Características sociodemográficas, hábitos de sono, estado cognitivo e funcional após acidente vascular cerebral

ABSTRACT Introduction: The cerebrovascular accident (CVA) is an important cause of neurological impairment. Few data about the factors associated with morbidity of cerebrovascular accident are found in Brazil. Objectives: Evaluate sociodemographic characteristics, sleep habits, cognitive and functional status of patients with cerebrovascular accident. Methods: The patients evaluated through questionnaire Step 1 to survey the sociodemographic characteristics and Modified Rankin Scale for functional assessment. The neurological degree was evaluated by the National Institutes of Health Stroke Scale (NIHSS), the sleep Habits questionnaire for sleep and cognitive status by the Mini-Examination of the Mental State (MEMS). The data were analyzed using the chi-square test to determine differences in proportions of variables and linear regression analysis. Results: 305 patients were evaluated and the larger number of subjects was between 50 and 69 years (40%), most patients had no formal education (40.3%) and had ischemic type of cerebrovascular accident (72.5%). In the analysis of the functionality it was found that most patients had moderate impairment (55.1%). The results of the sleep habits showed that 63,6% of patients had one more person in the bedroom,12,3% complained about too much noise in the 11 room and 35% of too much light. From these patients 5,8% were smokers, 7,8% and 70,1% drank coffee drinkers, 28,6% had difficulty in initiate to sleep and woke up 37,6% in the middle of the night. Were showed complaints about nightmares (11%), feeling of suffocation (37,7%) and 35% felt very sleepy during the day. In addition, 95% were unemployed, 80,5% did not perform physical activities and 95,4% did not perform mental activities. The cognitive screening conducted a determined association of cognitive status with age and education level and neurological status. Conclusion: The study showed a high frequency of cases of cerebrovascular accident with functional dependence in a moderate degree, identified that many patients do not follow hygienic measures of sleep and found that the assessment of cognitive deficits must take into consideration the age, educational level and degree of neurological patients. We suggest the need for programs of assistance to victims of cerebrovascular accident patients, with a multidimensional approach including the rehabilitation team, the role of sleep medicine and Neuropsychology, so that patients have access to a more appropriate functional rehabilitation, develop a lifestyle that ensures a good sleep quality and are evaluated and rehabilitated with regard to cognitive impairment

Distúrbios do sono em pacientes com transtorno depressivo

To evaluate sleep disorder complaints in outpatients with depressive disorder from a general hospital. Methods: An observational, cross-sectional study was carried out with a study sample composed of 70 patients (44 women and 26 men) with diagnosis of depressive disorder, according to the DSM-IV criteria. The patients were interviewed and evaluated by the Identification Questionnaire, the Sleep Habits Questionnaire and the Beck Depression Inventory (BDI). Results: In this study, 50 (71.3%) patients had recurrence of sleep disorder complaints. Mean BDI score was 35.83+8.85, with significant differences between patients with (38.50+8.70) and without (29.60+7.80) recurrence (p<0.05) and among patients with 1, 2, 3 and >3 episodes (p<0.05). In this study, 49 (70%) patients had insomnia and 21 (30%) had subjective excessive sleepiness. Significant differences were observed between the mean duration in months of the sleep disorders (7.16+2.10) and the depressive disorder (6.12+1.90) (p<0.05). Discussion: In the study sample, recurrence of sleep disorder complaints was high and significantly associated with severe depression. Insomnia was prevalent and the mean duration of sleep disorders was higher in relation to depressive disorder

Análise do sono e da utilização de cartilhas educativas em pacientes com acidente vascular cerebral

