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9. Physically active elderly women sleep more and better than sedentary women
Society Proceedings / Clinical Neurophysiology 120 (2009) e1–e7
part. Patients under dialysis are especially at risk for RLS with a estimated prevalence of 6.6–21.5%. The treatment for uremic RLS has been controversial thus a systematic synthesis of evidence is necessary to evaluate the effectiveness and safety of treatment for uremic RLS. Method: Systematic review of randomized or quasi-randomized, double blind trials on treatment for uremic RLS. Outcomes: relief of restless legs symptoms marked on a validated scale, subjective sleep quality, sleep quality measured by night polysomnography and actigraphy, quality of life measured by subjective measures, adverse events associated with the treatments. Results: Six eligible clinical trials were included. The subjective analyses of these studies showed controversial results, although the objective analyses showed in one trial that treatment group had a statistically significant improvement of periodic leg movement during time asleep (PLM). Combined analyses (metanalysis) were not done. The most commonly adverse event seen was gastrointestinal symptoms. Conclusions: Only a few therapeutic trials in uremic patients with RLS have been published, and there is no high level scientific evidence of a specific therapeutic regimen for uremic-associated RLS, and recommendations for practice can be done based on both individual trials results on uremic and non-uremic RLS patients and physician experience yet.
e3
Introduction: Population studies carried out in many countries have shown that sleep is a growing reason for complaints with increasing age. Experimental evidence indicates that a program of regular physical exercise can improve sleep quality in elderly individuals. The objective of the present study was to compare the sleep of physically active and sedentary elderly women. Methods: We evaluated 101 elderly women, with 53 women practicing physical activity and 48 being sedentary. All women kept a sleep log and were asked to rate their sleep quality on a Visual Analog Scale (VAS) daily for 30 days. Total sleep time (TST), total nap time (TNT) during the 30 days of the study, number of naps, number of awakenings after sleep onset, and VAS scores were analyzed. Results: Mean daily sleep time was 7 h 12 min for physically active elderly women and for sedentary women (p < 0.01). Mean TNT over the 30 days as a whole was 4 h 22 min in the physically active group and 7 h 6 min in the sedentary group (p < 0.05). The number of naps was 6 and 12 in the physically active and sedentary groups, respectively (p < 0.05). The number of awakenings during the night was one in the physically active group and two in the sedentary group (p < 0.05). The mean perception of sleep quality was 8.3 for physically active elderly women and 5.8 for sedentary women (p < 0.0001). Conclusion: Physically active women sleep more and better than sedentary women.
doi:10.1016/j.clinph.2008.07.256 doi:10.1016/j.clinph.2008.07.258
8. Restless legs syndrome during pregnancy—D.C.A. Galdino, L.B.C. Carvalho, C.O. Oliveira, L.B.F. Prado, G.F. Prado (Neuro-Sono, Department of Neurology and Department of Emergency and Evidence, Federal University of São Paulo – UNIFESP, São Paulo, Brazil) Introduction: Restless legs syndrome (RLS) is a movement disorder characterized by uncomfortable and unpleasant sensations in the legs that appear at rest, which induces an irresistible urge to move the legs. Pregnant women present two to three times more chances to have RLS then the general population. The symptoms bother them, but they are not mentioned to doctors at pregnant women preventive assistance. Objective: The aim of this study was to determine the prevalence of the restless legs syndrome in pregnant women by clinical interview. Methods: We evaluated 228 normal pregnant women at the out patients clinic of Obstetrics Discipline of UNIFESP and UNILAVRAS. The pregnancy periods goes from the first to the third trimester. A diagnostic-clinical interview for RLS was done with all participants by a trained researcher for a diagnosis of RLS. Results: We interviewed 228 pregnant women and we found 18% with RLS. There was no difference among the trimesters (p = 0,013). Conclusions. Pregnancy is associated with a larger predominance of RLS with the general population, these data that are valuable because the results were from an interviews and not questionnaires. doi:10.1016/j.clinph.2008.07.257
9. Physically active elderly women sleep more and better than sedentary women—L.H.C.T. Guimaraes, L.B.C. Carvalho, G.F. Prado (Neuro-Sono, Department of Neurology and Department of Emergency and Evidence, Federal University of São Paulo – UNIFESP, São Paulo, Brazil)
