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61.
62.
63.
J. Carrier 《Douleur et Analgésie》2003,16(2):99-104
Résumé De la puberté à la ménopause, les femmes sont soumises à d'importantes fluctuations hormonales. Les femmes rapportent en général
plus de plaintes de fatigue et plus de difficultés reliées au sommeil que les hommes et elles consomment également plus de
somnifères. Il est probable que la ménopause, le cycle menstruel, l'utilisation de contraceptifs hormonaux et l'hormonothérapie
seraient des facteurs influen?ant la qualité du sommeil chez les femmes. Les études chez l'animal et l'être humain montrent
que l'administration de progestérone et d'estrogène influence la qualité et l'architecture du sommeil. Les effets du cycle
menstruel sur le sommeil demeure encore une question en litige dans la littérature alors que vraiment peu d'études se sont
intéressées jusqu' à maintenant aux effets des contraceptifs hormonaux sur la qualité du sommeil. Les difficultés à dormir
et la fatigue s'avèrent des plaintes importantes chez les femmes ménopausées. Il semble que les bouffées de chaleur jouent
un r?le important dans la détérioration de la qualité du sommeil chez les femmes ménopausées. Il existe encore très peu d'études
portant sur les effets de l'hormonothérapie sur les paramètres polysomnographiques du sommeil. La plupart des ces études ont
rapporté de faibles améliorations sur différents paramètres de sommeil. Une meilleure compréhension des mécanismes qui sous-tendent
les modulations hormonales du cycle éveil-sommeil, nous permettra de mieux développer des mesures préventives et thérapeutiques
adaptées au sommeil des femmes à travers toutes les étapes de leur vie reproductive.
相似文献
64.
Résumé La douleur est une cause majeure de l'insomnie chez les malades et plus de 70% des patients en douleur se plaignent de troubles
du sommeil. Des études polysomnographiques ont démontré que les patients éprouvant de la douleur chronique affichent une perturbation
marquée de la structure et de la continuité du sommeil. Les constatations les plus courantes sont: changements fréquents de
phases de sommeil, augmentation des réveils nocturnes, diminution du sommeil à ondes lentes et du sommeil à mouvements oculaires
rapides, augmentation du sommeil superficiel et des mouvements du corps, intrusion électroencéphalographique (EEG) de sommeil
alpha-delta, augmentation du nombre d'éveils et du taux de pattern d'activation cyclique (PAC). Le PAC est un marqueur physiologique
du sommeil instable qui amplifie les réactions aux événements perturbateurs de la consolidation du sommeil. Ainsi, la qualité
du sommeil dépend de mécanismes cérébraux qui évaluent les événements externes afin de protéger l'intégrité vitale. Ces mécanismes,
situés au niveau thalamique, commande le maintien du sommeil, l'éveil bref ou le réveil comportemental, selon le risque que
représente l'événement en cause. Pendant le sommeil, le système neurovégétatif demeure réceptif aux stimuli externes et opère
en synchronie avec le processus PAC. Chez les sujets sains, la stimulation thermique nociceptive provoque une accélération
du rythme cardiaque peu importe la phase du sommeil, avec un gradient décroissant de la phase 2 au sommeil à ondes lentes
et au sommeil MOR. Les réponses autonomiques peuvent varier chez les patients fibromyalgiques n'affichant pas la diminution
normale de l'activité sympathique pendant le sommeil et chez les patients éprouvant de la douleur chronique qui sont déjà
aux prises avec la fragmentation du sommeil ou l'insomnie. Les modifications spécifiques du sommeil découlant d'un syndrome
unique de douleur ou de parasomnies associées à la douleur pendant le sommeil (par ex. le bruxisme, les crampes nocturnes
dans les jambes et le reflux gastro-œsophagien) sont également décrites.
相似文献
65.
The phasic phenomena of paradoxical sleep have been studied in anophthalmic mice: the “eyeless” ZRDCT/An strain. In completely anophthalmic mice or the heterozygous mice of the same strain with unilateral or bilateral eyeballs, tongue and vibrissae movements exist with patterns similar to those of the C57Br/cd/Orl control strain of mice. These events do not depend upon the integrity of visual and oculomotor systems. 相似文献
66.
