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Li DJ, Huang JJ, Hsu ST, Hsieh KY, Lin GG, Wu PJ, Liu CL, Wu HC, Chou FHC. Characteristics of Sleep Disturbance and Comparison Across Three Waves of the COVID-19 Pandemic Among Healthcare Workers. Psychiatry Investig 2024; 21:838-849. [PMID: 39111749 PMCID: PMC11321876 DOI: 10.30773/pi.2024.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/09/2024] [Accepted: 05/26/2024] [Indexed: 08/15/2024] Open
Abstract
OBJECTIVE Healthcare workers (HCWs) suffered from a heavy mental health burden during the coronavirus disease-2019 (COVID-19) pandemic. We aimed to explore the differences in sleep disturbance in three waves of the COVID-19 pandemic in Taiwan among HCWs. Moreover, factors associated with sleep disturbances in the third wave were investigated. METHODS This study, with three waves of cross-sectional surveys, recruited first-line and second-line HCWs. The level of sleep disturbance and related demographic variables were collected through self-report questionnaires. Differences in sleep disturbance across the three waves were compared with analysis of variance. Factors associated with the level of sleep disturbance were identified using univariate linear regression and further used for multivariate stepwise and bootstrap linear regression to identify the independent predictors. RESULTS In total, 711, 560, and 747 HCWs were included in the first, second, and third waves, respectively. For first-line HCWs, sleep disturbance was significantly higher in the third wave than in the first wave. The level of sleep disturbance gradually increased across the three waves for all HCWs. In addition, sleep disturbance was associated with depression, posttraumatic stress disorder (PTSD) symptoms, anxiety about COVID-19, vaccine mistrust, and poorer physical and mental health among first-line HCWs. Among second-line HCWs, sleep disturbance was associated with younger age, depression, PTSD symptoms, lower preference for natural immunity, and poorer physical health. CONCLUSION The current study identified an increase in sleep disturbance and several predictors among HCWs. Further investigation is warranted to extend the application and generalizability of the current study.
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Affiliation(s)
- Dian-Jeng Li
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Joh-Jong Huang
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Ting Hsu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Kuan-Ying Hsieh
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Guei-Ging Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Pei-Jhen Wu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chin-Lien Liu
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Hui-Ching Wu
- Department of Social Work, Taiwan Social Resilience Center, National Taiwan University, Taipei, Taiwan
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Martínez-García I, Saz-Lara A, Cavero-Redondo I, Otero-Luis I, Gómez-Guijarro MD, Moreno-Herraiz N, López-López S, Pascual-Morena C. Association between sleep duration and cardiovascular risk: the EVasCu cross-sectional study. Front Physiol 2024; 15:1430821. [PMID: 39129755 PMCID: PMC11310132 DOI: 10.3389/fphys.2024.1430821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 07/15/2024] [Indexed: 08/13/2024] Open
Abstract
Introduction Some cardiovascular risk markers have been associated with alterations in sleep duration in different populations; however, there is little evidence in a healthy population. Aim The aim of the present study was to analyze the associations between sleep duration and cardiovascular risk biomarkers, including advanced glycation end-products (AGEs) measured by skin autofluorescence (SAF), maximum carotid intima-media thickness (IMTMax), aortic pulse wave velocity (a-PWV), pulse pressure (PP), and low-density lipoprotein cholesterol (LDL-C), in healthy adults (EVasCu study). Methodology The EVasCu study included 390 participants. Simple and multiple linear regressions were performed between sleep duration and cardiovascular risk markers. ANOVA analysis and ANCOVA analysis adjusted for various covariates were then performed after categorizing sleep into 6 h, 6-8 h, and >8 h. Results 296 participants were included in the analyses (43.97 ± 12.60 years, 63.9% female). Simple linear regressions showed an inverse association between sleep duration and SAF, IMTMax, aPWV and PP. However, in the multiple linear regression with all the covariates, the statistical significance was lost. For its part, in the ANOVA analyses, sleep duration was also associated with the same parameters, but when performing the fully adjusted ANCOVA analyses, the statistical significance for SAF was maintained (p = 0.015), obtaining a difference of 0.223 arbitrary units (p = 0.017) when comparing the group <6 h vs. > 8 h. Finally, there was no association for LDL-C. Conclusion An inverse association was found between sleep duration and APS, which is considered a marker of cardiovascular risk. Although prospective studies are needed, it is suggested that insufficient sleep may increase cardiovascular risk, which could be a key factor in future public health policies to promote health and prevent CVD.
