Navegando por Palavras-chave "Excessive daytime sleepiness"
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- ItemAcesso aberto (Open Access)Distúrbio do sono em pacientes com esclerose múltipla : a relação entre fadiga e sonolência excessiva diurna(Universidade Federal de São Paulo (UNIFESP), 2017-08-31) Braga, Douglas Martins [UNIFESP]; Oliveira, Enedina Maria Lobato de [UNIFESP]; Prado, Gilmar Fernandes do [UNIFESP]; http://lattes.cnpq.br/2617510083171521; http://lattes.cnpq.br/9619603975043505; http://lattes.cnpq.br/8910992825218125; Universidade Federal de São Paulo (UNIFESP)Sleep disorders in patients with multiple sclerosis have various causes and interfere with daytime wakefulness. Objective: This study assessed the correlation between fatigue, excessive daytime sleepiness and level of disability. Method: Retrospective review of medical records from patients with multiple sclerosis to collect data on severity of fatigue, disability, daytime sleepiness, and depression. From 912 medical records reviewed, 122 reported daytime sleepiness: 67% had relapsing remitting, 12% had primary progressive, and 21% had secondary progressive. Results: In 95% of the patients with relapsing remitting who complained of daytime sleepiness and fatigue, association was found between these symptoms and neurological disability. Patients with relapsing remitting who complained of daytime sleepiness and fatigue also experienced depression (p = 0.001). No association between fatigue, excessive daytime sleepiness, depression, and disability was found in patients with progressive disease. Conclusion: In relapsing remitting, there is correlation between functional disability, excessive daytime sleepiness and fatigue, a finding not confirmed in primary progressive and secondary progressive form.
- ItemSomente MetadadadosDoes physical exercise reduce excessive daytime sleepiness by improving inflammatory profiles in obstructive sleep apnea patients?(Springer, 2013-05-01) Alves, Eduardo da Silva [UNIFESP]; Ackel-D'Elia, Carolina [UNIFESP]; Luz, Gabriela Pontes [UNIFESP]; Abrahao Cunha, Thays Crosara [UNIFESP]; Carneiro, Glaucia [UNIFESP]; Tufik, Sergio [UNIFESP]; Azeredo Bittencourt, Lia Rita [UNIFESP]; Mello, Marco Tulio de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Obstructive sleep apnea syndrome (OSAS) is associated with a variety of long-term consequences such as high rates of morbidity and mortality, due to excessive diurnal somnolence as well as cardiovascular and metabolic diseases. Obesity, recurrent episodes of upper airway obstruction, progressive hypoxemia, and sleep fragmentation during sleep cause neural, cardiovascular, and metabolic changes. These changes include activation of peripheral sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, insulin sensitivity, and inflammatory cytokines alterations, which predispose an individual to vascular damage.Previous studies proposed that OSAS modulated the expression and secretion of inflammatory cytokines from fat and other tissues. Independent of obesity, patients with OSAS exhibited elevated levels of C-reactive protein, tumor necrosis factor-alpha and interleukin-6, which are associated with sleepiness, fatigue, and the development of a variety of metabolic and cardiovascular diseases. OSAS and obesity are strongly associated with each other and share many common pathways that induce chronic inflammation. Previous studies suggested that the protective effect of exercise may be partially attributed to the anti-inflammatory effect of regular exercise, and this effect was observed in obese patients. Although some studies assessed the effects of physical exercise on objective and subjective sleep parameters, the quality of life, and mood in patients with OSAS, no study has evaluated the effects of this treatment on inflammatory profiles. in this review, we cited some studies that directed our opinion to believe that since OSAS causes increased inflammation and has excessive daytime sleepiness as a symptom and being that physical exercise improves inflammatory profiles and possibly OSAS symptoms, it must be that physical exercise improves excessive daytime sleepiness due to its improvement in inflammatory profiles.
