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Objectives: To investigate the correlation between sleep disorders and the concentrations of three metals analyzed from hair samples of PD patients.The hypothesis of an involvement of an imbalance of metals in the development of Parkinson's Disease (PD) has been strengthened by several clinical chemistry studies. Interestingly, while sparse, some studies have correlated the imbalance of metals in PD patients with comorbidities present in this disease. Although not all PD sufferers present sleep disturbances, significant disorders of sleep are common in this population. Methods: Sleep evaluation was divided into three parameters: sleep quality, excessive daytime sleepiness and clinically probable REM Sleep Behavior Disorder. Flame atomic absorption spectrometry (F AAS) was used to assess the concentrations of calcium, iron and zinc in hair samples collected from a population of PD patients registered in a Brazilian city and from controls (a total of 53 subjects). All subjects lived within a restricted geographical region and were exposed to similar environmental conditions. Results: PD patients with poor sleep quality and excessive daytime sleepiness exhibited significant differences in concentrations of calcium, but not iron or zinc when compared to levels found in controls and PD patients who do not report these sleeping problems. Discussion: Our data suggest that different subgroups of PD patients exist, and clinical chemistry could be useful as a biomarker for these subgroups, which needs to be confirmed in a larger patient population. Further, our data raise the question regarding whether normalization of calcium levels could improve the sleep quality and somnolence in PD patients.

Background: Patients in a critical care unit sleep quite poorly even when they appear to be sleeping. Sleep is light and fragmented. Acute lack of sleep causes patients suffering in the form of fatigue, irritability, disorientation and hallucinations. It may also affect their recovery and immune defence. To promote sleep, nurses must be able to evaluate patients' sleep reliably., Aim and Objectives: Our aim was to form a comprehensive overview of the sleep evaluation methods in critical care. Our objectives were to determine the content and the quality of the methods as reported by the researchers. This overview hopefully improves the use of the sleep evaluation methods as part of sleep promoting nursing interventions and practices., Method: The literature search was performed from the Ovid MEDLINE, CINAHL, an 'All EBM Reviews', and PsycINFO databases. The search terms sleep, evaluating sleep and critical care were used. An integrative review method was used to analyse the data., Results: According to the 52 articles of this review, there is a wide variety of methods to evaluate patients' sleep in critical care by observation, by asking for patient's own perception and by objective measures. Most instruments evaluate only total sleep time or the quality of sleep in general. The validity and reliability of the instruments has been insufficiently reported. Some questionnaires for patients' perception have been tested and used in several studies., Conclusion: Sleep evaluation instruments do not cover all dimensions of sleep since they mostly measure total sleep time or estimate the overall quality of sleep. The quality of the sleep evaluation instruments varies from scientifically tested tools to untested instruments. This review will allow nurses to recognise the strengths and limitations of sleep evaluation instruments when selecting one to be used in critical care. Valid information about patients' sleep enables nurses to facilitate it., (© 2013 Nordic College of Caring Science.)