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Affiliation(s)
- Irene Martínez-García
- CarVasCare Research Group, Facultad Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Alicia Saz-Lara
- CarVasCare Research Group, Facultad Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Iván Cavero-Redondo
- CarVasCare Research Group, Facultad Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Iris Otero-Luis
- CarVasCare Research Group, Facultad Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
| | | | - Nerea Moreno-Herraiz
- CarVasCare Research Group, Facultad Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Samuel López-López
- CarVasCare Research Group, Facultad Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Carlos Pascual-Morena
- Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
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Jáuregui-Renaud K, Cooper-Bribiesca D, Miguel-Puga JA, Alcantara-Calderón Y, Roaro-Figueroa MF, Herrera-Ocampo M, Guzmán-Chacón MJ. Quality of Sleep and Mental Symptoms Contribute to Health-Related Quality of Life after COVID-19 Pneumonia, a Follow-Up Study of More than 2 Years. Biomedicines 2024; 12:1574. [PMID: 39062147 PMCID: PMC11275141 DOI: 10.3390/biomedicines12071574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
A follow-up study was designed to assess correlations among physical signs, quality of sleep, common mental symptoms, and health-related quality of life after moderate to severe COVID-19 pneumonia. Daily changes in dyspnoea and pulse oximetry were recorded (200 days), and four evaluations (in >2 years) were performed on quality of sleep, mental symptoms, cognitive performance, and health-related quality of life. In a single center, 72 adults participated in the study (52.5 ± 13.7 years old), with no psychiatry/neurology/chronic lung/infectious diseases, chronic use of corticosteroids/immunosuppressive therapy, or pregnancy. Daily agendas showed delayed decreases in dyspnoea scores compared to pulse oximetry and heart rate recordings; however, changes in pulse oximetry were minimal. Slight changes in cognitive performance were related to the general characteristics of the participants (obesity and tobacco use) and with the severity of acute disease (MANCOVA, p < 0.001). Health-related quality of life gradually improved (MANCOVA, p < 0.004). During recovery, bad quality of sleep and mental symptoms (mainly attention/concentration) contributed to the subscores on health perception and vitality in the health-related quality of life assessment. Early mental support services including sleep hygiene could be beneficial during rehabilitation after acute COVID-19.
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Affiliation(s)
- Kathrine Jáuregui-Renaud
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico; (D.C.-B.); (J.A.M.-P.)
| | - Davis Cooper-Bribiesca
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico; (D.C.-B.); (J.A.M.-P.)
- Departamento de Psiquiatría, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico; (Y.A.-C.); (M.J.G.-C.)
| | - José Adán Miguel-Puga
- Unidad de Investigación Médica en Otoneurología, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico; (D.C.-B.); (J.A.M.-P.)
| | - Yadira Alcantara-Calderón
- Departamento de Psiquiatría, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico; (Y.A.-C.); (M.J.G.-C.)
| | - María Fernanda Roaro-Figueroa
- Programa de Apoyo y Fomento a la Investigación Estudiantil, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico; (M.F.R.-F.); (M.H.-O.)
| | - Mariana Herrera-Ocampo
- Programa de Apoyo y Fomento a la Investigación Estudiantil, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico; (M.F.R.-F.); (M.H.-O.)
| | - Melodie Jedid Guzmán-Chacón
- Departamento de Psiquiatría, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico; (Y.A.-C.); (M.J.G.-C.)
