Division of Medicine and Biology of Sleep, Department of Psychobiology, Universidade Federal de Sao Paulo - UNIFESP, Sao Paulo, SP, Brazil.
Sleep Med. 2010 Jun;11(6):520-4. doi: 10.1016/j.sleep.2009.12.011. Epub 2010 May 21.
The aim of this study was to compare the prevalence of sleep habits and complaints and to estimate the secular trends through three population-based surveys carried out in 1987, 1995, and 2007 in the general adult population of the city of Sao Paulo, Brazil.
Surveys were performed using the same three-stage cluster-sampling technique in three consecutive decades to obtain representative samples of the inhabitants of Sao Paulo with respect to gender, age (20-80 years), and socio-economic status. Sample sizes were 1000 volunteers in 1987 and 1995 surveys and 1101 in a 2007 survey. In each survey, the UNIFESP Sleep Questionnaire was administered face-to-face in each household selected.
For 1987, 1995, and 2007, respectively, difficulty initiating sleep (weighted frequency %; 95% CI) [(13.9; 11.9-16.2), (19.15; 16.8-21.6), and (25.0; 22.5-27.8)], difficulty maintaining sleep [(15.8; 13.7-18.2), (27.6; 24.9-30.4), and (36.5; 33.5-39.5)], and early morning awakening [(10.6; 8.8-12.7), (14.2; 12.2-16.5), and (26.7; 24-29.6)] increased in the general population over time, mostly in women. Habitual snoring was the most commonly reported complaint across decades and was more prevalent in men. There was no statistically significant difference in snoring complaints between 1987 (21.5; 19.1-24.2) and 1995 (19.0; 16.7-21.6), but a significant increase was noted in 2007 (41.7; 38.6-44.8). Nightmares, bruxism, leg cramps, and somnambulism complaints were significantly higher in 2007 compared to 1987 and 1995. All were more frequent in women.
This is the first study comparing sleep complaints in probabilistic population-based samples from the same metropolitan area, using the same methodology across three consecutive decades. Clear trends of increasing sleep complaints were observed, which increased faster between 1995 and 2007 than from 1987 to 1995. These secular trends should be considered a relevant public health issue and support the need for development of health care and educational strategies to supply the population's increased need for information on sleep disorders and their consequences.
本研究旨在比较睡眠习惯和睡眠障碍的流行情况，并通过在巴西圣保罗市进行的三次基于人群的调查来评估其随时间的变化趋势。这三次调查分别于 1987 年、1995 年和 2007 年进行。
使用相同的三阶段聚类抽样技术，在三个连续的十年中，对圣保罗市的居民进行了性别、年龄（20-80 岁）和社会经济地位的代表性抽样。1987 年和 1995 年的调查样本量为 1000 名志愿者，2007 年的调查样本量为 1101 名。在每次调查中，在每个选定的家庭中，面对面地使用 UNIFESP 睡眠问卷进行调查。
1987 年、1995 年和 2007 年，入睡困难（加权频率%；95%CI）[（13.9；11.9-16.2），（19.15；16.8-21.6）和（25.0；22.5-27.8）]、睡眠维持困难（加权频率%；95%CI）[（15.8；13.7-18.2），（27.6；24.9-30.4）和（36.5；33.5-39.5）]和早醒（加权频率%；95%CI）[（10.6；8.8-12.7），（14.2；12.2-16.5）和（26.7；24-29.6）]在普通人群中随时间推移而增加，主要在女性中增加。习惯性打鼾是几十年来最常见的抱怨，且在男性中更为普遍。1987 年（21.5；19.1-24.2）和 1995 年（19.0；16.7-21.6）之间的打鼾抱怨没有统计学上的显著差异，但在 2007 年（41.7；38.6-44.8）显著增加。与 1987 年和 1995 年相比，2007 年的梦魇、磨牙、腿部抽筋和梦游的抱怨明显更高。所有这些在女性中更为常见。
这是第一项在连续三个十年中，使用相同的方法，比较来自同一大都市区的概率人群样本中的睡眠抱怨的研究。观察到睡眠抱怨的明显增加趋势，且在 1995 年至 2007 年间的增长速度快于 1987 年至 1995 年。这些随时间的变化趋势应被视为一个相关的公共卫生问题，并支持制定医疗保健和教育策略的必要性，以满足人口对睡眠障碍及其后果相关信息的增加需求。