- ItemAcesso aberto (Open Access)Efeitos da sonolência excessiva diurna ou da insônia associadas á apneia obstrutiva do sono no risco cardiovascular: um estudo longitudinal prospectivo de base populacional.(Universidade Federal de São Paulo (UNIFESP), 2018-03-29) Kim, Lenise Jihe [UNIFESP]; Andersen, Monica Levy [UNIFESP]; http://lattes.cnpq.br/4951931552005515; http://lattes.cnpq.br/9426936592794461; Universidade Federal de São Paulo (UNIFESP)Introdução: Diversas são as apresentações clínicas da apneia obstrutiva do sono (AOS), as quais possuem associações distintas com comorbidades. Sonolência excessiva diurna (SED) e insônia são sintomas comuns da AOS. Uma susceptibilidade distinta à mortalidade e a doenças cardiovasculares entre pacientes com AOS sintomática e assintomática ainda é incerta. Objetivos: Investigar os efeitos das apresentações clínicas da AOS com sintomas de SED e insônia na mortalidade, incidência de doenças cardiovasculares e níveis de marcadores metabólicos e inflamatórios. Avaliamos também os possíveis fatores sociodemográficos associados aos efeitos da AOS nos desfechos cardiovasculares. Métodos: Nós conduzidos uma análise prospectiva em uma amostra de base populacional de 1.061 participantes provenientes do Estudo Epidemiológico do Sono (EPISONO) com um tempo médio de seguimento de 8 anos. AOS foi definida como um índice de apneia-hipopneia >5, SED por escores >10 na Escala de Sonolência de Epworth e a insônia pelo auto-relato de 1 ou mais queixas de dificuldade de iniciar o sono (DIS), dificuldade de manter o sono (DMS) ou despertar precoce (DP) por pelo menos 3 vezes/semana. Desfechos primários consistiram na mortalidade por todas as causas e por doenças cardiovasculares. Desfechos secundários incluíram a incidência de eventos cardiovasculares não-fatais e combinados, além dos níveis de marcadores metabólicos e inflamatórios. Resultados: Nos modelos ajustados, AOS foi um fator preditor de riscos 3,02 e 5,85 vezes maiores de eventos cardiovasculares combinados independentemente da SED e insônia, respectivamente. O risco cardiovascular aumentado na AOS foi ainda mais proeminente somente em mulheres (OR: 6,19; IC95%: 1,52-25,28; P=0,01). A insônia foi também um fator de risco de eventos cardiovasculares não-fatais (OR: 5,52; IC95%: 1,12-27,12; P=0,04) e combinados (OR: 6,74; IC95%: 1,39-32,63; P=0,02), com o subtipo da DMS apresentando as únicas associações positivas. A mortalidade e os níveis de marcadores metabólicos e inflamatórios não diferiram entre as apresentações clínicas da AOS. Conclusões: Nossos achados de um seguimento de 8 anos indicaram que a AOS assintomática para SED e insônia é uma apresentação de maior risco de desfechos cardiovasculares. Um risco cardiovascular aumentado foi também observado em pacientes com insônia, especificamente o subtipo de DMS, e em mulheres com AOS.
- ItemAcesso aberto (Open Access)Fatigue in a cohort of geriatric patients with and without Parkinson's disease(Associação Brasileira de Divulgação Científica, 2009-08-01) Goulart, F.o. [UNIFESP]; Godke, B.a. [UNIFESP]; Borges, V. [UNIFESP]; Azevedo-silva, S.m.c. [UNIFESP]; Mendes, M.f.; Cendoroglo, Maysa Seabra [UNIFESP]; Ferraz, H.b. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Irmandade da Santa Casa de São Paulo Disciplina de NeurologiaWe evaluated the frequency of fatigue in geriatric patients with and without Parkinson's disease (PD) and correlated it with depression and excessive daytime sleepiness. We evaluated 100 patients from Hospital São Paulo, 50 with PD from the Neurologic Outpatient Clinic and 50 with non-neurologic diseases or oncologic diseases from the Geriatric Outpatient Clinic (controls). All patients who scored 28 or more on the Fatigue Severity Scale (FSS) were considered to have fatigue. Also, all patients were submitted to a structured interview to diagnose depression by the criteria of the American Psychiatric Association (DSM-IV, 4th version) and were evaluated by the Modified Impact of Fatigue Scale and the Epworth Sleepiness Scale (ESE) to detect excessive daytime sleepiness. Demographic and disease details of all PD patients were recorded and the patients were examined and rated by the Unified Parkinson's Disease Rating Sale (UPDRS) and Hoehn-Yahr staging. Frequency of fatigue (FSS ≥28) was 70% for PD and 22% for controls. Twenty of 35 PD patients with fatigue had concomitant depression. Compared to controls, PD patients were found more frequently to have depression by DSM-IV criteria (44 vs 8%, respectively) and excessive daytime sleepiness by the ESE (44 vs 16%), although only depression was associated with fatigue. Fatigue was more frequent among depressed PD and control patients and was not correlated with PD duration or with UPDRS motor scores. ESE scores did not differ between patients with or without fatigue.
