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Background: The present study was carried out to evaluate the effect of melatonin and placebo in the patients with atypical facial pain (AFP). Method: This double blind randomized controlled study was carried out on 30 patients who were suffering from AFP. During this period, patients were divided in 2 study and control groups. Then, they were treated with melatonin. Melatonin group used four 3-mg daily and placebo group received 4 placebo which were similar in size, shape, color with melatonin until the end of treatment, and then the severity of burning sensation was measured by physician. Sleep quality was measured using the visual analog scale using the Petersburg questionnaire. Result: The results of the present study show that the use of melatonin and placebo in patients with AFP reduces sensation and improves their sleep quality, although it may not reduce it completely. In this study, severity of burning was 5.71±1.42 after treatment in the study group and 5.93±2.65 in the control group, which was not statistically significant (p=.46). The mean score of sleep before treatment was not significantly different between the study (9±1.23) and the control (8±1.56) groups. The mean score of sleep after treatment between the study group (8±1.45) and the control group (7±1.23) was not significantly different (p=.43). Conclusion: According to the result of the study, melatonin was not superior placebo in treatment of AFP. Resumen: Antecedentes: El presenteestudio se realizó para evaluar el efecto de la Melatonina y Placebo en el paciente con Dolor Facial Atípico (PFA). Método: Este estudiocontrolado, aleatorio, dobleciego se llevó a caboen 30 pacientes que padecían AFP. Durante esteperíodo, lospacientes se dividieronen 2 grupos de estudio y control. Luegofuerontratados con melatonina. El grupo de melatoninautilizócuatrodosis de 3 mg al día y el grupo de placebo recibió 4 placebos que eransimilaresentamaño, forma y color a la melatonina hasta el final del tratamiento, y luego el médicomidió la gravedad de la sensación de ardor. La calidad del sueño se midiómediante la escala VAS utilizando el cuestionario de Petersburgo. Resultado: Los resultados del presenteestudiomuestran que el uso de melatonina y placebo enpacientes con AFP reduce la sensación y mejora la calidad del sueño, aunquepuede no reducirloporcompleto. Enesteestudio, la gravedad del ardor fue de 5,71 ± 1,42 después del tratamientoen el grupo de estudio y de 5,93 ± 2,65 en el grupo de control, lo que no fueestadísticamentesignificativo (P = 0,46). La puntuación media del sueño antes del tratamiento no fuesignificativamentediferente entre losgrupos de estudio (9 ± 1,23) y de control (8 ± 1,56). La puntuación media del sueñodespués del tratamiento entre el grupo de estudio (8 ± 1,45) y el grupo de control (7 ± 1,23) no fuesignificativamentediferente (P = 0,43). Conclusión: Segúnlosresultados del estudio, la melatonina no fue superior al placebo en el tratamiento de la AFP.

Objective: This study assesses the presence of sleep disturbances and their relationship with clinical and demographic variables in patients with MS, with a view to establishing correlations between the different variables and the frequency of sleep disturbances. Methods: The Pittsburgh Sleep Quality Index (PSQI) was used to detect sleep disorders. We contacted patients treated at the MS unit and distributed a questionnaire (PSQI) to 221 patients, receiving 142 usable questionnaires between 8 and 30 September 2019. Results: The prevalence of patients with sleep disturbances in our study was 74.7% (73.7% in women and 76.8% in men). Therefore, sleep disorders are pervasive in patients with MS, with 3 out of 4 patients experiencing them, a higher rate than that observed in the population without the disease. The frequency of sleep disorders gradually increased in line with age. In the 2 age groups analyzed, 44–54 years and 55–68 years, the proportion of moderate and severe sleep disorders was 42.8% and 53.9%, respectively. Moderate and severe sleep disturbances were observed in 27.5%, 44.7%, and 58.3% of patients with Expanded Disability Status Scale scores of 0–3, 3–6, and >6, respectively. Conclusion: Our results indicate that sleep disorders are more common in patients with MS than in other populations. Patients with secondary progressive forms of MS more frequently present sleep disturbances, while patients with primary progressive forms report them less frequently. Age and degree of disability were positively correlated with the prevalence and severity of sleep disorders in MS patients. Resumen: Objetivo: Evaluamos la presencia de alteraciones del sueño en pacientes con EM y su relación con variables clínicas y demográficas en esta población para establecer correlaciones entre diversas variables y la frecuencia de trastornos del sueño. Métodos: Se utilizó el Índice de Calidad de Sueño de Pittsburgh para