Search

RESUMEN Introducción: la reciente aparición y rápida propagación en Wuhan (China) del nuevo coronavirus Covid-19 obligó a la cuarentena de millones de habitantes en el mundo entero generando un enorme impacto psicosocial. Objetivo: describir la frecuencia de depresión, ansiedad e insomnio durante la cuarentena en la población paraguaya. Metodología: se realizó un estudio trasversal descriptivo de corte prospectivo. Se aplicó una encuesta en forma virtual que llegó a las personas a través de las redes sociales. Para el diagnóstico de depresión y ansiedad se aplicó el cuestionario de Patient Health Questionaire-4 y para el insomnio el cuestionario Insomnia Severity Index. Resultados: se incluyeron 511 personas, 63% fue del sexo femenino, con 51,9% del rango etario 30- 50 años. El 49,3% de las personas fueron solteras y 79,8% vive en zona urbana. El 93,3% de los encuestados culminó la educacion terciaria. Con el cuestionario Patient Health Questionaire-4, 44,9% era normal, 21,3% presentó ansiedad y depresión moderada, mientras que 15,9% tenía síntomas de ansiedad y depresión severa. Con el Insomnia Severity Index, 37,5% presentó insomnio clinicamente insignificante, 31,1% insomnio leve, 24,6% insomnio moderado y 6,6% insomnio severo. Conclusión: 21,3% presentó ansiedad y depresión moderada, mientras que 15,9% tenía síntomas de ansiedad y depresión severa. Además, 62,5% presentaba algún grado de insomnio. ABSTRACT Introduction: The recent appearance and rapid spread in Wuhan (China) of the new Covid-19 coronavirus forced the quarantine of millions of inhabitants around the world, generating a huge psychosocial impact. Objective: To describe the frequency of depression, anxiety and insomnia during quarantine in the Paraguayan population. Methodology: A prospective descriptive cross-sectional study was carried out. A questionnaire was applied virtually reaching people through social networks. For the diagnosis of depression and anxiety, the Patient Health Questionnaire-4 was applied, and the Insomnia Severity Index questionnaire for insomnia. Results: Five hundred eleven people were included, 63% of them were female, 51.9% were in the age range 30-50 years, 49.3% of the people were single and 79.8% lived in urban areas and 93.3% of those surveyed completed tertiary education. With the Patient Health Questionnaire-4, 44.9% were normal, 21.3% had moderate anxiety and depression, while 15.9% had symptoms of anxiety and severe depression. With the Insomnia Severity Index, 37.5% had clinically insignificant insomnia, 31.1% mild insomnia, 24.6% moderate insomnia, and 6.6% severe insomnia. Conclusion: Twenty-one and three percent presented moderate anxiety and depression, while 15.9% had symptoms of anxiety and severe depression. Furthermore, 62.5% had some degree of insomnia.

El insomnio es un trastorno del inicio o mantenimiento del sueño; se clasifica según el tiempo de evolución, según si se asocia a otra patología y según su severidad. El diagnóstico es principalmente clínico, y no amerita de estudios complementarios como exámenes de laboratorio y gabinete. El tratamiento no farmacológico incluye la terapia de comportamiento cognitivo, las medidas de higiene del sueño, control de estímulos, y técnicas de relajación; mientras que el tratamiento farmacológico debe ser individualizado para cada paciente, y podría involucrar el uso benzodiacepinas, compuestos Z, antagonistas de melatonina o antidepresivos tricíclicos. Existe un gran impacto en la calidad de vida y salud física-mental en los pacientes que sufren de insomnio.