Étienne Challet 《Cahiers de Nutrition et de Diététique》2005,40(3):137-141
The suprachiasmatic nuclei of the hypothalamus are the site of the master circadian clock in mammals. The suprachiasmatic clock modulates sleep and food intake, so that both do not occur at the same times of the daily cycle. Hormonal rhythms are, to various degrees, under the control of sleep and/or the suprachiasmatic clock. Drastic changes in homeostatic processes of sleep (e.g., sleep deprivation) or calorie intake (e.g., food restriction) can have an impact on the master circadian clock. Moreover, a chronic desynchronization affects sleep and it can also lead to metabolic changes. Interactions between the circadian clock, sleep-wake cycle and food intake are thus complex, and these systems regulate each other. Their alterations are associated with a host of major health problems. 相似文献
67.
Objective
Modification of sleep behaviors in teenagers has been observed over the past 30 years with a reduction in overall sleep time and an increasing number of teenagers suffering from sleep deprivation. Sleep deprivation is linked to physical problems such as obesity but also to change in performance at school and mood disorders. Changes have been associated with the use of screens, cell phones, Internet and social media. Use of screens has been shown to delay sleep onset and melatonin secretion and stimulation of wake systems by interaction with social media may exacerbate these effects. The links between the use of social media and sleep patterns have not been fully explored. Our study aimed to evaluate the effects of social media on teenagers’ sleep and the impact of sleep deprivation.Methodology
As part of a sleep education program conducted in middle schools, teenagers from 6th to 9th grade were invited to complete an online questionnaire on sleep habits with teacher supervision and after parental consent. Outcome measures were sleep and wake times with estimated sleep duration in school (SP) and rest periods (RP), use of screens (computers, tablets, smartphones and video game consoles), the use of social media and impact on visual analogue scales of sleep quality, mood and daytime functioning. Students were divided into those with clear sleep deprivation (sleep time < 6 hours in SP) and those whose sleep time was in line with the National Sleep Foundations recommended sleep needs for teenagers (9 hours or more).Results
A total of 786 questionnaires were completed and 776 were exploitable. Four schools took part with 408/786 girls (64.2 %) and a mean age of 12.4 ± 1.24. Internet access was almost universal (98.3 %), 85.2 % had cell phones and 42.7 % had a personal computer in their bedroom. Social media was used by 64.6 %. After dinner, 52.6 % spent more than an hour and 14.7 % spent more than 2 hours in front of a screen. After bedtime, 51.7 % regularly used electronic devices of which 25.6 % had a screen-based activity (e.g. texts, social media, video games or television). During the night, some teens woke up to continue screen-based activities: 6.1 % in order to play online video games, 15.3 % to send texts and 11 % to use social media. Bedtimes were later in PR compared with PS (22h06 ± 132 vs. 23h54 ± 02; P < 0.0001) as were wake times (7h06 ± 36 vs. 10h06 ± 102; P < 0.0001). Sleep time was clearly longer in PR (10h12 ± 126 P < 0.0001) compared to PS. For students in 6th grade compared to 9th grade in sleep duration in SP decreased (8:55 ± 90 vs. 7:25 ± 93; P < 0.0001), whereas sleep duration during RP was stable (10h08 ± 118 vs. 10h08 ± 90 P < 0.029). No significant difference was found between girls and boys for sleep duration, sleep quality, performance during the day or mood. Sleep deprivation during the week (6 hours or less) was less common in 6th graders 5 % vs. 15 % (P < 0.0001). In sleep deprived teens compared to teens sleeping, the recommended ≥9 hours, difficulties falling asleep were reported with 33 % vs. 9 % taking over an hour to fall asleep (P < 0.0001) and difficulties getting up in the morning were more common (7.05 ± 3.27 vs. 5.74 ± 2.97; P = 0.0003). Sleep deprivation had an effect on daytime performance: teenagers deprived of sleep were more likely to report a need to fight sleepiness, (5.93 ± 3.24 vs. 2.84 ± 2.44 P < 0.0001) and had reduced energy during the day (6.21 ± 2.86 vs. 7.77 ± 2.07 P < 0.0001). A negative effect on mood was evident: in sleep, deprived teenagers irritability (5.28 ± 3.12 vs. 3.30 ± 2.34; P < 0.0001) and feelings of sadness (3.97 ± 2.99 vs. 2.59 ± 2.15; P = 0.003) were more common. There was a clear association between sleep deprivation and access to screens and social media: sleep deprived teens were at more risk of nocturnal disruption with a higher prevalence of computers (67 % vs. 33 %; P < 0.0001), cell phones (99 % vs. 80 %; P = 0.0001) and smart phones (85 % vs. 66 %; P = 0.0001) in their bedrooms.Conclusions
Access to social media and especially a cell phone in teenagers’ bedrooms is associated with a reduction in sleep time during the school week with negative effects on daily functioning and mood which increases with increasing age. Education about use of social media and sleep for teenagers needs to start early as modifications in sleep and evening use of screens was present on our population from 11 years on and to involve parents as setting parent controlled bedtimes has been shown to increase teenage sleep time. 相似文献68.
