Sleep disorders are common during the clinical course of the main
neurodegenerative diseases. Among these disorders, obstructive sleep apnea has
been extensively studied in the last decade and recent knowledge regarding its
relationship with the neurodegenerative process points a bidirectional
relationship. Neurodegenerative diseases can lead to functional changes in the
respiratory system that facilitate the emergence of apnea. On the other hand,
obstructive sleep apnea itself can lead to acceleration of neuronal death due to
intermittent hypoxia. Considering that obstructive sleep apnea is a potentially
treatable condition, its early identification and intervention could have a
positive impact on the management of patients with neurodegenerative
diseases.
COVID-19 has probably contributed as a risk factor for sleep disturbance. Actigraphy has been used to evaluate sleep complaints in self-isolated populations and frontline doctors during the COVID-19 pandemic. This systematic review aims to summarize the impact of the COVID-19 pandemic on sleep through wrist actigraphy, estimating sleep latency, total sleep time, awakening-after-sleep onset, and sleep efficiency. Searches were conducted of observational studies on the PubMed, Embase, Scopus, Web of Science, and PEDro databases from 1 December 2019 to 31 December 2022. Ninety articles were found, and given the eligibility criteria, fifteen were selected. Six studies were classified by the National Health and Medical Research Council as evidence level IV, two studies as level III-3, and seven studies as level III-2. According to the ACROBAT-NRSI instrument, three studies were classified as having a “serious” risk of bias, two as having “critical” risk, four as having “moderate” risk, and six as having “low” risk. In the selected publications, various populations were evaluated via actigraphy during the COVID-19 pandemic, with reports of “poor” sleep quality. Actigraphy may be a relevant tool to assess individual day–night rhythms and provide recommendations under enduring pandemic conditions. Moreover, as actigraphy presents objective data for sleep evaluations, it is suggested that this method be used in similar pandemics and that actigraphy be included as part of the sleep hygiene strategy.
Artigo de revisão Resumo A síndrome da apneia obstrutiva do sono (SAOS) tem sido extensivamente pesquisada nas últimas duas décadas, permitindo uma maior compreensão sobre sua relevância na prática clínica. Trata-se de uma doença com alta prevalência, acometendo até um terço da população adulta. A SAOS tem sido associada a condições sabidamente envolvidas no aumento do risco de eventos cerebrovasculares, como a hipertensão arterial sistêmica, diabetes mellitus tipo 2, obesidade e fibrilação atrial. Estudos recentes demonstram que a SAOS, por si só, pode levar à lesão cerebral isquêmica, possivelmente por alterações hemodinâmicas no fluxo cerebral, assim como alterações inflamatórias que promovem um estado de hipercoagulabilidade e aterosclerose na região encefálica. Ainda não estão totalmente esclarecidos os exatos mecanismos, mas há cada vez mais evidências de que a SAOS pode ser um fator de risco independente para o desenvolvimento da doença cerebrovascular. Descritores: Sono; Síndromes da apneia do sono; Transtornos cerebrovasculares; Fatores de risco.
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