O AVC é uma grande causa de mortalidade e uma das principais causas de incapacidade entre adultos. O presente estudo visa analisar o estado do sono e da utilização de cartilhas educativas em pacientes com AVC. No primeiro estudo foram abordados os fatores associados com os horários de dormir/acordar e no segundo estudo foi analisado o conhecimento e prática quanto às orientações sobre os hábitos de sono e estimulação cognitiva. No estudo 1 foram avaliados 50 pacientes sendo 28 homens, de faixa etária entre 25 e 90 anos que durante uma semana completaram um diário do sono e o registro de atividades através do Social Rhythm Metric (SRM) e do Indice de Nível de Atividades (ALI) e aplicação do questionário de cronotipo (MEQ). Utilizado o teste de correlação de Spearman verificou-se correlação significativa entre os horários de dormir/acordar com cronotipo e entre os horários de dormir/acordar com SRM e o ALI. No segundo estudo foram abordados 40 pacientes com idade média 56,1 ± 11,9 anos, sendo 15 homens e 25 mulheres; como instrumentos foram utilizados National Institute Health Stroke Scale (NIHSS) e em seguida os pacientes observaram cartilhas educativas sobre hábitos de sono e estimulação cognitiva respondendo se conheciam e se praticavam as orientações apresentadas. A análise estatística realizada através do teste de Fisher obteve como resultado, que das 10 orientações apresentadas sobre os hábitos de sono, 6 foram citadas como conhecidas e apenas 4 foram praticadas. Das 6 orientações cognitivas, não houve diferença significativa entre os que conheciam e não conheciam, mas em 5 delas a maior frequência foi dos pacientes que não praticaram. Os resultados dos estudos indicam a importância de avaliar o cronotipo antes do planejamento de reabilitação, e a necessidade de se estimular o ritmo social a fim de contribuir para a melhoria dos padrões de sono de pacientes. Verificou-se também que em relação ao conhecimento e prática de orientações apresentadas muitos pacientes não conheceram ou não praticaram orientações importantes a respeito de hábitos de sono e de estimulação cognitiva, mesmo na fase crônica da patologia, sugerindo que mais políticas de educação em saúde devem ser implementadas com intuito de causar mudança nos hábitos de vida dos pacientes com AVC

Qualidade subjetiva do sono e queixa de insônia em pacientes com Acidente Vascular Cerebral

Brain injury can be associated with changes in the sleep-wake cycle. However, studies about sleep disturbances and their relationship with quality of sleep are scarce. Besides, it remains to be known how stroke affects the mechanisms of sleep. The aim of this study was to investigate quality of sleep, complaints of sleep disturbances and associated factors in stroke patients from the Physical Therapy services in Natal -RN. This was a cross-sectional descriptive study involving 70 individuals (aged 45-65 years), 40 patients (57 ± 7 years), 11 ± 9 months after injury, and 30 healthy individua ls (52 ± 6 years), evaluated with the Pittsburgh Sleep Quality Index (PSQI) and Sleep Habits Questionnaire. The data were analyzed by Chi-square test, t Student test and logistic regression. Poor quality sleep was found in 57,5% of the patients (6,3 ± 3,5) and was significantly higher than in the control population (3,9 ± 2,2) (t Student test, p=0,002). The patients showed significantly higher value of PSQI than controls: sleep latency (p=0,019), length of sleep (p=0,039) and dysfunction during the day (p=0,001). Regarding complaints of sleep disturbances (dyssomnias and parasomnias) analyzed by Chi-square test, the complaint of insomnia was the most prevalent (patients: 37,5%; healthy subjects: 6,7%; p=0,007). Regression analysis showed that sl eep latency (p=0,036) and complaint of insomnia (p=0,036) were associated with quality sleep. In addition, female gender (p=0,036) and complaint of broken sleep (p=0,003) were considered risk factors for the presence of insomnia. Our results show that stroke affects the homeostatic process of sleep. Shorter sleep latency and the absence of insomnia are considered protective factors for good sleep quality and this should be taken into consideration in the diagnostic and therapeutic strategies

