Rest and Sleep Teresa V Hurley MSN RN

Rest and Sleep Teresa V. Hurley, MSN, RN

Sleep Physiology • Circadian Rhythm – Sleep-wake cycle or biological clocks – Early birds and night owls – Interruption of cycle • • Anxiety Restlessness Irritability Impaired judgment

Sleep Physiology • Sleep Regulation by CNS, peripheral nervous, endocrine, respiratory, muscular and cardiovascular systems • Stages of Sleep – Non-rapid eye movement (NREM) • • 4 stages during a 90 minute cycle from light to deep sleep (harder to arouse) Body tissue restoration HR decreases to 60/min or less Interruption (confusion, suspicion, mood changes, immune suppression, accidents) – Rapid eye movement (REM) • End of each sleep cycle • Dreams more vivid and elaborate • Learning, memory processing, stress adaptation

Factors Affecting Sleep Examples – – – Pain Physical Discomfort Difficulty Breathing (COPD, Asthma, Colds etc. ) Mood (anxiety or depression) Nocturia Restless legs syndrome prior to sleep (rhythmic movements and itching) – GERDS

Sleep Disorders • Dyssomnias – Intrinsic (initiate and maintain sleep due to psychophysiological) • Narcolepsy • Obstructive sleep apnea – Extrinsic (external factors) – Circadian (sleep time/preference) • Time zone change • Shift work • Parasomnias – – – – – Sleepwalking Sleep terrors Sleep talking Noctural leg cramps Nightmares Sleep paralysis Teethgrinding Bedwetting SIDS

Factors Affecting Sleep • Age: less time as age • Drugs (L-trytophan in cheese, milk and meats promote sleep) • Lifestyle (shift work, changing meal time) • Emotional Stress • Environment (temperature, sound, lighting) • Exercise (less than 2 hours before bedtime)

Factors Affecting Sleep • Food and Caloric Intake (caffeine, alcohol, spicy, large meal, milk allergies in infants and food allergies as corn, chocolate, yeast, food dyes, wheat, eggs; wtg loss and gain

Nursing Interventions • Promote bed time rituals and routines • Adjust environment • Back rub if not contra-indicated Provide Pain relief measures Do not interrupt sleep unless absolutely necessary Establish periods of rest and sleep

Pharmocolgic • Hypnotics produce sleep • Sedatives produce calming effect