Tratamento da sindrome da apnéia e hipopnéia obstrutiva do sono (sahos) com aparelhos intrabucais

The apnea and hypopnea sleep obstructive syndrome is a disorder that affects part of adult population. Some characteristics can come with this syndrome that cause social problems such as snoring and excessive daytime sleepiness, associated many times with pulmonary hypertension and cardiac insufficiency. The dentist who is inserted into a multidisciplinary team is a professional highly regarded for diagnosis and treatment of sleep disorders. Among treatments recommended, therapy with intraoral appliance shows an excellent non invasive alternative, achieving satisfactory results.

Características clínicas da associação entre o bruxismo do sono e o refluxo gastroesofágico merecem atenção profissional

Introduction: Bruxism has been defined as an oral parafunctional activity that includes clenching and/or grinding the teeth while asleep or awake. In addition to sleep bruxism (SB), various other orofacial movements sporadically occur during sleep. Occasional regurgitation and heartburn due to gastroesophageal reflux (GER) are frequent in the general population. GER refers to the presence of symptoms that are secondary to the reflux of gastric content through the esophagus with or without signs of esophageal mucosal lesions. Dentists are often the first health care professionals to diagnose GER through observation of its oral manifestation. Objective: The aim of the present case reports was to discuss the diagnosis and clinical procedures followed in two patients with SB and GER, thereby contributing to the dissemination of knowledge about these two entities. We therefore recommend dentists to be alert to identifying the first signs of GER that appear in the oral cavity. Conclusion: At this point, we highlight the importance of treating the patient as a whole, in an endeavor to identify other sources of the problems that could contribute as factors aggravating these conditions.

Promoção da saúde por meio de atividades educativas sobre hábitos de sono

A good night sleep is part of a healthy lifestyle. However, children and adolescents replace sleeping hours by several other activities. This project aimed to disseminate information about sleeping and stimulate some reflections about the risk factors to health arising frompersonal and collective habits. A group of 1014 junior high school students from five schools in the city of Assis-SP, participated in the project. The students visited an exhibition about the theme "sleeping and health" and took part of group assignments. Issues related to sleeping and alternatives to promote healthy sleeping habits in day-life context were discussed. The activities were planned and executed by six trainees under the supervision of the responsible teacher. The majority of the visitors reported pleasure (90% of students) and interest in the subject; (85%) enjoyed learning new information about it (93%). Among the activities performed, 25% of visitors particularly enjoyed playful educational activities, 19% the oral presentation and 23% all the activities without distinction. Group discussion on everyday situations encouraged the adolescents to reevaluate previous experiences and knowledge that were not always consistent with current scientific knowledge. Undergraduate students had a rich practical opportunity that stimulated them to create health education strategies for adolescents. Some adolescents got more involved in the activities and others were more stimulated by the change of school routine. The activities were feasible and can be designed according to the target public. Certainly individual experience was sporadic and we suggest that future projects might be improved by stimulating bigger schools and more teachers to participate.

Acompanhamento psicológico de criança com problema de sono: um relato de caso

Difficulties with sleep are frequent in the pre-schooler children. The aim of this study was to present a case report of behavioural intervention by parental guidance to sleeping problems in a pre-schooler child. Participated in this study a four years old boy that had difficulties to sleep without the presence of his parents and his mother who was oriented through a parental program. The program of intervention was composed by five sessions in which the mother acquired education about the child’s sleep, received orientation about the establishment of time and routine to sleep and about the use of techniques (extinction and positive reinforcement) for the improvement of the sleep difficulties. The sleep and behaviour were evaluated in four periods (pre-treatment, post-treatment, one and six months follow up) according to the following instruments: 1) UNESP Scale of Habits and Hygiene of the Sleep – Children Version, 2) Scale of Sleep Disorders for Children and Teenagers, 3) Child Behavior Checklist (CBCL 1,5-5) and 4) sleep diary. The results showed that after intervention the child developed independent sleep, reduced the bed resistance and showed improvement in daily behaviors. To conclude: a behavioral intervention by parental guidance was effective to sleep problems of the child.

