Search

© 2020 Elsevier B.V. All rights reserved., Objectives: We aimed to compare three variants of the Pittsburgh Sleep Quality Index (PSQI usual, work- and work-free days: PSQIu, PSQIw, PSQIf) and to assess whether chronotype (MSFsc)/social jetlag (SJL) are associated with sleep quality in patients with sleep disorders (SD). Methods: In sum, 431 SD patients and 338 subjects from the general population (GP) were included. Participants filled in three variants of the PSQI and the Munich ChronoType Questionnaire (MCTQ). We used Generalized Estimating Equations (GEE) to investigate effects of group (GP, SD), PSQI (usual, work or free) and their interaction (group∗PSQI) on scores. To investigate associations between MSFsc/SJL and the difference between PSQIw and PSQIf (PSQIdiff) in patients with SD we used linear regressions (N = 352). We used Sobel to test whether there was a mediation effect of SJL on the association between MSFsc and PSQIdiff. Results: PSQI scores differed between groups (p < 0.001). Post-hoc analysis revealed a significant difference between PSQIu vs. PSQIf and PSQIw vs. PSQIf with PSQIf presenting lower scores, while PSQIu vs. PSQIw did not differ in any group. In line with previous findings, SJL was associated to PSQIdiff in SD patients. Conclusions: PSQIu mainly represents sleep quality on workdays also in SD patients. Being a late chronotype seems to be associated with higher differences in sleep quality on work-vs. free days mostly when it coincides with societal time constraints. Since sleep quality is poorer on workdays even in SD patients, we suggest that treatment strategies should address social aspects affecting sleep, including ways of minimizing SJL., This study was financed in part by the Fundação para a Ciência e Tecnologia (FCT) PhD research grant PDE/BDE/114584/2016, the Coordenaçao de Aperfeiçoamento de Pessoal de Nível Superior, Brasil (CAPES - PVE A046/2013) - Finance Code 001, and the Deutscher Akademischer Austauschdienst (CAPES/DAAD - PROBRAL 12/2017).

The COVID-19 pandemic led to a worldwide implementation of measures to contain the virus from spreading, and social isolation was one of those measures. Social isolation is associated with increased susceptibility to various neuropsychiatric disorders, including depression. Because this risk varies between populations and their respective habits, understanding which behaviors play a positive or harmful role is fundamental for people with depression under these conditions. This study aims to 1) compare health-related behaviors (HRBs) and perceived addictions between healthy individuals and individuals who reported having a depressive disorder at the time of the first outbreak of the COVID-19 pandemic in Portugal, and 2) test which HRB and perceived addictions are associated with depression. Participants were a matched for age and sex and comprised 968 adults divided into two groups: healthy (484, 50%) and depressed (484, 50%). They completed online self-report questionnaires, and the data were analyzed in SPSS. Logistic regressions showed that being a health professional, getting up in a later time during weekends, and a higher consumption of soft drinks increased the risk for depression. In contrast, higher education and higher intensity of physical activity decreased this risk. Perceived addictions to TV, social networking, and gaming increased the risk for depression. HRBs and the identified addictions associated with depression during the confinement should be targeted in clinical and community interventions.

© The Author(s) 2020. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creat iveco mmons .org/licen ses/by/4.0/, In humans, sleep regulation is tightly linked to social times that assign local time to events, such as school, work, or meals. The impact of these social times, collectively-social time pressure, on sleep has been studied epidemiologically via quantification of the discrepancy between sleep times on workdays and those on work-free days. This discrepancy is known as the social jetlag (SJL). COVID-19-mandated social restrictions (SR) constituted a global intervention by affecting social times worldwide. We launched a Global Chrono Corona Survey (GCCS) that queried sleep-wake times before and during SR (preSR and inSR). 11,431 adults from 40 countries responded between April 4 and May 6, 2020. The final sample consisted of 7517 respondents (68.2% females), who had been 32.7 ± 9.1 (mean ± sd) days under SR. SR led to robust changes: mid-sleep time on workdays and free days was delayed by 50 and 22 min, respectively; sleep duration increased on workdays by 26 min but shortened by 9 min on free days; SJL decreased by ~ 30 min. On workdays inSR, sleep-wake times in most people approached those of their preSR free days. Changes in sleep duration and SJL correlated with inSR-use of alarm clocks and were larger in young adults. The data indicate a massive sleep deficit under pre-pandemic social time pressure, provide insights to the actual sleep need of different age-groups and suggest that tolerable SJL is about 20 min. Relaxed social time pressure promotes more sleep, smaller SJL and reduced use of alarm clocks.

