Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes.
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFMA |
Texto Completo: | https://tedebc.ufma.br/jspui/handle/tede/tede/3292 |
Resumo: | Sleep is essential for the healthy development of adolescents. Changes in sleep patterns can have their effects accumulated throughout life, associated with harmful consequences to health. The main modifiable behavioral risk factors for noncommunicable diseases (NCDs) – harmful use of alcohol, smoking, unhealthy diet and physical inactivity, according to the World Health Organization (WHO) – would be associated with poor sleep quality and excessive daytime sleepiness in adolescents. Objective: to analyze the associations between modifiable behavioral risk factors for NCDs and sleep in adolescents. Methods: crosssectional study nested in a cohort study developed in São Luís, Maranhão. 2,515 adolescents participating in the second cohort follow-up were evaluated. In the proposed theoretical model, estimated by structural equation modeling, socioeconomic status and behavioral risk factors for NCDs, including use of legal (alcohol and cigarette) and illicit drugs, consumption of an unhealthy diet (caffeine and sugar-sweetened beverages), screen time and physical inactivity were tested as predictors of worsening sleep in adolescents, assessed by sleep quality (Pittsburgh Sleep Quality Index - PSQI) and excessive daytime sleepiness (Epworth Sleepiness Scale - ESS). Excess weight was considered a mediator in the analysis, with all variables having an effect on him to reach the outcome, which may influence the effects of these on adolescents' sleep. Results: physical inactivity (Standardized coefficient, SC=0.112; p=0.001), higher consumption of alcohol (SC=0.168; p=0.019) and sugar-sweetened beverages (SC=0.128; p<0.001), in addition to better socioeconomic status (SC=0.128; p<0.001), were associated with excessive daytime sleepiness in adolescents. Physical inactivity (SC=0.147; p<0.001) and higher consumption of sugar-sweetened beverages (SC=0.089; p=0.003) were also associated with poor sleep quality. However, in this sample of adolescents, excess weight was not a mediator, nor was it associated with sleep quality and excessive daytime sleepiness. Conclusion: the main modifiable behavioral risk factors for NCDs are associated, at the same time, with poor sleep quality and excessive daytime sleepiness in adolescents, being independent of overweight. |
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BATISTA, Rosângela Fernandes Lucenahttp://lattes.cnpq.br/3936205532436748BATISTA, Rosângela Fernandes Lucenahttp://lattes.cnpq.br/3936205532436748ECKELI, Alan Luizhttp://lattes.cnpq.br/8031377932900248NASCIMENTO, Joelma Ximenes Prado TeixeiraRIBEIRO, Cecília Claudia Costahttp://lattes.cnpq.br/1783658679814263SIMÕES, Vanda Maria Ferreirahttp://lattes.cnpq.br/4024829764707677http://lattes.cnpq.br/4328302258085404LIMA, Raina Jansen Cutrim Propp2021-05-02T18:35:49Z2021-02-24LIMA, Raina Jansen Cutrim Propp. Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes.. 2021. 126 f. Tese( Programa de Pós-Graduação em Saúde Coletiva/CCBS) - Universidade Federal do Maranhão, São Luís, 2021.https://tedebc.ufma.br/jspui/handle/tede/tede/3292Sleep is essential for the healthy development of adolescents. Changes in sleep patterns can have their effects accumulated throughout life, associated with harmful consequences to health. The main modifiable behavioral risk factors for noncommunicable diseases (NCDs) – harmful use of alcohol, smoking, unhealthy diet and physical inactivity, according to the World Health Organization (WHO) – would be associated with poor sleep quality and excessive daytime sleepiness in adolescents. Objective: to analyze the associations between modifiable behavioral risk factors for NCDs and sleep in adolescents. Methods: crosssectional study nested in a cohort study developed in São Luís, Maranhão. 