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© 2023 The Authors. Journal of Pineal Research published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made., Due to time zones, sun time and local time rarely match. The difference between local and sun time, which we designate by Solar Jet Lag (SoJL), depends on location within a time zone and can range from zero to several hours. Daylight saving time (DST) simply adds 1 h to SoJL, independently of the location. We hypothesised that the impact of DST is particularly problematic in patients with delayed sleep-wake phase disorder (DSWPD), worsening their sleep debt. DSWPD is characterised by a chronic misalignment between the internal and social timing, reflected by an inability to fall asleep and wake-up at conventional or socially acceptable times. We analysed the clinical records of 162 DSWPD patients from a sleep medicine centre in Lisbon, Portugal (GMTzone), and separated them into two groups: the ones diagnosed across DST or across Standard Time (ST). We included 82 patients (54.9% male; age: median [Q1 , Q3 ] 34.5 [25.0, 45.3]; range 16-92; 54 in DST and 28 in ST) who had Dim Light Melatonin Onset (DLMO) measured as a marker for the circadian phase and sleep timing (onset, SO, mid-point, MS and end, SE) self-reported separately for work- and work-free days. Differences between ST and DST were compared using Mann-Whitney or Student's t-tests. On a weekly average, patients in DST slept less (difference between medians of 37 min. p < .01), mainly due to sleep on workdays (SDw, p < .01), which also correlated with SoJL (rsp = .38, p < .01). While the time from DLMO to SO was similar in those in ST or those in DST, the time from DLMO to SE was significantly shorter for those in DST. The average duration between DLMO and sleep end was close to 10.5 h in ST, the biological night length described in the literature. Our results favour perennial ST and suggest assigning time-zones close to sun time to prevent social jetlag and sleep deprivation.

In the confectionery market, jelly gums are one of the most relevant sectors, being frequently consumed by many people, from children to adults. The present work intended to evaluate the textural properties in newly developed jelly gums made with berry fruits and herbs, given the critical role of texture in products with a gel-like structure. Four types of gums were developed (Strawberry & Anise, Strawberry & Mint, Raspberry & Mint, Blueberry & Mint) and their texture was evaluated through two types of tests (compression with a 75 mm probe and puncture with a 2 mm probe) allowing to calculate several textural properties. The results showed some differences between the two faces of the jelly gums analysed, i.e. on the top and on the bottom. As for the compression test, the Strawberry & Anise gums were among the softer (25.6 N) and with lower resilience (36.3%) and chewiness (16.9 N), despite being more adhesive (−0.5 N s). As for the puncture test, the sample Strawberry & Mint had the highest adhesiveness (−2.0 N s) but the lowest stickiness (−0.38 N). Additionally, very strong correlations were encountered between some of the properties studied (r = 0.861 or r = 0.822), and the factor analysis allowed defining three factors, the first clearly associated with the puncture properties while the other two were related to the compression properties. This work allowed concluding that the jelly gums presented different textural properties, particularly when assessed through different types of measurements. Hence, the use of different types of tests for texture analysis is recommended, since the results are complementary. This is relevant when developing food products intended for industrial production and commercialization.

© 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).

© 2021 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society., Light is an important regulator of daily human physiology in providing time-of-day information for the circadian clock to stay synchronised with the 24-hr day. The coronavirus disease 2019 (COVID-19) pandemic led to social restrictions in many countries to prevent virus spreading, restrictions that dramatically altered daily routines and limited outdoor daylight exposure. We previously reported that sleep duration increased, social jetlag decreased, and mid-sleep times delayed during social restrictions (Global Chrono Corona Survey, N = 7,517). In the present study, we investigated in the same dataset changes in wellbeing and their link to outdoor daylight exposure, and sleep-wake behaviour. In social restrictions, median values of sleep quality, quality of life, physical activity and productivity deteriorated, while screen time increased, and outdoor daylight exposure was reduced by ~58%. Yet, many survey participants also reported no changes or even improvements. Larger reductions in outdoor daylight exposure were linked to deteriorations in wellbeing and delayed mid-sleep times. Notably, sleep duration was not associated with outdoor daylight exposure loss. Longer sleep and decreased alarm-clock use dose-dependently correlated with changes in sleep quality and quality of life. Regression analysis for each wellbeing aspect showed that a model with six predictors including both levels and their deltas of outdoor daylight exposure, sleep duration and mid-sleep timing explained 5%-10% of the variance in changes of wellbeing scores (except for productivity). As exposure to daylight may extenuate the negative effects of social restriction and prevent sleep disruption, public strategies during pandemics should actively foster spending more daytime outdoors.