RESUMEN Objetivo Identificar los factores asociados a insomnio en profesionales de salud de un hospital público de Trujillo, Perú. Materiales y métodos Se aplicó la Encuesta de Insomnio de Atenas (EIA) a 220 profesionales de la salud. Se emplearon las pruebas de la ji al cuadrado y t de Student. El análisis multivariado fue utilizado para identificar las variables asociadas al insomnio. Resultados Se demostró que existe menos riesgo de insomnio en profesionales menores de 38 años (OR 0,77; IC 95% 0,68-0,87; p < 0,05). Existe mayor riesgo de presentar insomnio cuando el profesional de salud tiene una sobrecarga horaria en el trabajo (OR 4; IC 95% 1,22-9,73; p < 0,05); si se trabaja en un turno nocturno (OR 3,12; IC 95% 1,01-9,73; p < 0,05); si el trabajador labora por más de siete años en la institución (OR 1,50; IC 95% 1,22-1,85; p < 0,001), y si el profesional de salud padece lumbalgia (OR 11,28; IC 95% 3,61-35,28; p < 0,05), esta última variable presenta el mayor valor de asociación. Conclusiones Nuestro estudio sugiere que los profesionales de la salud mayores de 38 años, con lumbalgia, sobrecarga laboral, trabajo nocturno y que trabajan más de siete años en la institución tienen mayor riesgo de riesgo de sufrir insomnio. ABSTRACT Objective To identify the factors associated with insomnia in health professionals of a public hospital in Trujillo, Peru. Materials and methods The Athens Insomnia Scale (AIS) was administered to 220 health professionals. The chi-square test and Student's t-test were used. In addition, the multivariate analysis was performed to identify the variables associated with insomnia. Results It was demonstrated that there is less risk of insomnia in professionals under 38 years of age (OR 0.77; 95 % CI 0.68 - 0.87; p < 0.05). There is more risk of insomnia in cases of work overload (OR 4; 95 % CI 1.22 - 9.73; p < 0.05), night shifts (OR 3.12; 95 % CI 1.01 - 9.73; p < 0.05), job tenure of more than 7 years in the hospital (OR 1.50; 95 % CI 1.22 - 1.85; p < 0.001) and low back pain (OR 11.28; 95 % CI 3.61 - 35.28; p < 0.05), the latter being the variable with the highest association value. Conclusions Our study suggests that health professionals older than 38 years of age, with low back pain, under work overload, who work night shifts and with a job tenure of more than 7 years in the hospital are more at risk of suffering insomnia.

This paper presents a case report of a perimenopausal woman who repeatedly attended health care institutions due to chronic insomnia, and underwent pharmacological treatments and psychiatric hospitalizations without achieving any positive result for nearly three years. After compiling all the information of the case, as well as analyzing previous and recent paraclinical studies, the patient was diagnosed with hypothyroidism.The purpose of this paper is to draw attention on the adequate use of clinical diagnostic tools and processes to optimize the medical practice and to offer a better service to patients. Se presenta el caso de una mujer adulta perimenopáusica quien consultó múltiples veces al sistema de salud por presentar insomnio crónico y, durante cerca de tres años, recibió tratamientos médicos farmacológicos e incluso hospitalizaciones psiquiátricas sin lograr mejoría. Tras la integración de la información de la cual se dispuso, así como la toma y revisión de paraclínicos previos, se documentó hipotiroidismo.En este estudio se intenta hacer un llamado a la utilización de las herramientas clínicas y a la implementación de adecuados procesos diagnósticos con el fin de optimizar la práctica médica y ofrecer un mejor servicio a los pacientes.

