Chapter 41
Sleep
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Physiology of Sleep
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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
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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)
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Insomnia
Sleep apnea
Narcolepsy
Sleep deprivation
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Normal Sleep Requirements
and Patterns
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Infants
Toddlers
Preschoolers
School-age children
Adolescents
Adults
Older adults
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Factors Affecting Sleep
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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
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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
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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
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