- ItemAcesso aberto (Open Access)A interação entre genótipos de apolipoproteína E, sonolência excessiva diurna e funções cognitivas na síndrome da apneia obstrutiva do sono(Universidade Federal de São Paulo (UNIFESP), 2018-11-28) Balthazar, Fernanda Maurer [UNIFESP]; Carvalho, Luciane Bizari Coin de [UNIFESP]; Moraes, Walter André dos Santos [UNIFESP]; http://lattes.cnpq.br/7253538129354609; http://lattes.cnpq.br/4508875707983155; http://lattes.cnpq.br/4084344291512584; Universidade Federal de São Paulo (UNIFESP)Objective: To determine the neuropsychological features and cognitive function of adults with obstructive sleep apnea syndrome (OSAS) with or without excessive daytime sleepiness (EDS) and with or without apolipoprotein E (ApoE) ε4 allele. Methods: 21 patients, from 33 to 79 yrs, males and females, underwent a clinical interview, ApoE genotyping, neuropsychological evaluation, Epworth sleepiness scale and polysomnography. Results: EDS is associated with lower IQ (total and performance) and lower immediate visual memory independently of ApoE genotype. Patients carrying ApoE ε4 allele presented worse performance in divided attention, constructional praxis, perceptual organization, and cognitive flexibility. Combination of ε4 allele and EDS potentiates the deleterious effect on cognition, except for immediate visual memory. It was also associated to worse cognitive processing speed, selective attention and visuomotor coordination. Conclusion: EDS and ε4 allele are associated to worse cognitive performance in OSA patients. The combination of EDS and ε4 allele possibly potentiates the cognitive impairment.
- ItemAcesso aberto (Open Access)Sleepiness, inflammation and oxidative stress markers in middle-aged males with obstructive sleep apnea without metabolic syndrome: a cross-sectional study(Biomed Central Ltd, 2015-01-14) Andaku, Daniela Kuguimoto [UNIFESP]; D'Almeida, Vania [UNIFESP]; Carneiro, Glaucia [UNIFESP]; Hix, Sonia [UNIFESP]; Tufik, Sergio [UNIFESP]; Togeiro, Sonia Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fac Med ABC FUABCBackground: the simultaneous occurrence of metabolic syndrome and excessive daytime sleepiness are very common in obstructive sleep apnea (OSA) patients. Both conditions, if present in OSA, have been reported to be associated with inflammation and disruption of oxidative stress balance that impair the cardiovascular system. To verify the impact of daytime sleepiness on inflammatory and oxidative stress markers, we evaluated OSA patients without significant metabolic disturbance.Methods: Thirty-five male subjects without diagnostic criteria for metabolic syndrome (Adult Treatment Panel III) were distributed into a control group (n = 10) (43 +/- 10.56 years, apnea-hypopnea index - AHI 2.71 +/- 1.48/hour), a non-sleepy OSA group (n = 11) (42.36 +/- 9.48 years, AHI 29.48 +/- 22.83/hour) and a sleepy OSA group (n = 14) (45.43 +/- 10.06 years, AHI 38.20 +/- 25.54/hour). Excessive daytime sleepiness was considered when Epworth sleepiness scale score was >= 10. Levels of high-sensitivity C-reactive protein, homocysteine and cysteine, and paraoxonase-1 activity and arylesterase activity of paraoxonase-1 were evaluated.Results: Patients with OSA and excessive daytime sleepiness presented increased high-sensitivity C-reactive protein levels even after controlling for confounders. No significant differences were found among the groups in paraoxonase-1 activity nor arylesterase activity of paraoxonase-1. AHI was independently associated and excessive daytime sleepiness tended to have an association with high-sensitivity C-reactive protein.Conclusions: in the absence of metabolic syndrome, increased inflammatory response was associated with AHI and daytime sleepiness, while OSA was not associated with abnormalities in oxidative stress markers.