Comfort and Sleep Essentials

Comfort, Rest, and Sleep

• Sleep is essential for health and healing. Without quality sleep, the body cannot adequately rejuvenate.
• Inadequate sleep affects nearly all bodily systems. Chronic health problems, such as depression, heart disease, hypertension, and diabetes can result from inadequate sleep.

Circadian Rhythm

• An internal process that controls the sleep-wake cycle.
• This cycle occurs approximately every 24 hours.
• It regulates biological clocks, leading to sleepiness at night and waking in the morning.
• Circadian rhythms synchronize with environmental cues like light and temperature, but the body maintains these rhythms even without external cues.

Sleep-Wake Homeostasis

• Aids the body in remembering to sleep after a period of time.
• Adjusts sleep levels based on the amount of sleep deprivation a person has experienced.
• Affected by various factors, which include lighting, medications, caffeine, diet, the sleep environment, and stress.

Brain Structures Essential to Sleep

• Hypothalamus: A key command center for nerve cells, influencing sleep and arousal.
• Suprachiasmatic Nucleus (SCN): Regulates behavioral rhythms, responding to light input from the eyes.
• Brain Stem: Controls transitioning between wake and sleep and influences rapid eye movement (REM) sleep.
• Thalamus: Blocks out external distractions. It relays sensory input during REM sleep.
• Pineal Gland: Produces melatonin, a natural substance that promotes sleep.

Stages of Sleep: Stage 1

• The lightest stage of sleep.
• Predominantly characterized by alpha and beta brain waves.
• Alpha waves occur in the 8-12 Hz range and beta waves are 12-30 Hz.
• Alpha waves dominate when eyes are closed and preparing for sleep.
• Breathing is normal, and skeletal muscle tone is present.
• Typically lasts 1-5 minutes and is approximately 5% of the entire sleep cycle.

Stages of Sleep: Stage 2

• A deeper stage of sleep.
• Includes sleep spindles and K-complex waveforms.
• These waveforms trigger brain areas crucial for sleep.
• Clients are harder to awaken, and heart rate/body temperature decreases.
• Stage 2 corresponds to approximately ~50% of the total sleep cycle
• Sleep cycles steadily lengthen with each successive cycle duration.

Stages of Sleep: Stage 3

• The deepest stage of sleep.
• Characterized by delta brain waves, which have a slower frequency and higher amplitude.
• If awoken during this stage, a person may experience mental cloudiness for 30 to 60 minutes.
• Muscles, tissues, and bones repair and regenerate during this stage.
• The immune system strengthens.
• This stage is shorter in older adults.

Stages of Sleep: Stage 4

• Includes REM sleep.
• Similar to an awake cycle, but with temporary skeletal muscle relaxation.
• Breathing is irregular and cardiac output may increase.
• Dreaming typically occurs.
• Stage 4 lasts up to 1 hour; the duration lengthens as the night progresses.

Sleep Patterns: Adults

• Adults (ages 20-35) spend approximately, 2-5% in stage 1, 45-55% in stage 2, 10-20% in stage 3, and 20-25% in REM sleep.
• Sleep cycles occur approximately 4-5 times during a night's sleep.

Sleep Patterns: Older Adults

• Older adults (65+) experience a decrease in stage 3 sleep and an increase in stage 2 sleep.
• Waking up more frequently and greater time to fall asleep are common.
• Longer periods in bed are potentially associated with musculoskeletal weakness, arthritis and pulmonary conditions.

Recommended Hours of Sleep

• Vary based on age. See appropriate table for specific durations.

Sleep Deprivation

• Occurs when a client does not meet their body's biological sleep requirements.
• Results in cognitive impacts, reaction time issues, and the potential for disorders(seizures, migraines, tension headaches).

Promoting Sleep

• Avoid stimulants (caffeine, alcohol, and nicotine) for a minimum of 4 hours before bed.
• Create a calming bedtime routine.
• Maintain a darkened, quiet, and cool sleeping environment.
• Go to bed only when feeling tired .
• Use relaxation techniques as needed to calm the mind.

Promoting Sleep (cont.)

• If unable to fall asleep after 20 minutes, leave the bedroom.
• Use other activities as needed until feeling sleepy.
• Refrain from electronic devices in the bedroom as needed.

Sleep Disorders

• Insomnia: Chronic inability to sleep.

• Sleep Apnea: A condition characterized by pauses in breathing during sleep.

  • Obstructive sleep apnea (OSA): a decrease in oxygen saturation, also resulting from obstruction(s) in the airways. This can result from recurring episodes of airway collapse during sleep

• Hypopnea: Reduced oxygen saturation lasting 10 seconds or more. This is an indicator of sleep apnea.

• Narcolepsy: Chronic sleep disorder with sudden sleepiness and sleep attacks.

• Hypersomnia: Excessive daytime sleepiness without improvement in sleep.

• Restless Legs Syndrome (RLS): An overwhelming urge to move legs, especially at night.

Sleep Disorders (cont.)

• OSA detected through nocturnal polysomnography.
• OSA risk factors include; excess weight, narrowed airways, large neck circumference, males, older adults, family history, use of medications (sedatives, tranquilizers), smoking, and nasal congestion.