Anum não canta em gaiola: estudo sobre as relações entre educação em arte-cultura e privação de liberdade

Este estudo buscou compreender traços da trajetória histórica e filiações teóricas na construção da Fundação CASA, logo, no significado da privação de liberdade em medidas socioeducativas. A partir disto, refletimos sobre o modo como as práticas educacionais artístico-culturais, aparecem enquanto elementos desestabilizadores da ordem, confrontando e sendo confrontadas pela lógica persecutória, comportamentalista e punitiva, inerentes ao ambiente carcerário. Neste contexto, a pesquisa investigou a tensa relação entre o canto do anum e as gaiolas, ou seja, a educação em arte-cultura e a privação de liberdade. Para tanto, realizamos um estudo bibliográfico que colocou em diálogo: documentos institucionais como o Estatuto da Criança e do Adolescente - ECA, o Sistema Nacional de Atendimento Socioeducativo - SINASE e Regimento Interno da Fundação CASA; com produções teóricas que permitiram a reflexão e auxiliou na compreensão da complexidade destas relações como, Loïc Wacquant, Michel Foucault e Roberto da Silva, sobre o sistema carcerário; Stuart Hall, Frantz Fanon e Muniz Sodré, sobre identidade cultural e cultura negra; Paulo Freire e Boaventura de Souza Santos sobre educação, e por fim, nossas memórias enquanto arte-educador que, há mais de dez anos, atua diretamente com adolescentes em diversas unidades desta instituição. Enfim, buscamos responder a inquietação central deste trabalho: Como se dão os movimentos de captura e esquiva entre arte-cultura e privação de liberdade? Com a intenção de contribuir com processos de reflexão e construção de práticas educacionais direcionadas aos adolescentes encarcerados

Fatores de risco para complicações respiratórias após adenotonsilectomia em crianças com apneia obstrutiva do sono

Identificar fatores de risco para complicações respiratórias após adenotonsilectomia em crianças ≤ 12 anos com apneia obstrutiva do sono encaminhadas à UTI pediátrica (UTIP). Estudo de coorte histórica com corte transversal que analisou 53 crianças após adenotonsilectomia que preencheram os critérios pré-estabelecidos para encaminhamento à UTIP em um hospital escola de nível terciário. Foram utilizados o teste t de Student, o teste de Mann-Whitney e o teste do qui-quadrado para identificar os fatores de risco. Das 805 crianças submetidas à adenotonsilectomia entre janeiro de 2006 e dezembro de 2012 no hospital escola, 53 foram encaminhadas à UTIP. Vinte e uma crianças (2,6% do total de submetidas à adenotonsilectomia e 39,6% das que foram encaminhadas à UTIP) apresentaram complicações respiratórias, sendo 12 do gênero masculino e a idade média de 5,3 ± 2,6 anos. Maior índice de apneia-hipopneia (IAH; p = 0,0269), maior índice de dessaturação de oxigênio (IDO; p = 0,0082), baixo nadir da SpO2 (p = 0,0055), maior tempo de intubação orotraqueal (p = 0,0011) e rinopatia (p = 0,0426) foram preditores independentes de complicações respiratórias. Foram observadas complicações respiratórias menores (SpO2 entre 90-80%) e maiores (SpO2 ≤ 80%, laringoespasmos, broncoespasmos, edema agudo de pulmão, pneumonia e apneia). Em crianças de até 12 anos e com apneia obstrutiva do sono, aquelas que têm maior IAH, maior IDO, menor nadir da SpO2 e/ou rinopatia são mais predispostas a desenvolver complicações respiratórias após adenotonsilectomia do que aquelas sem essas características.

Repercussões cardiovasculares em crianças com distúrbios respiratórios obstrutivos do sono: revisão de literatura

Objective: To review the cardiovascular consequences of obstructive sleep-disordered breathing in children Data source: Medline and Ovid data base. Study selection: pediatric articles (original articles and case report) that investigated the obstructive sleep-disordered breathing in children Data synthesis: The obstructive sleep-disordered breathing can lead to serious cardiovascular consequences such as pulmonary hypertension, pulmonary edema and anatomic and functional abnormalities Conclusions: The knowledge of cardiovascular repercussions allows in better management of pediatric patients and may result in positive consequences for treatment and follow up of these patients.

Disturbios neuropsicológicos e síndrome da apneia do sono em crianças

Obstructive Sleep Apnea Syndrome (OSAS) is characterized by snoring and / or repetitive pauses in breathing during sleep associated with hypoxemia and hypercapnia. Affects approximately 1-3% of children, especially preschoolers. There is an association of OSAS with negative impact on neurocognitive development. However, there are few studies using protocols to assess cognition and behavioral disorders in children with OSAS. The objective of this study was to analyze the major studies related to the topic within the last two decades. The main studies published between 1995 to 2011 were identified through MEDLINE and LILACS databases. We selected the most relevant for OSAS in children, neurocognitive effects and association between obstructive disorders / OSAS in the target population (children). It was concluded that the studies analyzed showed that there is strong evidence regarding the overlapping of OSAS in children with neurocognitive disorders and that treatment of OSAS has positive impact on neurocognitive development.