Objectives: Insomnia is the most prevalent sleep disorder in the general population, and one of the most frequent reasons for consultation in the Sleep Units. Perampanel is an antiepileptic also effective on the structure of sleep, and in restless legs syndrome. We describe the first study that evaluates perampanel in patients with chronic insomnia. Patients and methods: Observational retrospective cohorts study of 66 patients with chronic resistant insomnia, 33 exposed to perampanel, other 33 as non-exposed group. All patients attended in Neurology or Psychiatry Consultation, from November 2017 to November 2018. Patients included had been treated with more than 4 different drugs in the previous 4 years. We reviewed age, sex, insomnia etiology, years of evolution, number of previously used drugs, and the results of perampanel for insomnia after 3 months of treatment in the exposed cohort, measured by the improvement of 3 or more points in the ISI and Pittsburgh scales, as well as the average of hours of sleep gained. Non-exposed patients were matched with this variables, but never treated with perampanel. Results: We have included 66 patients. In the exposed cohort: we describe 33 patients with chronic resistant insomnia, 20 women (60 %), 13 men (40 %). Average age 53.48 years, average time of evolution: 11.25 years. Main etiology: depression 13 cases (40 %). After the combination of perampanel 2–4 mg (100 %) with antidepressants (17 cases, 51.5 %) or anxiolytics (12 cases, 36.36 %) along 3 months: the total number of hours of sleep improves in 2.5 h, the scale ISI improves by 6 points (± 2.1 SD, p = 0.02), and Pittsburgh scale improves in 4 points (± 1.7, p = 0.04). In non-exposed cohort, the improvement of the ISI scale was 2.2 points (±0.8, p = 0.06), on the Pittsburgh scale was 1.6 points (± 0.5, p = 0.01). The main adverse effect was irritability in 3 patients, without withdrawal perampanel. The treatment was abandoned by 4 patients (12.12%): 1 due to persistent irritability (3%), 2 due to lack of efficacy (6 %), 1 due to pregnancy wish (3 %). Conclusion: The combination of Perampanel with an antidepressant, or an anxiolytic, improves the quality of sleep measured by ISI and Pittsburgh scales (statistically significant), probably due to its antagonistic action on glutamate. A clinical trial compared with placebo would be necessary to corroborate these results. Sin financiación 1.876 JCR (2020) Q3, 142/211 Surgery 0.587 SJR (2020) Q2, 1153/2447 Medicine (miscellaneous) No data IDR 2020 UEM

Objective Sleep quality has a significant impact on health and quality of life and is affected, among other factors, by age and sex. However, the prevalence of problems in this area in the general population is not well known. Therefore, our objective was to study the prevalence and main characteristics of sleep quality in an adult population sample. Methods 2,144 subjects aged between 43 and 71 years belonging to the Murcia (Spain) Twin Registry. Sleep quality was measured by self-report through the Pittsburgh Sleep Quality Index (PSQI). Logistic regression models were used to analyse the results. Results The prevalence of poor sleep quality stands at 38.2%. Univariate logistic regression analyses showed that women were almost twice as likely as men (OR: 1.88; 95% confidence interval [95%CI]: 1.54 to 2.28) to have poor quality of sleep. Age was directly and significantly associated with a low quality of sleep (OR: 1.05; 95%CI: 1.03 to 1.06). Conclusions The prevalence of poor sleep quality is high among adults, especially women. There is a direct relationship between age and deterioration in the quality of sleep. This relationship also appears to be more consistent in women.

Objective: The aim of the study was to evaluate the association between sedentary lifestyle and the severity of menopausal symptoms and obesity in middle-aged women. Methods: The Menopause Rating Scale, the Goldberg Anxiety and Depression Scale, and the Athens Insomnia Scale were administered to 6,079 Latin American women aged 40 to 59 years. Sedentary lifestyle was defined as fewer than three weekly, 30-minute periods of physical activity. Results: Sedentary women had more severe menopausal symptoms (total Menopause Rating Scale score: 9.576.71 vs 8.01-6.27 points, P

There is a high prevalence of bad quality of sleep in university students, especially medicine. Sleep disturbance adversely affect the mental, physical health and quality of life. To evaluate the quality of sleep and insomnia and his association with the academic yield in medicine students of a public university from Colombian Caribbean Coast. Cross sectional study, carried out on sample of first to tenth-semester of medical students from Universidad de Cartagena, Colombia who agreed to participate in the investigation by signing an informed consent form. The Athens scale, the Epworth sleepiness scale and the Pittsburgh sleep quality index was applied with a survey compilation of socio-demographic and academic data. A global sum of five or greater in Athens scale indicates insomnia and a global sum of five or greater in Pittsburgh indicates a poor sleeper. A stratified sample by gender and semester was chosen. Data analysis was performed using Epi-Info statical program (version 7). A p value