identificar la presencia de trastornos del sueño. Distribuimos el cuestionario a 221 pacientes de nuestra unidad de EM, y recibimos respuesta de 142 de ellos entre el 8 y el 30 de septiembre de 2019. Resultados: En nuestra muestra, el 74,7% de los pacientes presentaban trastornos del sueño (73,7% de las mujeres y 76,8% de los hombres). Nuestros resultados muestran que los trastornos del sueño están muy presentes en la EM, detectándose en 3 de cada 4 pacientes, lo que supone una proporción mayor que en la población general. La presencia de trastornos del sueño aumenta con la edad. En los 2 grupos etarios analizados (44-54 años y 55-68 años), la proporción de pacientes con trastornos del sueño moderados o graves fue del 42,8% y el 53,9%, respectivamente. El 27,5%, el 44,7% y el 58,3% de los pacientes con puntuaciones de 0-3, 3-6 y >6 puntos en la Escala Expandida del Estado de Discapacidad, respectivamente, presentaron trastornos del sueño moderados o graves. Conclusión: Nuestros resultados indican que los trastornos del sueño son más prevalentes en los pacientes con EM que en otras poblaciones. Dichos trastornos son más frecuentes en pacientes con EM secundaria progresiva que en pacientes con la forma primaria progresiva. La edad y el grado de discapacidad mostraron una correlación positiva con la prevalencia y la gravedad de los trastornos del sueño.

Introduction: One of the factors contributing to transformation of migraine are sleep disorders, which can act as a trigger and/or perpetuating factor in these patients. This study's primary objective was to identify predictive factors related to sleep quality in patients with chronic migraine (CM); the secondary objective was to identify any differences in psychological variables and disability between patients with CM with better or poorer sleep quality., Methods: A total of 50 patients with CM were included in an observational, cross-sectional study. We recorded data on demographic, psychological, and disability variables using self-administered questionnaires., Results: A direct, moderate-to-strong correlation was observed between the different disability and psychological variables analysed (P<.05). Regression analysis identified depressive symptoms, headache-related disability, and pain catastrophising as predictors of sleep quality; together, these factors explain 33% of the variance. Statistically significant differences were found between patients with better and poorer sleep quality for depressive symptoms (P=.016) and pain catastrophising (P=.036)., Conclusions: The predictive factors for sleep quality in patients with CM were depressive symptoms, headache-related disability, and pain catastrophising. Patients with poorer sleep quality had higher levels of pain catastrophising and depressive symptoms., (Copyright © 2019 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Rationale: Obesity hypoventilation syndrome (OHS) with concomitant severe obstructive sleep apnea (OSA) is treated with CPAP or noninvasive ventilation (NIV) during sleep. NIV is costlier, but may be advantageous because it provides ventilatory support. However, there are no long-term trials comparing these treatment modalities based on OHS severity., Objective: To determine if CPAP have similar effectiveness when compared to NIV according to OHS severity subgroups., Methods: Post hoc analysis of the Pickwick randomized clinical trial in which 215 ambulatory patients with untreated OHS and concomitant severe OSA, defined as apnoea-hypopnea index (AHI)≥30events/h, were allocated to NIV or CPAP. In the present analysis, the Pickwick cohort was divided in severity subgroups based on the degree of baseline daytime hypercapnia (PaCO 2 of 45-49.9 or ≥50mmHg). Repeated measures of PaCO 2 and PaO 2 during the subsequent 3 years were compared between CPAP and NIV in the two severity subgroups. Statistical analysis was performed using linear mixed-effects model., Results: 204 patients, 97 in the NIV group and 107 in the CPAP group were analyzed. The longitudinal improvements of PaCO 2 and PaO 2 were similar between CPAP and NIV based on the PaCO 2 severity subgroups., Conclusion: In ambulatory patients with OHS and concomitant severe OSA who were treated with NIV or CPAP, long-term NIV therapy was similar to CPAP in improving awake hypercapnia, regardless of the severity of baseline hypercapnia. Therefore, in this patient population, the decision to prescribe CPAP or NIV cannot be solely based on the presenting level of PaCO 2 ., (Copyright © 2021 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: This study assesses the presence of sleep disturbances and their relationship with clinical and demographic variables in patients with MS, with a view to establishing correlations between the different variables and the frequency of sleep disturbances., Methods: The Pittsburgh Sleep Quality Index (PSQI) was used to detect sleep disorders. We contacted patients treated at