Rest comfort sleep
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REST, COMFORT, SLEEP. NUR 102 Module H Dianne Watts. REST. When people are at rest, they usually feel mentally relaxed, free from anxiety, and physically calm Rest does not imply inactivity. SLEEP. Sleep is a recurrent, altered state of consciousness that occurs for sustained periods

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REST, COMFORT, SLEEP

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Rest comfort sleep

REST, COMFORT, SLEEP

NUR 102

Module H

Dianne Watts


Rest comfort sleep

REST

  • When people are at rest, they usually feel mentally relaxed, free from anxiety, and physically calm

  • Rest does not imply inactivity


Sleep

SLEEP

  • Sleep is a recurrent, altered state of consciousness that occurs for sustained periods

  • Sleep is a cyclical physiological process

    • Circadian rhythm

    • Biological clocks


Sleep regulation

Sleep Regulation

  • Sleep involves a sequence of physiological states maintained by the CNS

  • RAS ( reticular activating system) = wakefulness & BSR (bulbar synchronizing region) = sleep


Stages of sleep

STAGES OF SLEEP

  • NREM sleep = nonrapid eye movement - involves 4 stages

  • REM sleep = rapid eye movement


Stage 1 nrem

Stage 1: NREM

  • Lightest level of sleep

  • Lasts a few minutes

  • Easily aroused by sensory stimuli

  • Waken, person feels as though daydreaming has occurred


Stage 2 nrem

Stage 2: NREM

  • Period of sound sleep

  • Relaxation progresses

  • Arousal is still relatively easy

  • Stage lasts 10-20 minutes

  • Body functions, vital signs & metabolism, slow


Stage 3 nrem

Stage 3: NREM

  • Involves initial stages of deep sleep

  • Sleeper is difficult to arouse and rarely moves

  • Muscles are completely relaxed

  • Lasts 15-30 minutes


Stage 4 nrem

Stage 4: NREM

  • Very difficult to arouse sleeper

  • Deepest stage of sleep

  • If sleep loss has occurred, sleeper will spend considerable portion of night in this stage

  • Vital signs are significantly lower than during waking hours

  • Lasts approximately 15-30 minutes

  • Sleepwalking and enuresis may occur


Rem sleep

Vivid, full-color dreaming may occur in REM.

Usually begins about 90 minutes after sleep has begun

Typified by autonomic response of rapidly moving eyes, fluctuating heart and resp rates, increased BP

Loss of skeletal muscle tone occurs

Gastric secretions increase

Very difficult to arouse

Duration of REM sleep increased with each cycle and averages 20 minutes

REM SLEEP


Functions purpose of sleep

Functions/Purpose of Sleep

  • Restoration

    • Psychological

    • Physiological

      • Biological

      • Cognitive

  • Conservation of energy


Factors that affect sleep

FACTORS THAT AFFECT SLEEP

  • Physical illness

  • Drugs and substances

  • Lifestyle

  • Emotional stress

  • Environment

  • Exercise and fatigue

  • Food and caloric intake


Sleep disorders

SLEEP DISORDERS

  • INSOMNIA

  • SLEEP APNEA

  • NARCOLEPSY

  • SLEEP DEPRIVATION

  • PARASOMNIAS


Insomnia

INSOMNIA

  • Chronic difficulty falling asleep

  • Frequent awakenings from sleep

  • Short sleep or nonrestorative sleep


Sleep apnea

SLEEP APNEA

  • Disorder in which the individual cannot breath and sleep at the same time

  • Lack of airflow through the nose and mouth for periods from 10 seconds to 1-2 minutes, there can be 10 or 15 to more than 100 respiratory events per hour of sleep

  • Three types: central, obstructive, and mixed


Central sleep apnea

CENTRAL SLEEP APNEA

  • Caused by cessation of diaphragmatic and intercostal respiratory effort as a result of dysfunction of the brain’s respiratory control center

  • Impulse to breath fails, temporarily

  • Least common form


Obstructive apnea

OBSTRUCTIVE APNEA

  • Most common form

  • Characterized by cessation of airflow despite the effort to breath

  • Occurs when muscles or structures of the oral cavity or throat relax during sleep

  • Usually have loud snoring


Narcolepsy

NARCOLEPSY

  • A CNS dysfunction of mechanisms that regulate the sleep and wake states

  • Falls asleep uncontrollably at inappropriate times

  • Treated with stimulants


Sleep deprivation

SLEEP DEPRIVATION

  • S/S: blurred vision, fine motor clumsiness, decreased reflexes, slowed response time, decreased reasoning and judgment, cardiac arrhythmias

  • Psychological S/S: confusion, disorientation, increased sensitivity to pain, irritable, withdrawn, agitation, decreased motivation


Parasomnias

PARASOMNIAS

  • Sleep problems that are more common in children, one common exception is bruxism (tooth grinding)

  • SIDS

  • Somnambulism(sleepwalking)

  • Nightmares

  • Nocturnal enuresis (bedwetting)


Assessment

ASSESSMENT

  • Normal sleep pattern, restful? sufficient?

  • Self- reported

  • Sleep log

  • Bedtime routines

  • Bedtime environment

  • Client expectations


Rest comfort sleep

Pain

  • Physical sensation

  • Involves physical, emotional and cognitive components

  • Stimulus


Physiology of pain

Physiology of Pain

  • Transduction

  • Transmission

  • Perception

  • Modulation


Types of pain

Types of Pain

  • Acute

  • Chronic

  • Idiopatic

  • Inferred

    • nociceptive

    • neuropatic


Pain assessment

Pain Assessment

  • Scales

  • Nonverbal pain indicators

  • Behavioral indicators


Pain management

Pain Management

  • Pharmacological interventions

  • Non-pharmacological interventions

  • Barriers

  • Cultural considerations

  • Reassessment


Environmental factors affecting common and sleep

Environmental factors affecting common and sleep

  • Comfortable room temperature

  • Proper ventilation

  • Minimal noise

  • Comfortable bed

  • Proper lighting


Promoting bedtime routines

Promoting Bedtime Routines

  • Help client to relax in preparation for sleep

  • Avoid mental stimulation before bedtime

  • Relaxation exercises

  • Guided imagery

  • Good sleep hygiene


Sleep hygiene

Sleep Hygiene

  • Avoid sleeping long hours during weekend or holiday

  • Bedroom should not be used for intensive studying, snacking, TV watching, or other nonsleep activity

  • Avoid worrisome thinking when going to bed

  • Avoid heavy meals for 3 hours before bedtime


Promoting comfort

Promoting comfort

  • Encourage client to wear loose-fitting nightwear

  • Instruct family on ways to position client and support dependent body parts to aid in muscle relaxation

  • Have client void before going to bed

  • Back massage

  • Keep bed linens dry


Activity

Activity

  • If client is at home, encourage physical activity during daytime

  • Avoid rigorous exercise at least several hours before bedtime


Control of noise in hospital

Control of noise in hospital

  • Close doors to client’s room

  • Keep doors to work areas closed

  • Reduce volume of nearby telephones and paging equipment

  • Avoid abrupt loud noises

  • Keep necessary conversations at low levels


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