Il ruolo dell'arousal nell'insonnia: una rassegna della letteratura.

Tutte le attuali teorie sull’eziologia dell’insonnia riconoscono all’arousal un ruolo chiave sia come fattore predisponente, sia come fattore di mantenimento del disturbo. Nel sonno si fa riferimento a due forme di arousal: l’arousal fisiologico (autonomo e corticale) e l’arousal mentale (cognitivo ed emozionale). Gli studi classici (ad esempio, Monroe, 1967) hanno indagato in particolar modo il ruolo dell’arousal fisiologico, mentre le teorie più recenti si sono focalizzate sul ruolo dell’arousal cognitivo ed emozionale (ad esempio, Espie, 2002; Morin, 1993), considerandoli come i principali fattori di mantenimento. Anche a livello clinico, infatti, la lamentela più frequentemente riportata dai pazienti è di fare esperienza di una elevata attività cognitiva nella fase di addormentamento, spesso associata a vissuti emotivi connotati negativamente. In questa rassegna è stato esaminato il ruolo attribuito all’arousal (autonomo, corticale, cognitivo ed emozionale) dalle teorie attuali sull’eziologia dell’insonnia e le evidenze empiriche di cui disponiamo a sostegno di tale ruolo

Quality of life in headache suffering children and adolescents: self-report and parent-report.

Background The evaluation of Quality of Life (QOL) in children is different from adults, because it should take into account age-related characteristics. QOL instruments often do not consider the differences between parents and children in reporting the impact of headache on QOL. Patients and methods 272 (158 F, 114 M) headache sufferers (9–15 years old; M=11.59; SD=± 2.03) and their parents (192 mothers; 34 fathers; 59 both parents; 3 care takers) had been enrolled. Both child- ren and their parents filled in the symptomatologic questionnaire and the Impact scale of the Headache Specific Quality of Life of Children (HSQOL-C), in its validated form. Results Factorial Anova showed that the agreement parents-children is significantly higher for 12–15 years old than for 9–11 years old [F(1.255)=10.80; p=0.001]. We found a higher level of congruence between child and parent reports for symptomatologic questionnaire (objective aspects) than Impact scale (subjective aspects). In the latter, headache sufferers obtained higher scores compared to their parents. Conclusions Agreement parents-children increases proportionately with children’s age. It is likely due to the child’s cognitive improve- ment, mental and language skills. QOL instruments should taken into account age-related characteristics of child development

Sonnolenza e incidentalità stradale notturna:uno studio sulle percezioni di rischio in giovani guidatori/ Sleepiness and nocturnal driving safety: a study on risk perception in young drivers

The present study is aimed to evaluate: 1) the factors that affect the risk perception of young people in nocturnal driving; 2) how the way of presenting information about the sleepiness-accident relationship influences attributions, goals and decisions about driver sleepiness. 572 young drivers answered to a questionnaires, composed according to the paradigms of study framing, on three decisional problems about sleepiness and nocturnal vehicle accidents. 285 answered to questionnaires with problems presented in a positive frame of and 287 in a negative frame. All subjects were requested to answer to questions on drive risk perception and nocturnal sleepiness, on nocturnal driving experience and on the adopted strategies to counterattack sleepiness. Results show that experiences of sleep attacks during driving and nocturnal driving frequency are factors that affect both the risk perception and the commitment in adopting preventive strategies. Furthermore, the manipulation on two out of the three problems (attributions and risk decisions frames) clearly affected the choices of responders. Present results can give useful suggestions about how to present information in educational programs aimed to the prevention of vehicle accidents among young peopl

Adolescents self-reported sleep quality and emotional regulation: a discordant twin study

Aim. This study explores the association between sleep quality and emotional regulation, and investigates the genetic and environmental bases of this association. Methods. Three-hundred-eighty-two adolescent twins, from the Italian Twin Registry, and their parents filled the Youth Self-Report and Child Behavior Checklist questionnaires, from which the construct of Effortful Control (EC) was derived as a measure of emotional regulation. Twins were identified as “good” or “non-good” sleepers based on answers to the Sleep Disorders Questionnaire. EC levels were compared between samesex sleep discordant twins.Results. A significant association was detected between EC scores and sleep quality. When controlling for shared (fetal or early life) environmental factors and genetic background in the discordant twin analysis, this association weakened in dizygotic twins and disappeared in monozygotic twins.Conclusion. Results support the association between sleep quality and EC in adolescence; furthermore, they suggest that sleep quality and emotional regulation may depend on common genetic or environmental factors.

Transitional Care for Patients with Congenital Colorectal Diseases:An EUPSA Network Office, ERNICA, and eUROGEN Joint Venture

Background: Transition of care (TOC; from childhood into adulthood) of patients with anorectal malformations (ARM) and Hirschsprung disease (HD) ensures continuation of care for these patients. The aim of this international study was to assess the current status of TOC and adult care (AC) programs for patients with ARM and HD. Methods: A survey was developed by members of EUPSA, ERN eUROGEN, and ERNICA, including patient representatives (ePAGs), comprising of four domains: general information, general questions about transition to adulthood, and disease-specific questions regarding TOC and AC programs. Recruitment of centres was done by the ERNs and EUPSA, using mailing lists and social media accounts. Only descriptive statistics were reported. Results:In total, 82 centres from 21 different countries entered the survey. Approximately half of them were ERN network members. Seventy-two centres (87.8%) had a self-reported area of expertise for both ARM and HD. Specific TOC programs were installed in 44% of the centres and AC programs in 31% of these centres. When comparing centres, wide variation was observed in the content of the programs. Conclusion: Despite the awareness of the importance of TOC and AC programs, these programs were installed in less than 50% of the participating centres. Various transition and AC programs were applied, with considerable heterogeneity in implementation, content and responsible caregivers involved. Sharing best practice examples and taking into account local and National Health Care Programs might lead to a better continuation of care in the future. Level of Evidence: III.</p