2,515 adolescents participating in the second cohort follow-up were evaluated. In the proposed theoretical model, estimated by structural equation modeling, socioeconomic status and behavioral risk factors for NCDs, including use of legal (alcohol and cigarette) and illicit drugs, consumption of an unhealthy diet (caffeine and sugar-sweetened beverages), screen time and physical inactivity were tested as predictors of worsening sleep in adolescents, assessed by sleep quality (Pittsburgh Sleep Quality Index - PSQI) and excessive daytime sleepiness (Epworth Sleepiness Scale - ESS). Excess weight was considered a mediator in the analysis, with all variables having an effect on him to reach the outcome, which may influence the effects of these on adolescents' sleep. Results: physical inactivity (Standardized coefficient, SC=0.112; p=0.001), higher consumption of alcohol (SC=0.168; p=0.019) and sugar-sweetened beverages (SC=0.128; p<0.001), in addition to better socioeconomic status (SC=0.128; p<0.001), were associated with excessive daytime sleepiness in adolescents. Physical inactivity (SC=0.147; p<0.001) and higher consumption of sugar-sweetened beverages (SC=0.089; p=0.003) were also associated with poor sleep quality. However, in this sample of adolescents, excess weight was not a mediator, nor was it associated with sleep quality and excessive daytime sleepiness. Conclusion: the main modifiable behavioral risk factors for NCDs are associated, at the same time, with poor sleep quality and excessive daytime sleepiness in adolescents, being independent of overweight.O sono é essencial para o desenvolvimento saudável de adolescentes. Alterações no padrão de sono podem ter seus efeitos acumulados ao longo da vida, associando-se a consequências prejudiciais à saúde. Os principais fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis (DCNT) – uso nocivo de álcool, tabagismo, dieta pouco saudável e inatividade física, segundo a Organização Mundial de Saúde (OMS) – estariam associados a qualidade do sono ruim e sonolência diurna excessiva em adolescentes. Objetivo: analisar as associações entre fatores de risco comportamentais modificáveis para DCNT e sono em adolescentes. Métodos: estudo transversal aninhado a um estudo de coorte desenvolvido em São Luís, Maranhão. Foram avaliados 2.515 adolescentes participantes do segundo seguimento da coorte. No modelo teórico proposto, estimado por modelagem com equações estruturais, situação socioeconômica e fatores de risco comportamentais para DCNT, incluindo uso de drogas lícitas (álcool e cigarro) e ilícitas, consumo de dieta não saudável (cafeína e bebidas ricas em açúcar de adição), tempo de tela e inatividade física foram testados como preditores de piora do sono em adolescentes, avaliado pela qualidade do sono (Índice de Qualidade do Sono de Pittsburgh - IQSP) e sonolência diurna excessiva (Escala de Sonolência de Epworth - ESE). Excesso de peso foi considerado mediador na análise, com todas as variáveis exercendo efeito sobre ele para chegar ao desfecho, podendo influenciar os efeitos destas sobre o sono dos adolescentes. Resultados: inatividade física (Coeficiente padronizado, CP=0,112; p=0,001), maior consumo de álcool (CP=0,168; p=0,019) e de bebidas ricas em açúcar de adição (CP=0,128; p<0,001), além de melhor situação socioeconômica (CP=0,128; p<0,001), foram associados à sonolência diurna excessiva nos adolescentes. A inatividade física (CP=0,147; p<0,001) e o maior consumo de bebidas ricas em açúcar de adição (CP=0,089; p=0,003) se associaram também a qualidade do sono ruim. Entretanto, nessa amostra de adolescentes, o excesso de peso não foi mediador e nem associado à qualidade do sono e sonolência diurna excessiva. Conclusão: os principais fatores de risco comportamentais modificáveis para DCNT estão associados, ao mesmo tempo, à qualidade do sono ruim e sonolência diurna excessiva em adolescentes, sendo independentes