RESUMO -A presença de distúrbios do sono e macroestrutura do sono foi avaliada em 39 pacientes com epilepsia do lobo temporal (ELT). Sonolência foi a queixa mais frequente (85%), seguida por despertares noturnos (75%), história de crise epiléptica durante o sono (69%) e dificuldade de iniciar o sono (26%). As parassonias, síndrome de pernas inquietas, apnéia de sono e movimentos periódicos de membros inferiores foram os distúrbios de sono mais frequentes. Principais alterações da arquitetura de sono foram: fragmentação do sono, aumento do número de mudanças de estágios (100%) e do tempo acordado após o início do sono (77%) e redução do sono REM (92%). Houve correlação inversa entre a escala de sonolência de Epworth e o teste de latências múltiplas de sono (p < 0,05). Concluímos que pacientes com ELT apresentam um sono fragmentado, aumento do numero de mudanças de estágios, de despertares noturnos e do tempo acordado após o início do sono com redução do sono REM. Sonolência diurna foi uma das principais queixas dos pacientes com ELT.PALAVRAS-CHAVE: sono, epilepsia do lobo temporal, sonolência, polissonografia. Sleep disorders in temporal lobe epilepsyABSTRACT -The objective of this study was to evaluate sleep macrostructure and sleep disturbance in a group of 39 patients with temporal lobe epilepsy (TLE). Patients completed questionnaires to evaluate their sleep and subjective daytime sleepiness (Epworth Sleepiness Scale [ESS]) and undergone Polysomnography and Multiple Sleep Latency Test (MSLT). Daytime sleepiness was the most frequent complaint (85%), followed by wakefulness during sleep, history of seizures during sleep (75%) and initial insomnia (26%). Parassomnias (67%), obstructive sleep apneas (13%), restless legs syndrome (15%) and periodic limb movements (5%) were the most frequent sleep disorders. The most frequent changes of sleep patterns were: sleep architecture fragmentation (100%), decreased amount of REM sleep (92%) and increase in time awake after sleep onset (77%). There were significative correlations between the ESS and the MSLT (p<0,05). In conclusion, TLE patients have fragmented sleep with increased sleep stages shifts, increased number of awakenings and in time awake after sleep onset. REM sleep was decreased. Daytime sleepiness was the most frequent complaint in TLE patients.KEY WORDS: sleep, temporal lobe epilepsy, sleepiness, polysomnography. Várias evidências indicam haver uma relação ínti-ma entre a epilepsia e o ciclo sono-vigília. Efeitos facilitadores e inibidores do sono sobre a epilepsia têm sido relatados 1-2 . Uma ação protetora do sono se revela pela maior ocorrência de crises epilépticas após a privação de sono 3 . Por outro lado um efeito facilitador do sono é evidenciado em algumas circunstâncias: a) algumas síndromes epilépticas se manifestam primariamente durante o sono ou durante o despertar 4 ; b) ocorrência de um aumento do número de descargas interictais durante o sono, particularmente o sono NREM 5 e c) pela relação existente entre produção de fusos de sono e descarg...
Air traffic controllers simultaneously develop complex and multiple tasks in the course of their activities. In this context, concern is raised over the high level of attention needed by these professionals which can ultimately be affected by stress and fatigue.ObjectivesThe objective of this study was to assess attention level in air traffic controllers (ATCo).Methods45 flight protection professionals were evaluated, comprising 30 ATCo, subdivided into ATCo with ten or more years in the profession (ATCo≥10, n=15) and ATCo with less than ten years in the profession (ATCo <10, n=15) and 15 aeronautical information services operators (AIS), subdivided into AIS with ten years or more in the profession (AIS≥10, n=8) and AIS with less than ten years in the profession (AIS <10, n=7), who were included as the control group. The digit symbol, d2 (the individual marks the letter d on a specific form containing 14 lines with 47 letters in each, maintaining focus on letter d followed by two dashes), forward digit span, backward digit span and PASAT (paced auditory serial addition test) attention tests were used. Kruskal-Wallis was used and data expressed as Median (Minimum and Maximum) with p<0.05.ResultsThe ATCo≥10 presented greater focus of attention, sustained attention, mental manipulation and resistance to interference capacity compared to the AIS≥10. Comparison of ATCo≥10 to the AIS<10 showed they presented only greater resistance to interference, and when compared to the ATCo<10 presented lower focus.ConclusionsThe air traffic control activity after ten years may be associated with a high level of attention.
Excessive sleepiness (ES) is an increased tendency to initiate involuntary sleep for naps at inappropriate times.ObjectiveThe objective of this study was to assess ES in air traffic controllers (ATCo).Methods45 flight protection professionals were evaluated, comprising 30 ATCo, subdivided into ATCo with ten or more years in the profession (ATCo≥10, n=15) and ATCo with less than ten years in the profession (ATCo<10, n=15) and 15 aeronautical information services operators (AIS), subdivided into AIS with ten years or more in the profession (AIS≥10, n=8) and AIS with less than ten years in the profession (AIS<10, n=7), who were included as the control group. The Epworth Sleepiness Scale and Maintenance of Wakefulness Test were used for evaluating subjective and objective excessive sleepiness. Kruskal-Wallis was used for ES and Mann-Whitney for sleep latency (SL), collection time in minutes (mins), and expressed as Median (Minimum-Maximum), p<0.05.ResultsATCo≥10 12 (6-14) mins and ATCo<10 10 (1-15) mins showed greater sleepiness compared to CONTROL1 7 (3-8) mins and CONTROL2 6 (4-6) mins, p=0.001*. A total of 77.27% of the ATCo and 16.67% of the AIS had an SL of less than 20 minutes. The ATCo presented an SL of 16.59 (3.25-40), lower than that of the AIS of 31.71 (10.63-40) mins, p<0.05*.ConclusionBrazilian air traffic controllers exhibit excessive sleepiness.
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