the MS unit and distributed a questionnaire (PSQI) to 221 patients, receiving 142 usable questionnaires between 8 and 30 September 2019., Results: The prevalence of patients with sleep disturbances in our study was 74.7% (73.7% in women and 76.8% in men). Therefore, sleep disorders are pervasive in patients with MS, with 3 out of 4 patients experiencing them, a higher rate than that observed in the population without the disease. The frequency of sleep disorders gradually increased in line with age. In the 2 age groups analyzed, 44-54 years and 55-68 years, the proportion of moderate and severe sleep disorders was 42.8% and 53.9%, respectively. Moderate and severe sleep disturbances were observed in 27.5%, 44.7%, and 58.3% of patients with Expanded Disability Status Scale scores of 0-3, 3-6, and >6, respectively., Conclusion: Our results indicate that sleep disorders are more common in patients with MS than in other populations. Patients with secondary progressive forms of MS more frequently present sleep disturbances, while patients with primary progressive forms report them less frequently. Age and degree of disability were positively correlated with the prevalence and severity of sleep disorders in MS patients., (Copyright © 2021 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: To analyze if there is a higher prevalence of sleep disturbances and hygiene disorders in patients with monosymptomatic enuresis (MEN) with respect to general population and to patients with corrected MEN. Assess the usefulness of the BEARS sleep disorder screening tool for children with MEN., Material and Methods: Transverse observational study (n=341) classified as: MEN (n=122), corrected MEN (≥ 1 one year without recurrence) (ANTENUR) (n=47) and controls (n=172). The BEARS childhood sleep disorder screening questionnaire was used. Clinical variables were collected, as well as variables related to sleep hygiene., Statistics: Chi-square, Student's t, ANOVA, Mann-Whitney U and Kruskal-Wallis. Significance p<.05., Results: Mean age 9.7±3.0 years. There were no statistically significant differences in terms of age, sex, BMI, history of tonsillectomy, asthma and sleep time hours. With respect to sleep hygiene, patients with MEN presented a higher percentage of alterations than controls. As for the BEARS questionnaire, it showed a higher prevalence of sleep disorders in the group of patients with MEN, with respect to the other two groups: 60.7% (n=74) versus 18.6% (n=32) and 38.3% (n=18) of controls and ANTENUR, respectively (p<.05)., Conclusions: Children with MEN had a higher prevalence of sleep disturbances and sleep disorders than controls. The BEARS questionnaire is a useful clinical tool in the detection of sleep disorders in children., (Copyright © 2020 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Burnout syndrome has increased dramatically in urology within recent years. A healthy lifestyle has been described as a protective factor. However, data on lifestyle is lacking among residents and urologists and remains to be elucidated. We aim to assess lifestyle among urology residents and young urologists across Europe., Materials and Methods: Members of the European Society of Residents in Urology (ESRU) designed a 34-item online survey via surveymonkey.com. The survey was designed in accordance with Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines and was distributed via e-mail and social media in 23 European countries to urology residents and young urologists. The primary endpoint was reported as self-perceived health status. Secondary endpoints included questions on sleeping disorders, exercise and dietary habits. Data was analyzed SPSS software., Results: A total of 412 residents and young urologists responded to the survey. The mean age of the respondents was 31.4±3.9 yr. The data on dietary intake demonstrate a mean of 2 or more cups/day of coffee and alcohol consumption 2-3 times/week. The intake of fruits and vegetables is very low, almost 60% of responders consume<1 portions of fruit/day and more than half (52%) eat<1 portion of vegetable/day. Overall, the majority of respondents reported to have a moderate to low satisfaction with lifestyle (59.65%) and low to moderate self-perceived health status (45.94%). Moreover, 46% of respondents reported to have some kind of sleep disturbance and 60% only slept 6hours/night or less with 53% reporting a moderate to very low quality of Sleep. Regular exercise of at least 30min twice weekly was only performed by 33% of the respondents., Conclusions: Residents and young urologists have unbalanced diet, tend to exercise too little and often suffer from sleep disturbances all of which increases the risk of burnout. Physicians, organizations and institutions should strive to promote healthy lifestyle, resiliency and support programs., (Copyright © 2019 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: REM sleep behaviour disorder (RBD) is