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Chapter 41

Sleep

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Physiology of Sleep

• Rhythms

• Sleep regulation

• Stages of sleep: REM, NREM

• Sleep cycle

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Functions of Sleep

• Contribution to physiological and psychological restoration

• Conservation of energy

• Dreams

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Physical Illness

• Pain

• Respiratory disease

• Heart disease

• GI distress

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Sleep Disorders

• Dyssomnias

• Parasomnias

• Disorders associated with medical/psychiatric problems

• Proposed sleep disorders

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Sleep Disorders (cont'd)

• Insomnia

• Sleep apnea

• Narcolepsy

• Sleep deprivation

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Normal Sleep Requirements and Patterns

• Infants

• Toddlers

• Preschoolers

• School-age children

• Adolescents

• Adults

• Older adults

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Factors Affecting Sleep

• Drugs and substances

• Lifestyle

• Usual sleep patterns

• Emotional stress

• Environment

• Exercise and fatigues

• Food and caloric intake

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Sleep Assessment

• Sources

• Tools

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Sleep History

• Description of sleeping problems

• Usual patterns

• Physical and psychological illness

• Current life events

• Emotional and mental status

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Sleep History (cont'd)

• Bedtime routines

• Bedtime environment

• Behaviors of sleep deprivation

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Nursing Diagnoses

• Ineffective breathing pattern

• Compromised family coping

• Disturbed sensory perception

• Sleep deprivation

• Disturbed sleep pattern

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Planning

• Goals and outcomes– Client will identify factors in the immediate home environment that disrupt sleep in 2 weeks

• Setting priorities

• Continuity of care

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Implementation: Health Promotion

• Environmental controls: temperature, noise, light

• Promoting bedtime routines

• Promoting comfort

• Establishing periods of sleep and rest

• Stress reduction

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Implementation: Health Promotion (cont'd)

• Bedtime snacks

• Pharmacological approaches

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Implementation: Acute Care

• Environmental controls: climate, privacy, light, noise

• Promoting comfort

• Establishing periods for rest and sleep

• Stress reduction

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Implementation: Restorative Care

• Promoting comfort

• Controlling physiological disturbances: symptoms

• Pharmacological approaches: hypnotics, sedatives

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Evaluation

• Client care

• Client expectations