NSGA 144 - Sleep & Rest

- very light sleep
- only a few minutes long
- muscle relaxation
- loss of awareness of surroundings
- vital signs and metabolism beginning to decrease
- awakens easily
- feels relaxed and drowsy

- deeper sleep than stage 1
- 10 to 20 minutes long
- vital signs and metabolism continuing to slow
- requires slightly more stimulation to awaken
- increased relaxation

- slow wave or delta sleep
- vital signs decreasing
- more difficult to awaken
- psychological rest and restoration
- reduced sympathetic activity

- vivid dreaming
- about 90 minutes after falling asleep, recurring every 90 minutes
- longer with each sleep cycle
- average length of 20 minutes
- varying vital signs
- very difficult to awaken
- loss of skeletal muscle tone
- cognitive restoration

9 to 15 hrs/day

9 to 10 hrs/day

7 to 8 hrs/day

most common sleep disorder. the inability to get an adequate amount of sleep and to feel rested. might mean difficulty falling asleep and/or difficulty staying asleep.
women and older adults have agreat risk.

lasts a few days possibly due to personal or situational stressors

lasts a month or more

sleeping well for a few days and then having insomnia for a few days

more than five breathing cessations lasting longer than 10 seconds per hour during sleep
can be a single disorder or a mixture of central and obstructive.

central nervous system dysfunction in the respiratory control center of the brain that fails to trigger breathing during sleep

structures in the mouth and throat relax during sleep and occlude the upper airway

sudden attacks of sleep that are often uncontrollable.
can occur at inappropriate times and increases the risk of injury.

excessive daytime sleepiness lasting at least 3 months.
impairs social and vocational activities.
increased risk for accident or injury related to sleepiness

- ask about sleep patterns/historyecent changes
- identify usual sleep requirements
- ask about sleep problems (type/timing/factors/etc)
- use a linear or visual scale with 'best sleep' on one end and 'worst sleep' on the other and ask for a 0 to 10 rating
- check for common factors that interfere with sleeping (heavy meals before bed/high fluid intake/alcohol before bed/stress/etc)

- physiologic disorders (nocturia/sleep apnea)
- current life events (traveling/schedule change)
- emotional stress or mental illness (anxietyrief/fear)
- diet (caffeine consumption/heavy meals before bed)
- exercise (3 hrs before bed promotes sleep

- helps pts establish and follow a bedtime routine
- limit exercising pts before bed
- promote quiet hospital environment
- consult provider about OTC products (melatonin/chamomile)

- exercise no less than 3 hrs before bed
- establish bedtime routine and schedule
- limit alcohol

- exercise regularly
- eat small meals high in protein
- avoid activities that increase sleepiness
- avoid activities that could cause injury if pt were to fall asleep (driving/heights)
- take naps when drowsy or narcoleptic events are likely
- take prescribed stimulants

- maintain a regular sleep/wake schedule
- provide ample sleep opportunities