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        "titulo" => "Abstract"
        "resumen" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">There is a 10&#8211;36&#37; rate of obstructive sleep apnoea syndrome &#40;OSAS&#41; associated with rapid eye movement &#40;REM&#41; in the OSAS population&#46; Prior studies have suggested an increased prevalence of psychiatric disorders and an effect of gender and age on these patients&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Our aim was to study the clinical and polysomnograph &#40;PSG&#41; characteristics of our patients with REM-related sleep disordered breathing &#40;REM SDB&#41;&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Inclusion criteria was the identification of REM SDB detected by PSG defined as apnea-hypopnea index &#40;AHI&#41; in REM sleep<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>h&#44; AHI in non-REM sleep &#40;NREM&#41;<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>15<span class="elsevierStyleHsp" style=""></span>h and REM&#47;NREM AHI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Several Sleep Disorders Questionnaire &#40;SDQ&#41; version 1&#46;02 parameters were analysed&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The study comprised 19 patients with a mean age of 54&#46;0 &#40;SD<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;97&#41;&#44; a mean BMI of 29&#46;01 &#40;SD<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;10&#41; and a 0&#46;58 female &#47; male ratio&#46; The mean Epworth Sleepiness Scale score was 12&#46;74 &#40;SD<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;86&#41;&#46; Mean AHI was 9&#46;16&#47;h &#40;SD 4&#46;09&#41;&#59; mean AHI in REM sleep 37&#46;08&#47;h &#40;SD 25&#46;87&#41; and mean REM-AHI&#47;NREM-AHI 8&#46;86 &#40;SD 8&#46;63&#41;&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">The anxiety disorder rate was 33&#46;3&#37;&#59; 44&#46;4&#37; in females&#44; 16&#46;7&#37; in males&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The average deep sleep was 20&#46;7&#37; &#40;SD 10&#46;42&#41; and REM sleep 15&#46;45&#37; &#40;SD 9&#46;96&#41;&#44; with a sleep efficiency of 85&#46;3 &#40;SD 8&#46;70&#41;&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">No significant statistical correlation was found between the REM&#47;NREM AHI index and anxiety symptoms&#44; daytime sleepiness and sleep quality &#40;REM and deep sleep percentages&#41;&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">These patients differ from the general OSAS population&#58; on average&#44; they are not obese&#44; there are a greater number of females affected and they do not present a very significant diurnal hypersomnia&#46; Reduced deep sleep and increased REM sleep were also present versus general population data&#44; and sleep efficiency was just below the normal limit&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Anxiety disorders were more prevalent in this group than described for the general population &#40;3&#37;&#41; and OSAS patients&#46;</p>"
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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A s&#237;ndroma de apneia obstrutiva do sono &#40;SAOS&#41; associada ao sono REM tem uma incid&#234;ncia de 10&#8211;36&#37; na popula&#231;&#227;o com SAOS&#46; Estudos anteriores t&#234;m sugerido&#44; nestes doentes&#44; um aumento de preval&#234;ncia de dist&#250;rbios psiqui&#225;tricos&#44; bem como um efeito da idade e do g&#233;nero&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Propusemo-nos&#44; por isso&#44; estudar as caracter&#237;sticas cl&#237;nicas e polissonogr&#225;ficas de doentes com o referido diagn&#243;stico&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Os crit&#233;rios de inclus&#227;o foram a identifica&#231;&#227;o de SAOS em REM&#44; por polissonografia &#40;PSG&#41;&#44; definida como IAH em REM<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>5&#47;h&#44; IAH em sono n&#227;o REM &#40;NREM&#41;<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>15&#47;h&#44; IAH REM&#47;NREM<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2&#46; Foram ainda analisados alguns par&#226;metros do <span class="elsevierStyleItalic">sleep disorders questionnaire</span> &#40;SDQ&#41; vers&#227;o 1&#46;02&#44; nomeadamente os relacionados com ansiedade ou depress&#227;o&#46; Foram estudados 19 doentes com m&#233;dia de idades de 54&#44;0 anos &#40;SD 13&#44;97&#41; e m&#233;dia de IMC de 29&#44;01 &#40;SD Dev 4&#44;10&#41;&#46; A raz&#227;o entre g&#233;nero feminino&#47;masculino foi de 0&#44;58&#46; O valor m&#233;dio da escala de Epworth foi de 12&#44;74 &#40;SD 4&#44;86&#41;&#46; Em rela&#231;&#227;o &#224; gravidade da SAOS&#44; a m&#233;dia do IAH foi de 9&#44;16&#47;h &#40;SD 4&#44;09&#41; e a do IAH em REM de 37&#44;08&#47;h &#40;SD 25&#44;87&#41;&#46; Para a rela&#231;&#227;o IAH-REM&#47;IAH-NREM