Caracterização do ciclo sono/vigília de professores do ensino médio em natal/rn

In the school environment is fundamental the knowledge about the sleep-wake cycle (SWC), because we find children and adolescents with excessive sleepiness and learning difficulties. Furthermore, teachers with high demand and with different work schedule, which may contribute to changes in SWC. The aim of this study was to describe the SWC of high school teachers in Natal/RN. Habits and knowledge about sleep, chronotype, SWC, daytime sleepiness, sleep quality and job satisfaction were described in 98 high school teachers from public and private school. These parameters were compared according to the characteristics of work, family structure and gender. Data collection was performed with the use of questionnaires in two stages: 1) "health and sleep" (general characterization of sleep habits), Horne & Ostberg questionnaire (characterization of chronotype), Epworth Sleepiness Scale and the Index of Pittsburg Sleep Quality, 2) The sleep diary for 14 days. From the results, we observe that the teachers woke up and went to bed earlier in the week and showed a reduction of time in bed around 42min comparing to weekend. This reduction in time in bed during the week was accompanied by an increase in nap duration on weekend. In addition the teachers woke up earlier on Saturdays than on Sundays, probably due to housework and leisure. The teachers' knowledge about sleep was low in relation to individual differences and effect of alcoholic beverages on sleep, and high in the consequences of sleep deprivation. The differences found in comparisons on the characteristics of work, family structure and gender were punctual, except concerning the work schedule. The teacher who started work in the morning and finished in the night, woke up earlier, went to bed later and had less time in bed, when compared to teachers who work only in two shifts. In addition, teachers with late chronotypes who begin the work in the morning had a greater irregularity in the wake up time compared to teachers with earlier and intermediate chronotypes. Half of teachers have excessive sleepiness, which was positive correlated with work dissatisfaction. In general, teachers showed IPSQ averages equivalent to poor sleep quality and the women showed worst averages. From the results, it is suggested that the SWC of teachers varies according to work schedule, leading to irregularity and partial sleep deprivation in the week, although these responses vary according to chronotype. These changes are accompanied by excessive daytime sleepiness and poor sleep quality. However, it is necessary to expand the sample to clarify the influence of variables related to work, family structure and gender together

Avaliação do padrão do ciclo sono-vigília e a cognição em estudantes de medicina com diferentes esquemas de horários de aulas

The sleep patterns of students entering the university, is accompanied by many factors that can lead to changes in sleep habits, such as academic demands, new social opportunities, reduced parental care and irregular teaching schedules. The irregular pattern of sleep-wake cycle is usually accompanied by several daytime consequences, for example, reduced levels of motivation, performance, concentration, alertness and mood as well as increased fatigue and sleepiness.Thus, there are numerous reasons to support the fact that these students may suffer damage in their academic performance. The aim of this study was to evaluate the sleep-wake cycle (SWC) and cognition in medical students with different schemes teaching schedules. One group started classes at 08am, while the other started at 07am. We analyzed the data from 88 volunteers, 39 from each group. However, only those who participated in both stages of the study (n = 78) underwent cognitive testing. For subjective evaluation of the SWC was used questionnaires to check the quality of sleep, chronotype, daytime sleepiness and sleep habits. For objective evaluation was used actigraphy. For cognitive assessment was used the test MoCA (Montreal Cognitive Assessment). The results indicate that the group has class earlier had a greater irregularity of the SWC and a worse performance in cognitive testing. There was a difference between the schedules the week and weekend in the subjective variables, bedtime, wake up and sleep duration in both groups. The objective variables, time in bed showed difference between the schedules the week and weekend to the group started class at 08am and the variables bedtime, get up time, actual sleep time, time in bed and wake bouts in the class at 07am. In the cognitive test, there were differences between the groups in overall score and in the areas of executive function and memory recall. Thus, it is suggested that the class starting time may cause irregularity of the SWC and the irregularity may cause mild cognitive impairment. Moreover, cognitive testing MoCA was sensitive to detect differences among students, although the difference between the schedules is small

Sono e percepção visuoespacial em trabalhadores de uma empresa petroquímica submetidos a esquemas de trabalho em turnos alternantes

Shift work consists of an array of unusual work hours, such as evenings and weekends, and increasing workload, in order to meet the uninterrupted production, which leads to changes in the quality, duration and regularity of sleep. Research indicates that sleep alteration cause cognitive processes to become slower, unstable and prone to errors, leading to loss of cognitive functions such as visuospatial perception. In this sense, this research aimed to evaluate sleep quality and its relation to visuospatial perception in workers in alternating shifts. Participants were 21 panel operators in a petrochemical company, male, aged 19-53 years. All participants were subjected to schedules of alternating shifts (day and night) of 12 nonstop hours and data were collected from 10 workers who were assigned to the day shift and 11 workers assigned to the night shift. For the sleep evaluation were used the Sleep Diary, the Sleep Habits Questionnaire, the Chronotype Identification Questionnaire and the Pittsburgh Sleep Quality Index (PSQI). The visuospatial skills were assessed using the Rey Complex Figure Test and attention was assessed using a portable version of the Psychomotor Vigilance Task (PVT). The results showed that the general sample of workers obtained poor sleep quality on working days and good sleep quality during the work break. There was shortened sleep duration in the work week and appropriate duration in the work break. No losses were found in the workers visuospatiality, but the good quality of sleep during the work break was correlated to adequate visuospatial performance, for the day shift workers. The attention performance oscillated throughout the work hours, especially on the night shift. It is concluded that the alternating shifts work scheme can be detrimental to the sleep quality workers and a good sleep quality can contribute to a better visuospatial performance

