Bell Ringer 1. _________ is a hormone that induces drowsiness and sleep. 2. __________ are drugs that excite structures in the brain, causing wakefulness. 3. T or F -The elasticity of lung tissue allows the lungs to stretch and fill with air during expiration and return to a resting position after inspiration. 4. T or F - Respiratory treatments that provide a mixture of oxygen, humidification, and aerosolized medications directly to the lungs are forms of inhalation therapy.

Chapter 18: Comfort, Rest, and Sleep

Comfort, Rest, and Sleep Comfort facilitates rest and sleep Safe, clean, and attractive environment contributes to comfort

The Client Environment Environment: nursing care room, furnishings Client rooms Wall: relaxing color schemes, wallpapers Floor: carpeted or linoleum surface Lighting: adequate lighting, adjustable intensity Climate control: temperature, humidity, ventilation

The Client Environment (cont’d) Room furnishings Bed Mattress Pillows Linen Privacy curtain Overbed table Bedside stand Chairs

Sleep and Rest Functions of sleep Promotes emotional well-being Reducing fatigue Stabilizing mood Improving blood flow to the brain Increasing protein synthesis Maintaining the disease-fighting mechanisms of the immune system Promoting cellular growth and repair Improving the capacity for learning and memory storage

Sleep and Rest (cont’d) Sleep phases Nonrapid eye movement (NREM) Quiet sleep Rapid eye movement (REM) Active or deepest stage of sleep

Sleep and Rest (cont’d) Sleep cycles Alternate through NREM and REM phases Sleep requirements Vary among different age groups

Sleep and Rest (cont’d) Factors affecting sleep Old age Light Activity Environment Motivation Emotions and moods Food and beverages

Sleep and Rest (cont’d) Factors affecting sleep (cont’d) Illness Drugs Sedatives and tranquilizers Hypnotics and stimulants

Question Is the following statement true or false? Alcohol is a depressive drug that promotes healthy sleep.

Answer False. Alcohol is a depressive drug that promotes sleep, but it tends to reduce normal REM and deep sleep stages of NREM sleep.

Sleep Assessment Sleep questionnaires Sleep diary Nocturnal polysomnography Multiple sleep latency test

Sleep Disorders Insomnia-difficulty falling asleep, wake up multiple times at night, or awaken early Hypersomnia-feeling sleepy despite getting normal sleep Narcolepsy Sleep paralysis and cataplexy Hypnogogic hallucinations Sleep apnea/hypopnea syndrome

Question Is the following statement true or false? Apneic episodes can be reduced by sleeping in other than the supine position, losing weight, and avoiding substances that depress respirations such as alcohol or sleeping medications.

Answer True. Apneic episodes can be reduced by sleeping in other than the supine position, losing weight, and avoiding substances that depress respirations such as alcohol or sleeping medications.

Sleep Disorders (cont’d) Sleep-wake cycle disturbances Shift work Jet travel Seasonal affective disorder 

Parasomnias

Nursing Implications Identify nursing diagnoses Fatigue Disturbed sleep patterns Sleep deprivation Sleep-promoting nursing measures Maintaining sleep rituals Reducing intake of stimulating chemicals Promoting daytime exercise

Nursing Implications (cont’d) Sleep-promoting nursing measures (cont’d) Adhering to regular schedule for retiring and waking Progressive relaxation Back massage Various techniques and purposes

General Gerontologic Considerations More comfortable with own bed furnishings Prefer warmer room temperatures Insomnia and hypersomnia are frequent manifestations of depression Sundown and sunrise syndrome Relaxation techniques before bedtime

General Gerontologic Considerations (cont’d) Hypnotic medications not recommended for use longer than 2 weeks Difficulty falling asleep Institutional schedules may interfere with established pattern of sleep; modifications may be necessary Important to identify potential sources of sleep disorders

General Gerontologic Considerations (cont’d) Cognitive impairments may result in sundown or sunrise syndromes Chronic conditions may interfere with sleep: Pain Difficulty breathing Frequent urination Short naps or rest periods can restore energy without interfering with nighttime sleep