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Keskin G, Gümüşsoy S, Taşdemir Yiğitoğlu G. The relationship between sleep quality and fear of COVID-19, anxiety, personality traits in working women. Work 2024:WOR230724. [PMID: 39031422 DOI: 10.3233/wor-230724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024] Open
Abstract
BACKGROUND Disasters such as the COVID-19 pandemic have serious traumatic effects on people, who may experience sleep problems, anxiety, and fear in the face of such a stressor. OBJECTIVE This study is conducted to examine the relationship between sleep quality and fear of COVID-19, anxiety, and personality traits in working women. METHOD This research was a descriptive study between June to August 2021. The study was conducted with 425 participants. The Pittsburgh Sleep Quality Index, COVID-19 Fear Scale, Beck Anxiety Scale, and the revised Eysenck Personality Questionnaire-Short Form were applied to the participants. T-test, ANOVA, and Pearson correlation analysis, were used. RESULTS In the study, it was found that the total average score of the Fear of COVID-19 Scale was 18.83±5.5, while the score of sleep quality was 5.40±3.3 and the anxiety score was 14.01±12.4. On the other hand, the score of Extraversion was determined as 3.73±1.7, Neuroticism was 3.79±1.8, and Psychoticism was 1.97±1 in the study. Moreover, a statistically significant positive correlation was found between sleep quality and fear of COVID-19, anxiety, and neuroticism in working women (p < 0.05). CONCLUSION Sleep quality, sleep latency, sleep disturbance; daytime dysfunction, use of sleep medication, sleep duration, sleep latency with anxiety; sleep latency, sleep quality, daytime dysfunction, sleep duration were found to be linked to neuroticism, and use of sleep medication and sleep duration were found to be linked to psychoticism. It was concluded that there was a relationship between sleep quality and fear of COVID-19, anxiety, and personality traits in working women.
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Affiliation(s)
- Gülseren Keskin
- Ege University Atatürk Medical Vocational Training School, Bornova, İzmir/Türkiye
| | - Süreyya Gümüşsoy
- Ege University Atatürk Medical Vocational Training School, Bornova, İzmir/Türkiye
| | - Gülay Taşdemir Yiğitoğlu
- Departmant of Nursing, Faculty of Health Science, Pamukkale University, Kınıklı Campus, Denizli/Türkiye
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Budikayanti A, Hakim M, Mutiani F, Handayani S, Lailiyya N, Khosama H, Jehosua SY, Puspitasari V, Gunawan PY, Hambarsari Y, Islamiyah WR, Gofir A, Vidyanti AN, Devicaesaria A, Ibonita R, Suryawati H, Tedjasukmana R. The Impact of Post-COVID-19 Conditions on Sleep and Quality of Life in Indonesia: A Nationwide Cross-Sectional Study. Nat Sci Sleep 2024; 16:907-916. [PMID: 38979547 PMCID: PMC11228322 DOI: 10.2147/nss.s456979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/05/2024] [Indexed: 07/10/2024] Open
Abstract
Background Sleep disturbances are included in the six most commonly cited complaints in post-COVID-19 conditions. In order to find the optimal management approach and enhance Quality of Life (QoL), we intend to explore sleep disturbances that occur in post-COVID-19 conditions. Methods This was a cross-sectional study conducted with interviews and questionnaires using the Pittsburgh Sleep Quality Index (PSQI) for assessing sleep quality, Insomnia Severity Index (ISI) for assessing insomnia, Epworth Sleepiness Scale (ESS) for assessing Excessive Daytime Sleepiness (EDS), STOP-BANG questionnaire for assessing Obstructive Sleep Apnea (OSA), and Short Form 36 (SF-36) for assessing QoL. We recruited respondents from several cities in Indonesia and performed an analysis to find the relationship between sleep disturbance and its association with QoL. Results This study involved 757 respondents. They were predominantly female, with a median age of 39 years, no comorbidities, and had exhibited mild COVID-19 severity. Subjects with post-COVID-19 conditions experienced insomnia, poor sleep quality, normal sleepiness, and low risk of OSA. Sleep quality caused role limitations due to decreased physical and mental health. Insomnia caused role limitations due to emotional and social functioning problems. Meanwhile, OSA only affected physical functioning. Conclusion Numerous aspects of patients' QoL are affected by sleep disturbance in post-COVID-19 conditions. A comprehensive approach and coordinated care pathways must be effectively managed to improve QoL among individuals experiencing sleep disturbance.
