to severe TBI survivors and healthy control subjects. The severity of the trauma, the presence of comorbidities (anxiety, depression, pain) and the use of psychotropic medications have also been documented. The first study showed that compared to controls, people with moderate to severe TBI reported significantly lower sleep quality, and higher levels of daytime sleepiness and fatigue. Yet, a seven-day actigraphy recording did not show any disturbances in the nighttime sleep efficiency. Rather, sleep duration over a 24h period was significantly increased in participants with TBI compared to controls, particularly in a subgroup of TBI who used psychotropic medications and suffered a more severe overall trauma. The presence of comorbidities was also associated with sleep-wake complaints in TBI group. In the second study, the sleep architecture as measured by polysomnography was evaluated. Again, the results indicated that despite significant sleep-wake complaints in TBI group, the macro- and micro-architecture of sleep measured in the TBI group were similar to those in the control group. However, an association between sleep quality and post-TBI cognition was shown, as higher slow-wave-activity sleep was associated with better memory performance the day after. This association was stronger following more severe TBI compared to milder TBI, suggesting that adults who sustained more severe TBI are more dependent on sleep slow-wave-activity for next- day memory function. iii This thesis brings new evidence that the injured brain following moderate to severe TBI appears to be able to produce sleep architecture comparable to healthy control subjects. Persistent sleep- wake complaints following moderate-to-severe TBI appear to be influenced by other factors, including the occurrence of more complex trauma requiring pharmacological management, as well as environmental and comorbid factors. In addition, this thesis supports the need to further explore the role of sleep in post-TBI cognitive abilities.
27

Impacts fonctionnels diurnes et corrélats psychopathologiques dans le somnambulisme adulte

Labelle, Marc-Antoine 12 1900 (has links)
No description available.
28

L’effet du port nocturne des prothèses complètes sur le sommeil et la qualité de vie liée à la santé buccodentaire : une étude pilote expérimentale

Nguyen, Phan The Huy 05 1900 (has links)
Problématique : L’édentement et les troubles du sommeil sont des affections chroniques fréquentes chez les personnes âgées et qui peuvent avoir des conséquences défavorables sur le bien-être de ces personnes, ainsi que sur leur qualité de vie. L’édentement pourrait perturber le sommeil par la modification de la structure crânio-faciale et des tissus mous environnants. Cependant, cette relation n'est pas suffisamment documenté. Objectifs : Le but de cette étude pilote était de préparer la mise en œuvre d’une étude clinique randomisée contrôlée concernant l’effet du port nocturne des prothèses complètes sur la qualité du sommeil. Méthodologie : Treize aînés édentés ont participé à cette étude clinique randomisée contrôlée de type croisé. L’intervention consistait à dormir avec ou sans les prothèses durant la nuit. Les participants à l'étude ont été assignés à porter et ne pas porter leurs prothèses dans des ordres alternatifs pour des périodes de 30 jours. La qualité du sommeil a été évaluée par la polysomnographie portable et le questionnaire Pittburgh Sleep Quality Index (PSQI). Les données supplémentaires incluent la somnolence diurne, évaluée par le questionnaire Epworth Sleepiness Scale (ESS), et la qualité de vie liée à la santé buccodentaire, évaluée par le questionnaire Oral Health Impact Profile 20 (OHIP-20). De plus, à travers les examens cliniques et radiologiques, les données des caractéristiques sociodémographiques, de la morphologie oropharyngée, des caractéristiques buccodentaires et des prothèses ont été recueillies. Les modèles de régression linéaire pour les mesures répétées ont été utilisés pour analyser les résultats. Résultats : L’étude de faisabilité a atteint un taux de recrutement à l’étude de 59,1% et un taux de suivi de 100%. Le port nocturne des prothèses dentaires augmentait l’index d'apnée-hypopnée (IAH) et le score PSQI par rapport au non port nocturne des prothèses : (IAH : Médiane = 20,9 (1,3 - 84,7) versus 11,2 (1,9 - 69,6), p = 0,237; le score PSQI : Médiane = 6,0 (3,0 - 11,0) versus 5,0 (1,0 - 11,0), p = 0,248). Cependant, ces différences n'étaient pas statistiquement significatives, sauf que pour le temps moyen d’apnée (plus long avec des prothèses) (p < 0,005) et le temps de ronflement relatif (moins élevé avec des prothèses) (p < 0,05). La somnolence diurne excessive et la qualité de vie liée à la santé buccodentaire étaient semblables pour les deux interventions (le score ESS : Médiane = 4,0 (3,0-10,0) versus 5,0 (2,0-10,0), p = 0,746; le score OHIP-20: Médiane = 31,0 (20,0-64,0) versus 27,0 (20,0-49,0), p = 0,670). L’impact néfaste du port nocturne des prothèses complètes sur le sommeil a été statistiquement significatif chez les personnes souffrant de l’apnée-hypopnée moyenne à sévère (p < 0,005). Conclusion : L’essai clinique pilote a montré que le port nocturne des prothèses complètes a un impact négatif sur la qualité du sommeil des gens âgés édentés, surtout chez les personnes avec l’apnée obstructive du sommeil modérée à sévère. Les résultats doivent être confirmés par l’étude clinique randomisée contrôlée de phase II. / Problem: Edentulism and sleep disturbance are common chronic conditions in older people and may have adverse consequences on well-being of these persons, as well as their quality of life. Indeed, edentulism can modify the craniofacial structure and surrounding soft tissue, and lead to sleep disturbance in edentate individuals. However, this relationship is not sufficiently documented. Objectives: The aim of this study was to prepare a pilot randomized controlled trial on the effect of nocturnal complete denture wear on sleep quality. Methods: Thirteen edentate elders participated in this randomized cross-over clinical trial. The intervention consisted of sleeping with or without dentures at night. The study participants were assigned to wear and not wear their denture in alternate orders for periods of 30 days. Sleep quality was assessed by portable polysomnography and the Pittsburgh Sleep Quality Index (PSQI). Additional data included: daytime sleepiness assessed by the Epworth Sleepiness Scale (ESS) and oral-health-related quality of life assessed by the Oral Health Impact Profile 20 (OHIP-20). Furthermore, through the clinical and radiographic examinations, data on sociodemographic, oropharyngeal morphology, and oral and prosthesis characteristics were gathered. Linear regression models for repeated measures were used to analyze the data. Results: The recruitment rate for this study was 59.1% and the follow-up rate was 100%. Sleeping with dentures resulted in higher apnea-hypopnea index (AHI) and higher PSQI score when compared with sleeping without dentures (AHI: Median = 20.9 (1.3-84.7) vs. 11.2 (1.9-69.6), p = 0.237; PSQI score: Median = 6.0 (3.0-11.0) vs. 5.0 (1.0-11.0), p = 0.248). However, these differences were not statistically significant, except for the mean apnea time (more with dentures) (p < 0.005) and the relative snoring time (less with dentures) (p < 0.05). Excessive daytime sleepiness and the oral-health-related quality of life were similar for two interventions (ESS score: Median = 4.0 (3.0-10.0) vs. 5.0 (2.0-10.0), p = 0.746; OHIP-20 score: Median = 31.0 (20.0-64.0) vs. 27.0 (20.0-49.0), p = 0.670). The negative impact of sleeping with complete dentures wear was statistically significant in individuals suffering from moderate and severe apnea-hypopnea index (p < 0.005). Conclusion: The pilot clinical trial showed that wearing complete dentures at night has negative effects on the sleep quality of edentate elders, especially in individuals with moderate and severe obstructive apnea sleep. The results need to be confirmed with phase-II randomized clinical trial.

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