Alteración de la atención y concentración en estudiantes de medicina que realizan turnos de noche


Autoria(s): Munévar Sánchez, Diego Fernando
Contribuinte(s)

Pérez Olmos, Isabel Regina

Ibáñez-Pinilla, Milcíades

Data(s)

21/11/2012

31/12/1969

Resumo

El sueño, es indispensable para la recuperación, física, mental y de procesos como la consolidación de memoria, atención y lenguaje. La privación de sueño (PS) incide en la atención y concentración. La PS es inherente a la formación médica, pero no es claro el papel de los turnos nocturnos en estudiantes, porque no cumplen con un objetivo académico, pero hay relación con disminución de la salud, productividad, accidentes, y alteraciones en diversas actividades. Está descrito el impacto de la PS sobre la capacidad de aprendizaje y aspectos como el ánimo y las relaciones interpersonales. MÉTODOS: Se realizó un estudio analítico observacional de cohorte longitudinal, con tres etapas de medición a 180 estudiantes de Medicina de la Universidad del Rosario, que evaluó atención selectiva y concentración mediante la aplicación de la prueba d2, validada internacionalmente para tal fin. RESULTADOS: Se estudiaron 180 estudiantes, 115 mujeres, 65 hombres, entre los 18 y 26 años (promedio 21). Al inicio del estudio dormían en promedio 7,9 horas, cifra que se redujo a 5,8 y 6,3 en la segunda y tercera etapa respectivamente. El promedio de horas de sueño nocturno, disminuyó en el segundo y tercer momento (p<0,001); Además se encontró mediante la aplicación de la prueba d2, que hubo correlación significativa directa débil, entre el promedio de horas de sueño, y el promedio del desempeño en la prueba (r=0.168, p=0.029) CONCLUSIONES: La PS, con períodos de sueño menores a 7,2 horas, impactan de manera importante la atención selectiva, la concentración

Sleep is essential for physical and mental recovery, also for some processes like memory, attention and language. Sleep deprivation (SD) affects selective attention and concentration. The SD is inherent in the medical training, however, it is unclear the role of night shifts in medical students, as they do not meet a pure academic objective, and instead has shown the association of SD with declining health, productivity and some accidents, or some alterations in different activities. METHODS: An observational longitudinal cohort analytic study, measurement three stages to 180 medical students at the University of Rosario, which sought to assess selective attention and concentration by applying the d2 test, internationally validated for that purpose. RESULTS: A total of 180 students, 115 women and 65 men, aged between 18 and 26 years (mean 21), At baseline slept on average 7.9 hours, and this was reduced to 5.8 and 6.3 in the second and third stages respectively. The average hours of nightly sleep, decreased in the second and third time (p <0.001) was also found by applying d2 test, there was a weak direct significant correlation between the average hours nocturnal sleep, and average performance as the test concentration (r = 0.168, p = 0.029). CONCLUSIONS: The night shifts performance, and the SD resulting, with sleep periods less than 7.2 hours, has an important impact on selective attention

Formato

application/pdf

Identificador

http://repository.urosario.edu.co/handle/10336/4032

Idioma(s)

spa

Publicador

Facultad de medicina

Direitos

info:eu-repo/semantics/embargoedAccess

Fonte

reponame:Repositorio Institucional EdocUR

instname:Universidad del Rosario

1. Sabaté, J. Ergonomía de los turnos de trabajo a través de un estudio estadístico sobre varios tests psicológicos. MAPFRE Seguridad: Segundo Trimestre.2001; 86

2. Vander Helm, E; Walker MP. Overnight Therapy? The Role of Sleep in Emotional Brain Processing. Psychol Bull. 2009 ; 135(5): 731–74

3. Orozco A, Ayala C, Cortés O. Descripción de los efectos de los cambios en ciclos circadianos del sueño causados por los turnos de trabajo y su relación con procesos cognoscitivos de atención y memoria. (Tesis Doctoral). Facultad de Psicología. Universidad del Bosque Colombia.2000

4. Diekelmann S, Born J. The memory function of sleep. Nature Reviews Neuroscience 2010;11:114e26

5. Van Der Werf Y, Van Der Helm E., Schoonheim M, Ridderikhoff A, Van Someren E. Learning by observation requires an early sleep window. PNAS. 2009; 106 (45): 18926-18930

