1. 1 Chapter 18 Comfort, Rest, and Sleep Bader EL Safadi BSN, MSc Fundamental of Nursing - A Feb,05,2012

2. 2 Comfort : ) state is which a person is relieved of distress ) that facilitates rest and sleep Rest : (waking state characterized by reduced activity and mental stimulation) Sleep :(state of arousable unconsciousness) Safe, clean, and attractive environment contributes to comfort. Environment : refers to room where the client receives nursing care and its furnishing LIGHTING — adequate lighting, both natural and artificial is important to the comfort of clients and nursing personnel. Bader EL Safadi BSN, MSc Fundamental of Nursing - A Feb,05,2012 Comfort, Rest, and Sleep

3. 3 Environment: nursing care room, furnishings Client rooms Wall: relaxing color schemes, wallpapers Floor: carpeted or linoleum surface Lighting: adequate lighting, both natural and artificial is important to the comfort of clients and nursing personnel. Climate control: 1. Temperature :most clients are comfortable if temp is 68-74 ˚F 2. Humidity: Amount of moisture in the air. 3. Ventilation: Movement of air Bader EL Safadi BSN, MSc Fundamental of Nursing - A Feb,05,2012 The Client Environment

4. 4 Room furnishings – Bed o Mattress o Pillows o Linen – Privacy curtain – Overbed table – Bedside stand – Chairs Bader EL Safadi BSN, MSc Fundamental of Nursing - A Feb,05,2012 The Client Environment (cont’d)

5. 5 Functions of sleep 1. Reduces fatigue 2. Stabilizes mood 3. Improves blood flow to brain 4. Enhances various physiologic processes (Increasing protein synthesis.) 5. Improves immune system 6. Promotes emotional well-being 7. Improves capacity for learning and memory storage Bader EL Safadi BSN, MSc Fundamental of Nursing - A Feb,05,2012 Sleep and Rest

6. 6 Sleep phases 1. Non rapid eye movement (NREM) o Quiet sleep 2. Rapid eye movement (REM) o Active or deepest stage of sleep Bader EL Safadi BSN, MSc Fundamental of Nursing - A Feb,05,2012 Sleep and Rest (cont’d)

7. 7 Effect of chronic sleep deprivation 1. Altered comfort. 2. Impaired coordination. 3. Loss of muscle mass and weight. 4. Increased susceptibility to infection. 5. Slower wound healing. 6. Decreased pain tolerance. 7. Poor circulation. 8. Unstable moods. 9. Impaired judgment. Bader EL Safadi BSN, MSc Fundamental of Nursing - A Feb,05,2012 Sleep and Rest (cont’d)

8. 8 Sleep cycles Alternate through NREM and REM phases Sleep requirements Vary among different age groups Bader EL Safadi BSN, MSc Fundamental of Nursing - A Feb,05,2012 Sleep and Rest (cont’d)

9. Factors affecting sleep 1. Old age 2. Light 3. Activity 4. Environment 5. Motivation 6. Emotions and moods 7. Food and beverages 8. Illness 9. Drugs o Sedatives and tranquilizers o Hypnotics and stimulants Bader EL Safadi BSN, MSc Fundamental of Nursing - A Feb,05,2012 9

10. 10 Sleep questionnaires Sleep diary Nocturnal polysomnography Multiple sleep latency test Bader EL Safadi BSN, MSc Fundamental of Nursing - A Feb,05,2012 Sleep Assessment

11. 11 INSOMNIA: difficulty falling asleep, awakening frequently during the night or awakening early. HYPERSOMINA: characterized by feeling sleepy despite getting normal sleep. SLEEP APNEA: cessation of breathing. HYPOPNEA: hypoventilation PARASOMNIA : conditions associated with activities that cause arousal or partial arousal, usually during transitions in NREM periods of sleep. Bader EL Safadi BSN, MSc Fundamental of Nursing - A Feb,05,2012 Sleep Disorders

12. 12 Identify nursing diagnoses Develop plan of care Sleep-promoting nursing measures Maintaining sleep rituals Reducing intake of stimulating chemicals Promoting daytime exercise Adhering to regular schedule for retiring and waking Progressive relaxation Back massage o Various techniques and purposes Bader EL Safadi BSN, MSc Fundamental of Nursing - A Feb,05,2012 Nursing Implications