Abordando o sono no ensino médio: proposta de unidade didática contextualizada com o tema saúde

Biological rhythms are part of the life from the simplest to the most complex living beings. In humans, one of the most important biological rhythms is the sleep-wake cycle (SWC), which represents an indispensable behavior for health, since sleep deprivation can lead to deficits in attention and memory, mood and daytime sleepiness which may affect school performance. Nevertheless, the SWC is a content rarely discussed in schools. Thus, the aim of this research was to address contents of the sleep-wake cycle, related to the content of Health to encourage healthy sleep habits. This study was conducted in a public school with 33 students of the 3rd year of high school and is divided into four stages: 1st) Study and analysis of the content of the textbook adopted by the school to subsidize the activities covered in the teaching unit (TU) and approximation with the biology teacher from the class to evaluated the feasibility of schedules for the development of TU; 2nd) Survey of students' prior knowledge, through a questionnaire, to guide the development of the TU; 3rd) Development and implementation of a TU based on meaningful learning and characterization of the students sleep habits, 4th) Evaluation of the TU as a viable proposal to teach biological rhythms concepts. Previous knowledge of students about the SWC are scarce and this content is not covered in the books adopted by the school. Alternative conceptions were observed, particularly with regard to individual differences in sleep, which may contribute to the occurrence of inadequate sleep habits, as reported by the adolescents in this study. The activities developed during UD were well received by the students who showed participative, motivated and evaluated positively the procedures used by the researcher. After the TU, students' knowledge about the concept of biological rhythms has been increased and they started to identify that the SWC changes throughout life and occur due biological and socio-cultural factors. Thus, the UD elaborated in this study represents a viable proposal to teach the concepts of biological rhythms contextualized to the content of Health, in high school

Influência do horário de trabalho, do gênero e de um programa de educação sobre o sono no ciclo sono/vigília de professores do ensino fundamental e médio

The teaching profession is often associated with extensive workload inside and outside the classroom, poor teaching conditions, among other challenges that can cause sleep problems. These problems may be even greater in women, due to the professional and domestic work hours and to the major sleep necessity. Considering that sleeping problems may result from the practice of poor sleep habits, sleep education programs are conducted with the aim to reduce sleep deprivation, irregularity on sleep schedules, daytime sleepiness and improve sleep quality. In this sense, the objective of this study is to evaluate the influence of working hours, gender and a sleep education program on sleeping habits, quality of sleep, daytime sleepiness and the level of stress in teachers of elementary and secondary education. For that, teachers filled the questionnaires that assessed: 1. Sleeping habits (Sleep & Health), 2. Chronotype (Horne & Ostberg), 3. Daytime sleepiness (Epworth Sleepiness Scale), 4. Sleep Quality (Pittsburgh Sleep Quality Index), 5. Level of stress (The Inventory of Stress for Adults of Lipp) and 6. Daily pattern of sleep/wake cycle (Sleep Diary). The questionnaires 1, 4, 5 and 6 were repeated 3 weeks after the sleep education program. Teachers who begin work in the morning (7:11 ± 0:11 h) wake up earlier in the week and often have poor sleep quality compared to those who start in the afternoon (13:04 ± 00:12 h). Among those who begin work in the morning, the intermediate types and those with an evening tendency were more irregular in the wake up time than morning types and increased sleep duration on weekend. In relation to gender, women had longer sleep duration than men, although the majority presented excessive daytime sleepiness and poor sleep quality. However, when work schedule and age are similar between genders, the difference in sleep duration becomes a tendency and the difference in the percentage of excessive daytime sleepiness disappears, but the poor sleep quality persists in women. With respect to teachers who have gone through the sleep education program, there was an increase in knowledge about the subject, which may have contributed to the reduction in the frequency of coffee consumption close to bedtime and to the sleep quality improved in 18 % of participants. In the control group, there were random differences in knowledge in 3rd stage, and sleep quality improved in only 9% of teachers. The participation in the sleep education program was not enough to change the hours of sleep and decrease stress of teachers. Therefore, the start time school in the morning was preponderant in determining the wake up time of teachers, especially for intermediates types and those with an evening tendency. Furthermore, the poor quality of sleep was more common in women, and the sleep education program contributed to increase knowledge on the subject and to improve sleep quality.

