Section IV
Design Development
21 | Human Body–Sleep System Interaction in Young Adult Residence |
| A Methodology and Tool for Measure and Evaluation of Interaction Patterns Using a Software iSEE with Observation of Postural Behaviors during Sleep |
| Gustavo Desouzart, Ernesto Filgueiras, Rui Matos, and Filipe Melo |
CONTENTS
21.1Introduction
21.2Methodology
21.2.1Study Site and Residence Bedrooms' Properties
21.2.2Subjects and Night Activities
21.2.3Recording Procedure and Features
21.2.4Data Collection and Analysis Method
21.2.4.1Level 1: Observation Categories Refer to Activities
21.2.4.2Observation Categories Related to Postures
21.3Results
21.4Conclusion
Acknowledgments
References
21.1INTRODUCTION
Sleep disruption is a growing problem that may have serious health effects (Wright et al., 2007). In many Western societies, decreased time available for sleep and/or increased sleep disturbance is often associated with a demanding life style and is a growing problem (Rajaratman and Arendt, 2001; National Sleep Foundation, 2005; Soares, 2005; Wright et al., 2007).
Sleep and circadian rhythms, one of several biological rhythms found in humans, are produced jointly by the action of various structures of the nervous system and are influenced by various environmental factors. The importance of sleep as a restorative and homeostatic agent has evident influence on the waking state of the individual. Sleep disorders can bring various effects to humans, causing loss of quality of life, autonomic dysfunction, and decreased professional or academic performance (Danda et al., 2005).
Many young adults have occasional sleep disorders and pain may be one of the factors that cause them. However, in some cases, these problems can become chronic, causing serious consequences in their behavior and their quality of life (Pter, 1990).
Humans spend approximately one-third of their lives in bed, while a synergy of psychological, physiological, and physical conditions affects the quality of sleep. An insufficiently adapted sleep system (i.e., mattress + support structure + head cushion) or an incorrect sleeping posture may cause back pain (BP) or sleep disorders in general (Haex, 2005). The comfort and support of the sleep surface are related to problems of sleep quality and efficiency. Certain sleep surfaces have resulted in complaints of lower back discomfort, pain, or stiffness (Addison et al., 1986; Jacobson et al., 2009). The risk of BP has a multi-factorial nature and is one of the most compelling problems in the industrialized world, being that poor posture is one of these factors (Vieira and Kumar, 2004; Haex, 2005; Geldhof et al., 2007; Silva et al., 2009). Posture, according to Silva et al. (2009), is considered to be the biomechanical alignment and the spatial arrangement of body parts in relation to their segments.
BP is a leading cause of disability. It occurs in similar proportions in all cultures, interferes with quality of life and daily performance, and is the most common reason for medical consultations. Few cases of BP are due to specific causes; most cases are nonspecific. Acute BP is the most common presentation and is usually self-limiting, lasting less than 3 months regardless of treatment. Chronic BP is a more difficult problem, which often has a strong psychological overlay (Ehrlich, 2003).
BP is one of the most common forms of chronic pain and is a significant cause of disability and cost in society (Andersson et al., 1993; Mantyselka et al., 2001; Walker et al., 2004). Chronic BP substantially influences the capacity to work and has been associated with the inability to obtain or maintain employment and productivity lost (Stang et al., 1998; Stewart et al., 2003). About 80% of the population have experienced BP at some time in their lives (Schmidt and Kohlmann, 2005).
For example, musculoskeletal BP is the most common reason for medical evacuation in the military with return to occupation being uncertain. BP is also a common reason for long-term disability (Lincoln et al., 2002; Cohen et al., 2009, 2010).
Despite continuous research and development of new interventions, BP remains a clinical challenge because it is a condition with high incidence and prevalence (Koes et al., 2010; Mayer et al., 2010) and a condition that has a considerable cost in health care, with negative socioeconomic impact in industrialized societies (Apeldoorn et al., 2010; Van Middelkoop et al., 2011).
Pain results from either exacerbated noxious impulses, or lack of them. In addition, pain cannot be conditioned by peripheral nociceptive stimuli, and psychogenic pain a good example of these exacerbated impulses (World Health Organization, 2001).
Maintaining an ideal posture and exercise are essential for a healthy body, free of pain, especially the spine.
Gross et al. (2000), often claim that the occurrence of BP precedes or is concomitant with changes in body posture. This association can be explained by the fact that many body postures adopted in day to day are inadequate to the anatomical structures, increasing the total stress on the body elements, especially on the spine, which may cause discomfort, pain, or functional disability.
Current research and international clinical guidelines recommend people with BP to take a more active role in their recovery, to prevent pain chronicity (Moffett, 2002; van Tulder et al., 2005; Liddle et al., 2007). A postural intervention program is often used for people with complaints of BP, predominantly based on postural recommendation approaches, which enables a more active participation of this population in their rehabilitation process (Moffett, 2002; Casserley-Feeney et al., 2008; Liddle et al., 2009; Hurley et al., 2010).
However, little or nothing is referenced in the literature on the effectiveness of the physical therapy approach using postural recommendations for aspects such as pain in the region of the spine or related disorders in the sleep period (Hurley et al., 2010). According to the American College of Physicians and the American Pain Society, one of the recommendations made to patients with complaints of BP is postural intervention, such as cognitive behavioral therapy (recommendations of postural behavior) (Chou et al., 2008).
Sleep and rest are as essential for the musculoskeletal system as they are for the central nervous system. It would be illogical for the musculoskeletal system to remain fully operational during the body's rest periods (Gracovetsky, 1987). The behavioral and postural habits and sleep rhythm can be changed depending on the type of daily activity (work or academic activities) or other types of events, but this has rarely been reported in the literature, which would allow an analysis and evaluation of this behavior through sleep disorders. The decreased time available for sleep and/ or increased sleep disturbance is often associated with a demanding life style and other challenges imposed by modern society. Perhaps, this is related to the fact that the evaluation of this behavior is complex and the observation of these postural behaviors in the environmental context is needed.
Curcio et al. (2006) reported that many young adults of different educational levels and different type of work suffer from sleep disorders. It was found that higher cognitive functions such as attention, memory, or performance of complex tasks are compromised when there are changes in sleep patterns. On the same theme, Ban and Lee (2001) reported that the deficiency or sleep disorders are known to have serious consequences in various ways, particularly causing problems such as decreased concentration, memory, decreased ability to perform daily tasks, decreased willingness, and decreased interpersonal relationships.
Young adults are recognized as having insufficient sleep on weekdays and sleeping long hours during the weekends. For example, two-thirds of young adult university students reported occasional sleep disturbances, and about a third of these reported suffering regularly from severe sleep difficulties. These disorders are marked by gradual late waking up or more absences from classes, leading to poor academic performance and excessive sleepiness durin...