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      Prevalência da apneia obstrutiva do sono em trabalhadores de turno: uma revisão sistemática Translated title: Prevalence of obstructive sleep apnea in shift workers: a systematic review

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          Abstract

          Resumo A apneia obstrutiva do sono (AOS) é um dos distúrbios do sono mais frequentes, associada ao risco aumentado para obesidade, hipertensão e evento cardiovascular. O presente estudo buscou investigar a prevalência da AOS em trabalhadores de turno. Foi realizada a revisão sistemática da literatura, utilizando-se os descritores “sleep apnea” AND “shift work”, nas bases de dados do PubMed Central, Biblioteca Virtual em Saúde, Web of Science e Scopus, incluindo-se artigos que apresentaram a frequência da AOS em trabalhadores de turno, publicados entre 2004 e 2014, em inglês, português ou espanhol, apenas com seres humanos, maiores de 18 anos, utilizando polissonografia. Artigos de revisão ou com participantes com comorbidades prévias (exceto sobrepeso/obesidade), tratados para doença do sono ou gestantes foram excluídos. Dos 1.428 artigos identificados, quatro foram incluídos para análise, totalizando 819 participantes, com predomínio do sexo masculino. A prevalência da AOS em trabalhadores de turno variou de 14,3% a 38,1%, superior à estimada para a população geral, sugerindo associação importante com o trabalho de turno e a necessidade de prevenção, diagnóstico e intervenção sobre possíveis impactos negativos da escala de trabalho na saúde desses trabalhadores.

          Translated abstract

          Abstract The obstructive sleep apnea (OSA) is one of the most common sleep disorders and is associated with increased risk for obesity, hypertension and cardiovascular event. The present study aimed to investigate the prevalence of OSA in shift workers. The systematic literature review was performed using the descriptors “sleep apnea” and “shift work”, in the databases PubMed, PubMed Central, Biblioteca Virtual em Saúde, Web of Science and Scopus, including studies that presented the frequency of OSA in shift workers; published between 2004 and 2014; in English, Portuguese or Spanish; only with human beings, older than 18 years old; using the polysomnography. Review articles or those including participants with previous comorbidities (except overweight/obesity), treated for sleep disorders or pregnant women were excluded. From 1,428 studies identified, four were included in the analysis, resulting in 819 participants, with a predominance of men. The prevalence of OSA in shift workers varied from 14.3% to 38.1%, higher than that estimated for the general population, suggesting an important association with shift work and the need for prevention, diagnostic and intervention on the possible negative impacts of working range on the health of shift workers.

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          Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study.

          To estimate the prevalence of Obstructive Sleep Apnea Syndrome (OSAS), using current clinical and epidemiological techniques, among the adult population of Sao Paulo, Brazil. This population-based survey used a probabilistic three-stage cluster sample of Sao Paulo inhabitants to represent the population according to gender, age (20-80 years), and socio-economic status. Face-to-face interviews and in-lab full-night polysomnographies using a nasal cannula were performed. The prevalence of OSAS was determined according to the criteria of the most recent International Classification of Sleep Disorders (ICDS-2) from American Academy of Sleep Medicine (2005). A total of 1042 volunteers underwent polysomnography (refusal rate=5.4%). The mean age+/-SD was 42+/-14 years; 55% were women and 60% had a body mass index>25 kg/m(2). OSAS was observed in 32.8% of the participants (95% CI, 29.6-36.3). A multivariate logistic regression model identified several independent and strong associations for the presence of OSAS: men had greater association than women (OR=4.1; 95% CI, 2.9-5.8; P<0.001) and obese individuals (OR=10.5; 95% CI, 7.1-15.7; P<0.001) than individuals of normal weight. The adjusted association factor increased with age, reaching OR=34.5 (95% CI, 18.5-64.2; P<0.001) for 60-80 year olds when compared to the 20-29 year old group. Low socio-economic status was a protective factor for men (OR=0.4), but was an associated factor for women (OR=2.4). Self-reported menopause explained this increased association (age adjusted OR=2.1; 95% CI, 1.4-3.9; P<0.001), and it was more frequent in the lowest class (43.1%) than either middle class (26.1%) or upper class (27.8%) women. This study is the first apnea survey of a large metropolitan area in South America identifying a higher prevalence of OSAS than found in other epidemiological studies. This can be explained by the use of the probabilistic sampling process achieving a very low polysomnography refusal rate, the use of current techniques and clinical criteria, inclusion of older groups, and the higher prevalence of obesity in the studied population. Copyright 2010 Elsevier B.V. All rights reserved.
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            Iniciativa STROBE: subsídios para a comunicação de estudos observacionais

