Search

Background: Child malnutrition represents a major public health problem with physiological, psychological, and social short- and long-term implications. Objective: To compare the influence of nutri...

Homeless people face stressful circumstances influencing drug consumption, mental health, and sleep disorders. We performed an interdisciplinary study involving psychometric, polysomnographic, and ethnographic records to relate stress, psychiatric disorders, drug consumption, and sleep in ten people (four women, M = 32 y/o) living on the streets of Mexico City. Toluene-based inhalant dependence and suicidality were the more common psychiatric disorders among participants. They also presented sleep fragmentation; some manifested insomnia or sleep restriction, whereas others displayed extended rapid-eye movement sleep latencies associated with depression or inhalant consumption. Inhalants are used to improve mood, strengthen social bonds, and induce either sleep or alertness during the night. Inter-individual distinctions may be related to differential levels of intoxication, stress perception, backgrounds, and abilities to live and sleep on the street. Sleep restriction seems to be the more common factor, which may enhance the negative consequences of street situation.

Obstructive sleep apnea (OSA) is a condition characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep. An accessible method to facilitate self-management education is through information and communication technologies (ICTs).To assess the frequency of and preferences for ICT use in patients with sleep apnea.A multicenter, multinational, observational cross-sectional survey study was conducted between 2018 and 2019 in sleep units in different countries of Latin America, including patients of both genders older than 18 years with a diagnosis of sleep apnea. Participants were asked to complete 20 questions in a self-administered survey about the frequency of use of ICTs and their preferences for receiving disease-related information.A total of 435 patients participated in the study, with a mean age of 59.1 ± 14.0; 62.5% (n = 272) were males. Most patients had access to cellphones (92.4%, n = 402), smartphone (83.0%, n = 361) and an internet connection (82.3%, n = 358). One-to-one ICTs were regarded as the most frequently used ICT type, as 75.4% (n = 328) of participants reported using them daily (χ2(4) = 848.207, p =.000). With respect to categories of interest, one-to-one ICTs were also the best rated ICT type to receive (59.1%, n = 257; χ2(2) = 137.710, p =.000) and ask physicians (57.0%, n = 248; χ2(2) = 129.145, p =.000) information about OSA. Finally, older adults and those with lower educational levels were found to be less likely to use and be interested in ICTs.Most patients have access to different ICTs and often use them to seek and receive medical information. The preferred ICTs include those in the one-to-one category (WhatsApp, email) and the one-to-many category (web browsers) for general health and OSA-related information.

Objective In this study we analyzed the effects of transcranial magnetic stimulation (TMS) on sleep and on the self-perceived quality of life in epileptic patients. Methods A total of 24 male patients diagnosed with focal epilepsy were included in the study. Pharmacological treatment with levetiracetam was standardized at 2 g daily. Before TMS onset, all-night polysomnographic recording (PSG) was performed, and the Quality of Life in Epilepsy Inventory (QOLIE-31) was administered. Thereafter, patients underwent low-frequency repetitive TMS (1000 pulses/1 Hz) daily for 10 days. After the end of the treatment, a second polysomnographic study was performed, and the QOLIE-31 questionnaire was administered again. Results TMS induced a significant increase in sleep efficiency and in total sleep time, along with a decrease in sleep latency and the number of awakenings. In addition, the number of interictal discharges during sleep decreased significantly. Concerning the QOLIE-31 scale values, the patients showed great improvement in the self-perceived quality of life. Conclusion The present results indicate that TMS may mediate therapeutic effects in the treatment of patients with focal epilepsy, and that TMS treatment is accompanied by improvement of sleep patterns as well as improvement in self-perceived quality of life. However, a study that includes a control group undergoing sham stimulation is needed to confirm these findings.

