Sleep and Sleep Disorders Overview

Study Notes

Sleep is a fundamental human need that accounts for about one third of a person's life, serving purposes like coping with stress, preventing fatigue, conserving energy, and enhancing overall functioning.
The reticular activating system (RAS) in the brain regulates wakefulness and sleep transitions, requiring an intact cerebral cortex and reticular formation for proper functioning.
Biologic rhythms, including circadian rhythms, exist in humans and are internally controlled but synchronized with environmental factors like light and darkness, affecting functions such as the sleep-wake cycle, body temperature, and blood pressure.
Circadian rhythm, a natural internal process repeating roughly every 24 hours, governs the sleep-wake cycle, body temperature, and other physiological functions to maintain harmony when biologic clocks align with sleep-wake cycles.
Sleep includes two main types: non-rapid eye movement (NREM) sleep, which constitutes about 75-80% of sleep during a night, with three distinct stages characterized by varying brain activity and physiology.- Stage 2 of sleep is characterized by slowing body processes, decreased heart and respiratory rates, and lowered 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 drop in heart and respiratory rates, relaxed muscles, decreased reflexes, and minimal response to sensory stimuli. This stage is crucial for restoring energy and releasing growth hormone.
REM sleep occurs about every 90 minutes, lasts 5-30 minutes, and is characterized by distinctive eye movements, decreased muscle tone, and irregular heart and respiratory rates. It is essential for stimulating regions of the brain used in learning and organizing information.
Sleep cycles consist of NREM and REM sleep, lasting about 90-110 minutes. Deep sleep periods are longer in the early part of the night, with REM sleep increasing as the night progresses.
Sleep is necessary for restoring normal nervous system activity, protein synthesis, and psychological well-being. Inadequate sleep can lead to emotional irritability, poor concentration, and decision-making difficulties.
Sleep deprivation is associated with cognitive and health problems, emphasizing the importance of quality and quantity of sleep. Regular sleep patterns are crucial.
Different age groups have varying sleep requirements: newborns need 12-18 hours, infants 9-12 hours, toddlers 12-14 hours, preschoolers 11-13 hours, school-age children 10-11 hours, adolescents 9-10 hours, adults 7-8 hours, and older adults may experience disturbed sleep patterns.
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 (hyperinsomnia, narcolepsy, sleep apnea), and parasomnias (associated with different stages of sleep).
Insomnia is characterized by difficulty falling or staying asleep, while sleep apnea involves frequent breathing interruptions during sleep. Treatment for sleep apnea includes weight loss, surgical procedures, or CPAP devices.- Periodic Limb Movement Disorder is characterized by leg jerking during sleep, especially common in older adults, potentially disrupting sleep quality.
Sleep talking occurs during NREM sleep before REM sleep, usually not problematic for the individual unless it disturbs others.
Sleepwalking, or somnambulism, occurs during stage 3 of NREM sleep, generally happening 1 to 2 hours after falling asleep, with sleepwalkers being unaware of dangers like stairs.
Assessment of sleep difficulties involves a comprehensive approach including sleep history, health history, physical exam, sleep diary, and diagnostic studies.
Polysomnography, also known as a sleep study, is a test used to diagnose sleep disorders by monitoring various physiological parameters during sleep.
Nursing diagnoses related to sleep issues include risk for injury, ineffective coping, fatigue, impaired gas exchange, deficient knowledge, anxiety, and activity intolerance.
Goals of care for individuals with sleep disturbances aim to establish a healthy sleep pattern, improve well-being, and enhance the quality and quantity of sleep through tailored nursing interventions.
Sleep hygiene practices involve promoting healthy sleep habits, bedtime rituals, creating a restful environment, offering comfort measures, and educating on the safe use of sleep medications.

Description

Explore the fundamental human need for sleep, the importance of circadian rhythms, the stages of sleep, common sleep disorders, sleep requirements across different age groups, factors affecting sleep quality, assessment of sleep difficulties, and nursing interventions to address sleep disturbances.