To evaluate the effect of smoking habits on sleep, data from 1492 adults referred to the Sleep Institute were accessed and divided into 3 categories of smoking status: current, former and non-smokers. Categories of pack-years (<15 and ≥15) defined smoking severity. The association of smoking status and smoking severity with sleep was analyzed for sleep parameters, especially apnea and hypopnea index (AHI) ≥5, more than 5% of total sleep time (TST) spent with oxyhemoglobin saturation (SaO 2 ) <90%, and arousal index. The arousal index was higher among current (21 ± 17) and former smokers (20 ± 17) than non-smokers (17 ± 15; P < 0.04). Former smokers had a higher percent of TST at SaO 2 <90% than non-smokers (9 ± 18 vs 6 ± 13; P < 0.04). Former smokers with pack-years ≥15 compared to <15 exhibited higher AHI (22 ± 24 vs 16 ± 21; P < 0.05) and arousal index (22 ± 19 vs 18 ± 15; P < 0.05). Current smokers with pack-years ≥15 compared to <15 exhibited higher arousal index (23 ± 18 vs 18 ± 16; P < 0.05) and percent of TST at SaO 2 <90% (11 ± 17 vs 6 ± 13; P < 0.05). Smoking status and pack-years were not associated with AHI ≥5 on logistic regression analysis, but current smokers with pack-years ≥15 were 1.9 times more likely to spend more than 5% of TST at SaO 2 <90% than non-smokers (95%CI = 1.21-2.97; P = 0.005). The variability of arousal index was influenced by gender, AHI and current smokers with pack-years ≥15 (all P < 0.01). Smoking habits seem to be associated with arousal and oxyhemoglobin desaturation during sleep, but not with AHI. The effect was more pronounced in current than former smokers.

A b s t r a c t A b s t r a c t A b s t r a c t A b s t r a c t A b s t r a c t Sleepiness is a physiological function and can be defined as an increased

A 2-month exercise training associated with CPAP treatment for OSAS patients has a positive impact on subjective daytime sleepiness, quality of life (physical functioning and general health perception), and mood state (tension and fatigue).

The aim of this study was to determine whether an orientation session led by a polysomnography (PSG) technician during the night of positive airway pressure (PAP) titration can improve objective sleep quality and acceptance of nasal mask in patients referred to a sleep laboratory. Consecutive patients (n = 1,481), referred for PAP titration during PSG, were retrospectively evaluated. Patients were distributed in two groups: the control group, patients referred for PAP titration (n = 699) who did not undertake an orientation session led by a PSG technician, and the oriented group, patients referred to PAP titration (n = 782) who followed the orientation session. Demographic data were similar (p > 0.05) between groups (control vs oriented) for: male/female proportion (76:24 vs 75:25%), age (mean +/- SD; 53 +/- 12 vs 52 +/- 12 years), Epworth Sleepiness Scale score (12 +/- 6 vs 12 +/- 6), and body mass index (31 +/- 6 vs 31 +/- 6 kg/m(2)). PSG data were different (p < 0.05) between the groups for: total sleep time (312 +/- 81 vs 326 +/- 85 min), sleep efficiency (74 +/- 17 vs 77 +/- 14%), sleep latency (22 +/- 24 vs 18 +/- 29 min), S1 (8 +/- 8 vs 6 +/- 5%), S3 4 (19 +/- 11 vs 21 +/- 13%), rapid eye movement sleep (17 +/- 9 vs 18 +/- 9%), and wake after sleep onset (106 +/- 68 vs 93 +/- 58 min). After the orientation session, the number of patients who did not accept nasal mask during PSG recording was higher in the control group than the oriented group (80 vs 44; p = 0.001). An orientation session led by a PSG technician can improve objective sleep quality and nasal mask acceptance during the night of PAP titration. Such an addition to PAP titration could be an efficient intervention to improve PAP compliance.

Systematic evaluation of the facial skeleton, mouth, throat, and nose, between volunteers with upper airway resistance syndrome and volunteers without sleep-related breathing disorders, showed that the presence of upper airway resistance syndrome is mainly associated with nasal alterations and oropharyngeal dryness, in addition to the risk of hypertension, regardless of gender and obesity.

A desminagem humanitária é uma das atividades das missões de paz e de assistência militar que envolvem, mesmo com as precauções, riscos na sua execução. Desde o aprimoramento durante a Guerra da Secessão, nos Estados Unidos, as minas terrestres fizeram parte de quase todos os conflitos. A vida útil de uma mina antipessoal pode chegar a 30 anos, o que representa uma ameaça de longa duração e com o conflito em curso, torna-se quase impossível identificar todas as zonas minadas. A medicina operacional é a assistência médica integrada e abrangente, a consulta e a administração de informações médicas em operações táticas, que contribuem para a segurança e o sucesso de uma missão primariamente militar. Este estudo mostra a necessidade de ampliar os conhecimentos das lesões provocadas por explosivos, sobretudo, para os integrantes das missões de desminagem humanitária, diminuindo a mortalidade e a perda de membros.