10. The phone interview for RLS diagnostic—T. Gruber, R.C. Silva, L.B.C. Carvalho, C.O. Oliveira, S.V. Fontes, A.H. Masuko, L.B.F. Prado, G.F. Prado (Neuro-Sono, Department of Neurology and Department of Emergency and Evidence, Federal University of São Paulo – UNIFESP, São Paulo, Brazil) Restless Legs Syndrome (RLS) is a common disease, with prevalence about 10% of the general population. Its symptoms appear before bedtime, causing sleeping disorders, and consequently, a worsening of the patient quality of life. The diagnostic is clinical, based on the history presented by the patient that relates unpleasant sensations and uncomfortable sensations in the legs, mainly at the night, and experience relief or absence of the sensations with legs movements. In spite of having described for the first time 330 years ago, this disorder is still little known in the Brazilian medical community. Objective: Evaluate the sensibility and specificity of the questionnaire ‘‘Restless Legs Syndrome’s Clinical-Diagnostic Interview (RLSCDI) used at the Johns Hopkins RLS outpatient clinic, translated and adapted to Brazilian Portuguese. Method: We studied 19 patients with RLS clinic diagnostic and 22 without, from Neuro-Sono Outpatients, UNIFESP, Sao Paulo, Brazil. A blind and trained researcher interviewed the patients by phone. Chi-square and Kappa test were used for statistical analysis. Results: The questionnaire identified 15/19 patients in the group with RLS and there was no agreement between clinic diagnostic and questionnaire in 4 cases. In the group without RLS, the questionnaire identified 20/22 and there was no agreement in the other two cases. The agreement of RLSCDI and clinical diagnostic was high (Kappa = 69%) with 83% of specificity and 88% of sensibility. Conclusion: The Portuguese version of the RLSCDI is a good instrument to diagnose RLS, throughout phone interview in a set of Brazilian speakers. doi:10.1016/j.clinph.2008.07.259
part. Patients under dialysis are especially at risk for RLS with a estimated prevalence of 6.6–21.5%. The treatment for uremic RLS has been controversial thus a systematic synthesis of evidence is necessary to evaluate the effectiveness and safety of treatment for uremic RLS. Method: Systematic review of randomized or quasi-randomized, double blind trials on treatment for uremic RLS. Outcomes: relief of restless legs symptoms marked on a validated scale, subjective sleep quality, sleep quality measured by night polysomnography and actigraphy, quality of life measured by subjective measures, adverse events associated with the treatments. Results: Six eligible clinical trials were included. The subjective analyses of these studies showed controversial results, although the objective analyses showed in one trial that treatment group had a statistically significant improvement of periodic leg movement during time asleep (PLM). Combined analyses (metanalysis) were not done. The most commonly adverse event seen was gastrointestinal symptoms. Conclusions: Only a few therapeutic trials in uremic patients with RLS have been published, and there is no high level scientific evidence of a specific therapeutic regimen for uremic-associated RLS, and recommendations for practice can be done based on both individual trials results on uremic and non-uremic RLS patients and physician experience yet.
e3
Introduction: Population studies carried out in many countries have shown that sleep is a growing reason for complaints with increasing age. Experimental evidence indicates that a program of regular physical exercise can improve sleep quality in elderly individuals. The objective of the present study was to compare the sleep of physically active and sedentary elderly women. Methods: We evaluated 101 elderly women, with 53 women practicing physical activity and 48 being sedentary. All women kept a sleep log and were asked to rate their sleep quality on a Visual Analog Scale (VAS) daily for 30 days. Total sleep time (TST), total nap time (TNT) during the 30 days of the study, number of naps, number of awakenings after sleep onset, and VAS scores were analyzed. Results: Mean daily sleep time was 7 h 12 min for physically active elderly women and for sedentary women (p < 0.01). Mean TNT over the 30 days as a whole was 4 h 22 min in the physically active group and 7 h 6 min in the sedentary group (p < 0.05). The number of naps was 6 and 12 in the physically active and sedentary groups, respectively (p < 0.05). The number of awakenings during the night was one in the physically active group and two in the sedentary group (p < 0.05). The mean perception of sleep quality was 8.3 for physically active elderly women and 5.8 for sedentary women (p < 0.0001). Conclusion: Physically active women sleep more and better than sedentary women.
