Sleep

Presenter: Susan Dellos, MSN, RN
Objectives
  • Define Health, Wellness, Illness, & Injury.
  • Discuss three levels of prevention, with examples.
  • Describe impact of client needs, values, and choices on health outcomes.
  • Discuss nurse's role in health promotion and injury prevention.
  • Discuss hygiene's role in wellness, health, and illness.
  • Discuss principles of complementary and alternative medicine.
  • Apply nursing process to promote sleep-rest health.
Health
  • WHO Definition: "A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity."
  • Health & Wellness: Optimal physical, emotional, and social well-being.
  • Personal Definition: Encourages self-reflection.
Wellness
  • Multi-dimensional state.
  • 7 Components:
    1. Physical
    2. Financial
    3. Intellectual
    4. Environmental
    5. Emotional
    6. Spiritual
    7. Social
Illness and Disease
  • Illness: Personal state of diminished physical, emotional, intellectual, social, developmental, or spiritual functioning, causing discomfort.
  • Disease: Detectable alteration in body function due to infectious microorganisms, reducing capacity or shortening lifespan (pathogenesis).
  • Chronic Illness: Long-term, affecting daily functioning.
  • Acute Illness: Short-duration, potentially severe, with a typical recovery period.
  • Safety: Essential consideration.
  • Intervention Example: Nurse's role in managing illnesses.
  • Effective Teaching: Strategies to ensure patient education on diagnosis is understood.
Injury
  • Definition: Act or event causing damage, harm, or loss to body functioning.
  • Impact Factors:
    1. Nature
    2. Severity
    3. Duration
    4. Precipitating Factors
    5. Financial Costs
    6. Lifestyle Changes
    7. Role Adjustments
  • Autonomy: Relation to managing injury.
The Health Continuum
  • Spectrum from illness (premature death, disease) to wellness (good health, optimal health).
  • Comfort Zone: False sense of wellness.
  • Encourages self-assessment of one’s position.
Prevention
Three Levels of Prevention
  1. Primary: Interventions before disease/injury. Aims to reduce risk factors (e.g., nutrition, vaccinations).
  2. Secondary: Interventions after disease onset but before symptoms. Focus on early identification and treatment (e.g., screenings).
  3. Tertiary: Interventions post-disease/injury. Aims to prevent sequelae and manage health (e.g., diabetes management).
Social Determinants of Health
  • Key Determinants:
    1. Neighborhood & Built Environment
    2. Economic Stability
    3. Health & Health Care
    4. Education
    5. Social & Community Context
Internal and External Variables Affecting Health Choices
Internal Variables
  • Example: Personal beliefs.
  • Nursing Intervention: Tailored counseling.
External Variables
  • Example: Socioeconomic status, cultural influences.
  • Nursing Intervention: Community resource awareness.
Health Promotion Across the Lifespan
  • Reference Table 7-7 for recommended health promotion activities by age.
  • Discuss importance and resistance factors in patients/parents.
Behavioral Changes
  • Theories:
    • Integrative Behavioral Health Model
    • Cognitive Dissonance Theory
    • Diffusion of Innovation
    • Social Cognitive Theory
    • Stages of Change Theory
    • Theory of Reasoned Action
    • Theory of Planned Behavior
    • Value-Belief-Norm Theory
    • Adult Learning Theory
    • Transformational Education
    • Social Marketing Theories
Stages of Change
  1. Precontemplation: Unaware of problem.
  2. Contemplation: Aware, desires change.
  3. Preparation: Intends to act.
  4. Action: Practices desired behavior.
  5. Maintenance: Sustains behavior.
  6. Termination: Behavior solidified.
Complementary Health
  • Practices: Acupuncture, Biofeedback, Chiropractic Medicine, Deep Breathing, Dietary & Herbal Supplements, Homeopathy, Massage Therapy, Meditation, Naturopathy, Osteopathic Medicine, Traditional Chinese Medicine, Yoga.