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Affiliation(s)
- Astri Budikayanti
- Department of Neurology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Manfaluthy Hakim
- Department of Neurology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Faradillah Mutiani
- Department of Neurology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Sri Handayani
- Department of Neurology Faculty of Medicine Universitas Sriwijaya - Dr. Mohammad Hoesin Hospital, Palembang, Indonesia
| | - Nushrotul Lailiyya
- Department of Neurology Faculty of Medicine Universitas Padjajaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Herlyani Khosama
- Department of Neurology Faculty of Medicine Universitas Sam Ratulangi - Prof. dr. RD Kandou Hospital, Manado, Indonesia
| | - Seilly Yunita Jehosua
- Department of Neurology Faculty of Medicine Universitas Sam Ratulangi - Prof. dr. RD Kandou Hospital, Manado, Indonesia
| | - Vivien Puspitasari
- Department of Neurology Faculty of Medicine Universitas Pelita Harapan - Siloam Kelapa Dua Hospital, Tangerang, Indonesia
| | - Pricilla Yani Gunawan
- Department of Neurology Faculty of Medicine Universitas Pelita Harapan - Siloam Kelapa Dua Hospital, Tangerang, Indonesia
| | - Yetty Hambarsari
- Department of Neurology Faculty of Medicine Universitas Sebelas Maret - Dr. Moewardi Hospital, Surakarta, Indonesia
| | - Wardah Rahmatul Islamiyah
- Department of Neurology Faculty of Medicine Universitas Airlangga - Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Abdul Gofir
- Department of Neurology Faculty of Medicine Universitas Gajah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Amelia Nur Vidyanti
- Department of Neurology Faculty of Medicine Universitas Gajah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | | | - Rizka Ibonita
- Department of Neurology, National Brain Center Hospital, Jakarta, Indonesia
| | - Herlina Suryawati
- Department of Neurology Faculty of Medicine Universitas Diponegoro - Dr. Kariadi Hospital, Semarang, Indonesia
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Zhao M, Wang Y, Zeng Y, Huang H, Xu T, Liu B, Wu C, Luo X, Jiang Y. Gene‒environment interaction effect of hypothalamic‒pituitary‒adrenal axis gene polymorphisms and job stress on the risk of sleep disturbances. PeerJ 2024; 12:e17119. [PMID: 38525273 PMCID: PMC10960531 DOI: 10.7717/peerj.17119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
Background Studies have shown that chronic exposure to job stress may increase the risk of sleep disturbances and that hypothalamic‒pituitary‒adrenal (HPA) axis gene polymorphisms may play an important role in the psychopathologic mechanisms of sleep disturbances. However, the interactions among job stress, gene polymorphisms and sleep disturbances have not been examined from the perspective of the HPA axis. This study aimed to know whether job stress is a risk factor for sleep disturbances and to further explore the effect of the HPA axis gene × job stress interaction on sleep disturbances among railway workers. Methods In this cross-sectional study, 671 participants (363 males and 308 females) from the China Railway Fuzhou Branch were included. Sleep disturbances were evaluated with the Pittsburgh Sleep Quality Index (PSQI), and job stress was measured with the Effort-Reward Imbalance scale (ERI). Generalized multivariate dimensionality reduction (GMDR) models were used to assess gene‒environment interactions. Results We found a significant positive correlation between job stress and sleep disturbances (P < 0.01). The FKBP5 rs1360780-T and rs4713916-A alleles and the CRHR1 rs110402-G allele were associated with increased sleep disturbance risk, with adjusted ORs (95% CIs) of 1.75 [1.38-2.22], 1.68 [1.30-2.18] and 1.43 [1.09-1.87], respectively. However, the FKBP5 rs9470080-T allele was a protective factor against sleep disturbances, with an OR (95% CI) of 0.65 [0.51-0.83]. GMDR analysis indicated that under job stress, individuals with the FKBP5 rs1368780-CT, rs4713916-GG, and rs9470080-CT genotypes and the CRHR1 rs110402-AA genotype had the greatest risk of sleep disturbances. Conclusions Individuals carrying risk alleles who experience job stress may be at increased risk of sleep disturbances. These findings may provide new insights into stress-related sleep disturbances in occupational populations.