O tratamento da apneia obstrutiva do sono e a utilização de implantes osseointegráveis: revisão da literatura

The obstructive sleep apnea syndrome affects millions of people around the world. The mandibular repositioning devices have been indicated in cases of mild/moderate syndrome; however in edentulous patients its use is deficient since there is no retention. Therefore the objective of this study was to conduct a review on the use of this treatment method combined to osseointegrated implants. A search on the theme: Dental implant and sleep apnea syndromewas performed in the Medline/PubMed, ISI, Cochrane, Dentistry Oral Science, Clinical Trials, Controlled Trials, and Bireme-BvS, databases, and 22 articles were found. After anevaluation 2 studies were selected and the review was complemented with an analysis of randomized controlled trials in the previous seven bases using the key-words: Sleep apnea syndrome, Oral appliance and Randomized controlled trial. The search returned 37 articles, and after they were submitted to inclusion criteria 17 studies were selected. There are a small number of studies presenting the use of dental implants as a mean to assist the stabilization of the mandibular repositioning appliances; those that are available are case reports that focusing on the effectiveness of the technique. Studies examining the effect these appliances in dentate patients indicate improvement in the levels of apnea and snoring. The use of mandibular repositioning appliances in dentate patients is an effective technique in treatment of patients with obstructive sleep apnea syndrome mild/moderate. Randomized controlled trialsare required in order to enable an analysis of the use of mandibular repositioning devices with the aid of dental implants .

Risco da síndrome da apneia obstrutiva do sono em amostra populacional da cidade de Botucatu - SP

The most common sleep disorder is obstructive sleep apnea syndrome (OSAS), that is characterized by repeated pauses in breathing during sleep, resulting in partial or complete obstruction of the upper airway. It is associated with systemic arterial hypertension and obesity. Objective: To assess the frequency of OSAS in the adult population of Botucatu by the Berlin questionnaire. Method: Transveral study was performed in which the sample size was estimated at 385 individuals. The Berlin questionnaire was administered to adults randomly on the streets, supermarkets and local shops. Data were analyzed taking into account age, gender, "high risk for OSAS", hypertension, obesity and correlations for OSAS. Results: 468 people interviewed were aged between 18 and 95 years, average of 59 years. 166 (35.25%) individuals were identified as "high risk for OSAS", being more frequent in the population above 40 years. Obesity was present in 23.3%, more common in women (60.2%). 83.5% of the population obese also had a "high risk for OSAS". Hypertension was observed in 27.3%, of these 71.9% were at "high risk for OSAS". Conclusion: The study showed a high frequency of "high risk for OSAS" in the adult population. Despite the dissemination by the media about sleep apnea, patients are not investigated, even under medical care for hypertension.

Nível de atividade física, sono e qualidade de vida em pacientes com doença de Alzheimer

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Relação entre transtorno do ciclo vigília-sono e trabalho noturno: desafios à segurança e saúde do trabalhador

The work and work organization influence the evolution of the health-disorder process by establishing a causal link with the work and the disorder. The present study aimed to verify the presence of the disorder of the sleepwake cycle triggered by non-organic factors, by identifying the possible effects on physical health, mental health and the social and family relations ten watchmen of a public institution of higher education. It was found that 80% of respondents had one or more of the symptoms that meet the criteria for the diagnosis of this non-organic disorder of sleep-wake cycle. We emphasize the need for specialized diagnostic, medical, psychological and social support for this population

Relaxamento progressivo, stress, enfrentamento e qualidade de vida em pessoas com apneia obstrutiva do sono

Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

Síndrome da apnéia obstrutiva do sono: diagnóstico e tratamento

The Syndrome Obstructive Sleep Apnea (OSA) is defined by recurrent episodes of a total or partial obstruction of the airway during sleep, considered apnea and hypopnea respectively. Considered to be increasing by increasing the number of individuals with a disorder breathing, Being continually increasing the number of individuals with a respiratory disorder, OSA can be considered a public health problem that deserves greater attention in relation to diagnoses and treatments that are being conducted. The objective of this study is through a literature review which should be evaluated during the diagnosis and etiology, consequences and treatment of respiratory disorders not adequately treated. The etiology is multifactorial and may be associated with exogenous factors or pathological and anatomical factors. In addition to the own symptoms interfere with the quality of life of the individual, depending on the intensity, OSA can trigger more serious complications. This is a complex syndrome which may have varying degrees and irreversible consequences to the body. The choice of treatment should be based on clinical conditions, the severity of the apnea, the degree of urgency of treatment and the patient's preferences, but the treatments available will not be fully effective if there are no changes in lifestyle of it. The respiratory disorders can range from a simple nasal obstruction and intermittent obstruction more severe, emphasizing the importance of a complete diagnosis, which must be multidisciplinary, through a team relationship between doctor and dentist.

Qualidade do sono em pacientes com síndrome do túnel do carpo

Pós-graduação em Bases Gerais da Cirurgia - FMB