obtivemos a m&#233;dia de 8&#44;86 &#40;SD 8&#44;63&#41;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A preval&#234;ncia do dist&#250;rbio de ansiedade foi de 33&#44;3&#37; &#40;44&#44;4&#37; no sexo feminino e 16&#44;7&#37; no sexo masculino&#41;&#46; Na popula&#231;&#227;o estudada&#44; o tempo de sono profundo foi de 20&#44;7&#37; &#40;SD 10&#44;42&#41; e de sono REM de 15&#44;45&#37; &#40;SD 9&#44;96&#41;&#44; com uma efici&#234;ncia de sono de 85&#44;3&#37; &#40;SD 8&#44;70&#41;&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">N&#227;o se verificou qualquer correla&#231;&#227;o estatisticamente significativa entre o &#237;ndice de IAH REM&#47;NREM e a sintomatologia ansiosa&#44; a sonol&#234;ncia diurna e a qualidade do sono &#40;percentagem de sono profundo e de sono REM&#41;&#46; Conclu&#237;mos que a subpopula&#231;&#227;o estudada apresenta caracter&#237;sticas que divergem das descritas para a popula&#231;&#227;o com SAOS&#59; em m&#233;dia&#44; n&#227;o s&#227;o doentes obesos&#44; as mulheres s&#227;o mais afectadas&#44; a sintomatologia n&#227;o &#233; t&#227;o exuberante&#44; nomeadamente a hipersonia diurna&#46; Observa-se&#44; tamb&#233;m&#44; uma redu&#231;&#227;o do sono profundo e um aumento do sono REM neste grupo de doentes <span class="elsevierStyleItalic">versus</span> a popula&#231;&#227;o geral&#44; estando a efici&#234;ncia do sono no limite inferior da normalidade&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Ainda o dist&#250;rbio de ansiedade apresenta maior preval&#234;ncia em rela&#231;&#227;o &#224; descrita para a popula&#231;&#227;o geral &#40;3&#37;&#41; e em rela&#231;&#227;o &#224; descrita para a popula&#231;&#227;o com SAOS&#46;</p>"
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Clinical and polysomnographic characteristics of patients with REM sleep disordered breathing
Características clínicas e polissonográficas de doentes com distúrbio respiratório do sono em REM
Cláudia Chaves Loureiro1,
Corresponding author
cl_loureiro@hotmail.com

Address/Morada: Alameda Hernâni Monteiro, 4000 Porto.
, Marta Drummond2, João Carlos Winck3, João Almeida4, Venceslau Hespanhol5
1 Interna Complementar de Pneumologia, Serviço de Pneumologia dos Hospitais da Universidade de Coimbra/Resident, Pulmonology, Pulmonology Unit, Hospitais da Universidade de Coimbra
2 Assistente Hospitalar de Pneumologia, Serviço de Pneumologia do Hospital de São João, Porto/Consultant, Pulmonology, Pulmonology Unit, Hospital de São João, Porto
3 Professor da Faculdade de Medicina da Universidade do Porto, Serviço de Pneumologia do Hospital de São João, Porto/University of Porto School of Medicine, Pulmonology Unit, Hospital de São João, Porto
4 Chefe de Serviço do Hospital de São João, Porto/Unit Head, Hospital de São João, Porto
5 Trabalho realizado no Serviço de Pneumologia do Hospital de São João, Porto/Study performed at Pulmonology Unit, Hospital de São João, Porto
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        "titulo" => "Caracter&#237;sticas cl&#237;nicas e polissonogr&#225;ficas de doentes com dist&#250;rbio respirat&#243;rio do sono em REM"
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        "resumen" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">There is a 10&#8211;36&#37; rate of obstructive sleep apnoea syndrome &#40;OSAS&#41; associated with rapid eye movement &#40;REM&#41; in the OSAS population&#46; Prior studies have suggested an increased prevalence of psychiatric disorders and an effect of gender and age on these patients&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Our aim was to study the clinical and polysomnograph &#40;PSG&#41; characteristics of our patients with REM-related sleep disordered breathing &#40;REM SDB&#41;&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Inclusion criteria was the identification of REM SDB detected by PSG defined as apnea-hypopnea index &#40;AHI&#41; in REM sleep<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>h&#44; AHI in non-REM sleep &#40;NREM&#41;<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>15<span class="elsevierStyleHsp" style=""></span>h and REM&#47;NREM AHI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Several Sleep Disorders Questionnaire &#40;SDQ&#41; version 1&#46;02 parameters were analysed&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The study comprised 19 patients with a mean age of 54&#46;0 &#40;SD<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;97&#41;&#44; a mean BMI of 29&#46;01 &#40;SD<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;10&#41; and a 0&#46;58 female &#47; male ratio&#46; The mean Epworth Sleepiness Scale score was 12&#46;74 &#40;SD<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;86&#41;&#46; Mean AHI was 9&#46;16&#47;h &#40;SD 4&#46;09&#41;&#59; mean AHI in REM sleep 37&#46;08&#47;h &#40;SD 25&#46;87&#41; and mean REM-AHI&#47;NREM-AHI 8&#46;86 &#40;SD 