Sleep and Rest Marija Buttery 2009

SLEEP AND REST It is viewed as the role of the nurse to create, or assist in creating, an environment in which the individual will optimise their healing. This involves notions of: Comfort Rest and Sleep To be in a fulfilling and positive comfort zone, it is thought that one’s physiological and psychological needs are being met simultaneously. Therefore, physical and emotional comfort is seen as being interdependent, and when either is disrupted, it commonly affects the other.

NEGATIVE ZONE… For example . . . . Anxiety in relation to another client or another clients behaviour Anxiety related to medical or allied health staff Stress related to their own illness Helplessness regarding loved ones or pets Financial concerns

TO PROMOTE COMFORT To promote comfort and rest, consider the following interventions: Build trust Approach and attitude Dependability Reliability Respect for confidentiality Privacy Individualised care Listening skills

Rest “Rest implies calmness, relaxation without emotional stress, and freedom from anxiety.”

SLEEP THE NEED FOR REST AND SLEEP Sleep may be defined as a period of reduced consciousness, diminished muscular activity, and depressed metabolism. Sleep provides the greatest degree of rest, with all body systems functioning at a reduced level. Sleep is a basic physiological need of the human body necessary for survival. The body heals when it is at rest (that is why you want to sleep all the time when you are sick!)

SLEEP AND REST * Different individuals require different amounts of sleep. Quality is just as important as quantity. A common theory is that sleep promotes the growth and repair of body cells. It is therefore of utmost importance that people gain enough sleep whilst they are unwell. Sleep is also a time for conservation of energy, prevention of fatigue, and provision of organ respite.

SLEEP There are various sleep disorders which can develop at different times throughout our lives. If a sleep disorder persists people should seek assistance to prevent the long term effects of sleep deprivation. Sleep disorders include: - Insomnia - Snoring - Obstructive Sleep Apnoea - Narcolepsy - Central Sleep Apnoea - Parasomnias

INSOMNIA The person is having trouble either falling asleep or staying asleep Teaching patients about factors influencing sleep may help in improving sleep. Promoting a good sleep environment, and a good pre-sleep routine may assist in encouraging a sleep state.

SNORING Defined as breathing during sleep accompanied by harsh sounds. Poor muscle tone, excessive tissues or deformities such as a deviated septum are often causes of snoring. Snoring may also be a symptom of Sleep Apnoea. The snorer should exercise to promote muscle tone, and lose weight as required to improve their snoring.

SLEEP APNOEA Obstructive Sleep Apnoea – where breathing stops briefly during sleep. The person rouses briefly often snorting and gasping, but continues to sleep. Central Sleep Apnoea – occurs when the brain fails to send the signal to the lungs and diaphragm causing brief pauses in breathing. With any form of apnoea the patient has disturbed sleep often waking feeling fatigued and sleep deprived. Moderate to severe sleep apnoea may be treated with CPAP, continuous air pressure to force air into the lungs maintaining the airway.

NARCOLEPSY and PARASOMNIAS Narcolepsy – characterised by persistent and excessive daytime sleepiness, where uncontrollable periods of sleep occur during hour of wakefulness. Parasomnias – Tend to occur more in children than adults include : - Sleepwalking (somnambulism) - Bed-wetting (Nocturnal Enuresis) - Nightmares - Teeth Grinding (Bruxism)