Insomnia is one of the most frequently observed sleep disorders, affecting nearly 10% of the general population. It has multiple etiological factors. Recently, it has been reported that EEG abnormalities are associated with insomnia in patients previously diagnosed as idiopathic insomniacs. In addition, transcranial magnetic stimulation (TMS) has shown to be effective in the treatment of disorders characterized by neural hyper-excitability. Method: In the present study, patients with insomnia and EEG abnormalities were submitted to slow repetitive trans-cranial magnetic stimulation, for 15 minutes daily during 10 days. Polysomnographic recordings were performed before and after TMS. Results: The results indicate that the presence of EEG abnormalities significantly decreased after TMS. In addition, most of the sleep parameters showed significant improvement. Conclusions: These data support the notion that TMS is a reliable therapeutic tool for patients affected with abnormalities linked to neuronal hyper-excitability.

Objective: In the search for effective therapeutically tools for Psychogenic Non-epileptic Seizures (PNES), in the present study we analyzed the effect of two different psychotherapeutic approaches, Brief Psychodynamic Therapy (BPT) and Cognitive Behavioral Therapy (CBT) on the frequency of PNES as well as on quality of life in these patients. Methods: 23 patients displaying PNES were randomly assigned to a group receiving BPT for 6 months, a group receiving CBT for 6 months and a control group no receiving psychotherapy. Presence of PNES was confirmed by electroencephalography (EEG). To assess self-perception quality of life, the QOLIE-31 questionnaire was applied before and every three months including a six months’ follow-up after treatment ended. Results: PNES frequency decreased significantly after the first three months of both therapies compared to control group. No differences were observed when the two therapies were compared. The significant decrease of PNES frequency remains until six months after the end of psychotherapy. Concerning self-perceived quality of life, QOLIE-31 results indicate a significant improvement since the first three months. At the beginning all the patients report a poor quality of life. After three months of psychotherapy most of them improve to a normal quality of life. After 6 months of therapy patients showed values reflecting an excellent quality of life, remaining at these levels six months after therapies ended. Conclusion: The present results support the notion that both psychotherapeutic approaches are reliably procedures for decrease PNES frequency and improve quality of life in these patients.

Sleep clearly influences learning and memory since sleep deprivation and stress impairs both cognitive processes. Working memory is an essential cognitive process and refers to a short-term holding of incoming information required to update the long-term mnemonic storage and to manipulate new elements in order to solve problems and make decisions. Nevertheless, the influence of sleep deprivation on working memory has scarcely been studied. In this study we evaluated working memory using the N-back test after increasing periods of wakefulness. Healthy young males were kept awake for 36 hours and the two N-back tasks with low (1-Back) and high (3-Back) levels of complexity were applied every 6 hours. Additionally, salivary cortisol was determined along the study. Unlike the control non-deprived participants, the sleep deprived volunteers showed a significant decrease in their efficiency to solve the 1-Back task after 24 hours of sleep deprivation. However, no differences were observed after 30 and 36 hours of sleep deprivation. Concerning the 3-Back task no differences were observed after sleep deprivation. Regarding reaction time, the deprived group manifested slower responses for the 1-Back task and for the 3-Back task after 30 hours and 36 hours of sleep deprivation, respectively. Cortisol levels presented the normal daily oscillation and no differences were observed between groups. This data suggests that sleep deprivation affects basal states of attention instead of working memory while performing simple tasks. The impact of sleep deprivation on the cognitive performance depends on the moment of day when the task is applied and the complexity of the tests used to assess these mnemonic skills.

Thyroid hormones play a major role in the maturation process of the brain. Currently, congenital hypothyroidism is detected by mass screening. The impact of this early hormonal deficiency on the organization of the sleep pattern is not known. In this study, the polysomnographic features in children diagnosed with congenital hypothyroidism were analyzed. Children were detected by mass population screening and the hormonal replacement therapy starts immediately. Children's age ranged between 1.5 and 18 months of age. The duration of hormonal treatment before sleep recordings varied between 8 days and 17 months. Children were polysomnographically recorded in the morning, for at least 2h, obtaining more than one sleep cycle. Results showed a high prevalence of females (5/1) in the group studied. A high proportion of infants (43%) displayed central apnea in different degrees (mild, moderate and severe) as well as hypopnea (83%), mainly in subjects around 4 and 8 months of age. The proportion of infants displaying central apnea decreases as age increases. In addition, indeterminate (light) sleep increase and quiet (slow wave) sleep decrease significantly regardless of age and treatment. The percentage of REM sleep correlated positively with the age of the child at the beginning of the treatment, and negatively with their age at the time of the study. These data indicate that congenital hypothyroidism facilitates the presence of central sleep apnea. The decrease of these respiratory alterations correlates with the increase of the hormonal replacement therapy. It seems that sleep respiratory alterations in congenital hypothyroidism are linked to brain maturation processes in which thyroid hormones play a major role.