Pressão de sono e perfil acadêmico de estudante de medicina do 1º período da UFRN

Academic demands, new social context, new routines and decrease of the parental control, are factors that may influence the sleep pattern of freshman students at the University. Medical students from the Federal University of Rio Grande do Norte (UFRN) have a full-time course, subjects with high-level content, and, at the first semester, classes begin at 7 a.m. This group composed by young adults who still suffering with delayed sleep phase, common in adolescence, indicating that this class schedule can be inappropriate at this age. The reduction of nocturnal sleep during school days, and the attempt to recover sleep on free days – social jet lag (JLS), suggests that in the first semester, students suffer from high sleep pressure. High sleep pressure may reflect on cognitive tasks and performance. Therefore, the aim of this study was to investigate the relationship between sleep pressure and the academic profile of medical students from the first semester of UFRN, characterizing this population socio-demographically and investigating possible impacts on therestactivity rhytm and academic performance. A sample of 88 students, healthy men and women awswered the following questionnaires: Pittsburgh Sleep Quality (PSQI), Epworth Sleepiness Scale (ESS), Horne & Ostberg Chronotype (HO), Munich Chronotype (MCTQ) and “Health and Sleep” adapted. Actigraphy was used during 14 days to make actogramas and obtain non-parametric variables of the rest-activity rhythm and the grades of the morning schedule were used as academic performance. The JLS was used as a measure of sleep pressure. Statistics significance level was 95%. The population was sociodemographic homogeneous. Most students have healthy lifestyle, practice physical activity, use car to go to the university and take between 15 and 30 minutes for this route. Regarding CSV, most were classify as intermediate (38.6%) and evening (32%) chronotypes, needs to nap during the week, suffer daytime sleepiness and have poor sleep quality. 83% of the sample has at least 1h JLS, which led us to divide into two groups: Group <2h JLS (N = 44) and Group ≥ 2h JLS (N = 44). The groups have differences only in chronotype, showing that most evening individuals have more JLS, however, no differences were found in relation to sociodemographic aspect, rest-activity rhythm or academic performance. The homogeneity of the sample was limited to compare the groups, however, is alarming that students already present in the first half: JLG, poor sleep quality and excessive daytime sleepiness, which can be accentuated through the university years, with the emergence of night shifts and increased academic demand. Interventionsaddressingthe importance of good sleep habits and the change of the class start time are strategies aimed to improve student’s health.

Estratégias para ajuste do ciclo vigília-sono de adolescentes aos horários escolares matutinos: a educação sobre o sono e a exposição a luz solar

In adolescents, who tend to sleep and wake-up later, the school schedule in the morning is associated with sleep advancement and shortening besides bedtime and wake-up time irregularity between week and weekend days. As a result, there is an increase in daytime sleepiness and a drop in cognitive performance that interfer in students performance in classroom. These consequences reinforce the need to evaluate alternatives that help the adolescent to adapt their sleep needs to the time of start of classes in the morning. Accordingly, the general aim of this study was to evaluate the effects of a sleep program education and sunlight exposure in early morning on sleep-wake cycle (SWC) and daytime sleepiness of adolescents. The students chronotype were evaluated by the Horne-Ostberg questionnaire and the health and usual sleep habits by "the health and the sleep questionnaire. The SWC patterns were assessed by sleep log, the daytime sleepiness by Karolinska Sleepiness Scale (KSS) and the alertness by the Psychomotor Vigilance Test (PVT). These parameters were compared before and after a sleep education program and before and during the sunlight exposure. The sleep program was effective in increasing sleep knowledge of adolescents, in promoting a reduction of bedtime and wake-up time irregularity and increasing the sleep duration in school days. The sunlight exposure effect was evaluated in the return to classes after vacation due to the difference in sleep patterns between school and vacation days. During the intervention week it was observed an advance of sleep schedules, an increase on sleep duration and alertness at the end of the morning. Assessed separately, sleep education and sunlight exposure should contribute to minimize adolescents partial sleep deprivation, but daytime sleepiness effect must be better investigated. These strategies should be used jointly by school members to improve health and performance of their students

