Mosby items and derived items © 2005 by Mosby, Inc. Chapter 41 Sleep

Mosby items and derived items © 2005 by Mosby, Inc. Physiology of Sleep Rhythms Sleep regulation Stages of sleep: REM, NREM Sleep cycle

Mosby items and derived items © 2005 by Mosby, Inc. Functions of Sleep Contribution to physiological and psychological restoration Conservation of energy Dreams

Mosby items and derived items © 2005 by Mosby, Inc. Physical Illness Pain Respiratory disease Heart disease GI distress

Mosby items and derived items © 2005 by Mosby, Inc. Sleep Disorders Dyssomnias Parasomnias Disorders associated with medical/psychiatric problems Proposed sleep disorders

Mosby items and derived items © 2005 by Mosby, Inc. Sleep Disorders (cont'd) Insomnia Sleep apnea Narcolepsy Sleep deprivation

Mosby items and derived items © 2005 by Mosby, Inc. Normal Sleep Requirements and Patterns Infants Toddlers Preschoolers School-age children Adolescents Adults Older adults

Mosby items and derived items © 2005 by Mosby, Inc. Factors Affecting Sleep Drugs and substances Lifestyle Usual sleep patterns Emotional stress Environment Exercise and fatigues Food and caloric intake

Mosby items and derived items © 2005 by Mosby, Inc. Sleep Assessment Sources Tools

Mosby items and derived items © 2005 by Mosby, Inc. Sleep History Description of sleeping problems Usual patterns Physical and psychological illness Current life events Emotional and mental status

Mosby items and derived items © 2005 by Mosby, Inc. Sleep History (cont'd) Bedtime routines Bedtime environment Behaviors of sleep deprivation

Mosby items and derived items © 2005 by Mosby, Inc. Nursing Diagnoses Ineffective breathing pattern Compromised family coping Disturbed sensory perception Sleep deprivation Disturbed sleep pattern

Mosby items and derived items © 2005 by Mosby, Inc. Planning Goals and outcomes – Client will identify factors in the immediate home environment that disrupt sleep in 2 weeks Setting priorities Continuity of care

Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Health Promotion Environmental controls: temperature, noise, light Promoting bedtime routines Promoting comfort Establishing periods of sleep and rest Stress reduction

Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Health Promotion (cont'd) Bedtime snacks Pharmacological approaches

Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Acute Care Environmental controls: climate, privacy, light, noise Promoting comfort Establishing periods for rest and sleep Stress reduction

Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Restorative Care Promoting comfort Controlling physiological disturbances: symptoms Pharmacological approaches: hypnotics, sedatives

Mosby items and derived items © 2005 by Mosby, Inc. Evaluation Client care Client expectations