Sleep patterns and disorders in adults of the rural and isolated black community of Furnas do Dionísio, MS

THESES

SLEEP PATTERNS AND DISORDERS IN ADULTS OF THE RURAL AND ISOLATED BLACK COMMUNITY OF FURNAS DO DIONÍSIO, MS (ABSTRACT)^*. THESIS. SÃO PAULO, 2000.

RUBENS REIMÃO^**

The purpose of this research was to verify sleep disorder events in the population of Furnas do Dionísio, State of Mato Grosso do Sul (MS), Brazil . This population of that rural and isolated black community, in the Municipality of Jaraguari, MS, has been assessed. Interviews made in the period of January 1999 to January 2000 have been used. Census-type sampling has been used, assessing all community inhabitants, with age of 18 or more years (Furnas Group), in a total of 120 subjects. The Control Group has been collected in a neighboring rural zone, in the same Municipality, also using Census-type sampling and the same age range, in a total 101 subjects. Populations have been compared in relation to age and gender. Furnas Group was composed by 97.5% of non-white people and the Control Group by 3.9% of non-white people (p = 0.001).

The instruments used were the following: (a) Giglio adult sleep questionnaire (Giglio questionnaire); (b) Hamilton Depression Rating Scale; (c) CAGE scale, to assess the alcoholism behavior. In conclusion, the usual pattern of night sleep in Furnas Group showed a trend to have sleeping and wakening times earlier than those described in urban populations. Furnas Group sleeping times in the weekends, and wakening times, both in the weekdays and in the weekends, later than those of the Control Group. The usual standard diurnal sleep, in Furnas Group, showed a prevalence of regular siesta, similar to that observed in the Control Group. Both groups have siesta culture, since 66.3% of the Furnas Group and 59.4% of the Control Group regularly sleep during daytime.

The events presented at the research time verified when comparing Furnas Group with the Control Group, evidence the following sleep disorders, with higher access of Furnas Group: wish to change the sleeping habits; dissatisfaction with the sleeping place; complaints of sleeping problems; difficulty in falling asleep; irresistible diurnal sleep; sleepwalking; swallowing difficulty and suffocation during sleep; asthma crisis during sleep; sleep paralysis; nightmare; current insomnia. None of the sleep disorders have been found more in the Control Group than in the Furnas Group, in a statistically significant manner. Notwithstanding the differences of sleep impairment between groups, the search for consultation and use of sleeping medication has been similar. Among the assessed diseases, hypertension has been found more in Furnas Group than in the Control Group.

The prevalence of insomnia was largest in the Furnas Group (40.83%) in comparison with the Control Group (16.83%); such prevalence has been calculated based on the last week. The event of current insomnia in the Furnas Group showed to be directly related to the following sleep disorders: subjects with insomnia are older than those without insomnia; wish to change sleeping habits; complaints of sleep disorders; difficulty in falling asleep; wakening for many times during the night; earlier wakening at the end of the night; headache during sleep; nightmare. In Furnas Group, the search for care of sleep disorder and use of sleeping medication was similar among subjects with current insomnia and those without current insomnia. In the Control Group, the occurrence of current insomnia has been shown to be directly related to the following sleep complaints: wish to change sleeping habits; complaints of sleep disorders; difficulty in falling asleep; earlier wakening at the end of the night; excessive daytime sleepiness; asthma during sleep; tachycardia during sleep; headache during sleep; nightmare; cramp during sleep; to fall asleep earlier both in the week days and in the weekends. In the Control Group, the search for care of sleep disorders, use of sleeping medication and hypertension has been directly related to current insomnia.

The occurrence of previous insomnia in the Furnas Group showed to be directly related to the following sleep complaints: subjects with severe insomnia were older than those without insomnia; wish to change sleeping habits; wish to increase sleep duration; dissatisfaction with the sleeping place; episodes of irresistible sleep during daytime; excessive daytime sleepiness; sleepwalking; nightmare; current insomnia. In the Furnas Group, the search for care of sleep disorders and the use of sleeping medication was similar among those with previous insomnia and those without previous insomnia. In the Control Group, the occurrence of previous insomnia showed to be directly related to the following sleep alterations: subjects with severe insomnia were older than those without insomnia; wish to change sleeping habits; complaints of sleep disorders; episodes of irresistible sleep during daytime; excessive daytime sleepiness; swallowing difficulty, with suffocation feeling during sleep; tachycardia during sleep; presence of current insomnia. In the Control Group, the search for care of sleep disorders, the use of sleeping medications and the presence of hypertension were higher in the subjects with previous insomnia than in those without previous insomnia.

The study of the occurrence of current insomnia both in the Furnas Group and in the Control Group, showed direct correlation between the presence of current insomnia and the severity of the depression indexes, using the Hamilton Depression Rating Scale as instrument. The study of occurrence of previous insomnia both in the Furnas Group and in the Control Group showed direct correlation between the presence of previous insomnia and severity of the depression indexes, using the Hamilton Depression Rating Scale as instrument.

The occurrence of current insomnia in the Furnas Group showed to be directly related to the abuse of alcohol, using CAGE scale as instrument, which relation is not statistically significant. In the Control Group, the indexes of abuse of alcohol by the CAGE scale were similar in the subjects with current insomnia, in comparison with those without current insomnia. The occurrence of previous insomnia in the Furnas Group showed direct correlation between the severity of insomnia and the abuse of alcohol, using CAGE scale as instrument. In the Control Group, there was tendency to direct correlation between previous insomnia and abuse of alcohol using the CAGE scale, but the correlation had not been statistically significant.

In conclusion, Furnas Group evidenced to be more affected by sleep disorders than the Control Group. The prevalence of insomnia was larger in Furnas Group. Although being more affected, subjects with insomnia in the Furnas Group did not present search for consultation or for use of hypnotic medication. In both groups, current insomnia and previous insomnia were directly related to higher depression indexes. In Furnas Group, insomnia was also associated to abuse of alcohol.

KEY WORDS: sleep habits, sleep disorders, Black isolated rural community, Furnas do Dionísio MS Brazil.

**Address: Rua das Glicíneas 128, 04048-050 São Paulo SP, Brasil.

*

Padrões e distúrbios do sono em adultos da comunidade negra rural e isolada de Furnas do Dionísio, MS (Resumo). Tese de Livre-Docência, Departamento de Neurologia (Disciplina de Neurologia Infantil) da Faculdade de Medicina da Universidade de São Paulo.

Publication Dates

• Publication in this collection
  07 June 2001
• Date of issue
  June 2001