Sleep Disorders and Demand for Medical Services Evidence from a Population-Based Longitudinal Study 英文参考文献.docVIP

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Sleep Disorders and Demand for Medical Services Evidence from a Population-Based Longitudinal Study 英文参考文献.doc

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Sleep Disorders and Demand for Medical Services Evidence from a Population-Based Longitudinal Study 英文参考文献

SleepDisordersandDemandforMedicalServices: EvidencefromaPopulation-BasedLongitudinalStudy RogerioSantos-Silva1,LauraSiqueiraCastro1,JoseAugustoTaddei2,SergioTufik1,LiaRitaAzeredo Bittencourt1* 1DisciplinadeMedicinaeBiologiadoSono,DepartamentodePsicobiologia,UniversidadeFederaldeSa?o Paulo–UNIFESP,Sa?o Paulo,Brazil,2DisciplinadeNutric?a?o e Metabolismo,DepartamentodePediatria,UniversidadeFederaldeSa?o Paulo–UNIFESP,Sa?o Paulo,Brazil Abstract Background:Theaimofthisstudywastoinvestigatewhetherinsomniaandobstructivesleepapnea(OSA)werepredictors ofhospitalizationsoremergencydepartment visitsduring twoyears followingtheSaoPaulo EpidemiologicSleepStudy (EPISONO)sample. MethodsandFindings:Allparticipants(n=1,101)whounderwentabaselineevaluationbetweenJulyandDecember2007 werecontactedinDecember2009andaskedtofilloutaquestionnaireaboutbodyweightchanges,numberofhospitalizations andvisitstotheemergencydepartment.Participantslostduringthefollow-upperiodrepresented3.2%(n=35)and7subjects haddied.Hospitalizationswerereportedby116volunteers(10.5%)andemergencydepartmentvisitswerereportedby136 participants(12.4%).Theaveragebodymassindex(BMI)didnotvarysignificantlybetweenthefirstandthesecondassessment [26.7(95%CI:26.3–27.1)vs.26.9(26.5–27.4)kg/m2].Afteradjustingforconfounders,amultiplelogisticregressionmodelrevealed thatfemalegender[1.4(1.0–1.9)],age$40years,insomniadiagnosedaccordingtotheDSM-IVcriteria[1.6(1.0–2.6)],andapnea- hypopneaindex$15[1.5(1.0–2.2)]werepredictorsofhospitalizationsand/ordemandforemergencyservices. Conclusion:OurstudyofaprobabilisticsampleoftheSaoPauloinhabitantsshowsthatoveraperiodoftwoyears,insomnia andOSAwerebothassociatedwithhealthimpairment.Consideringthehighprevalenceandpublichealthburdenofsleep disorders,theconsequencesofuntreateddiseaseforboththeindividualandsocietyareundeniableandshouldbeaddressed. Citation:Santos-SilvaR,CastroLS,TaddeiJA,TufikS,BittencourtLRA(2012)SleepDisordersandDemandforMedicalServices:EvidencefromaPopulation-Based