characterised by violent behaviours (screaming, kicking, vivid dreams) during REM sleep. It has a prevalence of 1% to 2% of the general population and is especially frequent in men and the population older than 60. In the last decade, RBD has been suggested to be a prodrome of neurodegenerative disease. We analysed associated neurological diseases and responses to drug treatment in 33 patients with RBD treated in the multidisciplinary sleep disorders unit at Hospital Infanta Sofía., Patients and Methods: We conducted an observational descriptive retrospective analysis of patients diagnosed with RBD and treated in our multidisciplinary sleep disorders unit between October 2012 and December 2015. We recorded age, sex, associated diseases, and treatments administered to these patients., Results: A total of 365 patients were attended at our unit, including 33 with RBD: 13 women (40%) and 20 men (60%). Mean age was 62.72 years. An associated disorder was identified in 48%, with the most common being mild cognitive impairment (69%). The percentage of patients with RBD and an associated disorder among patients older than 60 was 68%. Eighty-two percent of the patients required treatment. The most commonly used drug was clonazepam (76%), followed by melatonin (9%), gabapentin (6%), and trazodone (3%)., Discussion: In our series, 48% of the patients had an associated disorder. The likelihood of detecting an associated disorder increases with patients' age. The vast majority of patients required drug treatment due to symptom severity; the most frequently administered drug was clonazepam (76%)., (Copyright © 2017 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: OSAHS is associated with an increased risk of cardiovascular disease and stroke. Arterial hypertension is a key risk factor to consider due to its impact on health., Method: Cross-sectional study carried out on Spanish public service workers. The nocturnal apnoea risk using the Epworth and STOP-Bang questionnaires and their influence on the mean values of blood pressure are assessed., Results: The detection of OSAHS using the Epworth test and, particularly with the STOP-Bang shows a significant relationship with the mean values of blood pressure, with differences between both questionnaires., Conclusion: The Epworth and STOP-Bang questionnaires are useful for the initial detection of OSAHS and a higher prevalence of high blood pressure. Both can be used in screening procedures in occupational health., (Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Chronic fatigue syndrome (CFS) is characterised by the presence of intractable fatigue and non-restorative sleep, symptoms which are also very prevalent in multiple diseases and appear as side effects of different drugs. Numerous studies have shown a high prevalence of sleep disorders in patients with CFS. However, non-restorative sleep and fatigue are frequently symptoms of the sleep disorders themselves, so primary sleep disorders have to be ruled out in many cases of CFS., Development: This review was performed using a structured search of the MeSH terms ([Sleep]+[Chronic fatigue syndrome]) in the PubMed database., Conclusion: Identifying primary sleep disorders in patients meeting diagnostic criteria for CFS will allow for a more comprehensive treatment approach involving new diagnostic and therapeutic strategies that may improve quality of life for these patients., (Copyright © 2016 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Quality of sleep and excessive daytime sleepiness (EDS) affect cognitive ability and performance of medical students. This study attempts to determine the prevalence of EDS, sleep quality, and assess their association with poor academic performance in this population., Material and Methods: A descriptive, observational study was conducted on a random sample of 217 medical students from the Universidad Tecnológica de Pereira, who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Epworth sleepiness scale. Sociodemographic, clinic and academic variables were also measured. Multivariate analyses for poor academic performance were performed., Results: The included students had a mean age of 21.7±3.3 years, of whom 59.4% were men. Almost half (49.8%) had EDS criteria, and 79.3% were poor sleepers (PSQI ≥ 5), while 43.3% had poor academic performance during the last semester. The bivariate analysis showed that having used tobacco or alcohol until intoxicated, fairly bad subjective sleep quality, sleep efficiency < 65%, and being a poor sleeper were associated with increased risk of low performance. Sleep efficiency < 65% was statistically associated with poor academic performance (P=.024; OR = 4.23; 95% CI, 1.12-15.42) in the multivariate analysis., Conclusions: A poor sleep quality determined by low efficiency was related to poor academic achievement at the end of semester in medical students., (Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.)