1. Rest and Sleep

2. Sleep Deprivation Symptoms PHYSICAL: Decreased reflexes Slowed response time Reduction in word memory Decreased reasoning and judgment Cardiac dysrhthmias Decreased auditory and visual alertness PSYCHOLOGICAL: Mood swings Disorientation Irritability Depression Decreased motivation agitation

3. Conditions for Rest ZZZZZZZ Physical comfort: Elimination of physical irritation or pain Proper body positioning Adequate ventilation Elimination of distractions in the environment Psychological comfort: Freedom from worry Proper nutrition & exercise Maintain normal routine Secure and safe environment

4. Sleep control centers

5. Adult sleep cycle Presleep (10-30 minutes) NonREM (stage 1) NonREM (stage 2) NonREM (stage 3) NonREM (stage 4) NonREM (stage 3) NonREM (stage 2) (about 90 minutes into sleep) REM sleep (30-60 minutes) Back to NonREM stage 2

6. Nursing interventions for sleep promotion: Take a sleep history Replicate normal sleep routine Eliminate evening caffeine/alcohol Adjust temperature and light in room Monitor vital signs electronically Cluster care activities Control noise Remove physical irritants Proper positioning Offer P.M. hygiene and massage Assist to void before sleep Provide restful activity before sleep Talk with sleepless patient Offer bedtime snack Other ideas?????

7. Being helpful: Approaches with the Hearing Impaired Get the person’s attention Face the person Articulate clearly and distinctly Rephrase rather than repeat Use visual aids Talk toward the best ear Be sensitive to distracting background noise

8. Being helpful: Approaches with the Visually Impaired: Announce your presence Orient to new environment Mental visualization Use normal speaking voice Let the person hold YOUR elbow for guidance