NRS 116 Sleep

Sleep

A natural, necessary shift in physiological and neurological activity that is intended to be restorative.

Attributes of sleep

1) Absence of wakefulness

2) Reduced conscious awareness of one’s surroundings

3) Presence of sleep stages

Scope of sleep

Chronic poor sleep disorder

to

Intermittent poor sleep

to

Restorative sleep

Sleep cycle

Must move through all four stages before reaching REM sleep

Each stage lasts 5-15 minutes

The whole cycle lasts 90-110 min REM gets

progressively longer during the night Restorative process of sleep ◦ Circadian rhythm ◦ Deep sleep

Risk factors for poor sleep

Family history of sleep disorders

Age: increasing age -> increasing risk Pregnancy and perimenopause

Obesity and other chronic conditions

Variable shift jobs

Irregular daily routines

Major life changes

Stress

Sleep in each age group hours

Babies 14-17

Toddlers 11-14

School children 9-11

Teenagers 8-10

Adults 7-9

Which of the following is a way to create a safe sleep area for an infant less than 6 months old?  

Place your baby on his or her back for all sleep times, no blankets, no sleeping in the same bed as anyone

Effects of sleep in the short term?

Irritability, exhaustion, yawning, memory impairment

Effects of sleep in the long term?

Increased risk of heart disease and diabetes.

◦ Reproductive challenges

◦ Increased mortality

◦ Metabolic syndrome

◦ Developmental disorders 

Collaborative Interventions (working with the health care team)

Sleep hygiene

• Support in making lifestyle changes

Pharmacologic agents

• Medications

Invasive procedures

• Dental appliances

• Continuous positive airway pressure machines (CPAP)

Primary prevention/health promotion

• Attention to environment, behavior, habits

• Help patients problem solve what might contribute to sleep challenges before sleep is affected

Secondary prevention (diagnosis)

• Screening tools available

General considerations when using medications to help with sleep

• short term for insomnia

• Risk of dependence

• Use with caution in untreated/ undiganosed ppl

Zolpidem and zaleplon are

Sleep in Context to nursing and health care

• that fatigue is a contributing factor in medication administration errors and near misses

Sleep apnea

Sleep apnea is a sleep disorder characterized by repeated episodes of breathing cessation or shallow breathing during sleep

Primary – exist as independent conditions

• Insomnia • Sleep related breathing disorders (obstructive sleep apnea) • Restless legs syndrome • Narcolepsy

Secondary – as the result of some other situation, such as:

• Pain • GERD • COPD • Use of sleep medications can interfere with restorative sleep

Circadian rhythm

Circadian rhythm refers to the natural, 24-hour cycle of physical, mental, and behavioral changes that occur in most living organisms, including humans

Assessment/Diagnostics of sleep

Risk factors

Quality of sleep

Diagnostic test ex: polysomnography