PHYSICAL ACTIVITY, SMOKING CESSATION AND SLEEP QUALITY OF SMOKERS

• Grant number: 23/15367-9
• Support Opportunities: Scholarships in Brazil - Doctorate
• Start date: January 01, 2025
• End date: December 31, 2027
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Ercy Mara Cipulo Ramos
• Grantee: Karina Arielle da Silva Souza
• Host Institution: Faculdade de Ciências e Tecnologia (FCT). Universidade Estadual Paulista (UNESP). Campus de Presidente Prudente. Presidente Prudente , SP, Brazil

Abstract

Introduction: The sleep quality of smokers may change during the smoking cessation process and be influenced by the level of physical activity (PA). In this context, it is necessary to investigate sleep quality, level of physical activity and their relationships in cessation programs. Objective: study I: to verify the effectiveness of interventions with physical activity on sleep of smokers; study II: to analyze aspects of sleep and level of physical activity of smokers enrolled in a smoking cessation program; study III: to evaluate the validity and reliability of the Brazilian version of the Pittsburgh Sleep Quality Index Brazilian Portuguese version (PSQI-BR) for the smoking population. Materials and methods: study I: this is a systematic review, with PICO search: P: smoking, smokers, cigarette smoking; I: exercise, pulmonary rehabilitation; C: NE (not specified); O: activities of daily living, sleep, tobacco use disorder. The data search will be performed in the Pubmed, Web of Science, Science Direct, Lilacs, Scielo, PEDro, Cochrane Library, Embase and CINAHL databases, and two researchers will extract the authors' names, year of publication, number of volunteers, among other information. Study II: smokers who are members of the Smoking Attention Group (GAT), which promotes smoking cessation through Cognitive Behavioral Therapy (CBT) and medication, will be evaluated. Assessments will be performed before cessation, one day, 15 days and one month after cessation, as well as follow-up at three, six, nine and 12 months. Composite assessments of initial evaluation (name, age, sex, weight, height, health history), level of nicotine dependence (Fagestrom Index), sleep quality and criteria (Pittsburgh Sleep Quality Index, Mini-Sleep Questionnaire, Epworth Sleepiness Scale, Insomnia Severity Index), quality of life (Medical Outcomes Study 36-Item Short-Form Health Survey-SF-36), anxiety and depression (State-Trait Anxiety Inventory and Beck Depression Inventory), monoximetry, spirometry, pedometry, accelerometry and actigraphy tests/examinations. Study III: this work will be carried out in conjunction with the description of work two, applying to the smokers included in GAT the initial evaluation, MoCA (Montreal Cognitive Assessment), monoximetry, Fagerström questionnaire, Pittsburgh Sleep Quality Index and Mini Sleep Questionnaire (MSQ). Statistical analysis: Study I: The PEDro (Physiotherapy Evidence Database) and GRADE (Grading of Recommendations Assessment, Development and Evaluation) scales will be used to assess the risk of bias and analyze reliability. If possible, the meta-analysis will be performed using the Review Manager® software version 5.4, in accordance with the recommendations of the Cochrane Handbook. The results will be expressed in forest plots. Study II: The SPSS statistical program version 29.0 will be used. Data normality will be verified by the Shapiro-Wilk test. In the case of normal distribution, the data will be expressed as mean and standard deviation, and in the case of non-normal distribution, the data will be expressed as median and interquartile range. For measurement variables, estimated sphericity will be verified using the Mauchly sphericity test and the Greenhouse-Geisser correction will be used when necessary. Changes within and between age and sex groups will be interpreted using the mean difference and 95% confidence interval. Sleep quality analysis at 3, 6 and 9 months of follow-up will be performed using the Chi-square test. The effect size (eta-squared ¿2) will be calculated over time. Statistical significance was established at p<0.05. Study III: analyses of metric properties, ceiling and floor effects, reliability and internal consistency, test-retest reliability, minimum detectable change, verification of discriminative validity, in addition to validity assessments, such as convergent, criterion and construct validity, will be performed.