title: Increasing trends of sleep complaints in the city of Sao Paulo, Brazil.
abstract: OBJECTIVE
  The aim of this study was to compare the prevalence of sleep habits and complaints and to estimate the secular trends through three population-based surveys carried out in 1987, 1995, and 2007 in the general adult population of the city of Sao Paulo, Brazil.
  
  
  METHODS
  Surveys were performed using the same three-stage cluster-sampling technique in three consecutive decades to obtain representative samples of the inhabitants of Sao Paulo with respect to gender, age (20-80 years), and socio-economic status. Sample sizes were 1000 volunteers in 1987 and 1995 surveys and 1101 in a 2007 survey. In each survey, the UNIFESP Sleep Questionnaire was administered face-to-face in each household selected.
  
  
  RESULTS
  For 1987, 1995, and 2007, respectively, difficulty initiating sleep (weighted frequency %; 95% CI) [(13.9; 11.9-16.2), (19.15; 16.8-21.6), and (25.0; 22.5-27.8)], difficulty maintaining sleep [(15.8; 13.7-18.2), (27.6; 24.9-30.4), and (36.5; 33.5-39.5)], and early morning awakening [(10.6; 8.8-12.7), (14.2; 12.2-16.5), and (26.7; 24-29.6)] increased in the general population over time, mostly in women. Habitual snoring was the most commonly reported complaint across decades and was more prevalent in men. There was no statistically significant difference in snoring complaints between 1987 (21.5; 19.1-24.2) and 1995 (19.0; 16.7-21.6), but a significant increase was noted in 2007 (41.7; 38.6-44.8). Nightmares, bruxism, leg cramps, and somnambulism complaints were significantly higher in 2007 compared to 1987 and 1995. All were more frequent in women.
  
  
  CONCLUSIONS
  This is the first study comparing sleep complaints in probabilistic population-based samples from the same metropolitan area, using the same methodology across three consecutive decades. Clear trends of increasing sleep complaints were observed, which increased faster between 1995 and 2007 than from 1987 to 1995. These secular trends should be considered a relevant public health issue and support the need for development of health care and educational strategies to supply the population's increased need for information on sleep disorders and their consequences.
authors.affiliation: Division of Medicine and Biology of Sleep, Department of Psychobiology, Universidade Federal de Sao Paulo - UNIFESP, Sao Paulo, SP, Brazil.
authors.forename: Rogerio
authors.initials: R
authors.lastname: Santos-Silva
authors.forename: Lia Rita Azeredo
authors.initials: LR
authors.lastname: Bittencourt
authors.forename: Maria Laura Nogueira
authors.initials: ML
authors.lastname: Pires
authors.forename: Marco Tulio
authors.initials: MT
authors.lastname: de Mello
authors.forename: Jose Augusto
authors.initials: JA
authors.lastname: Taddei
authors.forename: Ana Amelia
authors.initials: AA
authors.lastname: Benedito-Silva
authors.forename: Celine
authors.initials: C
authors.lastname: Pompeia
authors.forename: Sergio
authors.initials: S
authors.lastname: Tufik
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D002012:Bruxism / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003906:Developing Countries; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology; D004325:Dreams; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology; D020188:Sleep Paralysis / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D020922:Sleep-Wake Transition Disorders / Q000453:epidemiology; D012913:Snoring / Q000453:epidemiology; D012959:Socioeconomic Factors; D013009:Somnambulism / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult