Sleep and Sleep Disorders Overview

Study Notes

Sleep is a basic human need, with humans spending about one third of their lives asleep for various reasons such as coping with stress, preventing fatigue, and restoring the mind and body.
The reticular activating system (RAS) in the brain regulates wakefulness and sleep transitions, with an intact cerebral cortex and reticular formation being necessary for this regulation.
Biologic rhythms exist in humans, controlled internally and synchronized with environmental factors like light and darkness, with the circadian rhythm being the most familiar one regulating the sleep-wake cycle.
Circadian regularity typically develops by the sixth week of life, with most infants having a regular sleep-wake cycle by three to six months.
There are two types of sleep: non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep, which alternate in cycles during the night. NREM sleep accounts for about 75-80% of sleep and is divided into three stages with each stage associated with distinct brain activity and physiology.- Stage 2 of sleep is characterized by slowing body processes, still eyes, decreased heart and respiratory rates, and falling body temperature. It takes more intense stimuli to awaken someone in stage 2 compared to stage 1.
Stage 3 is the deepest stage of sleep, with a significant drop in heart and respiratory rates. The individual is difficult to awaken, not disturbed by sensory stimuli, and experiences very relaxed skeletal muscles.
REM sleep occurs about every 90 minutes, lasting 5 to 30 minutes. It is characterized by distinctive eye movements, decreased muscle tone, and irregular heart and respiratory rates.
Sleep cycles typically consist of NREM and REM sleep, with deep sleep periods being longer in the early part of the night and more REM sleep as the night progresses.
Sleep plays a crucial role in restoring energy, releasing growth hormone, and allowing for protein synthesis for repair processes.
Normal sleep patterns are essential for psychological well-being, with inadequate sleep leading to emotional irritability, poor concentration, and decision-making difficulties.
Sleep deprivation is associated with cognitive and health problems, emphasizing the importance of both sleep quality and quantity.
Different age groups have varying sleep requirements, from 12 to 18 hours a day for newborns to 7 to 8 hours for healthy adults.
Factors affecting sleep quality and quantity include illness, environment, lifestyle, emotional stress, stimulants/alcohol, diet, smoking, motivation, and medication.
Common sleep disorders include insomnia (acute and chronic), excessive daytime sleepiness, narcolepsy, sleep apnea (obstructive, central, mixed), and insufficient sleep. Each has specific characteristics and impacts on health.
Parasomnias are a group of sleep disorders involving unwanted events during sleep, classified into non-REM, REM, and miscellaneous categories. Examples include bruxism, enuresis, and abnormal behaviors during sleep stages.- Periodic Limb Movement Disorder involves legs jerking during sleep, common in older adults and can disrupt sleep.
Sleep talking occurs during NREM sleep without usually affecting the individual unless disturbing to others.
Sleepwalking (somnambulism) happens in NREM stage 3, typically 1-2 hours after falling asleep, with a lack of danger awareness.
Assessment of sleep difficulties includes a comprehensive sleep history, health history, physical exam, sleep diary, and diagnostic studies.
Polysomnography is used in sleep disorder labs to diagnose sleep disorders by measuring various physiological parameters during sleep.
Nursing diagnoses related to sleep include risk for injury, ineffective coping, fatigue, impaired gas exchange, deficient knowledge, anxiety, and activity intolerance.
Goals of care for sleep disorders focus on establishing a healthy sleep pattern to support daily activities and overall well-being.
Nursing interventions for sleep issues involve reducing distractions, promoting bedtime rituals, providing comfort measures, and teaching stress reduction techniques.
Sleep hygiene encompasses interventions to enhance sleep quality, including education on sleep habits, bedtime rituals, and creating a restful sleeping environment.
Promoting comfort and relaxation, administering sleep medications when necessary, and ensuring safe sleep environments are crucial in managing sleep disorders.

Description

Explore the fundamentals of sleep, including the stages of sleep, circadian rhythms, biologic rhythms, and the importance of sleep for physical and psychological well-being. Learn about common sleep disorders, assessment techniques, diagnostic studies, and nursing interventions for promoting healthy sleep patterns.