Nursing Process
  • Phases:
    1. Assessment: Data collection.
    2. Diagnosis: Problem identification.
  1. Planning: Management strategy.
  2. Implementation: Action on plan.
  3. Evaluation: Assess effectiveness.
Sleep
Stages of Sleep
  • Stage 1: Light sleep, easily awakened.
  • Stage 2: Eye movement and brain activity slow.
  • Stage 3: Delta waves begin.
  • Stage 4: Deep sleep, very difficult to awaken.
  • REM Stage: Rapid breathing, irregular patterns, dreams.
Sleep Cycle
  • Duration: 90−11090-110 minutes (average of 66 cycles/night).
  • NREM (8080%):
    • Stages 1−21-2: Light sleep, relaxation.
    • Stages 3−43-4: Deep sleep, slow brain waves, no eye/muscle movement.
  • REM: Dreams, active body, increased heart rate/blood pressure.
Circadian Rhythms
  • Nightly patterns of body temperature, hormonal activity (eosinophil, melatonin), and alertness peaks.
Factors Affecting Sleep
  • Physiologic Disorders
  • Emotional Stress
  • Stimulants, Alcohol, Smoking
  • Environmental Factors
  • Life Events
Importance of Sleep
Why Important?
  • Body Repair, Learning & Memory, Stress Management, Creativity, Growth & Development, Immune System.
Better Sleep Practices
  • Consistent sleep/wake times.
  • Avoid large meals before bed.
  • Regular exercise.
  • Limit screen time before sleep.
  • Optimal sleeping environment (cool, quiet, dark).
Consequences of Sleep Deprivation
  • Anxiety, depression, irritability, headaches, obesity, reduced vision.
Sleep Needs by Age
  • Newborn (0-3 months): 14−1714-17 hours.
  • Infant (4-12 months): 12−1612-16 hours.
  • Toddler (1-2 years): 11−1411-14 hours.
  • Preschooler (3-5 years): 10−1310-13 hours.
  • Schoolchild (6-12 years): 9−129-12 hours.
  • Teenager (13-18 years): 8−108-10 hours.
  • Adult (19+ years): 7−97-9 hours.
Effects of Sleep Deprivation
  • Physical: Daytime sleepiness, impaired immunity, irritability, weight gain.
  • Cognitive: Decreased reaction time, attention deficits, diabetes risk.
  • Mental Health: Depression, physical injuries.
Sleep Disorders
  • Insomnia: Difficulty falling/staying asleep (acute/chronic).
  • Sleep Apnea: Breathing interruptions (central/obstructive).
  • Narcolepsy: Uncontrollable sleep attacks, hypersomnolence.
Sleep Promotion
Strategies for Better Sleep:
  • Sunlight exposure.
  • Avoid electronics 2−32-3 hours before bed.
  • Caffeine curfew.
  • Cool bedroom temperature.
  • Magnesium supplements/baths.
  • Calming bedtime rituals.
  • Minimize melatonin reliance.
Diet Considerations for Sleep
  • Poultry: Tryptophan for serotonin.
  • Fish & Yogurt: Melatonin, calcium.
  • Bananas & Kale: Potassium, tryptophan, magnesium.
  • Whole Grains: Insulin release, activates tryptophan.
  • Nuts & Eggs: Tryptophan, magnesium.
  • White Rice: High glucose, facilitates tryptophan metabolism.
Nursing Process: Focused Sleep Assessment
  • Assessment: Inquire about sleep quality/duration.
  • Diagnosis: Identify inadequate sleep (e.g., due to stress).
  • Sleep Characteristics: Duration, quality, timing, daytime alertness, presence of disorders.
  • Influencing Factors: Alcohol, substance abuse, environment, chronic conditions.
Planning and Interventions
  • Expected Outcomes: Identify poor sleep factors, report 7−97-9 hours restful sleep, feel rested.
  • Education Strategies: Routine sleep habits, avoid daytime napping, bedroom for sleep only, improve environment, refer to specialists.