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Affiliation(s)
- Min Zhao
- Department of Public Health, Fujian Medical University, Fuzhou, China
| | - Yuxi Wang
- Department of Public Health, Fujian Medical University, Fuzhou, China
| | - Yidan Zeng
- Department of Public Health, Fujian Medical University, Fuzhou, China
| | - Huimin Huang
- Department of Public Health, Fujian Medical University, Fuzhou, China
| | - Tong Xu
- Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Baoying Liu
- Department of Public Health, Fujian Medical University, Fuzhou, China
| | - Chuancheng Wu
- Department of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiufeng Luo
- Fuzhou Municipal Center for Disease Control and Prevention, Fuzhou, China
| | - Yu Jiang
- Department of Public Health, Fujian Medical University, Fuzhou, China
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Wang X, Wang C, Liu K, Wan Q, Wu W, Liu C. Association between sleep-related phenotypes and gut microbiota: a two-sample bidirectional Mendelian randomization study. Front Microbiol 2024; 15:1341643. [PMID: 38371937 PMCID: PMC10869596 DOI: 10.3389/fmicb.2024.1341643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/15/2024] [Indexed: 02/20/2024] Open
Abstract
Background An increasing body of evidence suggests a profound interrelation between the microbiome and sleep-related concerns. Nevertheless, current observational studies can merely establish their correlation, leaving causality unexplored. Study objectives To ascertain whether specific gut microbiota are causally linked to seven sleep-related characteristics and propose potential strategies for insomnia prevention. Methods The study employed an extensive dataset of gut microbiota genetic variations from the MiBioGen alliance, encompassing 18,340 individuals. Taxonomic classification was conducted, identifying 131 genera and 196 bacterial taxa for analysis. Sleep-related phenotype (SRP) data were sourced from the IEU OpenGWAS project, covering traits such as insomnia, chronotype, and snoring. Instrumental variables (IVs) were selected based on specific criteria, including locus-wide significance, linkage disequilibrium calculations, and allele frequency thresholds. Statistical methods were employed to explore causal relationships, including inverse variance weighted (IVW), MR-Egger, weighted median, and weighted Mode. Sensitivity analyses, pleiotropy assessments, and Bonferroni corrections ensured result validity. Reverse causality analysis and adherence to STROBE-MR guidelines were conducted to bolster the study's rigor. Results Bidirectional Mendelian randomization (MR) analysis reveals a causative interplay between selected gut microbiota and sleep-related phenotypes. Notably, outcomes from the rigorously Bonferroni-corrected examination illuminate profound correlations amid precise compositions of the intestinal microbiome and slumber-associated parameters. Elevated abundance within the taxonomic ranks of class Negativicutes and order Selenomonadales was markedly associated with heightened susceptibility to severe insomnia (OR = 1.03, 95% CI: 1.02-1.05, p = 0.0001). Conversely, the augmented representation of the phylum Lentisphaerae stands in concord with protracted sleep duration (OR = 1.02, 95% CI: 1.01-1.04, p = 0.0005). Furthermore, heightened exposure to the genus Senegalimassilia exhibits the potential to ameliorate the manifestation of snoring symptoms (OR = 0.98, 95% CI: 0.96-0.99, p = 0.0001). Conclusion This study has unveiled the causal relationship between gut microbiota and SRPs, bestowing significant latent value upon future endeavors in both foundational research and clinical therapy.