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.

© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/)., Objective: The aim of this study was to evaluate sleep and awakening quality (SQ and AQ) during COVID-19 in a large and diversified population in order to identify significant associations and risks in terms of demography, health and health-related behaviors, sleep variables, mental health, and attitudes. Methods/results: Online surveys were used for data collection, received from 5479 individuals from the general population, sleep disorder patients, and COVID-involved (medical doctors (MDs) and nurses) and COVID-affected professionals (teachers, psychologists, and dentists). SQ and AQ were worse in adults, females, and high-education subjects. Feeling worse, having economic problems, depression, anxiety, irritability, and a high Calamity Experience Check List (CECL) score during COVID were significantly associated with poor SQ and AQ. Shorter sleep duration, increased latency, poor nutrition, low physical activity, increased mobile and social network use, more negative and less positive attitudes and behaviors were associated with poor AQ. Conclusions: The SQ logistic regression showed gender, morbidities, CECL, and awakenings as relevant, whereas, for AQ, relevant variables further included age and physical activity. Aiming to have a high stress compliance, each individual should sleep well, have important control of their mood, practice positive behaviors while dismissing negative behaviors and attitudes, practice exercise, have adequate nutrition, and beware of technologies and dependences.

© 2021 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited., Cardiovascular diseases cause >4 million deaths each year in Europe alone. Preventive approaches that do not only consider individual risk factors but their interaction, such as the Systematic COronary Risk Evaluation (SCORE), are recommended by European guidelines. Increased cardiovascular risk is associated with shift-work, surely interacting with the concurrent conditions: disruption of sleep, unhealthy behaviours, and circadian misalignment. Social jetlag (SJL) has been proposed as a way to quantify circadian misalignment. We therefore investigated the association between SJL and cardiovascular health in a cross-sectional observational study involving blue-collar workers, who either worked permanent morning, evening, or night shifts. Sociodemographic, health and productivity data were collected through questionnaires. Blood pressure and cholesterol were measured and the cardiovascular risk was estimated according to the relative risk SCORE chart. Bivariate analysis was performed according to the cardiovascular risk and the relationship between SJL and high cardiovascular risk was analysed through logistic regression. Cumulative models were performed, adjusted for various confounding factors. After 49 exclusions, the final sample comprised 301 workers (56% males; aged 30% (odds ratio 1.31, 95% confidence interval 1.02-1.68). This is the first study indicating that SJL potentially increases cardiovascular risk, and suggests that sleep and individual circadian qualities are critical in preventing negative health impacts of shift-work., This work was supported by the PhD research Grant PDE/BDE/127787/2016 from Fundação para a Ciência e Tecnologia/Fundo Social Europeu.

© 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

Background: Adequate sleep is essential for health. Both, short and long sleep durations are associated to worse quality of life and poor health outcomes. Portugal represents a specific population model, since according to European statistics it has high rates of chronic diseases like depression, hypertension, diabetes and stroke; and low quality of life as well as low index of physical activity, while in parallel it has some other good health indicators such as: low age-standardized mortality for both genders, nutrition in terms of energy and fruit consumption, smoking and alcohol, obesity and overweight prevalence. The aim of this study was to characterize health and chronic diseases, lifestyles and quality of life in subjects with short and long sleep duration. Methods: A populationbased cross-sectional evaluation of the third wave of follow-up of the EpiDoC Cohort was carried between 2015-2016. A sample of 5,436 adults ≥18 years, representative of the national population, self-reported their daily total sleep time. Associations between short sleep duration (SSD ≤5h), long sleep duration (LSD≥9h) and independent variables were determined. Results: The prevalence for SSD was high (20.7%) and the LSD (5.9%) was low. Being older, with lower education, retired and unemployed were associated to SSD and LSD (p

