Rest And Sleep

Question 1

Sleep

Answer 1

• Altered state of consciousness
• Decreased responsiveness to external stimuli
• Perception of environment decreased

Lack of sleep
• Low physical endurance, fatigue, irritability, depression and apathy
• Loss of concentration
• Inappropriate responses
• Distorted sensory interpretation
• Increase sensitivity to pain
• Altered social relationships because of delusions and hallucinations

Question 2

Physiology of sleep

Answer 2

• Inhibits wakefulness and causes sleep
• Circadian rhythm - sleep-wake cycle; biorhythm
• Cycle of 5 stages of sleep - usually 4-6 cycles per night (each approximately 70-90 minutes)

Question 3

Stages of sleep

Answer 3

NREM
• Most of the sleep during the night
• Deep and restful

Stages of NREM sleep
• Relaxed and drowsy - lasts few minutes; easily roused; floating sensation
• Light sleep - easily roused
• Physiological changes seen - decreased BP and T; snoring; muscles totally relaxed; more difficult to rouse
• Deep sleep - GRH release; restores physical part of body; some dreaming; parasomnias

REM
• 25% of sleep
• Lasts for 5-30 minutes
• Dreaming
• Irregular muscle movement and eye movements
• Psychological healing

Question 4

Functions of sleep

Answer 4

• Restores normal level of activity
• Increase PNS
• Protein synthesis used for repair
• Rhythm of sleep wake cycle more important than number of hours

Question 5

Factors affecting sleep

Answer 5

• Growth and development - 7-9 hours needed for all age groups
• Health and illness
• Emotional state
• Environment
• Fatigue
• Lifestyle and sleep/wake schedule
• Alcohol and stimulants
• Diet
• Smoking
• Motivation
• Medications

Question 6

Sleep disorders

Answer 6

• Insomnia - difficulty falling asleep or staying asleep
• Hypersomnia - excessive sleeping
• Narcolepsy - falling asleep at random
• Sleep apnea - cessation of breathing (associated with obesity)
• Insufficient sleep - not getting enough sleep
• Parasomnias - sleep talking, sleep walking, sleep eating, night terrors

Question 7

Assessing

Answer 7

• Sleep history
• Sleep patterns
• Usual sleep environment
• Sleep rituals
• Use of medications
• Preferred sleep environment
• Recent changes in sleep pattern
• Sleep diary
• Physical examination

Question 8

Rest

Answer 8

• Calmness, relaxation without emotional stress
• Freedom from anxiety and restoration of energy
• Lack of rest = irritability, depression, fatigue and poor emotional control

Question 9

Diagnoses

Answer 9

• Sleep pattern disturbance
• Knowledge deficit
• Anxiety
• Activity intolerance
• Fatigue
• Ineffective coping
• Altered thought process

Question 10

Planning

Answer 10

Goal: to maintain or develop sleeping pattern that provides enough energy to function

Interventions:
• Teaching client's about sleep habits
• Supporting bedtime rituals 
• Reducing environmental distractions 
• Establishing or maintaining sleep pattern
• Altering activity prior to sleep
• Anxiety reduction
• Creating a restful environment
• Altering diet prior to sleep
• Enhancing sleep with medications
• Promoting comfort and relaxation
• Providing back massage 
• Helping elderly patients keep warm