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Delayed sleep-wake phase disorder in a clinical population: gender and sub-population diferences

OBJECTIVE/BACKGROUND: Delayed sleep-wake phase disorder (DSWPD) is defined by a delay in the major sleep episode relative to desired or required sleep and wake times. The objectives of this study were to evaluate DSWPD in our population and to compare it with similar clinical data, to analyse gender...

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Detalles Bibliográficos
Autores principales: Reis, Cátia, Paiva, Teresa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Brazilian Association of Sleep and Latin American Federation of Sleep 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6932846/
https://www.ncbi.nlm.nih.gov/pubmed/31890097
http://dx.doi.org/10.5935/1984-0063.20190086
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author Reis, Cátia
Paiva, Teresa
author_facet Reis, Cátia
Paiva, Teresa
author_sort Reis, Cátia
collection PubMed
description OBJECTIVE/BACKGROUND: Delayed sleep-wake phase disorder (DSWPD) is defined by a delay in the major sleep episode relative to desired or required sleep and wake times. The objectives of this study were to evaluate DSWPD in our population and to compare it with similar clinical data, to analyse gender differences, and to identify possible subpopulations based on circadian timing and alignment. PATIENTS/METHODS: 162 consecutive DSWPD patients from a sleep clinic with a median age of 35.5 (24.0) years, 85 (52.5%) males were studied. Patient data were obtained from a clinical interview composed of socio-demographic, life events, daily habits, consumptions, and comorbidities data; and from diaries, actimetry, melatonin and PSG T1. The Dim Light Melatonin Onset (DLMO) was used to define circadian alignment or misalignment. RESULTS: In our DSWPD cohort, there were gender differences for different age groups (p=0.028). Men were more likely to be single and women more likely to be married (p=0.034). In students, school failure was higher for women (p<0.001); for workers, absenteeism was higher in women (p=0.001). In the circadian aligned (compared to misaligned group), DLMO was later (p<0.001), sleep onset time (p=0.046) was later, total sleep time (p=0.035), and number of sleep cycles (p=0.018) were lower, as measured using PSG T1. CONCLUSIONS: In this clinical population, DSWPD is more prevalent in young men and in middle age women, although with no overall significant differences between genders. There are two different phenotypes of DSWPD: circadian misaligned and circadian aligned. Depression is prevalent in both groups. Better definition, classification and diagnostic criteria for DSWPD are still needed, and targeted therapeutical intervention should be evaluated.
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spelling pubmed-69328462019-12-30 Delayed sleep-wake phase disorder in a clinical population: gender and sub-population diferences Reis, Cátia Paiva, Teresa Sleep Sci Original Article OBJECTIVE/BACKGROUND: Delayed sleep-wake phase disorder (DSWPD) is defined by a delay in the major sleep episode relative to desired or required sleep and wake times. The objectives of this study were to evaluate DSWPD in our population and to compare it with similar clinical data, to analyse gender differences, and to identify possible subpopulations based on circadian timing and alignment. PATIENTS/METHODS: 162 consecutive DSWPD patients from a sleep clinic with a median age of 35.5 (24.0) years, 85 (52.5%) males were studied. Patient data were obtained from a clinical interview composed of socio-demographic, life events, daily habits, consumptions, and comorbidities data; and from diaries, actimetry, melatonin and PSG T1. The Dim Light Melatonin Onset (DLMO) was used to define circadian alignment or misalignment. RESULTS: In our DSWPD cohort, there were gender differences for different age groups (p=0.028). Men were more likely to be single and women more likely to be married (p=0.034). In students, school failure was higher for women (p<0.001); for workers, absenteeism was higher in women (p=0.001). In the circadian aligned (compared to misaligned group), DLMO was later (p<0.001), sleep onset time (p=0.046) was later, total sleep time (p=0.035), and number of sleep cycles (p=0.018) were lower, as measured using PSG T1. CONCLUSIONS: In this clinical population, DSWPD is more prevalent in young men and in middle age women, although with no overall significant differences between genders. There are two different phenotypes of DSWPD: circadian misaligned and circadian aligned. Depression is prevalent in both groups. Better definition, classification and diagnostic criteria for DSWPD are still needed, and targeted therapeutical intervention should be evaluated. Brazilian Association of Sleep and Latin American Federation of Sleep 2019 /pmc/articles/PMC6932846/ /pubmed/31890097 http://dx.doi.org/10.5935/1984-0063.20190086 Text en http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivative License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited and the work is not changed in any way.
spellingShingle Original Article
Reis, Cátia
Paiva, Teresa
Delayed sleep-wake phase disorder in a clinical population: gender and sub-population diferences
title Delayed sleep-wake phase disorder in a clinical population: gender and sub-population diferences
title_full Delayed sleep-wake phase disorder in a clinical population: gender and sub-population diferences
title_fullStr Delayed sleep-wake phase disorder in a clinical population: gender and sub-population diferences
title_full_unstemmed Delayed sleep-wake phase disorder in a clinical population: gender and sub-population diferences
title_short Delayed sleep-wake phase disorder in a clinical population: gender and sub-population diferences
title_sort delayed sleep-wake phase disorder in a clinical population: gender and sub-population diferences
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6932846/
https://www.ncbi.nlm.nih.gov/pubmed/31890097
http://dx.doi.org/10.5935/1984-0063.20190086
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