do excesso de peso.Submitted by Maria Aparecida (cidazen@gmail.com) on 2021-05-02T18:35:49Z No. of bitstreams: 1 Raina Jansen C.P.L..pdf: 37915486 bytes, checksum: 4ca77a31e1d54ccaa0474db1e9f1f251 (MD5)Made available in DSpace on 2021-05-02T18:35:49Z (GMT). No. of bitstreams: 1 Raina Jansen C.P.L..pdf: 37915486 bytes, checksum: 4ca77a31e1d54ccaa0474db1e9f1f251 (MD5) Previous issue date: 2021-02-24application/pdfporUniversidade Federal do MaranhãoPROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA/CCBSUFMABrasilDEPARTAMENTO DE SAÚDE PÚBLICA/CCBSSono;Saúde do Adolescente;Sonolência;Qualidade do SonoSleep;Adolescent Health;Sleepiness;Sleep QualityMedicina PreventivaFatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes.Modifiable behavioral risk factors for noncommunicable diseases and sleep pattern in adolescents.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFMAinstname:Universidade Federal do Maranhão (UFMA)instacron:UFMAORIGINALRaina Jansen C.P.L..pdfRaina Jansen C.P.L..pdfapplication/pdf37915486http://tedebc.ufma.br:8080/bitstream/tede/3292/2/Raina+Jansen+C.P.L..pdf4ca77a31e1d54ccaa0474db1e9f1f251MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82255http://tedebc.ufma.br:8080/bitstream/tede/3292/1/license.txt97eeade1fce43278e63fe063657f8083MD51tede/32922021-05-02 15:35:49.562oai:tede2: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Biblioteca Digital de Teses e Dissertaçõeshttps://tedebc.ufma.br/jspui/PUBhttp://tedebc.ufma.br:8080/oai/requestrepositorio@ufma.br||repositorio@ufma.bropendoar:21312021-05-02T18:35:49Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA)false |
dc.title.por.fl_str_mv |
Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes. |
dc.title.alternative.eng.fl_str_mv |
Modifiable behavioral risk factors for noncommunicable diseases and sleep pattern in adolescents. |
title |
Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes. |
spellingShingle |
Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes. LIMA, Raina Jansen Cutrim Propp Sono; Saúde do Adolescente; Sonolência; Qualidade do Sono Sleep; Adolescent Health; Sleepiness; Sleep Quality Medicina Preventiva |
title_short |
Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes. |
title_full |
Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes. |
title_fullStr |
Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes. |
title_full_unstemmed |
Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes. |
title_sort |
Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes. |
author |
LIMA, Raina Jansen Cutrim Propp |
author_facet |
LIMA, Raina Jansen Cutrim Propp |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
BATISTA, Rosângela Fernandes Lucena |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/3936205532436748 |
dc.contributor.referee1.fl_str_mv |
BATISTA, Rosângela Fernandes Lucena |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/3936205532436748 |
dc.contributor.referee2.fl_str_mv |
ECKELI, Alan Luiz |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/8031377932900248 |
dc.contributor.referee3.fl_str_mv |
NASCIMENTO, Joelma Ximenes Prado Teixeira |
dc.contributor.referee4.fl_str_mv |
RIBEIRO, Cecília Claudia Costa |
dc.contributor.referee4Lattes.fl_str_mv |
http://lattes.cnpq.br/1783658679814263 |
dc.contributor.referee5.fl_str_mv |
SIMÕES, Vanda Maria Ferreira |
dc.contributor.referee5Lattes.fl_str_mv |
http://lattes.cnpq.br/4024829764707677 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/4328302258085404 |
dc.contributor.author.fl_str_mv |
LIMA, Raina Jansen Cutrim Propp |
contributor_str_mv |
BATISTA, Rosângela Fernandes Lucena BATISTA, Rosângela Fernandes Lucena ECKELI, Alan Luiz NASCIMENTO, Joelma Ximenes Prado Teixeira RIBEIRO, Cecília Claudia Costa SIMÕES, Vanda Maria Ferreira |
dc.subject.por.fl_str_mv |
Sono; Saúde do Adolescente; Sonolência; Qualidade do Sono |
topic |