© 2020 European Sleep Research Society, Excessive daytime sleepiness (EDS) is a common feature among shift workers as well as in obstructive sleep apnea (OSA) patients. There are several important accidents related to sleep disturbances causing EDS. The aim of this study was to evaluate EDS in a group of shift workers (regular rotating) from civil aviation and to compare them with OSA patients (n = 300) and with a group of regular workers (RW) (n = 140). Our sample was composed of 730 working-age individuals (aged 18-67 years). The regular rotating shift workers (SW) sample was composed of 290 aeronautical mechanics. EDS was evaluated with the Epworth Sleepiness Scale (ESS) and defined as a score ≥ 11. The prevalence value obtained for the EDS of RW was 37.1%, for SW it was 60.7% and for OSA patients it was 40.7%. A logistic regression model for EDS in a subsample composed of men and matched for age and BMI, controlling for self-reported sleep duration, showed an increased risk of EDS for SW (OR = 3.91, p = .001), with the RW group as reference. OSA patients did not differ from RW on EDS levels. This study emphasizes the presence of EDS in a shift work group of civil aviation professionals, which exceeded the EDS level of a positive control group of OSA patients. Sleep hygiene education for companies' workers and management is important and mitigation strategies should be implemented to reduce excessive sleepiness among workers., Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Grant/Award Number: 88887150178/2017-00; Fundação para a Ciência e Tecnologia (FCT), Grant/ Award Number: PDE/BDE/114584/2016

Introduction Optimal sleep duration varies significantly between individuals, age, gender, and world region. The value established for short sleep duration (SSD) in adults is £ 5 h and long sleep duration (LSD) is 39 h. The aim of this study was to study potential associations between SSD and LSD with sociodemographic variables and lifestyles. Methods Cross-sectional evaluation of the third wave of follow-up of the EpiDoC Cohort that enrolled in 2011 10,661 adults living in private residences in Portugal, (i.e., EpiDoC3 study, population interviewed 5653). Participants from EpiDoc3 who answer the question regarding hours of sleep/day (n = 5436) compose the current analysis. Data collection was performed Sept 2015–July 2016, by telephone. The EpiDoC cohort measurements were sociodemographic, socioeconomic characteristics and socioeconomic variables. The lifestyle habits evaluated were alcohol intake, smoking habits, physical activity, frequency of watching television and of using a computer. Height and weight were collected. For the dietary intake, the number of meals/day and the adherence to the Mediterranean diet was assessed by the PREDIMED score; for the daily total sleep time three categories were established: SSD (£ 5 h), normal sleep duration (NSD) (6 h–8 h) and LSD (9 h). To verify the representativeness of the sample according to the Portuguese population, we first compared the participants and non-participants of the EpiDoC3 study with respect to their sociodemographic, socioeconomic, and health status characteristics. Extrapolation weights were computed and used in the subsequent statistical analysis. These were obtained by calibrating the extrapolation weights originally designed for the EpiDoC1 study sample. Baseline characteristics of the study cohort were described according to SSD, NSD and LSD. Absolute frequencies and weighted proportions were used to summarize categorical variables. Two logistic regression models were performed in order to find lifestyle predictors for SSD and LSD. All analyses were performed using STATAICv12. Results Prevalence values for SSD and LSD were 24.6% and 7.5%. The region with higher prevalence for SSD was Algarve (SSD 26.5%, LSD 6.1%), while Azores have the lowest value (16.4%). Furthermore, the higher prevalence NSD was found in Azores (80.5%). The higher prevalence values for SSD and LSD were both found in females 22.0% and 2.1%. Variables associated to a higher risk of SSD were having 65 years (OR = 1.92; CI = 1.48, 2.50); being female (OR = 1.26; CI = 1.00–1.58); being overweight (OR = 2.25; CI = 1.03–4.87) or obese (OR = 2.74; CI = 1.24–6.02) and having 0–4 years of education (OR = 1.95; CI = 1.32–2.86); protective variables to SSD were to watch TV 3–4 h/day (OR = 0.45; CI = 0.22–0.90) and 5 h/day (OR = 0.38; CI = 0.19–0.80); to use computer 3–4 h/day (OR = 0.50; CI = 0.30–0.84) and 5 h/day (OR = 0.56; CI = 0.37–0.83); have 2 meals/day (OR = 0.46; CI = 0.22–0.98), 3 meals/day (OR = 0.36; CI = 0.17–0.78) and 4 meals/day (OR = 0.33; CI = 0.15–0.73). Variables associated to a higher risk of LSD were, having 65 years (OR = 1.94; CI = 1.41–2.67); to have 10–12 (OR = 2.03; CI = 1.15–3.56) and 0–4 (OR = 2.28; CI = 1.21–4.28) years of education and to live in Azores (OR = 1.69; CI = 1.14–2.52); protective variables for LSD were, to drink alcohol daily (OR = 0.63; CI = 0.43–0.92); to watch TV £2 h/day (OR = 0.39; CI = 0.18–0.88) and 3–4 h/day (OR = 0.38; CI = 0.16–0.88); and to use computer £2 h/day (OR = 0.52; CI = 0.34–0.80) and 5 h/day (OR = 0.37; CI = 0.18–0.77). Conclusions SSD is highly prevalent in the Portuguese population when compared to other population studies. Lower educational level and to have 65 years are risk factors for SSD and LSD. EpiDoc3 study emphasizes the burden of SSD and LSD in Portugal and the need to increase sleep awareness. Being SSD and LSD predictors of mortality and chronic diseases, these numbers highlight the magnitude of this problem to Portugal.

