Efeitos de um treinamento de mindfulness e relaxamento para insônia (TMRI) em mulheres na pós menopausa : um ensaio clínico randomizado
Arquivos
Data
2017-08-31
Autores
Garcia, Marcelo Csermak 
Orientadores
Campos, Helena Hachul de
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
É na menopausa que há o cessamento da produção hormonal ovariana, que pode ser de forma natural ou cirúrgica, acarretando uma importante diminuição de estrogênio e progesterona no organismo. O hipoestrogenismo decorrente da pós-menopausa acarreta diversos efeitos no organismo, sendo a insônia e os sintomas vasomotores muito prevalentes nesta fase, onde há razoável prejuízo e diminuição na qualidade de vida desta mulher. A insônia é uma das queixas mais comuns e prevalentes na transição menopáusica e pós menopáusica e causa repercussões como dores de cabeça, dificuldade de atenção e memória, irritabilidade, entre outros sintomas com algum prejuízo na vida e no comportamento desde indivíduo. Assim, em razão das repercussões importantes deste distúrbio, o presente trabalho, baseado nestas premissas, avaliou o impacto de técnicas do uso de meditação denomidas de mindfulness na insônia, sintomas vasomotores, atentividade e qualidade geral de vida destas mulheres. Este estudo avaliou a intervenção desta técnica nesta população por um período de 8 semanas de treinamento seguido, com instruções presenciais semanais e a continuidade da prática em 3 x ao dia. Foram avaliadas 30 mulheres, sendo 19 que praticaram a técnica e 11 foram um grupo de espera participando de encontros informais semanais realizando palavras cruzadas nível fácil em casa, sendo que este grupo após as 8 semanas também recebeu instruções com a prática da mesma forma que o grupo intervenção. As voluntárias foram avaliadas por questionários de sono, sintomas menopausais, atenção e qualidade de vida geral na menopausa e também passaram por 2 exames de polissonografia ambulatorial antes e depois da interveção em ambos os grupos. Foram encontradas diferenças significantes para o grupo que recebeu treinamento em mindfulness em relação ao grupo controle, indicando a melhora na qualidade do sono e na severidade da insônia, na qualidade de vida, nos níveis atencionais e diminuição dos sintomas menopausais e vasomotores. Não encontramos diferenças entre os grupos e entre as noites pela avaliação da polissonografia. O treinamento de 8 semanas em meditação mindfulness melhorou a qualidade de sono, a qualidade de vida geral, o nível de atenção e diminuiu os sintomas vasomotores neste grupo. Este estudo mostra a eficácia da aplicação da técnica de meditação mindfulness para esta população insone menopsausada. Nossos achados sugerem que esta prática pode ser aplicada de forma complementar aos tratamentos já existentes para insônia e fogachos e sintomas menopausais, contribuindo para a aquisição de qualidade de vida para esta população.
Menopause is the permanent cessation of menstrual cycles following the loss of ovarian follicular activity, which can be natural or surgical, leading to a significant reduction of estrogen and progesterone in the body. Hypoestrogenism due to postmenopáusica, causes several effects on the body, with insomnia and vasomotor symptoms being very prevalent at this stage, where there is a reasonable loss and a decrease in the quality of life. Insomnia is one of the most common and prevalent complaints in the menopáusica and postmenopáusica transition and causes repercussions such as headaches, difficulty in attention and memory, irritability, among other symptoms with some impairment in life and behavior. Based on these assumptions, the present study evaluated the impact of mindfulness meditation on insomnia, vasomotor symptoms, attention and general quality of life. This study evaluated the intervention of this technique in this population for a period of 8 weeks of training followed with weekly instructions and 3 times in a daily practice. Thirty women were evaluated, 19 of them practicing the technique, and 11 were a waiting group participating in informal weekly meetings and performing easy cross-checking at home, and this group after 8 weeks also received instructions with the practice in the same way as the intervention group. The volunteers were evaluated by sleep, menopáusica symptoms, attention and general quality of life in menopause and underwent 2 ambulatory polysomnography examinations before and after the intervention in both groups. Significant differences were found for the group that received training in mindfulness in relation to the control group, indicating improvement in sleep quality and severity of insomnia, quality of life, attentional levels and reduction of menopáusica and vasomotor symptoms. We found no differences between groups and between the nights by polysomnography evaluation. The 8-week meditation training in mindfulness improved sleep quality, overall quality of life, attention level and decreased vasomotor symptoms in this group. This study shows the effectiveness of applying the mindfulness meditation technique to this menopáusica insomnia population. Our findings suggest that this practice can be applied in a complementary way to existing treatments for insomnia, hot flushes and menopáusica symptoms, contributing to the acquisition of quality of life for this population.
Menopause is the permanent cessation of menstrual cycles following the loss of ovarian follicular activity, which can be natural or surgical, leading to a significant reduction of estrogen and progesterone in the body. Hypoestrogenism due to postmenopáusica, causes several effects on the body, with insomnia and vasomotor symptoms being very prevalent at this stage, where there is a reasonable loss and a decrease in the quality of life. Insomnia is one of the most common and prevalent complaints in the menopáusica and postmenopáusica transition and causes repercussions such as headaches, difficulty in attention and memory, irritability, among other symptoms with some impairment in life and behavior. Based on these assumptions, the present study evaluated the impact of mindfulness meditation on insomnia, vasomotor symptoms, attention and general quality of life. This study evaluated the intervention of this technique in this population for a period of 8 weeks of training followed with weekly instructions and 3 times in a daily practice. Thirty women were evaluated, 19 of them practicing the technique, and 11 were a waiting group participating in informal weekly meetings and performing easy cross-checking at home, and this group after 8 weeks also received instructions with the practice in the same way as the intervention group. The volunteers were evaluated by sleep, menopáusica symptoms, attention and general quality of life in menopause and underwent 2 ambulatory polysomnography examinations before and after the intervention in both groups. Significant differences were found for the group that received training in mindfulness in relation to the control group, indicating improvement in sleep quality and severity of insomnia, quality of life, attentional levels and reduction of menopáusica and vasomotor symptoms. We found no differences between groups and between the nights by polysomnography evaluation. The 8-week meditation training in mindfulness improved sleep quality, overall quality of life, attention level and decreased vasomotor symptoms in this group. This study shows the effectiveness of applying the mindfulness meditation technique to this menopáusica insomnia population. Our findings suggest that this practice can be applied in a complementary way to existing treatments for insomnia, hot flushes and menopáusica symptoms, contributing to the acquisition of quality of life for this population.
Descrição
Citação
GARCIA, Marcelo Csermak. Efeitos de um treinamento de mindfulness e relaxamento para insônia (TMRI) em mulheres na pós menopausa : um ensaio clínico randomizado. São Paulo, 2017. [94] p. Tese (Doutorado em Psicobiologia) - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, 2017.