Sono; Saúde do Adolescente; Sonolência; Qualidade do Sono Sleep; Adolescent Health; Sleepiness; Sleep Quality Medicina Preventiva |
dc.subject.eng.fl_str_mv |
Sleep; Adolescent Health; Sleepiness; Sleep Quality |
dc.subject.cnpq.fl_str_mv |
Medicina Preventiva |
description |
Sleep is essential for the healthy development of adolescents. Changes in sleep patterns can have their effects accumulated throughout life, associated with harmful consequences to health. The main modifiable behavioral risk factors for noncommunicable diseases (NCDs) – harmful use of alcohol, smoking, unhealthy diet and physical inactivity, according to the World Health Organization (WHO) – would be associated with poor sleep quality and excessive daytime sleepiness in adolescents. Objective: to analyze the associations between modifiable behavioral risk factors for NCDs and sleep in adolescents. Methods: crosssectional study nested in a cohort study developed in São Luís, Maranhão. 2,515 adolescents participating in the second cohort follow-up were evaluated. In the proposed theoretical model, estimated by structural equation modeling, socioeconomic status and behavioral risk factors for NCDs, including use of legal (alcohol and cigarette) and illicit drugs, consumption of an unhealthy diet (caffeine and sugar-sweetened beverages), screen time and physical inactivity were tested as predictors of worsening sleep in adolescents, assessed by sleep quality (Pittsburgh Sleep Quality Index - PSQI) and excessive daytime sleepiness (Epworth Sleepiness Scale - ESS). Excess weight was considered a mediator in the analysis, with all variables having an effect on him to reach the outcome, which may influence the effects of these on adolescents' sleep. Results: physical inactivity (Standardized coefficient, SC=0.112; p=0.001), higher consumption of alcohol (SC=0.168; p=0.019) and sugar-sweetened beverages (SC=0.128; p<0.001), in addition to better socioeconomic status (SC=0.128; p<0.001), were associated with excessive daytime sleepiness in adolescents. Physical inactivity (SC=0.147; p<0.001) and higher consumption of sugar-sweetened beverages (SC=0.089; p=0.003) were also associated with poor sleep quality. However, in this sample of adolescents, excess weight was not a mediator, nor was it associated with sleep quality and excessive daytime sleepiness. Conclusion: the main modifiable behavioral risk factors for NCDs are associated, at the same time, with poor sleep quality and excessive daytime sleepiness in adolescents, being independent of overweight. |
publishDate |
2021 |
dc.date.accessioned.fl_str_mv |
2021-05-02T18:35:49Z |
dc.date.issued.fl_str_mv |
2021-02-24 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
LIMA, Raina Jansen Cutrim Propp. Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes.. 2021. 126 f. Tese( Programa de Pós-Graduação em Saúde Coletiva/CCBS) - Universidade Federal do Maranhão, São Luís, 2021. |
dc.identifier.uri.fl_str_mv |
https://tedebc.ufma.br/jspui/handle/tede/tede/3292 |
identifier_str_mv |
LIMA, Raina Jansen Cutrim Propp. Fatores de risco comportamentais modificáveis para doenças crônicas não transmissíveis e padrão de sono em adolescentes.. 2021. 126 f. Tese( Programa de Pós-Graduação em Saúde Coletiva/CCBS) - Universidade Federal do Maranhão, São Luís, 2021. |
url |
https://tedebc.ufma.br/jspui/handle/tede/tede/3292 |
dc.language.iso.fl_str_mv |
por |
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por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal do Maranhão |
dc.publisher.program.fl_str_mv |
PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA/CCBS |
dc.publisher.initials.fl_str_mv |
UFMA |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
DEPARTAMENTO DE SAÚDE PÚBLICA/CCBS |
publisher.none.fl_str_mv |
Universidade Federal do Maranhão |
dc.source.none.fl_str_mv |
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Biblioteca Digital de Teses e Dissertações da UFMA |
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