Avaliação do sono e enfermeiros nos diferentes turnos hospitalares

This study aimed to analyze the pattern characteristics of sleep and sleep quality of nurses who worked day and night shifts. This is a study with a quantitative approach, cross-sectional, descriptive. The study was conducted at the University Hospital of Rio Grande do Norte. Data were collected in full in the period from January to September 2015, through the instruments: Pittsburgh Sleep Quality Index and Sleep Diary. Subjects were interviewed according to their work shift, day or night, during the working hours of the nursing team. After being coded and tabulated, data were analyzed using SPSS version 20.0. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, in the Opinion No. 751 567. For a description of continuous variables were used position measurements (mean and median), dispersion (standard deviation) and correlation (Spearman correlation test), to a 0.05 significance level. The socio-demographic profile of the sample showed a total of n = 104 participants, distributed in: 64 on day shift and night shift 40; wherein 90.4% are female, aged between 24-45 years, corresponding to 73% of the sample. There was the presence of statistically significant differences for the variables: employment and living habits (inpatient and outpatient sector (p = 0.003), have more than one job (p = 0.002), use cordial (p = 0.021); Sleep pattern: nap time (p = 0.003), sleep latency (p = 0.013), total sleep time (p = 0.001), how it felt to wake up (p = 0.017), quality of nighttime sleep (p = 0.001) and sleep quality (p = 0.007) compared between the day shift and the night shift. It was concluded that shift work has changed the pattern and sleep quality of nurses working day and night shifts.

Avaliação do sono e enfermeiros nos diferentes turnos hospitalares

This study aimed to analyze the pattern characteristics of sleep and sleep quality of nurses who worked day and night shifts. This is a study with a quantitative approach, cross-sectional, descriptive. The study was conducted at the University Hospital of Rio Grande do Norte. Data were collected in full in the period from January to September 2015, through the instruments: Pittsburgh Sleep Quality Index and Sleep Diary. Subjects were interviewed according to their work shift, day or night, during the working hours of the nursing team. After being coded and tabulated, data were analyzed using SPSS version 20.0. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, in the Opinion No. 751 567. For a description of continuous variables were used position measurements (mean and median), dispersion (standard deviation) and correlation (Spearman correlation test), to a 0.05 significance level. The socio-demographic profile of the sample showed a total of n = 104 participants, distributed in: 64 on day shift and night shift 40; wherein 90.4% are female, aged between 24-45 years, corresponding to 73% of the sample. There was the presence of statistically significant differences for the variables: employment and living habits (inpatient and outpatient sector (p = 0.003), have more than one job (p = 0.002), use cordial (p = 0.021); Sleep pattern: nap time (p = 0.003), sleep latency (p = 0.013), total sleep time (p = 0.001), how it felt to wake up (p = 0.017), quality of nighttime sleep (p = 0.001) and sleep quality (p = 0.007) compared between the day shift and the night shift. It was concluded that shift work has changed the pattern and sleep quality of nurses working day and night shifts.

Estudos analíticos dos grafoelementos do eletroencefalograma em sono: fusos do sono, ondas agudas do vértex e o gradiente de freqüência e amplitude, como indicadores de comprometimento neurológico na criança