6. Yoo, S-S., Gujar, N., Hu, P., Jolesz, F.A., & Walker, M.P. The human emotional brain without sleep – a prefrontal amygdala disconnect. 2007.Current Biology, 17, 877-878

7. Djonlagic I, Saboisky J, Carusona A, Stickgold R, Malhotra A. Increased Sleep Fragmentation Leads to Impaired Off-Line Consolidation of Motor Memories in Humans. 2012. PLoS ONE 7(3): e34106. doi:10.1371/journal.pone.0034106

8. Ellenbogen J, Hu P., Payne J., Titone D., Walker M. Human relational memory requires time and sleep. PNAS.2007; 104 (18): 7723–7728

9. Gomez, R. L., Bootzin, R. R., & Nadel, L. Naps Promote Abstraction in Language-Learning Infants. 2006; Psychological Science, 17(8), 670-67

10. Wagner U, Gais S, Haider H, Verleger R, Born J. Sleep inspires insight.2004: Nature 427: 352-355

11. Durmer, D.S., and Dinges, D.F. (2005). Neurocognitive consequences of sleep deprivation. Seminars Neurology. Vol. 25 pp 117-129

12. Rial, R.V. and Nicolau, M.C. (2007). The trivial function of sleep. Sleep Med Rev. Vol. 11 pp 311-325

13. Curcio, G., Ferrara, M., Gennaro. L. D. (2006). Sleep loss, learning capacity and academic performance. Sleep Med Rev. Vol. 10 No.5 pp. 323–337

14. Born, J., Rasch, B. and Gais, S. (2006). Sleep to remember. Neuroscientist. Vol.12 pp. 410.

15. Papp, K. K., Miller, C. M., Strohl, K. P. (2006). Graduate medical training, learning, relationships, and sleep loss. Sleep Med Rev. Vol. 10 No.5 pp. 339–345

16. Born J, Wilhelm I., System consolidation of memory during sleep Psychological Research. 2012; 76:192–203

17. Marshall, L., & Born, J. The contribution of sleep to hippocampus-dependent memory consolidation. Trends in Cognitive Sciences2007. 11, 442–450

18. Urréa, E. Documento conferencia Universidad Javeriana. Facultad de Medicina, elaborado por el Centro de Investigaciones Neurológicas (CINEO).2003

19. Diekelmann, S., Buchel, C., Born, J., & Rasch, B. Labile or stable: opposing consequences for memory when reactivated during waking and sleep. Nature Neuroscience, 2011. 14, 381–386.

20. Meerloa P, Mistlbergerb R, Jacobsc B, Hellerd H.C, McGitye D. New neurons in the adult brain: The role of sleep and consequences of sleep loss

21. Guzman-Marin R, Suntsova N, Bashir T, Szymusiak R, McGinty D. Cell proliferation in the dentate gyrus of the adult rat fluctuates with the light–dark cycle. Neurosci Lett 2007;422:198–201

22. Guzman-Marin R, Bashir T, Suntsova N, Szymusiak R, McGinty D. Hippocampal neurogenesis is reduced by sleep fragmentation in the adult rat. Neuroscience 2007;148:325–33

23. Stickgold R. Sleep-dependent memory consolidation. Nature 2005;437:1272–8.

24. McDermott CM, LaHoste GJ, Chen C, Musto A, Bazan NG, Magee JC. Sleep deprivation causes behavioral, synaptic, and membrane excitability alterations in hippocampal neurons. J Neurosci 2003;23:9687–95

25. Ambrogini P, Orsini L, Mancini C, Ferri P, Barbanti I, Cuppini R. Persistently high corticosterone levels but not normal circadian fluctuations of the hormone affect cell proliferation in the adult rat dentate gyrus. Neuroendocrinology 2002;76:366–72

26. Graven S. Sleep and brain development. Clin Perinatol. 2006; 33:693–706

27. Ednick M, et al. A review of the effects of sleep during the first year of life on cognitive, psychomotor, and temperament development. Sleep. 2009; 32:1449–1458

28. Stickgold, R. Walker MP. Memory consolidation and reconsolidation: what is the role of sleep?. Trends Neurosci. 2005; 28 (8):408-415

29. Toni N, Teng EM, Bushong EA, Aimone JB, Zhao C, Consiglio A, et al. Synapse formation on neurons born in the adult hippocampus. Nat Neurosci 2007;10:727–34

30. Giuseppe C, Ferrara M, De Gennaro L. Sleep loss, learning capacity and academic performance. Sleep Medicine Reviews. 2006;10:323-337

