Search

Chronobiology and sleep medicine are pivotal disciplines for understanding human health. Additionally, the lack of training in medical schools exacerbates the underdiagnosis and undertreatment of sleep disorders. This study investigated the exposure of Brazilian medical students to chronobiology and sleep medicine during their undergraduate education and assessed their knowledge in these areas. The study was conducted between December 2021 and June 2022 through the administration of an online questionnaire (Google Forms) to medical students in the final two years of undergraduate studies. The questionnaire gathered student data (i.e., sex, age, and educational institution), research data (stage in the medical program with exposure to chronobiology or sleep medicine), and responses to a questionnaire on basic knowledge of sleep medicine and chronobiology (adapted from Assessing Sleep Knowledge in Medical Education - ASKME). A total of 240 students from medical schools in Brazil participated, 4.6% of whom reported no exposure to either subject, with exposure declining as students progressed through the curriculum. Only 3.7% reported specific disciplines covering these topics. Over half of the students encountered learning barriers, such as limited curriculum time. Despite these challenges, the accuracy rate in responses regarding chronobiology and sleep medicine was 79.75%, positively correlating with exposure level and knowledge retention. This study underscores the urgent need for enhanced education in sleep medicine and chronobiology within Brazilian medical schools. It offers insights into the current landscape of sleep medicine education in Brazil and lays groundwork for future efforts to integrate these essential subjects into medical school curricula.

Given psychologists' role and the use of psychotherapies for sleep issues, our study explored: (1) whether psychologists inquire about patients' sleep quality and their beliefs regarding the relationship between mental health and biological rhythms, and (2) global trends in psychological approaches through a bibliometric analysis. We analyzed responses from 1011 Brazilian clinical psychologists (October 2018-May 2019) and found that most routinely inquire about sleep quality and address sleep problems, while a small portion did not perceive a direct link between mental disorders and biological rhythms. Behavioral psychotherapy practitioners showed greater interest in sleep quality. The bibliometric analysis revealed that cognitive behavioral therapy had the strongest associations with sleep-related terms compared to other approaches. In conclusion, clinical psychology plays a key role in addressing human health. Given rising concerns about biological rhythms, further exploration across psychological approaches is essential, especially to enhance education in this field., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: The reproductive system is tightly regulated by environmental and physiological signals. Melatonin, known as the hormone of darkness, plays a crucial role in regulating both the circadian and reproductive systems in mammals. Hypothyroidism is a key endocrine disorder that harms the reproductive system. Despite many studies on melatonin's effects on the reproductive system, there is conflicting information regarding melatonin synthesis modulation in hypothyroidism. The objective of this study was to investigate the modulation of plasma melatonin levels and gene expression of Aanat and Asmt in the pineal gland and gonads of rats with hypothyroidism at different times of the day., Methods: Female and male Wistar rats were divided into control and hypothyroid groups. Hypothyroidism was induced using propylthiouracil (PTU) for 15 days, rats were euthanized six hours after lights on (ZT6), before lights off (ZT11.5), and six hours after lights off (ZT18). Free thyroxine (FT4) and melatonin were quantified in plasma, and gene expressions of melatonin synthesizing enzymes ( Aanat and Asmt ) were measured in pineal and sexual organs (testis and ovary). Also, morphological analysis was performed in sexual organs., Results: The results reveal some disparities between the sexes. Hypothyroidism reduced antral and primary follicles in the ovary, and reduced the weight of testis, epididymis, and prostate. In relation to gene expression, we observed a reduction in Aanat expression in the pineal gland during the light phase (ZT6), and in males, this reduction occurred during the dark phase (ZT18). Regarding Asmt expression, there was a decrease in females also during the dark phase (ZT18). In the gonads, there was an increase in expression in both sexes at ZT11.5. Additionally, it was interesting to observe the association between FT4 levels and Asmt expression in the gonads., Conclusions: This study showed that acute hypothyroidism can affect components of the melatonergic system in gonads, particularly gene expression of melatonin synthesis enzymes ( Aanat and Asmt ) contributing to changes in reproduction organs during disease progression. These findings enhance our understanding of melatonin synthesis in the reproductive system during hypothyroidism, showing distinct responses in male and female rats, and suggest that hypothyroidism affects the circadian rhythmicity of melatonin synthesis in a sex-dependent manner., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Paiva, Mondes, Brandão, Sant’Anna, Freire dos Santos, Fighera, Santos, Markus, Fernandes, Silva and Tamura.)

Desynchronization of circadian rhythms and sleep-wake patterns impacts biochemical, physiological, and behavioral functions, including mental processes. The complex relationship between circadian rhythms and mental health makes it challenging to determine causality between circadian desynchronization and mental disorders. Regarding the fact that psychologists act as the front line for initial mental health care, we aimed to assess the knowledge and use of sleep science and basic chronobiology by professional psychologists in Brazil. Data were collected via an online questionnaire completed by 1384 professional psychologists between October 2018 and May 2019. Our findings revealed that ±80% of psychologists reported that at least half of their patients presented some sleep-related complaints; however, only ±27% routinely inquired about sleep quality even in the absence of patient complaints. Additionally, only ±66% initiated treatments to understand these complaints, potentially influenced by the lack of prior academic exposure to biological rhythms as reported by ±76% of Brazilian psychologists interviewed. Importantly, ±15% did not believe in an association between mental health and biological rhythms, and even a significant ±67% were unfamiliar with the term chronobiology and ±63% were not able to describe any other biological rhythm except for the sleep-wake cycle. These results demonstrate that fundamental concepts in chronobiology and sleep science are unknown to a substantial proportion of Brazilian psychologists. In conclusion, we propose that this subject could be more effectively integrated into psychologists' academic training, potentially promoting benefits through the incorporation of a chronobiological approach in mental health practice.