8&#46;63&#41;&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">The anxiety disorder rate was 33&#46;3&#37;&#59; 44&#46;4&#37; in females&#44; 16&#46;7&#37; in males&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The average deep sleep was 20&#46;7&#37; &#40;SD 10&#46;42&#41; and REM sleep 15&#46;45&#37; &#40;SD 9&#46;96&#41;&#44; with a sleep efficiency of 85&#46;3 &#40;SD 8&#46;70&#41;&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">No significant statistical correlation was found between the REM&#47;NREM AHI index and anxiety symptoms&#44; daytime sleepiness and sleep quality &#40;REM and deep sleep percentages&#41;&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">These patients differ from the general OSAS population&#58; on average&#44; they are not obese&#44; there are a greater number of females affected and they do not present a very significant diurnal hypersomnia&#46; Reduced deep sleep and increased REM sleep were also present versus general population data&#44; and sleep efficiency was just below the normal limit&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Anxiety disorders were more prevalent in this group than described for the general population &#40;3&#37;&#41; and OSAS patients&#46;</p>"
      ]
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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A s&#237;ndroma de apneia obstrutiva do sono &#40;SAOS&#41; associada ao sono REM tem uma incid&#234;ncia de 10&#8211;36&#37; na popula&#231;&#227;o com SAOS&#46; Estudos anteriores t&#234;m sugerido&#44; nestes doentes&#44; um aumento de preval&#234;ncia de dist&#250;rbios psiqui&#225;tricos&#44; bem como um efeito da idade e do g&#233;nero&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Propusemo-nos&#44; por isso&#44; estudar as caracter&#237;sticas cl&#237;nicas e polissonogr&#225;ficas de doentes com o referido diagn&#243;stico&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Os crit&#233;rios de inclus&#227;o foram a identifica&#231;&#227;o de SAOS em REM&#44; por polissonografia &#40;PSG&#41;&#44; definida como IAH em REM<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>5&#47;h&#44; IAH em sono n&#227;o REM &#40;NREM&#41;<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>15&#47;h&#44; IAH REM&#47;NREM<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2&#46; Foram ainda analisados alguns par&#226;metros do <span class="elsevierStyleItalic">sleep disorders questionnaire</span> &#40;SDQ&#41; vers&#227;o 1&#46;02&#44; nomeadamente os relacionados com ansiedade ou depress&#227;o&#46; Foram estudados 19 doentes com m&#233;dia de idades de 54&#44;0 anos &#40;SD 13&#44;97&#41; e m&#233;dia de IMC de 29&#44;01 &#40;SD Dev 4&#44;10&#41;&#46; A raz&#227;o entre g&#233;nero feminino&#47;masculino foi de 0&#44;58&#46; O valor m&#233;dio da escala de Epworth foi de 12&#44;74 &#40;SD 4&#44;86&#41;&#46; Em rela&#231;&#227;o &#224; gravidade da SAOS&#44; a m&#233;dia do IAH foi de 9&#44;16&#47;h &#40;SD 4&#44;09&#41; e a do IAH em REM de 37&#44;08&#47;h &#40;SD 25&#44;87&#41;&#46; Para a rela&#231;&#227;o IAH-REM&#47;IAH-NREM obtivemos a m&#233;dia de 8&#44;86 &#40;SD 8&#44;63&#41;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A preval&#234;ncia do dist&#250;rbio de ansiedade foi de 33&#44;3&#37; &#40;44&#44;4&#37; no sexo feminino e 16&#44;7&#37; no sexo masculino&#41;&#46; Na popula&#231;&#227;o estudada&#44; o tempo de sono profundo foi de 20&#44;7&#37; &#40;SD 10&#44;42&#41; e de sono REM de 15&#44;45&#37; &#40;SD 9&#44;96&#41;&#44; com uma efici&#234;ncia de sono de 85&#44;3&#37; &#40;SD 8&#44;70&#41;&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">N&#227;o se verificou qualquer correla&#231;&#227;o estatisticamente significativa entre o &#237;ndice de IAH REM&#47;NREM e a sintomatologia ansiosa&#44; a sonol&#234;ncia diurna e a qualidade do sono &#40;percentagem de sono profundo e de sono REM&#41;&#46; Conclu&#237;mos que a subpopula&#231;&#227;o estudada apresenta caracter&#237;sticas que divergem das descritas para a popula&#231;&#227;o com SAOS&#59; em m&#233;dia&#44; n&#227;o s&#227;o doentes obesos&#44; as mulheres s&#227;o mais afectadas&#44; a sintomatologia n&#227;o &#233; t&#227;o exuberante&#44; nomeadamente a hipersonia diurna&#46; Observa-se&#44; tamb&#233;m&#44; uma redu&#231;&#227;o do sono profundo e um aumento do sono REM neste grupo de doentes <span class="elsevierStyleItalic">versus</span> a popula&#231;&#227;o geral&#44; estando a efici&#234;ncia do sono no limite inferior da normalidade&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Ainda o dist&#250;rbio de ansiedade apresenta maior preval&#234;ncia em rela&#231;&#227;o &#224; descrita para a popula&#231;&#227;o geral &#40;3&#37;&#41; e em rela&#231;&#227;o &#224; descrita para a popula&#231;&#227;o com SAOS&#46;</p>"
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Pulmonology

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