Impact of sleep hygiene on patients with obstructive sleep apnoea syndrome

Mariana Guedes Bahia¹

Vera Soares²

João Carlos Winck³

Resumo

Este estudo pretendeu avaliar o impacto de um folheto sobre medidas de higiene do sono (MHS) numa população de 36 doentes recém-diagnosticados com síndroma de apneia obstrutiva do sono (SAOS) e a iniciar tratamento. Esperava-se que: 1) A informação sobre as MHS transmitida através do folheto alterasse alguns dos hábitos relativos ao sono da população; e que, 2) A intervenção em forma de folheto informativo se traduzisse numa melhoria da avaliação subjectiva das queixas relativas ao sono. No pré-teste, avaliaram-se os hábitos e as queixas relativas ao sono da população. No pós-teste reavaliaram-se os hábitos de sono e os doentes fizeram uma avaliação da contribuição das MHS para a diminuição das suas queixas relativas ao sono. Não houve diferenças significativas na adopção de MHS entre os dois momentos; porém, globalmente, os doentes consideraram que as MHS contribuíram ligeiramente para a melhoria das suas queixas. A adopção pouco visível das MHS pode ter-se devido ao facto de os doentes já possuírem uma higiene do sono razoável no pré-teste, bem como ao facto de a escala utilizada não ser suficientemente discriminativa. Além disso, a exigência de uma auto-disciplina associada à implementação das MHS pode ter colidido com exigências várias, entre as quais a adaptação ao tratamento com CPAP (continuous positive air pressure). Seria interessante, num estudo posterior, avaliar em que medida é que após a adaptação inicial ao CPAP se alterariam os níveis de implementação das medidas de HS, o que implicaria um estudo longitudinal. Convém por isso não desistir de recordar aos doentes da importância das MHS, oferecendo novos folhetos actualizados em consultas de seguimento.

Abstract

The purpose of this study was to evaluate the impact of a Sleep Hygiene brochure on a population of 36 patients recently diagnosed with Obstructive Sleep Apnoea Syndrome and beginning treatment. One expects that: 1) the information about Sleep Hygiene offered in the brochure would change some of the patients' habits toward sleep; and that, 2) this intervention in the form of a free informative brochure would have an echo in terms of a better subjective evaluation of sleep complaints. The sleep habits and the sleep complaints were evaluated in the pre-test. Those variables were re-evaluated in the post-test and at that time the patients filled in a scale of satisfaction with the information about Sleep Hygiene, in terms of its contribution to improving their sleep complaints. There were no significant differences in the level of compliance to Sleep Hygiene between the two periods, although the majority of the patients considered that Sleep Hygiene did improve their sleep difficulties. The low level of compliance may be due to the fact that patients already had reasonable Sleep Hygiene habits, and also to the fact that the scale was not sufficiently discriminative. In addition, the self-discipline that Sleep Hygiene involves may have collided with other demands such as the adaptation to treatment with CPAP (Continuous Positive Air Pressure). In a following study, it would be interesting to find if the levels of sleep hygiene compliance would change if they were implemented after the initial adaptation to CPAP, which would imply a longitudinal study. It would be helpful to keep reminding the patients of Sleep Hygiene importance, offering new and update brochures to the patients during consultations.

Key-words: Sleep obstructive apnoea syndrome, sleep hygiene, therapeutic compliance.

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

Bibliografia/Bibliography

1. Winck JC, Dias JR, Santos JM. Sono: 25 Perguntas Frequentes em Pneumologia. Lisboa: Marques Gomes MJ, Sotto-Mayor R (eds.). Permanyer Portugal, 2001         [ Links ]

2. Morin CM, Kwentus JA. Area Review: Sleep Disorders. Annals of Behavioral Medicine, 10 (3): 91-100.

3. Karacan I, Thornby JI, Anch AM, et al. Dose related sleep disturbances induced by coffe and caffeine. Clinical Pharmacology and Therapeutics 1976; 20: 682-689.

4. Soldatos CR, Kales JD, Sharf MB, Bixler, EO, Kales A. Cigarette smoking associated with sleep dificulty. Science 1980; 207: 551-553.

5. Rundell OH, Lester BK, Griffiths WJ, Williams HL. Alcohol and sleep in young adults. Pshycopharmacology 1972; 26: 201-208.

6. Adam K. Dietary habit and sleep after bedtime food or drinks. Sleep 1980; 3: 47-58.

7. Hartman E. L-tryptophane: A rationale hypnotic with clinical potential. American Journal of Psychiatry 1977; 134: 366-370.

8. Wurtman RJ, Fernstrom JD. L-tryptophan, L-tyrosine and the control of brain monoanine biosynthesis. In Snyder, SH (ed), Perspectives in Neuropharmacology 1972:143. New York: Oxford University Press. ]]> 9. Nicholson AN, Stone BM. L-tryptophan and sleep in healthy man. Electroencephalography and clinical Neurophisiology 1979; 47: 539-545

10. Ogden J. Health Psychology 1999. Buckingham: Open University Press

11. Leventhall H, Diefenbach M, Leventhall EA. Illness Cognition: Using Common Sense to Understand Treatment Adherence and Affect Cognitions Interactions. Cognitive Therapy and research 16 (2), 143-163.

12. Chesson AL, Murphy PW, Arnold CL, Davis TC. Presentation and Reading Level of Sleep Brochures: Are They Appropriate for Sleep Disorders patients? Sleep 1998; 21 (4); 406-411.

13. Schwarz N. Self-Reports: How the questions shape the answers. American Psychologist 1999; 54 (2), 93-105.

¹ Estagiária de Psicologia pela Universidade do Minho/Psychology Intern, University of the Minho

² Assistente no Departamento de Psicologia da Universidade do Minho/Assistant, Department of Psychology, University of the Minho

³ Professor Auxiliar da Faculdade de Medicina da Universidade do Porto/Assistant Professor, University of Porto Medical School. ]]> 2001