Cugy D Penide D Paty J Balan J Vinclair J Cugy S Lenain JL Giordanella JP 《L'Encéphale》2004,30(3):228-235
Primary healthcare checkups are regularly performed by French healthcare centers. We report analysis of sleep disorders complaint registered from 1988 to 1998 in Bordeaux-Cauderan and Cenon CPAM welfare centers. The prevalence of sleep disorders is estimated from a total of 205 347 checkups. The population is segmented by age (18-24: 19 332, 25-34:46 694, 35-44:51 072, 45-54:46 886, 55-64:32 658, 65 +:7 705), gender (male: 101 801; female: 103 546) and population category (general: 147 188, underprivileged: 22 785, prioritized: 35 374). Datas shows a relationship between sex and age. Surprisingly we found a relation between Buying Power for Net Wages and Prevalence of Sleep Complaint. There is a significant correlation (R(2)=0,718, p<0,0079). These data are in relationship with M. Ohayon findings relatively to low income and sleep complaint. 相似文献
69.
The placebo response is a psychobiological phenomenon for clinical benefits following the administration of an inert substance whatever its form. This phenomenon can be attributed to a wide range of neurobiological processes, such as expectations of relief, the Pavlovian conditioning and learning, emotional regulation, and reward mechanisms, which are themselves under the influence of processes that take place during sleep. The study of placebo analgesia in healthy from a placebo conditioning associated with analgesic suggestions has highlighted a relationship between sleep, expectations of relief and placebo analgesia: when the induction is persuasive before sleep, expectations of relief modulate placebo response the next morning and paradoxical sleep correlates negatively with both expectations and the placebo response. When the analgesic experience before sleep is less persuasive, expectations of relief are still present but no longer interact with placebo analgesia while paradoxical sleep no longer correlates with the analgesic placebo response. Sleep-processes especially during paradoxical sleep seem to influence the relationship between expectations of relief and placebo analgesia. In this review, we describe the relationship between sleep and placebo analgesia, the mechanisms involved in the placebo response (e.g., conditioning, learning, memory, reward) and their potential link with sleep that could make it a special time for the building placebo response. 相似文献
70.
Karroum EG Raux M Riou B Arnulf I 《Annales fran?aises d'anesthèsie et de rèanimation》2010,29(12):920-924
Restless legs syndrome, or Ekbom syndrome, is a common (yet poorly recognized) neurological condition, with sensitive and motor symptoms and a probable genetic vulnerability. The subjects experience an imperious urge to move their legs at rest, possibly associated with paresthesia and pain, which occurs mostly in the evening and night, and is transiently relieved by movements and walking. Severe cases suffer from involuntary leg jerks during quiet wake and severe insomnia. The syndrome is more frequent in middle-aged subjects, in women, and in iron deficient subjects (renal insufficiency, pregnancy, multiparous mothers). We report a series of patients with a severe restless legs syndrome, adequately treated with small doses of dopamine agonist in the evening. They experienced a perioperative, acute exacerbation of their syndrome. The inability to stay still with involuntary jerks in the operating room, the generalized pain followed by suicidal thoughts, and the agitation with akathisia in the recovery room, complicated the surgery procedures and their follow-ups. The prevention of restless legs exacerbation includes: (i) contra-indicating hydroxyzine, droperidol and any other drug blocking the central dopamine transmission before and during anaesthesia; (ii) using intravenous or subcutaneous opioids, and benzodiazepines during and after the surgery procedure; (iii) temporary increasing the dosage of dopamine agents after surgery; (iv) monitoring (and compensating if low) the iron stores after surgery. 相似文献