doi:10.1016/j.clinph.2008.07.256 doi:10.1016/j.clinph.2008.07.258
8. Restless legs syndrome during pregnancy—D.C.A. Galdino, L.B.C. Carvalho, C.O. Oliveira, L.B.F. Prado, G.F. Prado (Neuro-Sono, Department of Neurology and Department of Emergency and Evidence, Federal University of São Paulo – UNIFESP, São Paulo, Brazil) Introduction: Restless legs syndrome (RLS) is a movement disorder characterized by uncomfortable and unpleasant sensations in the legs that appear at rest, which induces an irresistible urge to move the legs. Pregnant women present two to three times more chances to have RLS then the general population. The symptoms bother them, but they are not mentioned to doctors at pregnant women preventive assistance. Objective: The aim of this study was to determine the prevalence of the restless legs syndrome in pregnant women by clinical interview. Methods: We evaluated 228 normal pregnant women at the out patients clinic of Obstetrics Discipline of UNIFESP and UNILAVRAS. The pregnancy periods goes from the first to the third trimester. A diagnostic-clinical interview for RLS was done with all participants by a trained researcher for a diagnosis of RLS. Results: We interviewed 228 pregnant women and we found 18% with RLS. There was no difference among the trimesters (p = 0,013). Conclusions. Pregnancy is associated with a larger predominance of RLS with the general population, these data that are valuable because the results were from an interviews and not questionnaires. doi:10.1016/j.clinph.2008.07.257
9. Physically active elderly women sleep more and better than sedentary women—L.H.C.T. Guimaraes, L.B.C. Carvalho, G.F. Prado (Neuro-Sono, Department of Neurology and Department of Emergency and Evidence, Federal University of São Paulo – UNIFESP, São Paulo, Brazil)
10. The phone interview for RLS diagnostic—T. Gruber, R.C. Silva, L.B.C. Carvalho, C.O. Oliveira, S.V. Fontes, A.H. Masuko, L.B.F. Prado, G.F. Prado (Neuro-Sono, Department of Neurology and Department of Emergency and Evidence, Federal University of São Paulo – UNIFESP, São Paulo, Brazil) Restless Legs Syndrome (RLS) is a common disease, with prevalence about 10% of the general population. Its symptoms appear before bedtime, causing sleeping disorders, and consequently, a worsening of the patient quality of life. The diagnostic is clinical, based on the history presented by the patient that relates unpleasant sensations and uncomfortable sensations in the legs, mainly at the night, and experience relief or absence of the sensations with legs movements. In spite of having described for the first time 330 years ago, this disorder is still little known in the Brazilian medical community. Objective: Evaluate the sensibility and specificity of the questionnaire ‘‘Restless Legs Syndrome’s Clinical-Diagnostic Interview (RLSCDI) used at the Johns Hopkins RLS outpatient clinic, translated and adapted to Brazilian Portuguese. Method: We studied 19 patients with RLS clinic diagnostic and 22 without, from Neuro-Sono Outpatients, UNIFESP, Sao Paulo, Brazil. A blind and trained researcher interviewed the patients by phone. Chi-square and Kappa test were used for statistical analysis. Results: The questionnaire identified 15/19 patients in the group with RLS and there was no agreement between clinic diagnostic and questionnaire in 4 cases. In the group without RLS, the questionnaire identified 20/22 and there was no agreement in the other two cases. The agreement of RLSCDI and clinical diagnostic was high (Kappa = 69%) with 83% of specificity and 88% of sensibility. Conclusion: The Portuguese version of the RLSCDI is a good instrument to diagnose RLS, throughout phone interview in a set of Brazilian speakers. doi:10.1016/j.clinph.2008.07.259