1. 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.

2. Chapter 18:
Comfort, Rest, and Sleep

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

4. 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

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

6. 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

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

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

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

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

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

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

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

14. 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

16. 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.

17. 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.

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

19. Parasomnias

20. 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

21. 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

23. 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

24. 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

25. 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