            Freqüentemente, a descrição de pesquisas de natureza observacional é inadequada, dificultando a avaliação de seus pontos fracos e fortes e, em conseqüência, a generalização de seus resultados. A iniciativa denominada Strengthening the Reporting of Observational Studies in Epidemiology (STROBE), formulou uma lista de verificação que contém 22 itens, denominada STROBE Statement ("Declaração STROBE"), com recomendações sobre o que deveria ser incluído em uma descrição mais precisa e completa de estudos observacionais. Entre junho e dezembro de 2008, um grupo de pesquisadores brasileiros dedicou-se à tradução e adaptação da "Declaração STROBE" para o português. O objetivo do estudo foi apresentar a tradução para o português, bem como introduzir a discussão sobre o contexto de utilização, as potencialidades e limitações da Iniciativa STROBE.
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              Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses.

              Nurses working 12-h shifts complain of fatigue and insufficient/poor-quality sleep. Objectively measured sleep times have not been often reported. This study describes sleep, sleepiness, fatigue, and neurobehavioral performance over three consecutive 12-h (day and night) shifts for hospital registered nurses. Sleep (actigraphy), sleepiness (Karolinska Sleepiness Scale [KSS]), and vigilance (Performance Vigilance Task [PVT]), were measured serially in 80 registered nurses (RNs). Occupational fatigue (Occupational Fatigue Exhaustion Recovery Scale [OFER]) was assessed at baseline. Sleep was short (mean 5.5 h) between shifts, with little difference between day shift (5.7 h) and night shift (5.4 h). Sleepiness scores were low overall (3 on a 1-9 scale, with higher score indicating greater sleepiness), with 45% of nurses having high level of sleepiness (score  > 7) on at least one shift. Nurses were progressively sleepier each shift, and night nurses were sleepier toward the end of the shift compared to the beginning. There was extensive caffeine use, presumably to preserve or improve alertness. Fatigue was high in one-third of nurses, with intershift fatigue (not feeling recovered from previous shift at the start of the next shift) being most prominent. There were no statistically significant differences in mean reaction time between day/night shift, consecutive work shift, and time into shift. Lapsing was traitlike, with rare (39% of sample), moderate (53%), and frequent (8%) lapsers. Nurses accrue a considerable sleep debt while working successive 12-h shifts with accompanying fatigue and sleepiness. Certain nurses appear more vulnerable to sleep loss than others, as measured by attention lapses.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro, RJ, Brazil )
                1413-8123
                1678-4561
                2018
                : 23
                : 10
                : 3381-3392
                Affiliations
                [1] Salvador Bahia orgnameEscola Bahiana de Medicina e Saúde Pública Brazil yurisaho@ 123456yahoo.com
                Article
                S1413-81232018001003381
                10.1590/1413-812320182310.21362018
                30365857
                768efe10-6b0e-4774-bc32-576d95f1a0ee

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 17 March 2016
                : 23 October 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 39, Pages: 12
                Product

                SciELO Public Health


                Trabalhadores,Sleep apnea,Obstructive,Shift work,Prevalence,Trabalho em Turnos,Apneia do Sono tipo Obstrutiva,Prevalência,Workers

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