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

Reprint & Copyright © by the Aerospace Medical Association, Alexandria, VA., BACKGROUND: Sleep and fatigue management is one of the main challenges in airline operations scheduling. Our aim was to compare the differences regarding fatigue, sleep, and labor specificities between the two most common types of flight, short/medium haul (SM-H) and long haul (L-H), in a large sample of airline pilots. METHODS: A self-report questionnaire was developed, composed of socio-economic and labor questions, and psychological assessment scales for fatigue and sleep. Associations of these variables and type of flight were tested. RESULTS: Of the total sample of Portuguese airline pilots (N 5 435), 313 (72%) were from SM-H and 122 (28%) were from L-H. For SM-H, the values obtained for sleep complaints were 34.2%, daytime sleepiness 61.6%, and fatigue 93.0%. For L-H, 36.9%, 53.3%, and 84.4%, respectively. Looking at labor variables, the differences between the two types of flights were evident, with SM-H pilots’ having statistically significant higher mean values of duty and flight hours, numbers of sectors, and early mornings. Only the mean number of night periods was higher in L-H pilots. All values were reported for 28 consecutive scheduling days. CONCLUSION: Night periods and time-zone crossing may explain higher prevalence levels of sleep disturbances in L-H pilots. However, the values for daytime sleepiness were higher in SM-H pilots, which may be attributed to diminished sleep caused by a combination of frequent early starts and long duty periods. Taking into account the large differences between the two types of flights, different regulatory limits should be considered by aviation authorities.

Open Access funded by Brazilian Association of Sleep Under a Creative Commons license © 2016 Brazilian Association of Sleep. Production and Hosting by Elsevier B.V. This is an open access article under the CCBY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)., This work aimed to determine daytime sleepiness and sleep complaints prevalence and the corresponding influence on perceived fatigue and to evaluate the influence of sociodemographic parameters and labour variables on sleep complaints, sleepiness and fatigue. A questionnaire was developed including socio-economic and labour issues and instruments, focused in sleep and fatigue. The response rate was 32% and the final sample had 435 pilots. The prevalence of sleep complaints was 34.9%, daytime sleepiness 59.3% and fatigue 90.6%. The high prevalence of sleep complaints, sleepiness and fatigue was disclosed in pilots, with those who fly short/medium having an added risk of fatigue.

Although a number of inflammatory cytokines have been shown to be associated with periodontal pathogenesis, it is important to investigate further whether these biomarkers are associated with the degree of success in nonsurgical treatment of chronic periodontitis. The aim of the present study was to quantify the total levels of interleukin (IL)‑1α, ‑1β, ‑6, ‑10 and tumour necrosis factor (TNF)‑α in gingival crevicular fluid (GCF) of chronic periodontitis patients prior to and following nonsurgical periodontal therapy. In total, 52 GCF samples from disease sites of patients with chronic periodontitis, prior to and following periodontal therapy, and ten non‑disease sites from non‑periodontitis subjects, were collected and cytokine concentrations were determined using a multiplex method. Periodontal parameters, including bleeding on probing, probing pocket depth and the clinical attachment level, in all the sites were recorded. Untreated disease sites exhibited higher cytokine levels in the GCF when compared with the non‑disease sites. Nonsurgical periodontal therapy resulted in a statistically significant decrease in the total levels of IL‑1α, ‑1β and ‑6 in the GCF, but not in IL‑10 or TNF‑α. The results support the hypothesis that proinflammatory cytokines, including IL‑1α, IL‑1β and IL‑6, are likely to be involved in the pathogenesis of periodontitis and are good markers to evaluate the success of nonsurgical therapy in disease sites of patients with periodontitis., The study was supported by a grant from the Cooperativa de Ensino Superior, Politécnico e Universitário (CESPU), Portugal (no. 06‑GCD‑CICS‑09).

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.