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Affiliation(s)
| | | | | | | | - Wenzhong Wu
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Chengyong Liu
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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Drager LF, Assis M, Bacelar AFR, Poyares DLR, Conway SG, Pires GN, de Azevedo AP, Carissimi A, Eckeli AL, Pentagna Á, Almeida CMO, Franco CMR, Sobreira EST, Stelzer FG, Mendes GM, Minhoto GR, Linares IMP, Sousa KMM, Gitaí LLG, Sukys-Claudino L, Sobreira-Neto MA, Zanini MA, Margis R, Martinez SCG. 2023 Guidelines on the Diagnosis and Treatment of Insomnia in Adults - Brazilian Sleep Association. Sleep Sci 2023; 16:507-549. [PMID: 38370879 PMCID: PMC10869237 DOI: 10.1055/s-0043-1776281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
Chronic insomnia disorder (simplified in this document as insomnia) is an increasingly common clinical condition in society and a frequent complaint at the offices of different areas of health practice (particularly Medicine and Psychology). This scenario has been accompanied by a significant evolution in treatment, as well as challenges in approaching patients in an appropriately way. This clinical guideline, coordinated by the Brazilian Sleep Association and the Brazilian Association of Sleep Medicine and counting on the active participation of various specialists in the area, encompasses an update on the diagnosis and treatment of insomnia in adults. To this end, it followed a structured methodology. Topics of interest related to diagnosis were written based on theoretical framework, evidence in the literature, and professional experience. As for the topics related to the treatment of insomnia, a series of questions were developed based on the PICO acronym (P - Patient, problem, or population; I - Intervention; C - Comparison, control, or comparator; O - Outcome). The work groups defined the eligible options within each of these parameters. Regarding pharmacological interventions, only the ones currently available in Brazil or possibly becoming available in the upcoming years were considered eligible. Systematic reviews were conducted to help prepare the texts and define the level of evidence for each intervention. The final result is an objective and practical document providing recommendations with the best scientific support available to professionals involved in the management of insomnia.
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Affiliation(s)
- Luciano Ferreira Drager
- Associação Brasileira do Sono, São Paulo, SP, Brazil.
- Unidades de HipertenSão, Instituto do Coração (InCor) e Disciplina de Nefrologia, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Márcia Assis
- Associação Brasileira do Sono, São Paulo, SP, Brazil.
- Clínica do Sono de Curitiba, Hospital São Lucas, Curitiba, Brazil.
| | - Andrea Frota Rego Bacelar
- Associação Brasileira do Sono, São Paulo, SP, Brazil.
- Clínica Bacelar - Neuro e Sono, Rio de Janeiro, RJ, Brazil.
| | - Dalva Lucia Rollemberg Poyares
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
- Instituto do Sono, São Paulo, SP, Brazil.
| | - Silvia Gonçalves Conway
- Instituto de Psiquiatria (IPq), Universidade de São Paulo, São Paulo, SP, Brazil.
- Departamento de Otoneurologia, Universidade de São Paulo, São Paulo, SP, Brazil.
- AkasA - Formação e Conhecimento, São Paulo, SP, Brazil.
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
- Instituto do Sono, São Paulo, SP, Brazil.
| | | | - Alicia Carissimi
- Faculdade Dom Bosco, Porto Alegre, RS, Brazil.
- Cronosul Clínica de Psicologia do Sono, Psicoterapia e Neuropsicologia, Porto Alegre, RS, Brazil.
| | - Allan Luiz Eckeli
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Álvaro Pentagna
- Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | | | | | - Emmanuelle Silva Tavares Sobreira
- AkasA - Formação e Conhecimento, São Paulo, SP, Brazil.
- Universidade Federal do Ceará, Fortaleza, CE, Brazil.
- Clínica Sinapse Diagnóstico, Fortaleza, CE, Brazil.
| | - Fernando Gustavo Stelzer
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | | | | | - Ila Marques Porto Linares
- Instituto de Psiquiatria (IPq), Universidade de São Paulo, São Paulo, SP, Brazil.
- Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
| | - Ksdy Maiara Moura Sousa
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
- SleepUp Tecnologia e Saúde LTDA, São Paulo, SP, Brazil.
| | | | - Lucia Sukys-Claudino
- Disciplina de Neurologia, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.
| | | | - Marcio Andrei Zanini
- Instituto de Assistência Médica ao Servidor Público Estadual (IAMPSE), São Paulo, SP, Brazil.
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