The Epworth Sleepiness Scale (ESS) has been reputed as a quick, valid, and reliable method to assess Daytime sleepiness (DS). Since its publication, it has been translated into a number of languages. Our aim was to determine valid- ity and reliability indicators of an Spanish language version ESS for Mexican population. Considering that in developing countries the majority of persons use public transportation, validity and reliability indicators were also assessed utilizing the ESS without item 8. ESS was applied to a Group of college students (GCS), a selected group of Healthy subjects (HS), and a Group of patients with Sleep disorders (GPSD). We made an ESS comparison among the 3 groups, calculated the correlation between the ESS and the Multiple Sleep Latency Test (MSLT) and determined construct validity and internal consistency. GCS and GHS had lower ESS scores than GPSD. Regarding convergence validity, we obtained a negative correlation between the ESS and the MSLT; we also found a rise in the ESS score associated with an increase in the Ap- nea-hypopnea index (AHI). With respect to construct validity (employing main component analysis and varimax rotation), we found that one factor explains 52.01% of variance. We determined that the ESS internal consistency was 0.85. When item eight was suppressed, validity and reliability remained acceptable. The present ESS Spanish-language exhibited suit- able levels of validity and reliability. Use of the ESS, suppressing item eight, allows assessment of DS more accurately in individuals who do not travel by automobile on a regular basis.

Depression in children is often an elusive disorder and its diagnostic tools are a matter of controversy. Several scales have been developed in an attempt to specifically detect some of the major aspects of depression, i.e. anhedonia, sadness, hopelessness. On the other hand, in adults depression frequently induces changes in sleep patterns, particularly a shortening in REM sleep latency. The alteration of sleep patterns in depressed children has been a matter of controversy. It is possible that a diagnostic deficiency might be the source of the contradictory reports. In the present study, The Child Depression Inventory, a rating scale specifically developed for child depression was applied to 396 school children (8-12 years of age). Nearly 15% of the children (N = 45) obtained scores higher than the established limit in this test for normal healthy subjects. A sample of children found within the highest (N = 25) and within the lowest (N = 25) scores in the scale were selected. After a clinical evaluation, only those who meet the inclusion criteria (N = 21 for depressed and N = 7 for healthy controls) were electroencephalographically recorded. Children with depressive symptoms showed a significant shortening in REM sleep latency (mean = 108 min) when compared to non-depressed (mean = 150 min). In addition, significant increases were observed in sleep latency, REM sleep duration and the number of awakenings. Furthermore, results showed an unexpected high frequency of EEG abnormalities in children with depressive symptoms (75%) characterized by sharp waves and polyspikes in the frontal region. The present results support the notion that depression, in children, is accompanied by changes in sleep patterns, mainly concerning REM sleep.

In the search of the sleep substance, many studies have been addressed for different hormones, responsible for sleep-wake cycle regulation. In this article we mentioned the participation of steroid hormones, besides its role regulating sexual behavior, they influence importantly in the sleep process. One of the clearest relationships are that estrogen and progesterone have, that causing changes in sleep patterns associated with the hormonal cycles of women throughout life, from puberty to menopause and specific periods such as pregnancy and the menstrual cycle, including being responsible for some sleep disorders such as hypersomnia and insomnia. Another studied hormone is cortisol, a hormone released in stressful situations, when an individual must react to an extraordinary demand that threatens their survival, but also known as the hormone of awakening because the release peak occurs in the morning, although this may be altered in some sleep disorders like insomnia and mood disorders. Furthermore neurosteroids such as pregnanolone, allopregnanolone and pregnenolone are involved in the generation of slow wave sleep, the effect has been demonstrated in experimental animal studies. Thus we see that the sleep and the endocrine system saved a bidirectional relationship in which depends on each other to regulate different physiological processes including sleep.