Innumerable studies have focused been reported on the sleep spindles (SS), Sharp Vertex Waves (SVW) and REM, NREM Sleep as indicators interpreting EEG patterns in children. However, Frequency and Amplitud Gradient (FAG) is rarely cited sleep parameter in children,that occurs during NREM Sleep. It was first described by Slater and Torres, in 1979, but has not been routinely evaluated in EEG reports. The aim of this study was to assess the absence of SS, SVW and FAG, as an indication of neurological compromise in children. The sample consisted of 1014 EEGs of children referred to the Clinical Neurophysiology Laboratory, Hospital Universitário de Brasília (HUB), from January 1997 to March 2003, with ages ranging from 3 months to 12 years old, obtained in spontaneous sleep or induced by choral hydrate. The study was transversal and analytical, in which, visual analysis of EEG traces was perfumed individually and independently by two electroencephalographers without prior knowledge of the EEG study or neurological findings. After EEG selection, the investigators analyzed the medical reports in order to define and correlate neurological pattern was classified according to the presence or absence of neurological compromise, as Normal Neurological Pattern (NNP), and Altered Neurological Pattern (ANP) respectively. From the visual analysis of the EEG(s), it was possible to characterize 6 parameters: 1- FAG present (64,1%); 2- FAG absent (35,9%); 3 - normal SS (87,9%); 4 - altered SS s (12,1%); 5 - normal SVW s (95,7%); 6 - altered SVW s (4,3%). The prevalence of well-formed FAG is found in the 3 months to 5 years age group in the children with NNF. FAG was totally absent from the age of 10 years. When comparing the three sleep graphielements, it was observed that SVW and SS were predominant in children with NNF. However, FAG absent was more prevalent in the ANF than in altered SS an SVW. The statistical analysis showed that there is a strong association of FAG absent, with isolated alteration, in ANF patients, in that the prevalence ratio was 6,60. The association becomes stronger when FAG absent + altered SS(s) is considered (RP= 6,68). Chi-square test, corrected by Yates technique, showed a highly significant relation for FAG ρ= 0,00000001, for error X of 5%, or else the 95% confidence interval (ρ<0,05). Thus, the FAG absent were more expressive in ANF patient than altered SS(s) and SVW(s). The association becomes stronger in order to establish a prognostic relation, when the FAG is combined with the SS. The results os this study allow us to affirm that the FAG, when absent at ages ranging from 3 months to 5 years , is an indication of neurological compromise. FAG is an age-dependent EEG parameter and incorporated systematically, in the interpretation criteria of the EEG of children s sleep, not only in the maturational point of view, but also neurological disturbances with encephalic compromise

Diferenças de gênero na produção de associações livres de palavras através do ciclo sono-vigília

Although several studies, have shown differences in cognitive performance between men and women, it not yet known whether these differences occur in tasks involving free association of words (WA). Studies across the sleep-wake cycle (SWC) suggest that rapid eye movement sleep (REM) favors semantic flexibility, in comparison with pre-sleep waking (Pre-WK), slow-wave sleep (SWS) and post-sleep waking (Post-WK). The present work has two aims: (1) to evaluate the semantic distances of word pairs produced by AP, comparing men and women, (2) to evaluate semantic distance in word pairs produced by free association across the SWC in young adults of both sexes. To achieve aim (1), we applied a task of WA in 68 adult volunteers during waking (52 women and 16 men). The WA task consisted of writing the first word that came to mind after viewing another word offered as a stimulus (root Word). To achieve aim (2), we performed polysomnography to identify specific stages of the SWC. The experimental subjects were then awakened (if they were asleep) and were immediately given a WA task. The task was administered to 2 groups of 10 subjects each (G1 and G2). G1 subjects were stimulated with the same set of root words after waking from various states of SWC, while G2 subjects received sets of different root words at each state of the SWC. In the absence of a Portuguese corpus suitable for the measurement of semantic distances, the words collected in our experiments were translated to English, and semantically quantified within a systematic and representative corpus of that language (Wordnet). This procedure removed the polysemies typical of Portuguese, but preserved the semantic macrostructure common to both languages. During waking, we found that semantic distances are significantly lower in WA produced by women, in comparison with the distances observed in men. Through the SWC, there were no statistically significant differences in G1. In G2 women, we detected a significant increase of semantic distances upon being awakened from SWS. In contrast, G2 men showed a significant increase in semantic distances upon being awakened from REM. The results of the first experiment are consistent with the notion that women have a more concrete reasoning than men. The results of the second experiment indicate that men awakened from REM present more flexibility in word association than when being awakened from other states. In contrast, women showed more flexible word association after being awakened from SWS, in compared with other states. The results indicate that the cognitive flexibility attributed to different states of the SWC shows gender dependency