Efeitos do treinamento resistido sobre o sono, o ciclo sono-vigília e o músculo esquelético de idosos sarcopênicos

• Ano de defesa: 2019
• Autor(a) principal: De Sá Souza, Helton [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Aging; Sarcopenia; Sleep; Biological rhythms; Physical exercise; Envelhecimento; Sono; Ritmos biológicos; Exercício físico
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.xhtml?popup=true&id_trabalho=7959964; https://repositorio.unifesp.br/handle/11600/58757

Background: Sarcopenia is a multifactorial disease that affects the elderly and is related to higher mortality, metabolic, endocrine, neurodegenerative and inflammatory changes. Although elderly people often have changes in sleep, which may also cause these same deleterious health effects; so far little is known about the relationship between sleep and sarcopenia. On the other hand, resistance training (TR) is an intervention that can improve both factors. Thus, the aim of the study was to investigate whether sarcopenic elderly (IS) have a different sleep profile than non-sarcopenic ones (INS) and to investigate the effects of a 12-week TR program on sleep and muscle function in older adults with sarcopenia. Methods: In experiment 1, sixty-three elderly individuals were evaluated and distributed into 2 groups: sarcopenic elderly (IS) and non-sarcopenic elderly (INS). In experiment 2, the sarcopenic elderly (28) were redistributed into another 2 groups. The CTL group participated in weekly lifestyle change classes and the Resistance Exercise Training (TR) group participated in a 12-week progressive load TR program. Sleep was assessed by all-night polysomnography, actimetry and self-administered questionnaires. Isokinetic and isometric peak torque, anabolic and catabolic hormone levels, and pro and antiinflammatory cytokine concentrations were also evaluated. For the intention-to-treat analysis, a generalized linear/nonlinear model for absolute variables or the Wilcoxon ranksum test (Mann-Whitney) was used for the delta variation. Data were expressed as mean ± standard deviation or median, (minimum – maximum) values and, significance was set at p< 0,05. Results: The IS group is older (77.13 ± 10.75 vs 73.77 ± 9.68 years; p< 0,05), have lower handgrip strength (21.69 ± 7.57 vs 27.62 ± 10.41 kg; p< 0,05), lower physical performance (8.81 ± 2.28 vs 11.16 ± 1.02 points; p< 0,05) and higher TNF-α concentrations (4343.99 ± 394.17 vs 4077.43 ± 400.0 pg/dL; p< 0,05) compared to INS and most individuals have intermediate chronotype (95% of the total sample). Total sleep time was shorter in the IS vs INS group (307.65 ± 91.22 vs 351.94 ± 112.60 minutes; p< 0,05) and the number of obstructive apnea in the IS group, was higher than INS group (41.78 ± 46.77 vs 18.91 ± 30.96, events) as well as the apnea and hypopnea index (19.97 ± 17.88 vs 10.41 ± 10.58 nº/h; p< 0,05). Actimetry sleep efficiency was lower in the IS vs INS group (89.96 ± 6.63 vs 94.19 ± 4.07%; p< 0,05) and the awake time after sleep onset was longer in the IS vs INS group (35.38 ± 26.94 vs 18.14 ± 12.13 minutes; p< 0,05) as well as excessive daytime sleepiness (8.51 ± 5.59 vs 5.52 ± 3.66 points; p< 0,05). The peak torque values were lower for all parameters evaluated in the IS group when compared to the INS group. The TR group reduced the time to sleep onset compared to the CTL group (16.09 ± 15.21 vs 29.98 ± 22.57 minutes; p< 0,05). Intensity-to-treat analysis showed that the TR group had more N3 sleep than CTL (median: 0.90 (-1.40 – 25.00) vs median, -3.35 (-15.20 – 19.10%; p< 0,05) as well as reduced the severity of insomnia (median, -5.00; (-9.00 – 6.00) vs median, -0.50 (-3.00 – 6.00 points; p< 0,05), improved self-reported sleep quality (median, -1.50 (-9.00 – 4.00) vs median, 0.50; (-3.00 – 6.00 points; p< 0,05) and sleep efficiency (median 9.50 (-15.00 – 34.00%) vs median, 0.00; (-28.00 - 18.00%; p< 0,05). For all muscle function parameters (isokinetic or isometric knee extension and flexion), the TR group had higher values compared to the CTL group after 12 weeks of intervention. IL-1ra delta variation levels were higher in the TR group compared to CTL (median: 0.04 (-0.02 – 0.36) vs median, -0.01; (-0.12 – 0.07 ng/dL; p< 0,05). Conclusions: Progressive load TR improves sleep parameters associated with muscle recovery in older adults with sarcopenia and produces positive changes in physical performance.