BACKGROUND: Fatigue is a common phenomenon in airline pilots that can impair alertness and ability of crewmembers to safely operate an aircraft and perform safety related tasks. Fatigue can increase the risk of an incident or even an accident. This study provides the first prevalence values for clinically significant fatigue in Portuguese airline pilots. The hypothesis that medium/short-haul pilots may currently present different levels of fatigue than long-haul pilots was also tested. METHODS: A survey was conducted by requesting Portuguese airline pilots to complete questionnaires placed in the pilots' personal lockers from 1 April until 15 May 2012. The questionnaire included the self-response Fatigue Severity Scale (FSS) to measure subjective fatigue and some additional questions concerning perception of fatigue by pilots. RESULTS: The prevalence values for total and mental fatigue achieved in the Portuguese airline pilots were: 89.3% (FSS > or = 4) and 94.1% (FSS > or = 4) when splitting the sample in two subsamples, long- and medium/short-haul pilots. Levels of total and mental fatigue were higher for medium/short-haul pilots. DISCUSSION: The analysis of fatigue levels in each type of aviator showed that medium/short-haul pilots presented the highest levels of total and mental fatigue. This study produced the first prevalence values of total and mental fatigue among Portuguese airline pilots, which represents a great step to understanding and addressing this critical phenomenon. Language: en

With this study we attempted to estimate the prevalence of self-reported rheumatic diseases in a Portuguese population. It was also our objective to evaluate the influence of the variables sex and age on the prevalence of these diseases.The study population was comprised of 297 individuals from a total of 573 random telephone numbers selected from the city of Lisbon telephone book (landline/residents). Those 297 were the ones that agreed to answer the proposed questionnaire.The prevalence value of self-reported rheumatic diseases was 26.3%. A prevalence value of self-declared osteoarthritis of 21.2% was found, 7.7% for osteoporosis, 1.3% for rheumatoid arthritis and 0.3% each for gout, systemic lupus erythematosus, Behçet's disease and fibromyalgia. An association with the variables sex and age was achieved for the total of rheumatic diseases. The same association was obtained for osteoarthritis and osteoporosis.This study emphasizes the good self- -judgment that the inquired population has about their rheumatic diseases, and some of the obtained results are in agreement with the national and worldwide literature.