1. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 18 Comfort, Rest, and Sleep

2. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Comfort, Rest, and Sleep Comfort facilitates rest and sleep Safe, clean, and attractive environment contributes to comfort

3. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Client rooms resemble bedrooms that are bare, white, and have sterile environments.

4. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Client rooms are now bright, colorful, and tastefully decorated.

5. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins The Client Environment Environment: nursing care room, furnishings Client rooms –Wall: relaxing color schemes, wallpapers –Floor: carpeted or linoleum surface –Lighting: adequate lighting, adjustable intensity –Climate control: temperature, humidity, ventilation

6. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins The Client Environment (cont’d) Room furnishings –Bed oMattress oPillows oLinen –Privacy curtain

7. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins The Client Environment (cont’d) Room furnishings (cont’d) –Overbed table –Bedside stand –Chairs

8. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Sleep and Rest Functions of sleep –Promotes emotional well-being –Enhances various physiologic processes –Reduces fatigue

9. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Sleep and Rest (cont’d) Functions of sleep (cont’d) –Stabilizes mood –Improves blood flow to brain –Improves immune system –Improves capacity for learning and memory storage

10. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Sleep and Rest (cont’d) Sleep phases –Nonrapid eye movement (NREM) oQuiet sleep –Rapid eye movement (REM) oActive or deepest stage of sleep

11. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Characteristic Electroencephalogram Wave Form

12. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Sleep and Rest (cont’d) Sleep cycles –Alternate through NREM and REM phases Sleep requirements –Vary among different age groups

13. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Sleep and Rest (cont’d) Factors affecting sleep –Old age –Light –Activity –Environment –Motivation

14. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins REM and NREM Sleep in Younger Adults and Older Adults

15. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Sleep and Rest (cont’d) Factors affecting sleep (cont’d) –Emotions and moods –Food and beverages –Illness –Drugs o Sedatives and tranquilizers o Hypnotics and stimulants

16. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Alcohol is a depressive drug that promotes healthy sleep.

17. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Alcohol is a depressive drug that promotes sleep, but it tends to reduce normal REM and deep sleep stages of NREM sleep.

18. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Sleep Assessment Sleep questionnaires Sleep diary Nocturnal polysomnography Multiple sleep latency test

19. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Sleep Disorders Insomnia Hypersomnia –Narcolepsy oSleep paralysis and cataplexy oHypnogogic hallucinations –Sleep apnea/hypopnea syndrome

20. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Apneic episodes can be reduced by sleeping in other than the supine position, losing weight, and avoiding substances that depress respirations such as alcohol or sleeping medications.

21. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True. Apneic episodes can be reduced by sleeping in other than the supine position, losing weight, and avoiding substances that depress respirations such as alcohol or sleeping medications.

22. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Sleep Disorders (cont’d) Sleep-wake cycle disturbances –Shift work –Jet travel –Seasonal affective disorder Parasomnias

23. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Implications Identify nursing diagnoses –Develop plan of care Sleep-promoting nursing measures –Maintaining sleep rituals –Reducing intake of stimulating chemicals –Promoting daytime exercise

24. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Implications (cont’d) Sleep-promoting nursing measures (cont’d) –Adhering to regular schedule for retiring and waking –Progressive relaxation –Back massage oVarious techniques and purposes

25. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins General Gerontologic Considerations More comfortable with own bed furnishings Prefer warmer room temperatures Insomnia and hypersomnia are frequent manifestations of depression Sundown and sunrise syndrome Relaxation techniques before bedtime

26. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins General Gerontologic Considerations (cont’d) Hypnotic medications not recommended for use longer than 2 weeks Difficulty falling asleep Institutional schedules may interfere with established pattern of sleep; modifications may be necessary Important to identify potential sources of sleep disorders

27. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins General Gerontologic Considerations (cont’d) Cognitive impairments may result in sundown or sunrise syndromes Chronic conditions may interfere with sleep: –Pain –Difficulty breathing –Frequent urination Short naps or rest periods can restore energy without interfering with nighttime sleep