31. Fogel SM, Smith CT, Cote KA. Dissociable learning-dependent changes in REM and non-REM sleep in declarative and procedural memory systems. Behav Brain Res.2007;180(1);48–61

32. Ellenbogen J. Cognitive benefits of sleep and their loss due to sleep deprivation. Neurology. 2005;64: E25-E27

34. Wolfson AR, Carskadon MA. Understanding adolescents' sleep patterns and school performance: a critical appraisal. 2003. Sleep Med Rev. Dec;7(6):491-506

35. Boivin DB, Tremblay G, James F. Working on atypical schedules. Sleep Med (2007), doi:10.1016/ j.sleep.2007.03.015

36. Sallinen M, Härmä M, Mutanen P, Ranta R, Virkkala J, et al . Sleepiness in various shift combinations of irregular shift systems. Ind Health 2005; 43 (1): 114–22

37. Rollinson DC, Rathlev NK, Moss M, Killiany R, Sassower KC, et al .The Effects of Consecutive Night Shifts on Neuropsychological Performance of Interns in the Emergency Department: A Pilot Study. Ann Emerg Med.2004; 41:400-6

38. Tellez A. Trastornos del Sueño, Diagnóstico y Tratamiento. Editorial Trillas. 1998;225 – 227

39. Baldwin Jr DC, Daugherty SR. Sleep deprivation and fatigue in residency training: results of a national survey of first- and second-year residents. Sleep 2004;27:217–23

40. Cavallo A, Jaskiewicz J, Ris MD. Impact of night-float rotation on sleep, mood, and alertness: the resident's perception. Chronobiol Int.2002; 19: 893-902

41. Besedovsky L, Lange T., Born j. Sleep and immune function. Pflugers Arch - Eur J Physiol. 2012; 463:121–137

42. Kahol K, Leyba MJ, Deka M, Deka V, Mayes S, Smith M, Ferrara JJ, Panchanathan S. Effect of fatigue on psychomotor and cognitive skills. 2008: Am J Surg. ;195(2):195-204.

43. Barger LK, Cade BE, Ayas NT, Cronin JW, Rosner B, et al; Harvard Work Hours, Health, and Safety Group. (2005). Extended work Shifts and the Risk of Motor Vehicle Crashes among Interns; N Engl J Med.2005; 352:125-134

44. BesedovskyHO, del Rey A (2011) Central and peripheral cytokines mediate immune–brain connectivity. Neurochem Res 36:1–6 Pflugers Arch - Eur J Physiol (2012) 463:121–137

45. Karlsson B, Knutsson A, Lindahl B. Is there an association between shift work and having a metabolic syndrome? Results from a population based study of 27,485 people. Occup Environ Med. 2001; 58:747–52

46. Knutsson A. Health disorders of shift workers. Occupational Medicine.2003; 53:103–8

47. Gaba.D, Howard SK. Fatigue among Clinicians and the Safety Of patients. N Engl J Med. 2002; 347: 1249-1255

48. Kahol K, Leyba MJ, Deka M., Deka V., Mayes S., Smith M., Ferrara J.J, Panchanathan S., Effect of fatigue on psychomotor and cognitive skills Am J Surgery. 2008; 195: 195-204

49. Rufino M. Informe: El Trabajo Nocturno y Turnos, Los Efectos Sobre La Salud de Los Trabajadores. Fes-UGT.2001

50. Walker MP, Brakefield T, Morgan A, Hobson JA, Stickgold R. Practice with sleep makes perfect: sleep-dependent motor skill learning. Neurology. 2002; 35(1):205–211

51. Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E. Effect of Reducing Interns work Hours on Serious Medical Errors in Intensive Care Units. N Engl J Med. 2002; 351: 1838-1858

52. Toulouse E, Pierón H. Manual prueba perceptiva y de atención. TEA ediciones S.A. 1982.

53. Brickenkamp R, Zillmer E. Manual Test de Atención D2. TEA ediciones S.A. 2002

TEME 0091 2012

Palavras-Chave #TRASTORNOS DEL SUEÑO #MENTE Y CUERPO #SUBCONSCIENCIA #ENFERMEDADES DEL SISTEMA NERVIOSO #Sleep #Attention #Concentration #Students #Medicine #Health
Tipo

info:eu-repo/semantics/bachelorThesis

info:eu-repo/semantics/acceptedVersion