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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. [ABSTRACT FROM AUTHOR]

Abstract Background Considering the adverse effects of sleep disturbance in critical care settings, accurate assessment could aid therapy; however, methodological inadequacies mean that no viable option is currently available. Research in healthy population has recently shown that a non-wearable sleep measurement device placed under the mattress of the bed could be beneficial in intensive care settings. Therefore, we aimed to validate this device compared with polysomnography (PSG) and to assess how it related to subjective sleep evaluations. Methods This observational study measured the sleep of critically ill adult patients. The primary goal was to validate the Nemuri SCAN (NSCAN; Paramount Bed Co., Ltd., Tokyo, Japan) against the reference standard PSG for 24 h. The secondary goal was to evaluate the association between the objective parameters obtained from NSCAN and PSG and the subjective report data obtained using the Richards–Campbell Sleep Questionnaire (RCSQ) for the nighttime. Results Eleven participants were evaluated. The median of the total sleep time scored by PSG was 456.0 (353.0–517.5) min during the nighttime and 305.0 (186.2–542.5) min during the daytime. PSG over 24 h revealed significant decreases in restorative sleep, with excessive daytime sleep, but with a normal quantity of nighttime sleep. The agreement, sensitivity, and specificity rates (with 95% confidence intervals) for the NSCAN compared with PSG were 68.4% (67.9–69.0%), 90.1% (89.7–90.6%), and 38.7% (37.9–39.7%), respectively. The median RCSQ value when subjectively evaluating nighttime sleep was 68.0 (26.3–83.5); this showed no correlation with the NSCAN sleep parameters, despite a positive correlation with the ratio of the stage N2 isolated or combined with restorative sleep in the PSG assessment. Conclusions NSCAN had moderate agreement, high sensitivity, and poor specificity in intensive care settings, which is most likely due to its inability to identify immobile wakefulness often observed in critically ill patients or sleep depth. This remains a barrier to its use in the assessment of subjective sleep quality. Trial registration This investigation was part of an interventional trial registered with the University Hospital Medical Information Network Individual Clinical Trials Registry ( UMIN000026350 , http://www.umin.ac.jp/icdr/index-j.html ) on March 1, 2017.

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To investigate the curricular preparation in formal sleep evaluation tools and sleep interventions taught in entry-level occupational therapy (OT) and physical therapy (PT) academic programs. A national cross-sectional survey to examine sleep curriculum content. Accredited entry-level OT and PT programs in the United States. Faculty from entry-level OT (n=34) and PT programs (n=62) responsible for sleep instruction in the curriculum. Not applicable. Survey questions on sleep instruction practices including formal sleep evaluation tools, interventions taught in the curricula, total curricular hours devoted to sleep evaluation and management, and differences in sleep instruction between OT and PT programs. The majority of respondents indicated only 1-2 hours of content instruction related to formal sleep evaluations (OT, 66.8%; PT, 50.4%), and sleep interventions (OT, 62.2%; PT 63.1%). Formal sleep evaluation tools were taught more frequently in OT programs (50%), compared to PT programs (39%), p < 0.05. The most commonly taught evaluation tools were the Pittsburgh Sleep Quality Index (OT, 35.3%; PT 17.8%), the Epworth Sleepiness Scale (OT, 20.6%; PT 19.4%), Insomnia Severity Index (OT, 17.7%; PT 12.9%), and the Functional Outcomes of Sleep Questionnaire (OT, 17.7%; PT 9.7%). Preferred interventions included the use of regular sleep schedules, (OT, 73.5%; PT 58.1%), limiting screen time (OT, 75.9%; PT, 56.5%), and room lighting reduction (OT, 61.76%; PT ,53.3%). Significant utilization differences (p < 0.05) were found between OT and PT in the use of cognitive behavioral therapy-insomnia (OT, 41.2%; PT, 19.4%), sensory techniques (OT, 50.0%; PT, 21.0%), and weighted blankets (OT, 55.9%; PT, 24.2%). The primary reasons for limited instruction were inadequate faculty knowledge on the subject (38.20%) and lack of space in the curriculum (28.09%). Adequate sleep is vital to optimal health and function and has been shown to affect neuroplasticity, anxiety, depression, activity level, and cognition. Additional academic preparation in sleep management for OT and PT professionals may enhance overall patient health and well-being. None. [ABSTRACT FROM AUTHOR]

Background: Considering the adverse effects of sleep disturbance in critical care settings, accurate assessment could aid therapy; however, methodological inadequacies mean that no viable option is currently available. Research in healthy population has recently shown that a non-wearable sleep measurement device placed under the mattress of the bed could be beneficial in intensive care settings. Therefore, we aimed to validate this device compared with polysomnography (PSG) and to assess how it related to subjective sleep evaluations. Methods: This observational study measured the sleep of critically ill adult patients. The primary goal was to validate the Nemuri SCAN (NSCAN; Paramount Bed Co., Ltd., Tokyo, Japan) against the reference standard PSG for 24 h. The secondary goal was to evaluate the association between the objective parameters obtained from NSCAN and PSG and the subjective report data obtained using the Richards–Campbell Sleep Questionnaire (RCSQ) for the nighttime. Results: Eleven participants were evaluated. The median of the total sleep time scored by PSG was 456.0 (353.0–517.5) min during the nighttime and 305.0 (186.2–542.5) min during the daytime. PSG over 24 h revealed significant decreases in restorative sleep, with excessive daytime sleep, but with a normal quantity of nighttime sleep. The agreement, sensitivity, and specificity rates (with 95% confidence intervals) for the NSCAN compared with PSG were 68.4% (67.9–69.0%), 90.1% (89.7–90.6%), and 38.7% (37.9–39.7%), respectively. The median RCSQ value when subjectively evaluating nighttime sleep was 68.0 (26.3–83.5); this showed no correlation with the NSCAN sleep parameters, despite a positive correlation with the ratio of the stage N2 isolated or combined with restorative sleep in the PSG assessment. Conclusions: NSCAN had moderate agreement, high sensitivity, and poor specificity in intensive care settings, which is most likely due to its inability to identify immobile wakefulness often observed in critically ill patients or sleep depth. This remains a barrier to its use in the assessment of subjective sleep quality. Trial registration: This investigation was part of an interventional trial registered with the University Hospital Medical Information Network Individual Clinical Trials Registry (UMIN000026350, http://www.umin.ac.jp/icdr/index-j.html) on March 1, 2017. [ABSTRACT FROM AUTHOR]

Examining the impact of appropriate sleep evaluation on diagnosis of attention deficit disorders can improve the standard of care in pediatrics. This quality improvement project examined current practice and subsequent implementation of a validated standardized sleep evaluation tool in the assessment of children with symptoms of attention deficit. Retrospective chart review and implementation of the Children's Sleep Habits Questionnaire (CSHQ) for children 6 to 14years old with attention deficit symptoms. Rates of sleep screening, sleep referrals, diagnosis of sleep and attention deficit disorders, Vanderbilt scores, CSHQ scores. In the retrospective group (n = 41), 76% of patients had attention deficit disorder/attention deficit hyperactivity disorder, 19.5% had sleeping disorders. There were significant provider differences in diagnosing sleep problems (p =.007). In the intervention group (n = 5), 60% had abnormal CSHQ scores. There was considerable incidence of sleeping problems in children with symptoms of attention deficit and provider variation in sleep evaluation and diagnosis, with minimal referral to specialist care. Our findings support a more comprehensive and standardized evaluation of sleep when assessing for attention deficit disorders to improve appropriate referrals, diagnosis, and treatment in pediatrics. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnoea hypopnoea syndrome (OSAHS) is a common cause of breathing-related sleep disorder, causing excessive daytime sleepiness. Common clinical features of OSAHS include snoring, fragmented sleep, daytime somnolence and fatigue. This article aims to provide a comprehensive review of the condition, including its management.

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 Psyc INFO 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. [ABSTRACT FROM AUTHOR]

Polysomnographic (PSG) recording of multiple physiological measures remains the gold standard for sleep assessment in both basic and clinical human sleep research. However, PSG requires many unnatural conditions that can influence sleep phenomena. Recently, non-contact sheet sensors (SS) have been developed for sleep evaluation. Sheet sensor technology provides advantages over existing minimally intrusive devices used to analyze sleep-related behavior, such as wrist actigraphy (WA), beginning with freedom from attachment to any probes or devices. Current SS measures additionally include two physiological measures - heart rate (HR) and respiration rate (RR). To test the validity of SS analyses, we performed simultaneous recordings of SS and standard PSG in thirteen healthy adult sleepers, with WA additionally available for nine of the subjects. Sleep period features were compared among the three methods, and HR and RR data from SS and PSG were compared. Comparisons between the automatic scoring of SS and WA and visual PSG scoring showed good sleep-wake discrimination (88.3% and 89.4% respectively). Sleep onset estimation relative to PSG was also good for both SS and WA (0.38 and -2.44 epoch differences, respectively). In addition, HR and RR measured by SS were also compared with PSG. Both HR and RR closely approximated PSG physiological measures (error rates: HR 2.4%, RR 4.3%). In summary, SS is expected to be less disruptive and easier to use for long-term home sleep monitoring. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the results of the day-to-day self-evaluation of sleep quality by sleep logs with Parkinson’s disease sleep scale (PDSS) in Parkinson’s disease (PD) patients. Actigraphy was used as an independent analysis of nighttime activity interfering with sleep. A total of 71 idiopathic PD patients and 21 age- and sex-matched normal individuals lacking any type of sleep disturbance were recruited. Sleep was evaluated by PDSS, 7-d sleep log and actigraphy. Sleep logs and PDSS showed reduced sleep quality and daytime somnolence scores in moderate/severe PD patients as compared to healthy controls. Significant correlations were found between sleep quality in sleep logs and all domains of PDSS sleep quality, except for the presence of nocturia, which correlated with nocturnal activity. PD severity and depression were the only predictors of reduced sleep quality. The retrospective and day-to-day sleep self-evaluations were coincident. Reduced sleep quality was related to increased PD severity and depression scores. [ABSTRACT FROM AUTHOR]

Polysomnography provided a means to objectively study sleep. Initial challenges were technical; the next challenge was overcoming communication difficulties and lack of standardization. The new specialty, sleep medicine, created a huge demand for laboratory polysomnography. By the early 2000s, home sleep testing and treatment devices made inroads into clinical sleep practice. The economic consequence was shrinking demand for clinical laboratory polysomnography. Therefore, polysomnography must now find new directions, approaches, and purpose. Engineering challenges remain, and the "new" polysomnography needs to revisit some of the original questions about sleep, including what constitutes optimal sleep quantity, timing, and quality., (Copyright © 2016 Elsevier Inc. All rights reserved.)